MMI child protection scenarios involving children and families

Physicians care for children who can't speak for themselves, and for parents who don't always act in a child's interest. Interviewers use MMI child protection scenarios to see how you handle that gap before you hold a license. In every scenario in this topic you are a coach, a babysitter, a neighbor or a sibling, and a child's safety pulls against what the child or a parent wants.

What these questions test

Raters score whether you put the child's safety ahead of every other claim, including a parent's wishes and the child's plea for secrecy. The standard they listen for is the best interests of the child, which puts the child's welfare above the preferences of the adults around them. They also score judgment about scale, because a 13-year-old meeting a stranger from the internet and a 9-year-old home alone after school call for different responses.

How to approach them

1. Sort the risk by urgency. A danger to the child's safety needs an adult told before it happens. A welfare concern can start with a conversation, and the gap between the two decides how fast you move.
2. Work out who holds authority and what duty your role carries. Parents decide for a child in most matters, but their authority stops where the child is at risk. In many places, adults who work with children have a legal duty to report suspected abuse or neglect to child protection services, and in some places everyone does.
3. Take the child's wishes seriously without promising secrecy. Tell them you can't keep a secret that could get them hurt, explain who you'll tell and why, and involve them in how it's done.
4. Choose the smallest step that makes the child safe. For a neighbor whose 9-year-old is alone every afternoon, that may be an honest conversation with the boy's father and an offer of help. For a 13-year-old planning to meet a stranger from an online game, it is a call to her parents that evening.
5. In a role-play, say what your role allows and what it doesn't, keep your voice level, and never argue in front of the child. Expect the follow-up to remove your easiest option, and let the child's safety set your next step anyway.

Common mistakes

• Promising a child you won't tell anyone, then breaking it, costs you the trust the rest of your answer depends on.
• Treating a parent's instruction as the final word when the child is at risk shows you don't know where parental authority ends.
• Filing a formal report for a welfare concern a conversation would fix reads as a reflex, while staying silent about a real danger because the family is sympathetic reads worse.
• Ending without naming who you'd call, whether a parent, a doctor, the school or child protection, leaves the plan unfinished.