Professional Integrity · Ranking sample

Dr. Nadia Farooq, a family medicine resident, is covering a busy evening shift at an…

Read the scenario, answer it, then compare yourself to the answer key. Every option includes a rationale and a transferable principle.

b09Professional IntegrityRankinghardProfessional + Collaborator

Rank in order the following actions for Dr. Farooq to take in response to this situation (1 = Most desirable; 5 = Least desirable).

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.

Ranking scale: 1 is most desirable and 5 is least desirable. Use each rank exactly once. Pick one rank per option.

A. Wait until clinic closes tonight to speak with Dr. Reiss privately about the observed dosing errors and physical instability.

B. Speak privately with Dr. Reiss immediately alongside the charge nurse, advising him to step away from patient care tonight.

C. Call the on-call clinic medical director immediately to report suspected acute impairment and request urgent supervisor coverage.

D. Offer to take over seeing all remaining clinic patients tonight while advising Dr. Reiss to rest in his office.

E. Cross-check every prescription and chart Dr. Reiss writes for the remainder of the shift before patients leave.

Use each rank exactly once

Samples are graded anonymously. Nothing is saved.

Show answer and rationale

A. Wait until clinic closes tonight to speak with Dr. Reiss privately about the observed dosing errors and physical instability.

Key: 5

Rank 5. Postponing action until after the shift permits an acutely compromised physician to continue treating patients for two more hours. Loyalty and personal discomfort must never override imminent patient protection. It represents the least acceptable choice because it accepts active patient risk to avoid immediate conflict.

Never delay intervention when immediate patient safety is actively compromised.

B. Speak privately with Dr. Reiss immediately alongside the charge nurse, advising him to step away from patient care tonight.

Key: 1

Rank 1. This action prioritizes immediate patient safety while treating the colleague with dignity and ensuring an objective witness is present. It addresses the acute hazard directly before any further patients are exposed to potentially compromised care. It would move down if handled confrontationally in front of patients.

Address acute colleague impairment immediately and privately to safeguard patient welfare.

C. Call the on-call clinic medical director immediately to report suspected acute impairment and request urgent supervisor coverage.

Key: 2

Rank 2. Escalating directly to clinical leadership is a sound, responsible action that mobilizes institutional authority and backup coverage. However, it ranks just below direct intervention because waiting for leadership action may create a brief delay while the supervisor remains in active practice. It would rank higher if the supervisor had already refused to step down.

Escalate suspected impairment to administrative leadership to ensure safe clinic coverage.

D. Offer to take over seeing all remaining clinic patients tonight while advising Dr. Reiss to rest in his office.

Key: 3

Rank 3. While this option protects patients from the supervisor and shows initiative, it exceeds the resident's legal and training scope to manage an urgent clinic entirely without staff supervision. Furthermore, it informally conceals potential impairment rather than addressing it through proper channels. It ranks above passive monitoring because it removes the compromised physician from direct care.

Do not practice beyond educational scope to shield an impaired colleague.

E. Cross-check every prescription and chart Dr. Reiss writes for the remainder of the shift before patients leave.

Key: 4

Rank 4. This is a well-meaning attempt at damage control, but it leaves an impaired clinician actively delivering care and assessing patients. It is practically unfeasible during a busy shift and fails to prevent verbal misinformation, missed diagnoses, or procedural errors. It would rank lower only if no safety measures were taken at all.

Harm mitigation cannot substitute for removing an active safety hazard.

Exam context: FMProC assesses professional integrity alongside three other attributes. This is an unofficial worked example, not a live exam item.

Educational scenario only. Not clinical or professional advice.