Professional Integrity FMProC practice questions

Dr. Amara Okoye, a first-year Family Medicine resident on a General Internal Medicine ward rotation, is caring for Mr. Stein, a fully competent 68-year-old man recently diagnosed with locally advanced pancreatic cancer. During morning rounds, Mr. Stein's adult children, David and Sarah, intercept Dr. Okoye in the hallway and insist that their father must not be told the diagnosis directly. They explain that hearing such devastating news from a stranger would destroy him, asking that the clinical team allow them to disclose it gradually at home in their own way. When Dr. Okoye raises this with the attending physician, Dr. Vance, the attending remarks that the family knows the patient best and seems content to let them manage the information. Mr. Stein is scheduled for a discharge planning conference this afternoon and has just rung his call bell to ask for an update on his scan results.

Dr. Hana Yildiz, a family medicine resident, is running 40 minutes behind schedule in a busy ambulatory clinic. Her preceptor, Dr. Craig Campbell, observes the backlog and quietly suggests that everyone in the clinic saves an hour by copying the previous visit notes forward for routine follow-ups. Dr. Campbell demonstrates this on Dr. Yildiz's computer, pulling forward an unedited previous physical examination template into an unexamined patient's open encounter. Dr. Yildiz has not yet seen or examined the two remaining patients on her morning schedule. She understands that while note-forwarding is common practice, clinical records must accurately reflect services actually rendered during the specific visit. Dr. Yildiz must decide how to proceed.

Dr. Sarah Tremblay is a PGY1 family medicine resident rotating in a chaotic community emergency department during a surge in patient volume. Her senior resident, Dr. Dave Miller, dictates a formal inpatient admission note solely from the triage nurse's intake summary without evaluating the patient in person. Dr. Miller instructs Sarah to submit the electronic admission order set immediately so that emergency beds can clear before their shift ends. Sarah has not yet assessed or met the patient. Department policy requires an in-person physician evaluation prior to inpatient bed requests. Sarah feels substantial pressure from Dr. Miller to expedite bed turnover.

Dr. Nadia Farooq, a family medicine resident, is covering a busy evening shift at an after-hours clinic alongside her preceptor, Dr. Reiss. Over the past hour, Dr. Farooq observes Dr. Reiss give contradictory dosing instructions for the same standard antibiotic to two different adult patients, and notices him visibly swaying while standing at the charting desk. The charge nurse, Nurse Janet Gomez, approaches Dr. Farooq privately and whispers that she smells alcohol and is deeply worried about Dr. Reiss's fitness to continue seeing patients. Dr. Reiss has been an exceptionally supportive and kind preceptor throughout Dr. Farooq's rotation. Two hours remain in the clinic shift, and multiple complex patients are waiting in the reception area.

Dr. Maya Lin is finishing documentation in the clinic workroom when she notices her co-resident, Dr. Jordan Reed, updating his official residency procedural logbook. Jordan logs independent procedural credit for three knee joint arthrocenteses performed earlier that morning. Maya personally assisted on all three cases and knows Jordan merely observed the attending physician perform the procedures from across the examination table. When Maya privately asks about the entries, Jordan dismisses her concern, claiming that everyone logs observed procedures as independent to fulfill mandatory program quotas before CaRMS and graduation deadlines. Maya knows the residency program requires honest logging to certify clinical competence for independent practice.