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哈佛帶給我的衝擊:不用靠長輩、不要拍馬屁——無懼為自己相信的價值奮戰,才能常保初衷
https://crossing.cw.com.tw/blogTopic.action?id=689&nid=9796 2018/04/18
Y.C.Hung/脫下白袍後的各種可能

生為一個土生土長的台灣人,我過去在哈佛醫學院/波士頓兒童醫院,和現今在哈佛的麻州總醫院工作期間,所接受到的「衝擊」,大概絕不亞於提問的讀者朋友們。

因此,謹將我在這將近兩年來,所受到最大的幾個衝擊、感想和所學到的幾個「重要的小事」整理與此,希望也能帶給台灣的讀者朋友們,一些可能不同與以往的想法:

一、年輕,不代表你說的話沒有價值:「你不需要長輩、名人幫你背書」

我記得我在寫第一篇「第一作者」(First author)的學術論文時,因為寫的內容和主題,有些顛覆現在全球外科資源(Global Surgery)的主流想法。加上身為一個從來沒有寫過英文學術論文,想當然爾也從來沒有在美國學術期刊上發表過文章的外國人,當時我很希望可以找些「有名的權威人士」讀我的論文、給我意見,進而一起掛名到作者群裡「為我背書」。

然而,當我老闆發現,我對自己的東西沒有自信心,主因不是內容問題,而是擔心自己年輕、「太菜」,而顯現不出價值後,就非常直率地對我說:「你一點都不需要其他更年長、學術聲望顯赫的人,為你的論文背書。你的論點、佐證數據的價值都在你自己身上,好的論述、好的研究數據,就是對你自己論文最好的『背書』。」

老闆的這一席話,帶給了我相當大的衝擊。過去在台灣「長幼有序」、「上對下」關係濃厚的社會氣氛裡——或者,是習慣聽年長的人給專業意見的我自己的關係——不知不覺間,我開始習慣任何自己的成就,都必須由年長、具權威的人為我「背書」,才能得到肯定。

然而,在國外看重「能力」大於「輩份」的地方,我才驚 覺「年輕,不是原罪」——如果你的東西是真正具有價值的,那麼你需要的,是靠自己去發揚光大它,而不是急著想要找比你「高階」的人,把你的東西,沾上他們的光彩。

2.「不要拍馬屁」

這點,跟第一點其實是一體兩面。

很多人來到哈佛留學、做研究、交換......等時,為了想要在哈佛的教職員面前留下好印象,會刻意地「拍馬屁」——理由則大概和第一點所說的雷同,希望可以多沾點「有名機構」的光。但事實上,在某些主任級以上的高階教職員眼裡,「拍馬屁」其實是一個非常不可取的行為!

這些閱人經歷豐富的主任、教授,往往看過無數的計畫申請動機、求職、求學信,也讀過無數的履歷,並且和世界各地無數的學生、專業人士共事過。因此,他們可以非常輕易地發現一個人是否「真心熱愛」、「真正擅長」其所工作、面試的領域。

因此,如果只是為了「讓上位者留下好印象」而拍馬屁如吹捧對方、假裝熱情但其實根本不是真心熱愛你正在做的事,那麼,根據我老闆的觀察和他所看過的幾個實例——這些早就經歷過「無數被拍馬屁過程」的主任、掌權者,基本上是對你「謝謝再聯絡的。」

這些經驗豐富的「老闆」們,其實你仔細想一想,他們的人生也不乏想拍他們馬屁的人,因此,拍馬屁實在不缺你這個人,如果你只是為了想贏得上位者的歡心而拍馬屁,而非真心熱愛你所做的領域,工作也不認真,其實他們的心裡都非常的清楚,你就只是另一個不討人喜歡的「馬屁精」,然後「敬而遠之」或直接給閉門羹。

因此,在這個巨大的學術機構裡,「展現對學習的好奇心/初衷/熱情」這種最基本的小事,其實是比拍馬屁還重要的。

3. 好的導師(Mentor),不會只把學生綁在自己身邊、為自己做事

曾經,我以為年輕人因為年紀輕,形勢就是輸人──這句話在台灣或許是成立的,年紀輕讓你升遷時永遠只能排在年紀大的後面、年紀輕的不論多有能力、說話多言之有物,好像怎麼爬都爬不太上去,然而,我老闆教會我的震撼思考之一是:如果年輕人有什麼原罪,那年輕人的唯一原罪,就是認識的人不夠多、人脈不夠廣。

這和前兩個觀念:「年輕人不要急著沾大老的光來證明自己的能力」、「不要拍馬屁」其實是相輔相成的。但在年輕人「年輕人不要急著沾大老的光來證明自己的能力」、「不要拍馬屁」的情況下,年輕人到底要怎麼走出一片天呢?

我在哈佛的老闆認為:年輕人的能力,其實一點都不會輸給年長的人,他們唯一「輸」的,就是「社交網絡」。因此,年輕人需要的是「導師」(Mentor,帶有點專業導師與生涯導師兼具的意涵)介紹給年輕人「導師自己」所認識的人脈,「師傅帶進門」後,年輕人會更有機會憑實力開拓、建立起良好的社交網絡。

因此,他認為一個好的 Mentor,應該不是只把學生綁在他的身邊、只為自己做事,而是應該是要幫學生建立更多對外合作的機會——讓大家都有機會跟他的學生一起共事,別人也可以藉由共事,實際看到學生的能力。

這種「把自己的學生介紹出去的理念」,可不是說說而已:每次我和我的老闆去全美外科最大的學術會議時,在美國人脈相當廣的他已經連續第二年,會在會議期間的酒會中(所有美國知名醫院/大學,幾乎都會把酒會辦在同一個飯店裏,分佈在兩到三個不同樓層),向各知名大學的教授介紹我,也會積極地幫我介紹合作機會,讓我這個沒什麼成就的外國人無比感激。

4.「你未來十年後,將會發展成一個怎麼樣的人?」

我記得剛認識現在的老闆後不久,他有一天把我叫去一起吃午餐。午餐席間我屁股還沒坐熱,他就直接略帶嚴肅地問我:「你對未來有什麼打算?」

從來沒有被老師們認真問過這類問題的我,呆了半晌,然後支支吾吾地說了我近幾年的研究、工作目標、然後自己可以帶給醫學院什麼樣的貢獻......等等制式答案,但老闆卻不耐地直接打斷我,告訴我:「我想知道的是,你十年後、或更長久的未來,希望自己成為一個怎麼樣的人?」

他告訴我,他想知道我對未來有什麼願景、我希望有什麼成就,又希望成為一個什麼樣的「領導人」,希望我好好思考,並給他真心的答案。

那個當下我所震驚的,不只是在台灣成長中的我,早已經習慣要給長輩「固定、制式」的答案,但面前的這個人,卻完全不期待一個制式的回答——姑且不論我的未來是否真的可以自由發揮,他卻要求我自由描述自己的未來;甚至還在乎我未來十年後的發展!

在台灣我所聽聞、接觸的許多企業主,普遍都仍把員工當「成本」、「勞動力」管理,而非當成「資產」、「人才」在培育的情況下,我卻在老闆簡單的一個問話裡(當然往後我也從別人口中偶然得知,他願意接納我這個外國人,是因為看到我的可塑性,想把我當成「人才」在投資)發現他並不是把我當作「免洗筷」、用完就丟——而是真心希望有一天,當我離開現在的實驗室後,可以帶著他教會我的視野,成為另個地方的「領導人」。

5. 如果你看不順眼某件事,不要等待別人來改變,自己去成為可以改變事情的人

我一起工作的同事,最近找到了一筆資金,也得到了主管的大力支持,發起了一個叫做 Ether dome challenge(註一)的活動:

這個 Ether dome challenge 的目標,是希望所有在第一線的醫療人員,不論是醫師、護士、社工......等,只要在臨床上有什麼讓你感到痛苦、綁手綁腳的地方——而這也是你一直都很想要改變的臨床問題——便可以上網公開反應你的意見,提出你的解決辦法,然後再經過公眾投票、專家研議可行性後,選出來的贏家,將可以得到資金,真的去著手解決問題!

我認為這個活動的真正價值,是打破傳統中人們認為「改變」必須「由上而下」進行的迷思(例如仰賴政府出手制定法規、投入預算解決問題)——但事實上,許多改變是可以「從下而上」發生的:與其每天抱怨自己工作令人感到不合理的地方,不如去成為那個創造改變的人吧!

6. 不要害怕去當倡議者,勇於「打破同溫層」

在亞洲文化裡,大家通常並不喜歡當「發聲」的那個,但我過去在 Global Surgery 的團隊裡工作時,我們其實每個人都被我們的 program director 要求:「每個人都要有自己的推特帳號(因此他們還開了一個推特教學課),一起透過社群媒體的力量,將我們在乎的議題、主題、文章推廣出去。」(詳見:《我為什麼加入哈佛大學全球手術團隊──50 億人缺乏醫療資源,對我而言,這不只是統計數字而已》一文)

甚至,他們還請了一些全球衛生組織的專業公關,來幫大家上課,分享如何「倡議」的經驗,和需要注意的地方。這都是來自亞洲文化、不擅長發聲的我,前所未聞的訓練。

而在「進行倡議」的過程中,不可能一帆風順:一定會接觸到完全不懂自己領域的人、與對該議題主張完全不認可的人——因此,「倡議」的過程,更可以說是「打破同溫層」,和「非同溫層」的人們溝通的過程:

舉例來說,在全球衛生的領域裡,傳統上是不相信「手術推廣」之必要性的,因為許多人認為手術治療成本太高、不符合成本效益。

此時,在說服反對者的過程裡,很重要的第一步就是收集數據,用數據來證明「手術推廣」的成本效益。在我過往工作的組織,剛開始推廣 Global Surgery 時所採取的第一步正是如此:用可靠的數據與研究打破迷思,證明在全球衛生領域裡推廣外科治療,是非常有成本效益的!(也就是一般人常說的 CP 值很高的意思)

接著,在倡議的過程中,你更會看到這些前輩,真的是相當積極地舉辦各式各樣的講座、到各類研討會介紹自己領域的議題,增加議題能見度。

7. 不要失去你心中所相信的價值

在我這陣子的演講裡,有位讀者問我,我在美國學到最重要的一課是什麼?我毫不猶豫地回答了,我覺得是:「如果你的心中是有『價值』的,千萬不要放棄它。」

在我 2016 年剛到美國時,非常幸運地聽了兩場世界銀行總裁──金墉博士(Dr. Jim Yong Kim),以及非常多全球衛生,在世界各地奮鬥的前輩們的演講。(詳見:《「優先選擇窮人」的新任總裁,將如何改變世界銀行?》一文)

這其中,也不乏和許多學術、臨床都非常優秀的醫療人員的接觸——在這過程裡,我總是一次又一次地,從他們人生的故事裏聽到,他們是如何用其一生,來實現他們心中所相信的價值。

例如,法默醫師相信人是平等的,每個人都值得被治療——即使傳統公衛的成本效益分析下,無法呈現治療某些疾病的價值。

因此,當 1990 年代秘魯爆發多重抗藥性肺結核(multi-drug-resistant tuberculosis)疫情時,當時根本沒有什麼相對應的治療可言,政府高層甚至不願意承認多重抗藥性肺結核的存在時,金墉博士就在他演講中提到:他和法默醫師永遠都必須要分開坐在桌子的兩頭——因為如果他們兩個坐在桌子的同一側,當桌子這頭在討論要怎麼樣治療病人時,另一頭的人必定會開始說著「(因為治療成本太高)不要去治療這群多重抗藥性肺結核的病人,就把他們關起來,讓他們自生自滅就好了!」

也因此,他們必須要不斷不斷地去反覆遊說不同團體,最後終於說服政府當局一起努力。時至今日已經整整 30 年,法默醫師和金墉博士一起創辦的健康夥伴(Partners in Health),仍在秘魯毅立不搖地,繼續做多重抗藥性肺結核防治/治療計劃。

人之所以得到敬重,不在財富與地位,而在你所代表的價值

這點,和前述的:「不要放棄你所相信的價值」與「不要害怕去當倡議者」,其實是環環相扣的——而這兩點,於我在美時期所接觸的前輩們身上,總是不斷地被反覆印證。

他們在全球衛生界裡之所以世界知名,或者之所以受眾人仰慕、敬重,其實不是因為其頭銜或收入,而是這兩項價值的具體實踐:擁有價值的人,不能害怕去倡議;而不害怕去為自己相信的價值奮戰,才能常保那自己心中的價值。

這些人用自己的人生,去展現何謂「為了自己心中的價值奮戰」,而從中因而彰顯出的價值,在這個速食文化當道的社會裡,更顯彌足珍貴。

以上,是我在哈佛體系中研究、工作中,得到的幾點衝擊。而說實話,這些其實是「非常令我享受」的衝擊:

因為這些「衝擊」所帶來的視野,讓我開始逐漸用一個不同的角度與眼光來看社會、看我所做的工作,而我也很確定這些「令我享受」的衝擊,在種種初遇到時的不適應過後,所能帶來的成長,將可以成為我未來最大的養分來源。

衷心希望這些我所感受的「衝擊」,也可以成為閱讀完這篇文章的你/妳,在生涯路上面對未來時,能夠更為堅定一點點的養分。

註一:Ether dome:乙醚廳,是麻州總醫院最有名,也是最老的建築之一,他是全世界第一個實行手術實行麻醉,並公開「表演」的地方,而該麻醉藥物就是乙醚。

執行編輯:鄧紹妤
核稿編輯:張翔一

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Hypothesis來自細膩的觀察,科學家可以利用健保資料庫相關性的觀察中得到具有洞見的Hypothesis。這類研究除了可以提高台灣學術界的能見度,也可以當做深入研究的前哨,研究團隊若能繼續利用細胞或動物模型的基礎研究去探索機轉,並用前瞻性研究去証實他們報告的現象,就會有真正的科學價值。大家不必為了不同看法或少數錯誤的作法去否定這個工具。產量,是一個迷思,一輩子只發一篇不一定就代表品質好,每年發100篇也不見得每一篇都差。與其批評「量」,不如明確指出論文的問題,外國人的質疑是可以理解的,但是跟著盲目批評也不必要。總之,資料庫就是一個工具,用得對不對在個人,「量產化」後出錯的機率提高但不直接代表錯誤。

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Mariah Carey Opens Up About Bipolar Disorder
By JONAH ENGEL BROMWICH APRIL 11, 2018

Mariah Carey told People magazine that she had not previously disclosed the diagnosis because “I didn’t want to carry around the stigma of a lifelong disease that would define me and potentially end my career.” Credit Jordan Strauss/Invision, via Associated Press

https://www.nytimes.com/2018/04/11/style/mariah-carey-bipolar-disorder.html

Mariah Carey, the superstar singer who has lived in the public eye for three decades, has acknowledged that, in 2001, she learned that she had bipolar disorder.

Ms. Carey disclosed the diagnosis in an interview with People magazine’s editor in chief, Jess Cagle. A preview of the magazine’s cover story was published online Wednesday. The full interview will be available Friday.

The interview marks one of the first instances in which a celebrity of Ms. Carey’s stature has acknowledged her struggles with mental illness. In the interview, she explained why she had not previously revealed the diagnosis.

“I didn’t want to carry around the stigma of a lifelong disease that would define me and potentially end my career,” she said. “I was so terrified of losing everything.”

Ms. Carey said that she had lived in “denial and isolation and in constant fear someone would expose me,” and that she had come forward after the burden became too heavy to bear. She is in therapy and taking medication for bipolar II disorder, a disease that can cause sudden and extreme shifts in mood, among other symptoms.

People magazine declined to explain how the interview had come about, saying only that Ms. Carey had trusted Mr. Cagle to tell her story. A publicist for Ms. Carey did not immediately respond to a request for comment.

Ms. Carey was a teenager in the late 1980s when she was recruited by Tommy Mottola, the president of what was then CBS Records, to become a pop star. Her fame was swift with the backing of the label, and that placed enormous pressure on her from the beginning.

She spent long hours in the studio recording her debut, “Mariah Carey,” and was nominated for four Grammys in 1991. She won two that year, including the award for best new artist. Her third album, 1993’s “Music Box,” was also an enormous commercial success. By 2000, Billboard had crowned her the artist of the decade.

But the money behind Ms. Carey’s rise led to suspicion. Industry observers questioned the singer’s initial unwillingness to tour and asked whether her voice was less impressive than it sounded on record. The scrutiny increased in 1997, when Ms. Carey and Mr. Mottola parted ways, and she began to experiment with her style.

In the summer of 2001, after a drawn-out feud with her label, and the release of a new single, Ms. Carey was hospitalized for exhaustion. Soon after, her film project “Glitter” was released and widely panned by critics.

The latter half of her career has been characterized by inconsistent performances, and a string of high-profile relationships that have been obsessively covered by the tabloids.

She retained her hitmaking abilities (the blockbuster songs “We Belong Together” and “Touch My Body” were released during this period). For many critics, Ms. Carey’s music had become less of a focus than her public persona and live performances. In 2017, she was widely ridiculed for her failed lip-syncing performance on ABC’s “Dick Clark’s New Year’s Rockin’ Eve With Ryan Seacrest” in Times Square.

Ms. Carey’s disclosure of her diagnosis follows admissions of mental health problems by other celebrities. Last year, Chrissy Teigen wrote an essay about her experience with postpartum depression for Glamour magazine and Selena Gomez told Vogue about her struggles with anxiety and depression.

But Ms. Carey started her career during a different era and her interview with Mr. Cagle breaks new ground. She told People that she had decided to speak partly on behalf of others who might be suffering.

“I’m hopeful we can get to a place where the stigma is lifted from people going through anything alone,” she said. “It can be incredibly isolating. It does not have to define you and I refuse to allow it to define me or control me.”

Follow Jonah Bromwich on Twitter:@Jonesieman.

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Mariah Carey Opens Up About Bipolar Disorder
By JONAH ENGEL BROMWICH APRIL 11, 2018

Mariah Carey told People magazine that she had not previously disclosed the diagnosis because “I didn’t want to carry around the stigma of a lifelong disease that would define me and potentially end my career.” Credit Jordan Strauss/Invision, via Associated Press

https://www.nytimes.com/2018/04/11/style/mariah-carey-bipolar-disorder.html

Mariah Carey, the superstar singer who has lived in the public eye for three decades, has acknowledged that, in 2001, she learned that she had bipolar disorder.

Ms. Carey disclosed the diagnosis in an interview with People magazine’s editor in chief, Jess Cagle. A preview of the magazine’s cover story was published online Wednesday. The full interview will be available Friday.

The interview marks one of the first instances in which a celebrity of Ms. Carey’s stature has acknowledged her struggles with mental illness. In the interview, she explained why she had not previously revealed the diagnosis.

“I didn’t want to carry around the stigma of a lifelong disease that would define me and potentially end my career,” she said. “I was so terrified of losing everything.”

Ms. Carey said that she had lived in “denial and isolation and in constant fear someone would expose me,” and that she had come forward after the burden became too heavy to bear. She is in therapy and taking medication for bipolar II disorder, a disease that can cause sudden and extreme shifts in mood, among other symptoms.

People magazine declined to explain how the interview had come about, saying only that Ms. Carey had trusted Mr. Cagle to tell her story. A publicist for Ms. Carey did not immediately respond to a request for comment.

Ms. Carey was a teenager in the late 1980s when she was recruited by Tommy Mottola, the president of what was then CBS Records, to become a pop star. Her fame was swift with the backing of the label, and that placed enormous pressure on her from the beginning.

She spent long hours in the studio recording her debut, “Mariah Carey,” and was nominated for four Grammys in 1991. She won two that year, including the award for best new artist. Her third album, 1993’s “Music Box,” was also an enormous commercial success. By 2000, Billboard had crowned her the artist of the decade.

But the money behind Ms. Carey’s rise led to suspicion. Industry observers questioned the singer’s initial unwillingness to tour and asked whether her voice was less impressive than it sounded on record. The scrutiny increased in 1997, when Ms. Carey and Mr. Mottola parted ways, and she began to experiment with her style.

In the summer of 2001, after a drawn-out feud with her label, and the release of a new single, Ms. Carey was hospitalized for exhaustion. Soon after, her film project “Glitter” was released and widely panned by critics.

The latter half of her career has been characterized by inconsistent performances, and a string of high-profile relationships that have been obsessively covered by the tabloids.

She retained her hitmaking abilities (the blockbuster songs “We Belong Together” and “Touch My Body” were released during this period). For many critics, Ms. Carey’s music had become less of a focus than her public persona and live performances. In 2017, she was widely ridiculed for her failed lip-syncing performance on ABC’s “Dick Clark’s New Year’s Rockin’ Eve With Ryan Seacrest” in Times Square.

Ms. Carey’s disclosure of her diagnosis follows admissions of mental health problems by other celebrities. Last year, Chrissy Teigen wrote an essay about her experience with postpartum depression for Glamour magazine and Selena Gomez told Vogue about her struggles with anxiety and depression.

But Ms. Carey started her career during a different era and her interview with Mr. Cagle breaks new ground. She told People that she had decided to speak partly on behalf of others who might be suffering.

“I’m hopeful we can get to a place where the stigma is lifted from people going through anything alone,” she said. “It can be incredibly isolating. It does not have to define you and I refuse to allow it to define me or control me.”

Follow Jonah Bromwich on Twitter:@Jonesieman.
關於污名化
關於污名化
cobolsu.blogspot.com

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英國留學優勢多:教育品質高、學制短且精實
https://goo.gl/ALqk9q

近年來留學英國已成為勢不可擋的趨勢,根據英國高等教育統計局(Higher Education Statistics Agency)最近公布英國高等教育的相關數據,近六年來平均每年至少有43萬來自世界各地的學生至英國留學,在台灣,英國也是僅次美國之外的歐美留學熱門國家,每年有近4千位學生前往英國留學。為什麼要選擇到英國留學?讓我們來看看留學英國有哪些優勢:

一、世界一流的高等教育學府,學術環境品質高

英國擁有享譽全球的高品質高等教育,培育了131位諾貝爾獎得主外,在2017年全球創新指數(Global Innovation Index)也被評為全球前五大創新國,其高水準學術環境也能從各大知名排行中一窺端倪,泰晤士高等教育雜誌(Times Higher Education)最新公布2018年百大名校榜單中,英國就佔了12個席次。

二、學制精實,時間成本降低

英國高等教育體制分為學士、碩士及博士學位,學士修業時間為3年,授課型碩士1年、研究型碩士1至2年,博士學位平均3-4年可取得,課程緊湊嚴謹,獲取學位的時間和其他國家相對較短,表示學生可以更快開始投入就業市場,投資報酬率相對來說比較高。

三、學費經濟,CP值高

經濟學人雜誌(The Economist)表示,雖然英國學費漲不停,但與前往美國留學比較起來,CP值仍高許多,一來是英國平均學費仍較美國低,二來是不論何種學制,英國修業時間幾乎都比美國短,也等同於減少了整體留學費用,根據英國全國學生聯合會(National Union of Students)統計,學生平均一年生活開銷為1萬2千英鎊,等同於省下約49萬台幣。如果想要更精打細算,英國仍有許多學費比較經濟的大學,像是位於曼徹斯特的英國國立切斯特大學(Unversity of Chester)學費僅約9,700英鎊,可以說相當實惠。

四、地利位置便利,充分體驗歐洲文化:

到英國留學可以實際感受的迷人的英倫文化,更不用說其連結歐洲大陸的優異地理位置,利用假期探索各地風情,也是留學過程中不可或缺的體驗。

如何挑選一所適合自己的英國大學?
英國共有163高等教育學校,其中大學就佔了130所,選擇多元,但要怎麼樣才能挑選出最適合自己的學校呢?建議可以朝這三個方向來思考:

一、利用世界大學排行榜

大多數的申請者優先參考的就是大學排名了,以泰晤士高等教育Times世界Higher Education公布的大學排行為例,英國在前200名中佔了31名,若以歐洲區域來看,歐洲前五大大學,英國就稱霸了4所,在具公信力排行榜上的名校具有備受肯定的教學及研究品質,也代表著往後就業的保障。

再來,挑選自己有興趣的學習領域;每所學校都具備自己專長的領域,除了可以用各大排行榜針對系所作篩選,也可以運用完全大學指南(The Complete University Guide)查詢大學系所概況;有志唸商管科系可以選擇聖安德魯斯大學(University of St Andrews),新堡大學(University of Newcastle)則在建築方面的表現相當傑出,根據每個學校的專長來挑選志願可以找到最適合自己的英國大學。

-想了解各大排行榜的特色與指標?請閱讀:留學必懂!最新世界大學排行榜全攻略

二、選擇具有就業潛力的系所:

希望海外留學的經驗對未來的職涯發展有所助益的話,可以考慮以下三種人力市場需求看好的研究所:第一種是財務金融研究所(Banking and Finance),英國是全球金融重鎮之一,有許多和財金相關的科系可供選擇;醫療助理學研究所(Physician associate)在英美也非常熱門,醫療助理可以協助醫生給與整合性的協助,倫敦大學的聖喬治學院(St George’s, University of London)有相關科系;而第三種則是本來就是留學熱門選項的商業管理研究所(Management),畢業後出路廣,能往多種領域發展。

三、留意學校對就業輔導的投入心力:

求學的最大的目的之一就是為了將來的職涯作準備,因此一所優質的大學也要能對學生畢業後的職涯規劃提供全方面的協助。如果大學提供的就業輔導是選校的考量因素之一,英國的羅浮堡大學(Loughborough University)、謝菲爾德大學(Univerisity of Sheffiled)或鄧迪大學(Univeristy of Dundee),這三所大學由知名英國大學資訊網站StudentCrowd調查出最佳輔導學生就業服務大學前三名,皆有豐富經驗的教職員協助學生們規劃畢業後的出路。

-看更多提供就業輔導服務的英國大學:20間最佳學生就業輔導服務的英國大學

按部就班作好準備,開始申請英國大學!
選定志願學校後,接著就得開始準備申請文件,申請英國大學必須統一透過UCAS系統在系統上繳交文件,至多可以選擇5所大學,最後會得到類似臺灣大學指考的分發結果;申請英國研究所則是依照各學校的要求,繳交指定的文件至學校的申請系統或寄至招生信箱。申請文件的部分,英國與美國的審查委員看重的地方不一樣,簡單用表格的方式整理了兩國的重點比較,如果同時申請這兩個國家的考生,記得依國情調整文件,以免申請文件不符合審查者的胃口,大幅減少錄取的機會:

審查人員
英國
申請資料將由校內的學術人員負責審查,有可能是未來的指導老師,盡量在文件中表明自己對申請領域的了解。
美國
申請資料是由行政人員負責審查,對於申請者的特質比較有興趣,審查重點會放在申請者是否能對學校帶來價值。

課外表現
英國
此項並非挑選學生的主要因素,但可以用來強調學業上的優異表現外,也有豐富的課外活動經歷。
美國
課內外表現一樣重要,必須並重的書寫這兩方面的經歷,偏好具多元發展性的學生。

學術期待
英國
對於所選的特定專業需要專精。
美國
鼓勵學生學習不同的專業。

選校或選系
英國
學生需要在文件中說明選擇該系所的原因。
美國
學生需要在文件中說明選擇該所學校的主因。

綜觀來看,英國對於文件內容要求較為嚴謹,著重在申請者的學術知識,以及對該科目的熱忱,儘量避免不正式的用語或陳腔濫調,課外活動不是必須,但如果學術表現已經十分優異,課外活動的描述則可以加分。

除了文件以外,準備的過程中掌握申請時程也非常重要,最好提前一年開始籌備申請作業,在這期間盡可能地收集學校資料、準備申請文件、拿到所需要英文程度的測驗證明、請推薦人寫推薦函等,若不注意時間很容易錯過申請截止日,以下列出申請英國大學和研究所的申請時程,每年或許會有些許改變,別忘了再次到該校的招生網頁確認截止日期:

申請英國大學:透過UCAS,9月中即開放申請,10月中旬申請醫學相關課程、牛津及劍橋大學截止,1月中旬大部分的課程截止,3月中旬藝術及設計類課程截止。
申請英國研究所:依照各大學規定,大部分在10月開放申請,採先到先審制(Rolling Admission),因此就算有些大學的截止日為6月,也可能提前額滿,建議提早準備儘早申請。
利用托福網路測驗TOEFL iBT申請英國留學
英國留學考試最重要的資料之一就是語言能力測驗證明,托福網路測驗(TOEFL iBT)是國際性認證的學術英語測驗,大部分的英國大學都接受托福成績,名校如牛津大學(University of Oxford)、曼徹斯特大學(University of Manchester)、愛丁堡大學(University of Edinburgh)等羅素集團下的大學,以及英國工業城裡的紅磚大學。如果想要查詢申請的英國大學是否接受托福成績,可以上學校網站中的「Entry Requirements」,或是上ETS網站查詢。

只要申請學校接受托福成績,就可以用來英國學生簽證Tier 4,托福網路測驗(TOEFL iBT)每年舉辦超過50場的測驗,考試便利性高,想考TOEFL iBT的考生可以先透過托福紙筆測驗(TOEFL ITP)了解自身英文程度,達到至少550分以上再報考TOEFL iBT,就可以節省不少測驗費用。

-需要托福備考攻略?快看善用托福紙筆測驗,預先掌握題型 – 托福滿分達人分享讀書計畫

資料來源:
1. Higher Education Student Statistics: UK, 2016/17 – Where students come from and go to study
2. 106年度世界各主要國家之我留學生人數統計表
3. Higher education in Britain is still good value compared with America
4. Which Top UK Universities Have the Cheapest Postgraduate Fees for International Students?
5. Times Higher Education World University Rankings 2018
6. List of universities in England
7. How to choose a UK University
8. Students’ 20 top tips for picking a course
9. UK and US University Applications: The Key Differences
10. UK vs. USA Education System
11. Countries and Schools accepting TOEFL Score

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入睡的悖論
http://www.storm.mg/lifestyle/416567
而破除「越想睡、越失眠」的訣竅就是:別掙扎吧,允許自己失眠,不要跟自己說「趕緊睡」。不用執著於「這藥怎麼沒用!」或者「完蛋了,我怎麼還醒著……」這只會讓你陷入失眠焦慮的死循環。
不要把睡覺(或者失眠)當成一件很有負擔的事情。當你睡不著的時候,就起來做些別的事情。
睡眠的重要性已被強調了太多遍,睡眠剝奪的危害越來越聳人聽聞。導致人們一旦失眠,就立刻引發巨大的焦慮和恐慌,並且不斷重視自己的失眠問題。吃什麼東西是為了緩解失眠,規律運動是為了提高睡眠品質……彷彿活著就是為了治療失眠。這可以理解,因為失眠確實很痛苦,但當「治療失眠」的願望強烈到你生活完全圍繞它展開時,你也就離「睡個好覺」越來越遠了。

事實上,也許我們並不需要過分擔心失眠,因為雖然睡個好覺的確很重要,但其實有時睡不好也沒事。首先,失眠並不等於完全失去休息,也不是在浪費時間。其次,研究者發現,與我們常識相悖的是,失眠者的實際表現與正常睡眠的人並無差別(Drummond et. al., 2013)

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佛洛依德「精神分析」理論目前被推廣到臨床醫療之外的眾多跨領域應用,不僅是現代「音樂、文學、藝術」等創作的基礎,更化身為「高度精神壓力工作者」的身心修練之道。企業的CEO、頂尖運動員、卓越的演員、不再僅僅只能透過「靈性」的宗教,現在更常常透過「科學性」的精神分析,深入「探索自我」、認識自己的「另一面」,查察「潛意識」對生活和工作的影響,進而突破自我的迷宮,作出別具洞見的決策,成就出不凡的表現。

這種透過精神分析所經歷的自我探索,對於音樂家或藝術工作者而言難能可貴。感受生命、表達自我、表現藝術,都會反映出內在動機和深層情感,所以具備這種洞察能力,可以讓人的心靈層次更加提升。

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音樂及藝術的聆賞者對美學偏好的「興趣(interest)」、「品味(taste)」和「素養(literacy)」是不同的概念,例如,一個人可能本能地先對某一類型的音樂產生「興趣」,接著或許停留在該類型的音樂成為「嗜好(收集或重複欣賞)」、或許從深入熟悉以及具備知識的過程中,進而對該類型或延伸出去的相關領域,培養出獨特的「品味」,品味的提升可以經由訓練,也可能改變或加寬原始的興趣。至於「素養」,除了需要有足夠的品味、不會局限在表淺的形式,更重要的是能具有整體統合的洞見(Insight)。

興趣、知識、訓練、品味,如果停留在某個片面的觀點上,便失去其整體統合的洞見。音樂之美,有歷史、文學、表演、和美術為基礎;有科學(數學、物理、腦生理)、商業、和行銷的媒介;甚至有潛意識心理學和認知神經科學的重要層次。人文素養包括音樂素養的培養,最重要的就是對跨越領域的相互影響能有適切的反應。

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Practice MMI Questions Bank
https://bemoacademicconsulting.com/blog/files/sample-mmi-practice-questions

Who is this for?

The following is for students applying to any health related professional program that requires the multiple mini interview as part of their admissions process. The sample MMI questions below are relevant to medicine, dentistry, pharmacy, physical therapy, nursing, etc.

First Things First!

Before we jump into the sample questions, it is important to mention that sample questions are only effective if you:

1) Time yourself and utilize the questions in a realistic multiple mini interview simulation (MMI SIM), and,

2) You get expert feedback on your performance so you can identify your mistakes and learn from them way before your actual interview.

With that said, you are now ready to get started. Good luck on your multiple mini interview!

Note: The following is a compilation of 100 sample MMI questions. Some of the questions are from BeMo’s database of questions and some are from official universities and colleges that administer the MMI as part of their admissions process. A link to each source is provided, whenever an outside source is used. Please note that BeMo does not endorse nor affiliate with any of the mentioned universities and colleges. Each respective source is the copyright owner and the material is shared here under the fair use clause of Copyright Act.

UBC Center for Student Involvement and Careers:

1. A 14-year-old patient requests birth control pills from you and asks that you not tell her parents. What would you do?

2. A member of your family decides to depend solely on alternative medicine for treatment of his or her significant illness. What would you do?

3. If you have the choice of giving a transplant to a successful elderly member of the community and a 20-year-old drug addict – how do you choose?

4. An eighteen year-old female arrives in the emergency room with a profound nosebleed. You are the physician, and you have stopped the bleeding. She is now in a coma from blood loss and will die without a transfusion. A nurse finds a recent signed card from Jehovah's Witnesses Church in the patient's purse refusing blood transfusions under any circumstance. What would you do?

5. Your local Paediatric Association has recommended that circumcisions 'not be routinely performed'. They base this recommendation on their determination that 'the benefits have not been shown to clearly outweigh the risks and costs'. Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they are clearly not medically necessary. BC Medicare no longer pays for unnecessary circumcisions. Consider the ethical problems that exist in this case. Discuss these issues with the interviewer.

6. A biotech company was hired by the Military to develop a cure for Ebola. They successfully developed a vaccine to treat the symptoms of the virus and lowered the mortality rate for infected patients. Discuss the implications of this on a global scale.

7. Your mother calls you and asks you to help with a major family decision. Your maternal grandfather is 70 years old and has been diagnosed with a condition that will kill him some time in the next five years. He can have a procedure that will correct the disease and not leave him with any long-term problems, but the procedure has a 10% mortality rate. He wants to have the procedure, but your mother does not want him to. How would you help mediate this issue?

8. You are a genetic counselor. One of your clients, Linda, had a boy with a genetic defect that may have a high recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You offered genetic testing of Linda, her husband, and their son to find out more about their disease, to which everyone agreed. The result showed that neither Linda nor her husband carry the mutation, while the boy inherited the mutation on a paternal chromosome that did not come from Linda's husband. In other words, the boy's biological father is someone else, who is unaware that he carries the mutation. You suspect that Linda nor her husband are aware of this non-paternity. How would you disclose the results of this genetic analysis to Linda and her family? What principles and who do you have to take into consideration in this case?

9. A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is an exotic dancer; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. They anesthetize her and surgically repair the aneurysm. She survives, and sues the hospital for millions of dollars. Do you believe that the physician's actions can be justified in any way? Is it ever right to take away someone's autonomy?

10. You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. When should a physician step in to stop a cultural practice? Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine?

11. A patient with Downs Syndrome became pregnant. The patient does not want an abortion. Her mother and husband want the patient to have an abortion. What should a physician do in this situation?

12. A 12-year old boy is diagnosed with a terminal illness (e.g., malignancy). He asked the doctor about his prognosis. His parents requested the doctor not to tell him the bad news. What should the doctor do in this situation?

13. A couple has decided to have a child through artificial insemination. They asked the physician for sex selection of the child. What should a physician advise in this situation?

14. A physician became sexually involved with a current patient who initiated or consented to the contact. Is it ethical for a physician to become sexually involved?

15. A 17-year old boy lives independently. He is married and has one child. He wants to participate in a medical research study. Does he need his parents’ permission?

16. A physician went to vacation for 2 weeks. He did not find another physician to cover him. One of his patients with hypertension developed severe headache. The patient has an appointment with the doctor as soon as he comes back from vacation. The patient did not look for another physician and decided to wait. The patient suddenly collapses and was diagnosed to have intracranial haemorrhage. Is the physician responsible for this patient?

17. A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who understood the procedure. Can the patient give consent?

18. A physician picked up a car accident victim from the street and brought him to the ER in his car. He did not want to wait for an ambulance because the patient’s condition was critical. Physical examination in the ER reveals quadriplegia. Is the physician liable for this consequence?

19. As a physician at a local hospital you notice that there is a man with an alcohol dependency who keeps on consuming the hand sanitizer offered at the hand sanitizer stands throughout the hospital. He is not a patient at the hospital at present but has been many times in the past. Consequently, there is often no hand sanitizer for public use. What do you do? Do you remove/change location of hand sanitizer stands? Do you approach him?

20. A 18-year old man is diagnosed to have suspected bacterial meningitis. He refuses therapy and returns to the college dormitory. What should a physician do in this situation?

21. Is it ethical for doctors to strike? If so, under what conditions?

22. There is an outbreak of an incredibly contagious life-threatening disease. The disease is spreading across the country at a rapid rate and the survival rate is less than 50%. You are a senior health care administrator, and when the vaccine is developed, you have priority to receive the drug. Do you take the vaccine yourself or give it to another person? Why or why not?

23. You are a health researcher at an academic institution. You have been asked to work on a top-secret vaccine that would treat biomedical weapons or other communicable diseases. Before your break through, you are instructed by the government to stop all research and turn over all materials and copies of your work to be destroyed. You know you are very close to finding a cure. What do you do?

24. A patient requests needles and syringes at his/her local pharmacy. They do not present with a prescription, and based on the records you can access, they are not receiving treatment for diabetes. Do you sell the syringes or not?

25. Dr. Blair recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr. Blair doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches, because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems that Dr. Blair’s behaviour might pose. Discuss.

26. The City of Vancouver has taken great measures to increase accessibility to alternative forms of transportation (Canada Line, Hornby and Dunsmuir Bike Lanes, Proposed Evergreen Line, and Burrard Street Bridge closures). Discuss the impacts (both positive and negative) of these decisions?

27. If the Prime Minister/President were to ask your advice on one change that could be applied to the healthcare system that would improve it enormously and have the greatest positive effect, how would you answer?

28. The man who lives next door to you often rides his bicycle in the company of his two young children but without a helmet. In fact, on several occasions you have seen him riding with his helmet hanging by its straps from the handlebars. His young children sometimes wear a helmet, sometimes not. If the man fell off his bicycle and hurt his head in a way that would have been prevented if he had worn a helmet, would it be reasonable to ask him to contribute towards the treatment costs for his injury?

29. Due to a shortage of physicians in rural communities, some policy-makers have suggested that medical programs preferentially admit students who are willing to commit to a 2 or 3 year tenure in rural areas after graduation. Consider the broad implications of this policy for health care and the costs associated. Will this policy be effective?

30. Recently, certain hospitals have been charging patients $29/day for their hospital fee on top of the fees charged to MSP. What are the implications of this policy? Discuss both positive and negative impacts with the interviewer.

31. Do you think general practitioners have an obligation to report their patients' health status to a public health agency, if their patients have active infectious diseases?

32. Statistics have shown that effects of advanced age such as changes in vision and response time may adversely affect elderly drivers' ability to drive safely. As a matter of fact, many doctors discuss the issue of stopping driving with their older patients as a precaution for the safety of theirs as well as the public's. Do you think older drivers have to give up driving when they reach a certain age?

33. In recent years, there has been an increase in popularity of full contact sports, such as Ultimate Fighting Championship (UFC) and boxing. Should doctors have a role in regulating such sports?

34. Do you think medicine should be more about changing behaviour to prevent disease or treating existing disease?

35. Discuss the pros and cons of legalizing marijuana. How does this impact a physician’s present ability to write out prescription for ‘medical marijuana’? Would legalization cost the health care system more or less after it was passed?

36. Imagine your friend’s father is 70 years old and has lived in major North American City his whole life. He is taken to the emergency department at the local General Hospital. He has had good health until now and this is the first time he has been to hospital of any kind since he was 20 years old. What changes in the healthcare system and environment in the hospital do you think he would notice?

37. Discuss any topical health care issue that is unique to the region for Med School you are applying to?

38. Discuss one of these health care issues: human genome project, AIDS, abortion, the right to die, the cost of health care, and genetic engineering

39. How does Canadian health care system compare to that of Britain’s system vs. the American system?

40. What is the difference between Medicare and Medicaid? (American Question)

41. Recently, the Prime Minister suggested the idea of deterrent fees (a small charge, say $10, which everyone who initiates a visit to a health professional would have to pay at the first contact) as a way to control health care costs. The assumption is that this will deter people from visiting their doctor for unnecessary reasons. Consider the broad implications of this policy for health and health care costs

42. What is your opinion about stem cell research using fetal tissue?

43. How would you advise patients who are interested in visiting an acupuncturist or a chiropractor?

44. When is it appropriate to participate in assisted suicide of a patient? Why or why not?

45. A Kootenay town runs a health-collective that provides various alternative and traditional forms of medicine. The physicians there encourage parents of small children not to vaccinate their children. Discuss the positive and negative impacts of this opinion.

46. In June 2011, the Vancouver Canucks lost the Stanley Cup and riots broke out in Downtown Vancouver. Discuss the impact on the community and the range of health care professionals at St. Paul’s Hospital.

47. What is the difference between HMOs and PPOs? (American Question)

48. “Liberation Therapy” (LT), a vascular operation developed to potentially cure multiple sclerosis (MS) in certain patients, has recently come under very serious criticism – delaying its widespread use. Among other experimental flaws, critics cite a small sample size in the original evidence used to support LT. As a healthcare policy maker, your job is to weigh the pros and cons in approving novel drugs and therapies. Please discuss the issues you would consider during an approval process for LT.

49. In June 2011, the infamous Vancouver riots took place after their hockey team lost in the Stanley Cup Finals. Stores were ransacked and cars were burned. Hundreds of people were injured and sent to overcrowded hospitals. As the police chief in Vancouver, what measures or policies would you put in place to make sure this does not happen again?

50. You are a family physician. One of your patients, Mark, did not attend one of his classes and missed an important exam. He told you that his teacher would like a doctor's note explaining his absence from class; otherwise, he will receive zero, and all hell will break loose. He wants to you write a note for him, indicating that he was not feeling well enough to write the exam. Not able to find any physical symptoms, explain how you would deal with this. Enter the room and talk to Mark.

51. You are a 3rd year medical student doing hospital rotations. A fellow medical student who is doing rounds with you often show up to these sessions tired, messy, hung over, or even drunk. One day you found him in the lunchroom unaccompanied, so you decided to talk to him. Please enter the lunchroom.

52. Your friend Jason hasn't come to class for a few days. Being a hardworking pre-med student, he very seldom skips classes. You know that he is applying to medical school in the past several weeks. You called his house and he said you could visit him. You decided to pay him a visit after your classes. Enter the room and talk to Jason.

53. You are a cardiologist at a local hospital, who just finished a shift and has a tight run to your daughter's high school graduation ceremony. As you headed off to the door, Jennifer, a patient who knew you well, saw you from the waiting room and grabbed your attention. "Doctor! I have a bad chest pain. Please stay for a bit. I'll feel much better if you were here." Enter the waiting room and talk to Jennifer.

54. You are a current undergraduate student. During the week of graduation, you attend a number of parties around the Lower Mainland with your best friend, Kelly. The last party is held at a campground in Squamish. The morning after the party, you receive a call from Kelly. She asks that you come over and talk. Kelly reveals that she left early and drove home despite drinking that night. Enter the room and talk to Kelly.

55. You are an emergency room physician at a local hospital. A patient comes in requesting painkillers for his back. Upon reviewing his file, you realize that he frequently comes to the hospital requesting painkillers and he has already capped his prescription for the month. Upon examination, you notice no new injuries to indicate an increase in painkillers. You politely tell patient that you will not increase his dosage or re-fill out another prescription for him. He tells you that he will go and inject himself with heroin right now if he does not get the painkillers. What do you say next? What do you do?

56. Your 5 year old nephew asks you, "Why is the sky blue?” How would you answer him using a series of simple scientific experiments?

57. Your company needs both you and a co-worker (Sara, a colleague from another branch of the company, who is gripped by fear of flying since one of her friends narrowly escaped being at the World Trade Centre when it was destroyed) to attend a critical business meeting in San Diego. You have just arrived to drive Sara to the airport. Sara is in the room.

58. Nursing workload is a significant problem that needs to be addressed. Often nurses find they do not have adequate time to complete the tasks that are required of them in the time given each shift. How does this impact patient care? What are the implications for the nurses and the work culture and environment? What are the potential policy changes that can help alleviate some of this workload pressure?

59. As a physiotherapist, you are referred a 16 year-old for treatment of severe burns that limit function on the patient's arms and hands. Upon examination, you notice other burn marks and unexplained bruises on the patient. After working with the patient for a few weeks, you ask about the other marks on the patient's body. The patient admits to being abused by their parents but begs you not to tell anyone. What do you do?

60. As an occupational therapist, you work with clients of all ages. One of your younger clients begins searching you on the Internet and contacts you through social media sites. In this age, it is common for people to have many various personal and professional web profiles through sites like Facebook, LinkedIn, Twitter, Instagram, etc. What measures would you take if this happened? What would you do if the client would not stop?

61. You are an occupational therapist that works with a population with complex psychiatric histories. One of your older clients has been recently diagnosed with neurodegenerative disease, and she has schizophrenia. There is a history of the client’s children neglecting her needs and taking advantage of the client financially. Nevertheless, the client has a relationship with her family and they want to be named the primary decision maker for the client. How do you work with the client and her family knowing the past history of neglect and present needs of your client?

University of Alberta – School of Dentistry

62. In 2007 the Journal of Dental Education surveyed over 1000 dental students and found that 74.7% admitted to some form of cheating during their undergraduate career. The university has asked you to be part of a student focus group to determine how to reduce the incidence of cheating. You are well aware of this behavior as you have observed the reusing of old assignments on many occasions. What suggestions would you make to help reduce the incidence of cheating and improve the academic integrity of students?

63. The apartment next door is for rent. The previous tenants were nothing but trouble and have been evicted. Your landlord tells you about a new tenant he has found with more promising credentials. As he tells you about him, you realize that he is one of the drug addicts who was in treatment at a halfway house you volunteer at. You know that this person has a history of relapsing and may not have been completely honest on the application form. Do you warn your landlord about the person's history or do you keep your knowledge confidential?

64. Your neighbor has a five-year-old child who has many decayed teeth. The mother asks you for advice because she knows you volunteer for a dental professional and her child is in pain. The mother needs a dentist who will accept monthly payment for treatment. You provide her with different options and coach her on how to seek dental care for a child. One week later you see the mother and ask if she was able to acquire care for the child. She says no. What do you do?

65. In healthcare professions like dental care, you will be required to establish good working relationships with people from all walks of life. Talk about what you think will be your strengths and challenges in establishing these relationships with your future clients. Will you have more success or challenges in relation to:

young versus old clients
clients from different cultures
clients at different levels of health
66. A YouTube video of a group of junior high-school boys verbally abusing bus monitor Karen Klein went viral this July. The abuse included taunts, profanity, physical ridicule, and even threats to Karen’s person and home, ultimately resulting in her breaking down and crying. The video prompted an investigation on the part of school officials and local police. They were suspended from school and given 50 hours of community service. Klein stated that she would not press charges, partly because of the flood of criticism aimed at the boys. Do you believe the boys’ punishments were just, or what could have been done differently?

University of Victoria – Co-operative Education Program and Career Services

67. You are working alone in a convenience store as a cashier late at night. An older man comes in and buys a coffee. He is staggering, seems disoriented, and you smell alcohol on his breath. On the way out, he bumps into a shelf and knocks some cereal boxes off. He tries to put the boxes back, but cannot manage this task. What actions might you take in this situation? Provide reasons for your responses.

68. You are on holiday at a Mexican beach resort with some friends who are staying one floor down from you. In the middle of the night, a large earthquake takes place, and the building you are in is severely damaged. You have injured your leg, suspect it might be fractured, and you hear someone yelling for help near by. What would you do?

Tuft University - An Admissions OSCE: the multiple mini-interview

69. A message that recently appeared on the Web warned readers of the dangers of aspartame (artificial sweetener – Nutrasweet, Equal) as a cause of an epidemic of multiple sclerosis (a progressive chronic disease of the nervous system) and systemic lupus (a multisystem auto-immune disease). The biological explanation provided was that, at body temperature, aspartame releases wood alcohol (methanol), which turns into formic acid, which is in the same class of drugs as cyanide and arsenic." Formic acid, they argued, causes metabolic acidosis. Clinically, aspartame poisoning was argued to be a cause of joint pain, numbness, cramps, vertigo, headaches, depression, anxiety, slurred speech and blurred vision. The authors claimed that aspartame remains on the market because the food and drug industries have powerful lobbies in Congress. They quoted Dr. Russell Blaylock, who said, “The ingredients stimulate the neurons of the brain to death, causing brain damage of varying degrees." Critique this message, in terms of the strength of the arguments presented and their logical consistency. Your critique might include an indication of the issues that you would like to delve into further before assessing the validity of these claims.

70. Why do you want to be a physician? Discuss this question with the interviewer.

71. Universities are commonly faced with the complicated task of balancing the educational needs of their students and the cost required to provide learning resources to a large number of individuals. As a result of this tension, there has been much debate regarding the optimal size of classes. One side argues that smaller classes provide a more educationally effective setting for students, while others argue that it makes no difference, so larger classes should be used to minimise the number of instructors required. Discuss your opinion on this issue with the examiner.

72. The parking garage at your place of work has assigned parking spots. On leaving your spot, you are observed by the garage attendant as you back into a neighbouring car, a BMW, knocking out its left front headlight and denting the left front fender. The garage attendant gives you the name and office number of the owner of the neighbouring car, telling you that he is calling ahead to the car owner, Tim. The garage attendant tells you that Tim is expecting your visit. Enter Tim’s office.

73. What experiences have you had (and what insights have you gained from these experiences) that lead you to believe you would be a good physician? Discuss this question with the interviewer

74. Robert Collier stated: "Success is the sum of small efforts, repeated day in and day out." Consider the quote you have just read. What does this quote mean to you in terms of how you live your life and how you will pursue your career?

University of Calgary

75. In 2007, the American Family Physician Journal published an article exploring the issue of physicians as role models, using a scenario in which an obese physician is offering nutrition and exercise counselling to his obese patient. According to the author’s research, patients have more confidence in health-counseling advice from non-obese versus obese physicians, and physicians with poor personal lifestyle habits are less likely to counsel patients about a healthy lifestyle. Based on these research findings do physicians have a responsibility to act as healthy role models to their patients? Please elaborate.

76. A proposed bill would require all individuals to vote in federal elections or face a $100 fine. What do you think about this bill?

77. You are the director of a financially struggling hospital. You have been unable to generate enough revenues to implement some very important initiatives at the hospital and are at risk of inevitable service cuts, if more funding is not secured immediately. The only secure source of funds that is being offered is by a cigarette company. They are willing to provide your hospital with all the resources required in exchange for advertisement at your facility. What will you and should you do as the hospital director?

78. You are a specialist who has just received lab results with regard to one of your patients. The results indicate that your patient, a single mother of two young boys, has been diagnosed with a terminal cancer and that she will only have 4-6 months to live. There are not many treatment options aside from a few experimental procedures that are still under study. There are some alternative treatments available in Europe; however, they have not been validated by scientific studies in North America. What would you say to your patient once they are in the office? If an alternative treatment, without scientific evidence for its efficacy, existed for a terminal illness would you recommend it to a patient?

79. You are the father of a 12-year-old boy. Your son’s friend, who is also your neighbour, is playing with your son in the backyard. As you approach them to ask them about lunch, you notice some severe bruises on the friend’s arm and upper neck. You are worried about these obvious signs and decide to approach your neighbour (the young boy’s father).

How would you approach this situation? What would you say to the father of the young boy? What are some potential concerns that you may have?

80. You enter the cafeteria at work. You sit down to eat with a group of male colleagues who are having a conversation about a female colleague of yours. The comments they make are not very professional and can be deemed rude and offensive. You feel very uncomfortable. What do you do? What do you say to your male colleagues? If this became a regular occurrence, even after you speaking to your colleagues, what other steps would you take to resolve the situation?

81. Your best friend, Jennifer, calls you to tell you that she has been rejected for the 3rd time from all medical schools that she had applied to during the previous application cycle. She invites you over to her house to have a chat about her future plans. Go inside the room and speak with Jennifer.

82. "Education is the kindling of a flame, not the filling of a vessel." - Socrates What does this quote mean to you? Go inside the room and discuss your thoughts with the interviewer.

83. Every week, your classmates gather at the local coffee house to review the lessons from that week. In the last month, everyone has been working on a major paper on Roman history, which accounts for 40% of the course grade. One of your classmates has copies of two of the papers that last years’ students wrote for the same course. Your classmate has e-mailed copies of the paper to you and the other people in the group. What would you do in this situation and explain why? Discuss what values and choices are relevant in this situation? What are the implications if you decide to read the paper from last year?

84. Please describe the object presented to you to the interviewer. The interviewer has never seen the image. Note you are only allowed to use your words to describe the image. (The image could be any abstract image that you may have never seen before)

85. You are the team leader of a group assignment and two of your group mates inform you that one of the group members, Tim, has a very strong body odor and they are unwilling to take part in any further group meetings until Tim addresses this issue and takes care of his personal hygiene. Tim is waiting inside the room, go inside and discuss this issue with him.

86. Some medical schools have a preference for selecting medical candidates from certain geographical locations. What are your views about such selection policies? Please discuss your answer with the interviewer inside the room.

87. In a class of 78 students 41 are taking French, 22 are taking German. Of the students taking French or German, 9 are taking both courses. How many students are not enrolled in either course?

88. If you could have any superpowers, what would it be and why?

89. You are a PhD student and your supervisor Prof. Harry, has recently published the results of his publicly funded research project with the intention to commercialize his discovery. What are your views about university professors that use public funding to create for-profit solo ventures?

90. You are the emergency doctor on duty when two patients are rushed in within 7 seconds of each other and both desperately need a heart transplant. You only have one donor organ available. And both patients are a match and both are equally medically fit for the operation. One patient is a 35-year old single dad with 3 children, while the other is a 35 year old single male, who’s an Olympic Gold medalist. Who would you give the heart to and why?

91. You are a research supervisor and you notice that one of your graduate students has been sleeping in the lounge area within the research facility, because your student is recent international student she cannot afford to rent a place of her own with her student stipend. You are aware that the facilities safety policies prohibit overnight stays. How do you approach the student about this?

92. You are the executive director of a law firm. You find out that your articling student has accidentally destroyed an important piece of evidence that would have cleared a wrongfully accused person. If you reveal this to the authorities, your student will not only lose her job, but will face jail time for destroying court evidence. What will you do in this situation? What if you had information that the accused person is indeed guilty of other unrelated but more serious crimes for which you do not have any evidence that would hold up in the court?

93. Regardless of what we do in life, there will be times when we will come into disagreement with an authority figure or a superior. Describe a time when you came into conflict with an authority figure and how you dealt with it.

94. What is your favorite quote? Discuss the quote and what it means to you with the interviewer inside the room.

95. You are the Dean of Admissions at a very competitive medical school. One day as you are leaving your office at the end of the day, you are approached by the mother of a student who was recently rejected from your school. The mother explains that her son has a 4.0 GPA, scored 98th percentile on the MCAT, and has numerous awards and many relevant accomplishments. She wants answers right now and she demands to see every applicants’ file. Go inside the room and talk to the parent.

96. A friend of yours has a cat named Jingles. One day your friend calls you and tells you that Jingles is very ill and in need of a vet. Unfortunately, Jingles does not have insurance and the cost of seeing a vet will be around $1500, which your friend has to pay out of pocket. She cannot afford the cost and asking you for help. What would you do and say in this situation?

97. What do you do for hobbies and on your spare time?

98. Tell me about yourself.

99. “The first task of the doctor is political: the struggle against disease must begin with a war against bad government. Man will be totally and definitively cured only if he is first liberated...” What are your thoughts about this quote by Michel Foucault?

100. It is well known that big Pharmaceutical companies along with their expansive lobby have a huge influence on the medical profession and its education. In your opinion what are the positives and negatives of having the Pharmaceutical companies play a role, if any, within medical educational institutions? If you do not think that Pharmaceutical companies should have any role within medical schools, what steps would you take to remove big interest groups such as Big Pharma out of the education system if given the opportunity?

To your success,
Your friends at BeMo
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Dr to be ─ 醫學生甄試
Dr to be ─ 醫學生甄試
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An approach to the multiple mini interview (MMI)
https://bemoacademicconsulting.com/blog/multiple-mini-interview-mmi-tips-questions-answers

Synthesize, Don’t Summarize.
Clarify Context
Weigh both sides
Examine best possible outcomes.
Name the Ethical Tension
Take the Opportunity for Empathy
Answer the Question
Include appropriate caveats

Synthesize, Don’t Summarize:

Most students start their answer their multiple mini interview questions with a restatement of the question. This is fine. But is isn’t excellent.
A synthesis statement demonstrates that you read and understood the question, AND that you immediately bring some elevated insight to the response.
A synthesis statement typically alludes to the ethical tension but it can also reference current events (for questions related to hot issues in medicine) and very relevant personal experience (do not stretch to make this fit).

Clarify Context:

This includes:
Naming assumptions that you’re making when giving your response.
Weighing both sides in a more traditional pro-con manner.
Asking out loud the kinds of questions you would need answered in order to make the best possible decision.
Using ‘2x2 If-Then’ Tables to articulate anticipated outcomes of various scenarios.
For questions that ask you to make a choice between people – classically, these questions ask you who should get an organ in a time of need – or between Option A or B, think about these questions in terms of 2x2 tables. So, if you have to give a kidney to one of two people, what are the best and worst possible outcomes for each choice?
In an MMI, this might sound like, “If I select the 80 year old patient – I really don’t care if he is a professor or not because occupation shouldn’t matter – then the best outcome is that he lives another 20 years. The worst outcome is… If I select the 20 year old, then the best outcome is… and the worst outcome is…
Often, questions will offer you a choice between Option A and B. But, a critical thinker will be able to entertain Option C. And maybe D. Depending on your background, you may know that dialysis is a reasonable temporizing measure for people on kidney transplant waiting list and maybe it can be leveraged to help make the decision easier: Everyone gets a kidney. If you have no technical knowledge of medicine – and this will NOT be held against you in an MMI – then I am sure you could imagine that there are Ethics Boards and other people that will weigh into a decision. Asking for assistance after reasonable thought and description of the question is entirely reasonable as an Option C, IF you have already done the work around thinking through Option A and B.

Name the Ethical Tension:

Name the opposing conflicts in the scenario:
i.e. personal autonomy versus public health
i.e. protecting patient confidentiality versus protecting the public
i.e. maintaining a personal friendship versus following the duty to report
This doesn’t need to include lots of legal terms or medical ethics terms, it just needs to be a clear statement of the inner conflict you’re sensing and seeing in answering the question.

Take the Opportunity for Empathy:

This is where you simply put yourself in the shoes of everyone involved in the scenario.
Some often missed elements include the perspectives of the public, the person or group being cast ‘in the wrong’ by the scenario and unsympathetic bosses, landlords, teachers, professors, doctors, lawyers.
This can be as simple as saying “I would sit and have a conversation with this person and ask ‘What is going on for you? Share with me how you see this situation?”
Often taking the opportunity for empathy comes naturally when you’re clarifying context but make a point to think how you can think about the perspectives of al parties in your answer.

Answer the Question:

Never leave an interviewer wondering whether or not you would or would not report a colleague, give the organ to the younger patient, etc.
You want to leave the impression that – even in imperfect conditions – you have the ability to make a decision and act based on what you know and what you learned.
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Example Multiple Mini Interview (MMI) Question & Answer:

You are a medical student on a general surgery rotation. Your staff physician has delegated your learning to her Chief Resident who has a great surgical reputation and performs most operations with minimal supervision. On your first day, you report to him and he says, “I don’t care what you do, just don’t get in my way.” How do you approach this situation?

Synthesize: “I am on a rotation where there is a lot to learn – general surgery – and I don’t have a teacher which leaves my learning at risk. Also, my chief – who I am supposed to look up to – is neglecting his duties so that he can spend more time in the OR and my Staff Physician likely has no idea or doesn’t care.”
Clarify Context: “I would need to discuss with my fellow medical students to see if this particular general surgery service has a bad reputation for teaching, or if anyone else has had this problem. I also need to know if I am the only medical student assigned to this service, or if there is a group of us being neglected….”
Clarify Context (Cont’d): “…then I need to see if there are any Junior Residents who I can follow along to get something out of this rotation. I also need to figure out who from the medical school deals with situations like these so if I need some guidance, I can get some.”

Opportunity for Empathy: “A Chief Resident is a really tough job. I bet he is underslept, underfed and preparing for his final certification exams. Maybe he has had some really tough cases or maybe this is how all medical students are treated on general surgery rotations at this hospital, and he doesn’t know any better. Regardless, I am also in a vulnerable position because I don’t know if I can pass my exams or meet the requirements of the rotation if I don’t see any patients or any surgeries.”

Ethical Tension: “If I take steps and go above the Chief, I know I risk a poor evaluation and suffering while I am here. If I don’t, I might not pass the rotation. So it’s a matter of keeping the peace or standing up for what is right.”

Answer the Question: “Though I feel for this Chief, part of the job of being Chief is to teach medical students. I am here to work and I will show up early to work every day to gather lab results, examine my patients, discuss their progress with the nurses and see how my patients are doing. I will show this Chief that involving me in the care of the patients actually makes his life easier. Through this, I hope to convince him to take me seriously as a learner. However, if this doesn’t happen despite my efforts, I will work with the medical school to figure out who to talk to in order to improve the situation, if not for me, then for the next rotation. It is unfair to put a medical student in a situation that is hostile to learning but I also know that I have to make the most of any situation.”
Dr to be ─ 醫學生甄試
Dr to be ─ 醫學生甄試
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