FMProC sample 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.

Dr. Priya Sundaram is a family medicine resident at an urban community clinic. She is currently seeing Joy, a 17-year-old patient who attended the consultation alone under the clinic's mature minor youth confidentiality protocol. While discussing her tension headaches, Joy becomes visibly distressed, begins to weep, and discloses that she is attracted to girls. Joy suddenly grabs Dr. Sundaram's sleeve and whispers, 'Please don't tell them, please,' expressing acute terror that her parents waiting in the parking lot will find out. Moments later, the clinic medical office assistant sends an urgent instant message stating that Joy's parents have texted requesting a written summary of the visit before driving home. Dr. Sundaram must determine how to handle Joy's immediate distress alongside the parents' request.

Dr. Liam Chen is conducting a six-week postpartum check with Danielle Taylor and her newborn in the clinic. Danielle appears visibly exhausted and emotionally detached while her infant cries persistently in the car seat. When Dr. Chen asks how bonding is going, Danielle tearfully laughs and remarks that the infant would probably be calmer and happier with an adoptive family. Danielle immediately waves her hands, brushes off the remark as an exhausted joke, and asks to proceed with the infant's routine physical measurements. Dr. Chen observes significant distress and vulnerability despite her attempt to deflect.

Dr. Noah Tremblay is completing a rural northern rotation at a remote nursing station. Elder Thomas, a respected 74-year-old community leader, presents with severe lobar pneumonia, hypoxemia, and hemodynamic instability requiring urgent medevac transfer to an urban tertiary hospital. Elder Thomas has intact decision-making capacity but adamantly refuses evacuation, explaining that he survived residential school and a previous traumatic medical transport where relatives died alone in southern cities. Furthermore, he emphasizes his duty to lead an upcoming sacred community healing ceremony this evening. Marie, the nurse, warns that without tertiary transfer, Thomas faces high mortality, but Thomas states he would rather die on his ancestral land surrounded by community. Noah must balance life-threatening medical urgency with profound cultural safety, trauma-informed history, and respect for patient autonomy.

Dr. Callie Muir, a family medicine resident, is conducting a scheduled 30-minute home visit for Mrs. Okonkwo, a 78-year-old patient with multi-morbidity and declining mobility. Dr. Muir planned to introduce advance care planning today, but each time she broaches the topic, Mrs. Okonkwo politely deflects with 'not today, doctor'. Meanwhile, her adult son, Chidi, repeatedly speaks on her behalf and answers clinical questions before she can respond. Dr. Muir has approximately 20 minutes remaining in the visit. She wants to respect Mrs. Okonkwo's autonomy and comfort while addressing her care needs effectively.

You are a family medicine resident caring for Margaret MacIntyre, an elderly comatose patient experiencing multi-organ failure in a rural hospital. Her clinical condition is deteriorating rapidly, necessitating an immediate and definitive goals-of-care determination. Arthur, her common-law partner of twenty years, tearfully conveys that Margaret explicitly wished never to be maintained on invasive mechanical life support, though no written directive exists. Her estranged adult son, Derek, suddenly arrives from another province, angrily asserting kinship rights and demanding aggressive invasive resuscitation while dismissing Arthur's standing entirely. The interpersonal conflict is escalating outside Margaret's room, causing severe distress to both men as clinical decisions loom. You must resolve this dispute in accordance with provincial substitute decision-maker legislation while supporting a grieving, divided family.

You are Dr. Yusuf Ahmed, a PGY2 family medicine resident on a community medicine rotation. You are conducting a home visit with Rina Kowalski, an experienced public health nurse who has worked in this community for fourteen years. As you explain your proposed insulin titration schedule, Rina states flatly across the kitchen table that your plan completely ignores what was agreed upon at the prior care conference. This conference took place two weeks before your rotation began and utilized a different clinical protocol that you were not briefed on. Mr. Doiron looks visibly anxious and glances back and forth between you and Rina, waiting for guidance on what to do next. You must address Rina's concern while maintaining Mr. Doiron's trust and psychological safety in the moment.

Dr. Danielle Ross is completing a rotation on a busy inpatient family medicine teaching ward. Over the past three days, Dr. Alan Foster, the off-site attending physician, contacts Danielle expressing frustration about receiving multiple phone calls during his outpatient clinic for routine order clarifications, PRN medication approvals, and diet upgrades. Dr. Foster stresses that managing these routine ward issues is squarely within resident scope. Danielle approaches Nurse Gary, the day charge nurse, to discuss the issue. Gary candidly explains that past residents took hours to answer pages, so nursing staff found it far more efficient to call the attending directly. Danielle needs to re-establish proper paging workflow and rebuild trust with ward staff without alienating the nursing team.

You are Dr. Julian Roy, a PGY2 Family Medicine resident in a busy academic community clinic. The attending physician, Dr. David Sterling, has been delayed at the hospital for over an hour, causing afternoon appointments to back up severely. In the minor procedure room, Gail Simmons, a senior clinic nurse, is setting up a tray for a knee joint aspiration on an elderly patient with acute effusion. She instructs Chloe Martin, a third-year medical student, to perform the procedure independently right now, stating that doing so is the only way to keep the clinic on schedule and avoid cancelling appointments. Chloe looks nervous and pulls you aside into the hallway, whispering that she has only observed a joint aspiration once on a plastic model and feels completely unequipped to do it alone.

Dr. Ian Woods is a family medicine resident completing a rotation at a First Nations community health centre, with two weeks remaining. During an appointment for a nine-year-old child with poorly controlled asthma, Dr. Woods proposes scheduling weekly clinic appointments over the coming month for close monitoring. In front of the child's grandmother, Darlene, an experienced community wellness worker who coordinates local care, states, "We do not book visits like that. Families will not come three times a month for puffer checks." The grandmother nods in agreement with Darlene's statement. Dr. Woods wants to ensure adequate asthma control while respecting the community's context and care coordination norms.

Dr. Al-Mansoor is examining Mr. Henderson, a 68-year-old patient with severe osteoarthritis and limited mobility living on a guaranteed income supplement. Mr. Henderson reports that his publicly funded daily personal support and dressing changes were abruptly halted this week due to an unpaid fifty-dollar administrative enrollment fee. Without assistance, he cannot perform personal hygiene, and Dr. Al-Mansoor observes developing Stage II pressure injury breakdown over his sacrum. When Dr. Al-Mansoor phones the regional home care coordinator, Gail, she states agency fee rules are strictly enforced and services remain paused until payment. Dr. Al-Mansoor must address the acute clinical deterioration while advocating for systemic care resumption.

Dr. Priya Nair, a first-year family medicine resident, arrives for her scheduled outpatient rotation only to be abruptly redeployed to a community respiratory assessment centre due to an acute viral surge. For the next two weeks, she will manage high patient volumes in an unfamiliar ambulatory environment rather than her anticipated elective. On her first morning, she is informed that she must navigate a new electronic medical record, follow an unfamiliar clinical triage protocol, and adhere to updated infection-control personal protective equipment procedures. Forty symptomatic patients are already queued for assessment, and staff appear stretched thin. Dr. Nair must determine how best to approach the start of her shift.

Dr. Chloe Tremblay is a PGY1 resident completing a full daytime ward shift on the family medicine service. At 16:45, fifteen minutes before the scheduled handover, her co-resident Dr. Tariq Al-Mansoor receives devastating news of a sudden family crisis requiring his immediate physical departure out of town. Tariq is scheduled to complete a 24-hour overnight call shift covering the active ward and emergency consultations. The residency program's formal backup system is poorly outlined and lacks a clear designated on-call backup trainee for the day. Dr. Liam O'Reilly, the chief resident, approaches Chloe and requests that she step in and cover Tariq's entire overnight shift. Chloe has an important personal commitment that evening celebrating her sibling's long-planned graduation dinner, but she also recognizes that Tariq cannot safely remain on duty and that the ward cannot be left unstaffed.

Dr. Evan Ross is a PGY1 Family Medicine resident on his first rural family medicine block. The clinic is running forty-five minutes behind schedule due to an earlier complex emergency. His preceptor, Dr. Callum MacIntyre, asks Evan to independently perform a knee joint aspiration and corticosteroid injection on Mr. Kenneth Walsh, an established patient with severe osteoarthritis. Evan has only observed this procedure once previously during medical school and has never performed it on a human patient. Before Evan can explain his lack of hands-on experience, Dr. MacIntyre pats him on the shoulder, says he has complete confidence in Evan's skills, and leaves the clinic room to manage another waiting patient, adding that he will review and sign the procedural chart note later. Mr. Walsh is waiting on the examination table with the injection tray already prepped by the clinic nurse.

Dr. Hannah Cole, a family medicine resident on a long-term care rotation, is on-call overnight covering a 120-bed facility. At 23:00, the central nursing call-bell system unexpectedly shuts down across all wings, leaving residents unable to summon assistance electronically. Moments later, a personal support worker informs Dr. Cole that an 84-year-old resident, Mr. Abebe, is acutely hypotensive with rapidly declining vital signs. Simultaneously, the floor nurse presents Dr. Cole with routine, non-urgent evening medication queries for two stable residents. Dr. Cole's supervising physician has not responded to an urgent page placed fifteen minutes earlier. With limited overnight staff and multiple competing demands, Dr. Cole must determine her immediate course of action.

You are a family medicine resident staffing an isolated northern nursing station when an adult patient presents with atypical chest pain. Severe blizzard conditions have grounded all medevac aircraft, halting regional laboratory transport and preventing tertiary transfer for at least twenty-four hours. When preparing point-of-care testing, the clinic discovers that the entire supply of troponin and blood gas cartridges expired yesterday. Nurse Campbell advocates running the expired cartridges to gather approximate biochemical trends, whereas Nurse Tremblay refuses, arguing that invalid tests create medicolegal liability and false clinical reassurance. The nursing staff are deadlocked and awaiting your direction while the patient remains symptomatic. You must adapt clinical workflows to manage acute diagnostic uncertainty collaboratively.