Tell us about a time when you had to make a difficult clinical judgement. How did you approach it?

One time, I had a patient who presented with severe rectal bleeding and abdominal pain. The symptoms were concerning, and I had to make a difficult clinical judgement. I approached it by first conducting a thorough physical examination and ordering relevant diagnostic tests, including a colonoscopy and imaging studies. I consulted with the patient's primary care physician and discussed the case with a team of gastroenterologists, oncologists, and radiologists. Together, we reviewed the results and discussed potential treatment options. Based on the findings, we decided on an immediate surgical intervention to address the source of bleeding and provide relief to the patient. The procedure went smoothly, and the patient's condition improved significantly after surgery. This experience taught me the importance of collaboration and multidisciplinary approach in making difficult clinical judgements.

I had a patient with a history of colorectal cancer who presented with a new abdominal mass and increasing pain. As a colorectal surgeon, I was faced with the challenge of making a difficult clinical judgement. I approached the situation by conducting a comprehensive evaluation of the patient's medical history, performing a thorough physical examination, and ordering relevant diagnostic tests, including CT scans and tumor marker analysis. I collaborated with the patient's oncologist and pathologist to analyze the results and discuss potential treatment options. After reviewing the imaging findings, we determined that the abdominal mass was a recurrence of the colorectal cancer. We decided to perform a surgical intervention to remove the tumor and provide the patient with the best chance of remission. The procedure was successful, and the patient's symptoms and pain resolved post-operatively. This experience taught me the importance of clinical judgement in interpreting diagnostic results and collaborating with a multidisciplinary team to make informed treatment decisions in complex cases.

The solid answer provides a more detailed description of the difficult clinical judgement, including the patient's background and specific steps taken in the evaluation process. It emphasizes collaboration with the oncologist and pathologist, as well as the decision-making process based on imaging findings. However, it could benefit from further elaboration on the treatment decision and the impact of the intervention on the patient's outcome.

During my residency, I encountered a critically ill patient with a complicated case of diverticulitis. The patient presented with an abscess in the sigmoid colon, which had perforated and caused sepsis. As a colorectal surgeon, I was faced with the challenge of making a difficult clinical judgement that would determine the course of treatment and the patient's prognosis. I approached the situation by gathering all available information, including the patient's medical history, imaging studies, and laboratory results. I consulted with a team of gastroenterologists, infectious disease specialists, and intensive care physicians to discuss the best approach to manage the patient's condition. We reviewed the radiology findings and determined that surgical intervention was necessary to drain the abscess and remove the diseased portion of the colon. I performed the surgery with a laparoscopic approach, which minimized post-operative complications and facilitated the patient's recovery. The patient's sepsis resolved, and they were able to resume normal bowel function. This experience not only reinforced the importance of clinical judgement in critical situations but also highlighted the significance of interdisciplinary collaboration and the impact of surgical techniques on patient outcomes.

The exceptional answer provides a highly detailed and comprehensive account of a difficult clinical judgement. It includes specific details about the patient's condition, the steps taken in the evaluation process, the collaboration with a multidisciplinary team, and the surgical approach chosen. It also discusses the impact of the intervention on the patient's outcome. This answer demonstrates a deep understanding of the complexities involved in clinical decision-making and highlights the candidate's proficiency in the required skills for the position.