Being asked what you would do after giving a patient the wrong dose is one of a family of mistake scenarios that come up at most medical school interviews: a wrong prescription, a patient readmitted after a discharge error, a medication given to the wrong patient. They all have the same answer, and at the centre of it is the duty of candour, the professional obligation to be open and honest with patients when something goes wrong. This article goes through why schools ask it, the five-step structure that works for every version, a worked answer, and the variants you may meet instead.
Why medical schools ask it
Doctors make mistakes, and how they respond to them is one of the clearest tests of professionalism there is. Mistake scenarios check whether you put the patient's safety ahead of your own embarrassment, whether you would be honest when honesty is uncomfortable, and whether you understand that errors are reported so the system can learn from them rather than hidden so the individual can avoid blame.
Interviewers are also testing whether you know the duty of candour. Since 2014 it has been a statutory duty on NHS organisations in England, and GMC guidance makes it a personal duty on every doctor: tell the patient when something has gone wrong, apologise, offer a remedy, and explain the effects. An answer that never mentions telling the patient fails the station however well it handles the clinical side.
What interviewers are looking for
Our interviewers probe for five points if you miss them, and the model answer is built around the same five:
- 1.Patient safety first. Prevent further harm, reassess the patient, call for help if needed.
- 2.Take responsibility. Be honest, don't hide the error or shift blame, escalate early.
- 3.Communicate with the patient. Under the duty of candour, explain what happened, apologise, check understanding, outline next steps.
- 4.Report appropriately. Complete an incident form, inform senior staff.
- 5.Reflect and learn. Identify root causes, consider how to prevent recurrence, share learning with the team.
The order matters. If you start with the apology or the incident form before making sure the patient is safe, you lose the first point, and it is the one interviewers weight most heavily.
How to structure your answer
This is the model answer our interviewers mark against for the wrong-dose question. The same five steps answer every mistake scenario in the bank:
Key steps
1. Acknowledge patient safety first
1. Acknowledge patient safety first
2. Take responsibility (accountability)
3. Communicate with the patient
4. Report appropriately
5. Reflect and learn
Example answer
About seventy-five seconds spoken, one step per part:
- Safety
- The first thing is the patient. I would go back and reassess them straight away, check what dose they actually had and what the risks of that are, and if there was any chance of harm I would get a senior and the pharmacist involved immediately to decide on any treatment or monitoring.
- Responsibility
- I would not try to cover it up or wait to see if anything happened. I would tell my senior what I had done and accept that it was my error, because the quicker it is known the easier it is to manage.
- The patient
- Once I knew the patient was safe, I would explain to them what had happened in plain terms, apologise, say what we were doing about it and give them the chance to ask questions. That is the duty of candour, and patients are far more forgiving of an honest mistake than of finding out later.
- Reporting
- I would complete an incident report, not to assign blame but so that the pharmacy and the ward can look at whether something in the system, like a similar-looking label or a confusing chart, contributed.
- Learning
- Afterwards I would want to understand why it happened, whether I was tired, rushed or unsure of the dose, and change something, for example double-checking unfamiliar drugs with a colleague. Mistakes are inevitable in medicine; repeating the same one is not.
Practise this question out loud
Try answering it with the AI interviewer: it asks the question, follows up on what you say, and marks you against the points above.
Common follow-up questions
The scenario changes from school to school, and the follow-up usually turns the question on you. Prepare a real mistake of your own and run it through STARR, because "tell me about a time you made a mistake" is the most common second question.
A junior doctor prescribes antibiotics and discharges a patient, who is readmitted because of the mistake. What should the junior doctor do? Then: describe a time you made a mistake.
Asked at Birmingham and Newcastle. The same five steps, then your own example using STARR, then two things you learned about yourself.
A patient has been given the wrong medication by a pharmacist in your team. There are no adverse effects and the patient is unaware. What should you do?
Asked at Imperial and UCL. The point being tested is whether you would still tell the patient when nothing went wrong. The duty of candour applies regardless of harm, and you apologise on behalf of the team without blaming the individual.
You are a junior doctor and have prescribed the wrong medication. Who do you tell, and how?
Asked at Glasgow and St George's. Your senior first, then the patient, then the incident report. Involve pharmacy for the clinical side.
Have you ever made a mistake?
Reported at seven schools. Pick something real and modest, and spend most of the answer on what you did and learned.
Should doctors who make mistakes be punished?
Asked at Bristol and Sheffield. Distinguish honest error, which a learning culture should not punish, from recklessness or concealment, which it should.
Common pitfalls
Things to avoid when answering the question:
- Forgetting patient safety :
- In mistake scenarios, patient safety must come first. Address immediate risks before anything else.
- Deflecting blame :
- Avoiding responsibility rather than accepting it undermines the accountability you're supposed to demonstrate.
- Leaving out the patient :
- An answer that escalates and reports but never tells the patient has missed the duty of candour entirely.
- No harm, no disclosure :
- The duty applies whether or not the patient was harmed. The Imperial and UCL variant tests exactly this.
- Treating the incident report as punishment :
- Reporting is how systems learn. Say so; it shows you understand why it exists.
- No reflection :
- The last step is where you show you would be a safer doctor afterwards. Don't stop at the report.
Which schools ask it
This exact wording is reported at Aberdeen. Close variants are reported at Birmingham, Newcastle, Imperial, UCL, Glasgow, St George's, Bristol and Sheffield. Each link opens the school's interview page.
Frequently asked questions
What exactly is the duty of candour?
The professional obligation to be open and honest with patients when something goes wrong with their care. In practice: tell the patient, apologise, offer a remedy or support, and explain the short and long-term effects. It is a statutory duty on NHS organisations in England and a personal duty on doctors under GMC guidance.
Does apologising mean admitting liability?
No. An apology is an expression of regret, not an admission of legal fault, and the Compensation Act 2006 says so explicitly. Interviewers want to hear that you would apologise without hesitation.
What if the mistake was somebody else's?
The steps are the same: make the patient safe, make sure the error is known, make sure the patient is told, make sure it is reported. You apologise on behalf of the team and do not name or blame the colleague to the patient.