How to answer “What is a current issue in health care?” in a medical school interview

A strong answer to "what is a current issue in health care" picks one issue, defines it precisely, and explains who it affects and why it persists. It then describes a realistic way a physician could act on the issue over a career. The interviewer wants evidence that you've read about the system you're asking to join and that you've thought about your place in it.

What the interviewer is assessing

• Health systems and advocacy
• Critical thinking

Medical schools ask this to check whether you follow the health care system you want to work in and whether you can reason about a problem you can't fix alone. The interviewer listens for accuracy, for the ability to see more than one cause, and for an honest sense of what a single physician can and can't change. "Our health care system" means the system where the school is. A Canadian school expects you to know how provincial public coverage works under the Canada Health Act, and a US school expects you to know how employer insurance, Medicare, Medicaid and individual plans shape who gets care.

Applicants interviewing in both countries should prepare an issue for each. In a panel interview, this question is common and often leads to one about a policy you'd support. In a multiple mini interview (MMI), the same material appears as a policy station, usually with a prompt that names the issue for you.

How to structure your answer

1. Name the issue in one sentence, with enough precision that it's a problem rather than a topic, such as a shortage of family physicians in one region rather than access to care.
2. Name who it affects, starting with the patients who feel it first, then the clinicians, payers and institutions involved.
3. Give the main causes, including at least one that isn't obvious, such as how clinics are paid or how many training positions exist.
4. Describe what has been tried and why the problem remains.
5. Describe one or two ways you could act on it as a physician, such as where you practice, how you run a clinic, what you research or what you advocate for, and keep the claims modest.
6. Close with the sign that would tell you, years from now, that the issue had improved.

Choose an issue you've seen in a job, a volunteer role or your own family, because the panel will ask what you've witnessed. Long emergency department waits, the price of prescription drugs, burnout among nurses and worse outcomes for a specific population are all suitable, provided you can define them for the place you're interviewing in. Read the health ministry's or health department's own reports for the facts, and know two or three numbers you're sure of rather than ten you aren't. With a three-minute clock, give the issue about a minute and your impact the rest.

Common mistakes

• Choosing "health care costs" or "access" without narrowing it leaves you a topic too wide to say anything precise about.
• Describing the US insurance system to a Canadian panel, or the reverse, tells the interviewer you haven't researched the school you're sitting in.
• Promising to fix the problem personally, by founding a clinic or changing the law, sounds naive to physicians who've spent careers on it.
• Quoting a statistic you can't source invites a follow-up that exposes the guess.
• Leaving out the patients and talking only about funding and policy misses the reason the question is asked.

Follow-up questions to prepare for

• What policy would you support to address this, and what would it cost?
• Who would oppose that policy, and why?
• Have you seen this problem yourself, and where?
• How does this issue differ between Canada and the US?
• What would you do for your own patients if nothing had changed by the time you were in practice?