Ethical Reasoning & Professionalism

Understanding the ethical and professional standards expected in healthcare and academic environments; making decisions that align with fairness, honesty, and institutional rules.

What are these questions testing?

These questions explore your ability to act in a way that reflects integrity, responsibility, and respect for policies and systems. They ask you to assess what is fair, ethical, or expected in professional behaviour — especially in difficult or ambiguous situations.

The GMC’s Guide to Good Medical Practice outlines exactly what is expected from healthcare professionals. Reading this is essential to understand the standards required in real-life scenarios. You have 26 minutes for 69 questions, although SJT is not as time pressured as other sections.

Question Types in the SJT

These are the three main question types:

1. Appropriateness

You’ll rate actions from:

A very appropriate thing to do
Appropriate but not ideal
Inappropriate but not awful
A very inappropriate thing to do

2. Importance

You’ll rate factors from:

Very Important
Important
Of Minor Importance
Not Important At All

3. Most and Least Appropriate

You’ll be asked to pick:

The one most appropriate action
The one least appropriate action
A null option – an action that is neither the best nor the worst. This is not a ‘neutral’ option but simply an action that falls in between.

Worked Examples

Scenario 1: Appropriateness Question

Liam, a third-year medical student, accidentally sees a patient’s blood test results left open on a shared university printer. He knows the patient personally and is worried about what he’s seen. He tells a close friend (who is not involved in the patient’s care) about the result, saying he needed to “talk it through” with someone.

How appropriate are the following actions?

Difficulty: Medium

Telling his friend about the result.

Answer:

A very inappropriate thing to do.

Worked Solution:

This is a clear breach of confidentiality. Sharing patient information without consent, especially with someone not involved in care, is a serious ethical violation.

Reporting the data breach to the IT department or supervisor.

Answer:

A very appropriate thing to do

Worked Solution:

Raising a concern about a potential system error aligns with professional duty and helps improve confidentiality processes.

Ignoring it because the result wasn’t meant for him.

Answer:

Inappropriate but not awful

Worked Solution:

While not spreading the information is better than breaching confidentiality, ignoring a systems issue risks the problem happening again.

Looking for more details on the patient’s records to “check” accuracy.

Answer:

A very inappropriate thing to do

Worked Solution:

Accessing medical records without justification is a serious breach of both policy and ethics.

Scenario 2: Importance Question

Zara is asked to present a patient case in a group tutorial. She accidentally uses the patient’s full name in her slides, which are then uploaded to a shared university drive. A tutor notices the error and discusses it with her after the session.

How important are the following considerations when deciding how serious the issue is?

Difficulty: Medium

Whether the patient’s identity was clearly visible to anyone who viewed the slides.

Answer:

Very Important.

Worked Solution:

This directly impacts how much harm or risk the breach may have caused.

Whether Zara was nervous during her presentation.

Answer:

Not Important At All

Worked Solution:

Nerves are understandable but do not change the fact that there was a breach of confidentiality.

Whether Zara immediately took the slides down after realising.

Answer:

Important

Worked Solution:

Demonstrating accountability and acting quickly reduces further harm and reflects professionalism.

Whether other students have made similar mistakes before.

Answer:

Not Important At All.

Worked Solution:

Just because others did something similar does not justify the behaviour.

Scenario 3: Most/Least Appropriate Question

Ahmed, a final-year medical student, is working with a consultant on a busy ward. The consultant writes the wrong medication dose in a patient’s notes. Ahmed notices this but feels unsure whether to speak up, especially as the consultant appears stressed.

Choose both the one most appropriate and one least appropriate action Ahmed should take.

Difficulty: Hard

Quietly mention the error to the consultant after the ward round ends.

Answer:

Most Appropriate

Worked Solution:

This allows correction without embarrassment and prioritises patient safety.

Say nothing, as it’s not his responsibility to challenge senior staff.

Answer:

Appropriate

Worked Solution:

This endangers the patient and goes against GMC guidance, which encourages raising concerns.

Email the ward pharmacist asking them to check the dose, without mentioning the consultant.

Answer:

Null Option

Worked Solution:

This could indirectly solve the issue but avoids responsibility and may not be timely or effective.

Tips and Tricks

Use the GMC Guide to Good Medical Practice as your gold standard.
Don’t justify unethical behaviour with excuses like stress, seniority, or being “just a student”.
Confidentiality, patient safety, and honesty are always priorities.
Know that not every set of answers will include one from each category - choose based on the context.
In most/least appropriate, the third option is a null choice - not the best, not the worst.
The more scenarios you practise, the more instinctive ethical decision-making becomes.

No answer provided.