Stations

Every station marked real was recalled from an actual ACD interview. Predicted ones have never been asked — useful practice, but do not build confidence on them.

• The child in the corrections facilityMMIreal · 2025

  You are a dermatology registrar in a regional hospital. You are called to review a 15-year-old child who is accompanied by two guards and has her hoodie covering her handcuffs. She has eczema that was previously well managed by an injection medication. However, it has been some time since her last injection and she now has worse skin. She has not been prescribed and is not using any medications, including creams, to manage her eczema in the juvenile corrections facility. She is scratching throughout your review but is guarded in giving information. She admits that she is distressed about the appearance of her skin and is also not attending training or education classes.

  Vulnerable populations · Health Advocate · Culturally Responsive Practitioner · Communicator · Leader

• Isotretinoin review — live consultLIVEreal · 2025no reading time

  You are a dermatology registrar and you are reviewing a patient who was commenced on isotretinoin 6 weeks ago for a condition called steatocystoma multiplex. Please proceed with your consult.

  Live consultation · Communicator · Medical Expert · Professional

• The consultant criticising a colleague in front of the patientMMIreal · 2025

  You are a dermatology registrar sitting in on a consult with a consultant and a patient. Six months ago this patient was reviewed by another consultant, had a pigmented lesion reviewed with photographs taken, and the lesion was thought to be a benign naevus. Now the patient has returned a result of an invasive melanoma with a Breslow thickness of 2.4mm with early lymph node involvement. The current consultant is saying things like "This should have been picked up earlier" and "It should never have gotten to this stage" in the consult. The patient is now upset and saying "Was this because of a mistake?" After the review the consultant says to you, "What do you think of the previous review?"

  Professionalism · Professional · Communicator · Collaborator

• The merged biopsy book pagesMMIreal · 2025

  You are a dermatologist. You are informed that a patient has called your practice and has been verbally angry (but not abusive) about a situation where they have heard from their GP about the results of a biopsy that was done 2 weeks ago. This returned a melanoma in situ of the right shoulder. Your practice nurse, who was on her third coffee on a busy clinic day, had spilt her coffee and two pages had merged together in the biopsy book. You were in a procedure when this happened. The patient has been booked in as the last slot of the day for a wide local excision.

  Open disclosure · Communicator · Professional · Leader

• The cosmetic dermatologistMMIreal · 2025

  You are working with a consultant in a private dermatology practice. He is a highly regarded cosmetic dermatologist with over 20 years of experience and is thought to be a leader in his field. Together you are seeing a patient who is here for a cosmetic injection. Before you see this patient, the nurse approaches this consultant and asks a question about the medical questionnaire that the patient fills out before seeing the consultant. The consultant dismisses the nursing staff and she looks embarrassed. You note that there has been no taking of a medical history, regular medications, or whether the patient has had injections before. The patient has a lot of questions about the risks of the injections which the consultant brushes off. Just before the injection, he pulls you aside and says "This is how real private practice works, you don't get taught how to be efficient".

  Consent and regulation · Professional · Health Advocate · Communicator

• CV station 2025CVreal · 2025

  This is the CV and motivation station. Five interviewers, one doing the talking. Your CV is not in front of you — but they have read it.

  CV and motivation · Professional · Scholar · Leader

• CV station 2024 — health equity, with a verifierCVreal · 2024

  The CV and motivation station.

  CV and motivation · Health Advocate · Professional · Scholar

• The distressed colleagueMMIreal · 2024

  You see your colleague in the staffroom where they look visibly distressed and upset. They tell you that they just saw a very difficult patient. They have decided that they want to terminate the therapeutic relationship because they have no other choice.

  Colleague in difficulty · Collaborator · Professional · Communicator

• The $80 medicationMMIreal · 2024

  You prescribed a patient a medication that is not PBS listed and costs $80. After clinic, they return and ask for help as they cannot afford this.

  Cost of care · Health Advocate · Communicator · Professional

• Medicare and the PBSMMIreal · 2024

  In Australia, there is the Medicare scheme and the PBS, both funded by the Australian government.

  Health systems · Health Advocate · Scholar · Leader

• The uninsured patient in EDMMIreal · 2024

  You are an ED resident. You see a 22-year-old male who comes in with chest pain and shortness of breath. He came to Australia from overseas a few months before and is non-English speaking. His friend tells you that he has a severe lung condition and hasn't been able to afford to continue taking his medications. He does not have Medicare.

  Vulnerable populations · Health Advocate · Communicator · Culturally Responsive Practitioner

• Melanoma vs alternative medicineMMIreal · 2023, 2024

  You are about to see a 50-year-old builder. His wife is a midwife and they have been treating a pigmented lesion with natural herbal creams. The lesion is crusted and the biopsy you did has returned favouring a diagnosis of invasive melanoma. You suggest for the patient to have a wide local excision. However, the wife has already anticipated this and states that she has already ordered a stronger herbal cream which she has read about and that they will use to treat this.

  Difficult patient · Communicator · Medical Expert · Professional

• The acne patient who saved upMMIreal · 2023

  A 20-year-old female with moderate-to-severe cystic acne presents to your private clinic with worn-out shoes. She tells you that she has had to save up for months before seeing you. Upon reviewing her, you know it will take multiple visits to clear her skin, over 6–9 months.

  Cost of care · Health Advocate · Communicator · Medical Expert

• Seven presentations, and 'don't bother'MMIreal · 2023

  A 40-year-old Samoan man (who grew up in Australia) has presented to the ED 7 times over the last year. He has presented 5 times for infected eczema, managed with topical therapies only. He looks after his wife and four children and lives with his parents; all his children are younger than 10. He has a back injury and is currently on a short-term construction contract. He presents to your clinic. Another registrar says don't bother, he never shows up for appointments.

  Vulnerable populations · Health Advocate · Culturally Responsive Practitioner · Collaborator

• The hijab and the racist consultantMMIreal · 2023, 2025

  You are a first-year dermatology registrar wearing a hijab. Your registrar says that the consultant says that you are underperforming and cannot connect with patients. You attempt to address this with the consultant but they brush you off. The consultant makes racist remarks at work. However, people say it is part of his personality and nothing to be concerned about.

  Discrimination · Professional · Culturally Responsive Practitioner · Leader

• Psoriasis and the vaccination refusalMMIreal · 2022

  You are a dermatologist. Your patient, a 27-year-old male with moderate-to-severe psoriasis, has seen other colleagues. You think he needs immunosuppression but he refuses vaccination.

  Difficult patient · Medical Expert · Communicator · Professional

• Remote NT — lupus, methotrexate, sun protectionMMIreal · 2022

  Remote Northern Territory. A 28-year-old Indigenous woman with lupus on 20mg methotrexate. She has a baby with her. You need to explain sun protection to her.

  Cultural safety · Culturally Responsive Practitioner · Health Advocate · Communicator

• The patient who wasn't attendingMMIreal · 2022

  You are a GP registrar. A 27-year-old male patient with IBD has not attended the appointments you arranged with his gastroenterologist. You see him and find out that he is homeless.

  Vulnerable populations · Health Advocate · Communicator · Collaborator

• The registrar who isn't thereMMIreal · 2021, 2023

  You are working with several registrars and consultants. One of the registrars is arriving late, leaving early, and is not present during work. The nurses are concerned that patient documentation is poor. They approach you because you are the most approachable. The consultant is unaware of the situation.

  Underperforming colleague · Collaborator · Professional · Leader

• "Senile Sam"MMIreal · 2021

  You are in clinic. The clinic nurse comes to you and says: "You can have senile Sam, he's an 80-year-old man who always complains and never listens. The consultants usually just write him a prescription and then ship him out."

  Advocacy · Health Advocate · Professional · Communicator

• The result you missedMMIreal · 2021

  You've ordered pre-biologic bloods for a patient which you've "checked". You see the patient for a 3-month review after they've been commenced on the treatment and you notice that you've missed an abnormality and the patient has had a negative reaction, possibly as a result. The response isn't as good as what you'd hoped with the biologic.

  Error and open disclosure · Professional · Medical Expert · Communicator

• "Your work is sloppy"MMIreal · 2021

  You have just finished a busy clinic. You felt rushed and noticed that other people were working slower than you. You feel like you have done reasonably well. At the end of the clinic, your consultant gives you feedback and says that your work is sloppy and gives you several specific examples.

  Feedback · Professional · Scholar · Communicator

• The model who won't be biopsiedMMIreal · 2021

  You are referred a 32-year-old model who has a suspicious pigmented lesion on her face. You decide that it needs to be biopsied. But she says she doesn't believe it is as bad as you think it is, and says she doesn't have time for sickness, or scarring.

  Difficult patient · Communicator · Medical Expert · Professional

• Arriving to a rural rotationMMIreal · 2021

  You've just rotated to a new rural rotation. Upon arriving you notice that the previous registrar's documentation about patient care is inadequate and that they have not kept the practice manager up to date with equipment problems. You also note several other things haven't been done to your standard.

  Handover and transitions · Leader · Collaborator · Professional

• "Dermatology isn't real medicine"CVreal · 2019, 2023

  You are at a 10-year reunion when you find out that you have made it onto the Dermatology program. Your colleague comments that dermatology is not real medicine. You do not comment on this at the time. You ruminate at home and want to come up with a response.

  Motivation · Professional · Communicator

• The bruisesMMIreal

  You see an 18-year-old woman for her severe eczema, accompanied by her father. You also note bruises on her neck and arms. When you ask more about it she shushes you and then looks at her father.

  Safeguarding · Health Advocate · Professional · Communicator · Culturally Responsive Practitioner

• The only registrar getting feedbackMMIreal

  You work in a clinic with a consultant and two other registrars. A consultant gives you feedback that you think is incorrect. You notice that you are the only registrar that is being provided feedback.

  Feedback · Professional · Scholar · Communicator

• The registrar who is always lateMMIreal

  One of your co-registrars is always late in the morning. It hasn't really affected patient care directly, but it has meant rushing ward rounds to start patient clinic on time. The rest of the team do not seem bothered by this.

  Underperforming colleague · Collaborator · Professional · Leader

• Two weeks became two monthsMMIreal

  You order some blood test monitoring on an immunosuppressive agent and you ask for a case note review in two weeks to review the results. However, because of an administrative error the review was booked for two months instead. This resulted in affecting the patient, but it could have been worse.

  Error and open disclosure · Professional · Leader · Medical Expert

• The consultant managing against guidelinesMMIreal

  You notice that your consultant is managing patients in a way that departs from recommended guidelines.

  Disagreement with a senior · Medical Expert · Professional · Scholar

• Teledermatology triageMMIpredicted

  A GP in a remote town sends images of a pigmented lesion on a 68-year-old farmer's back. The images are poorly lit and out of focus. The GP's note says the patient has driven three hours to attend and cannot easily return. The GP asks you to advise on management now. Your consultant is in theatre.

  Rural access · Medical Expert · Health Advocate · Communicator

• Two patients, one meets criteriaMMIpredicted

  You are a dermatologist. Two patients with severe atopic dermatitis are before you. One meets the PBS authority criteria for a biologic. The other has an almost identical clinical burden — extensive disease, sleep disruption, unable to work — but narrowly fails the severity score threshold, and cannot afford the drug privately at approximately $20,000 per year. He asks you whether you could "just write the score a bit higher".

  Cost of care · Professional · Health Advocate · Medical Expert

• Acne review — live consultLIVEpredictedno reading time

  You are a dermatology registrar. You are seeing a 24-year-old woman for review, three months after starting a topical and oral regimen for acne. Please proceed with your consultation.

  Live consultation · Communicator · Medical Expert

• The colleague's social media accountMMIpredicted

  You are a dermatology registrar. A colleague in your department runs a popular social media account with a large following, posting before-and-after images of cosmetic procedures. You recognise one patient from your clinic. You do not know whether consent was obtained. The colleague is well liked, and the account brings referrals to the department.

  Professionalism · Professional · Health Advocate · Communicator

• The interpreter that wasn't bookedMMIpredicted

  You are a dermatology registrar. Your next patient is a 62-year-old woman with limited English who requires counselling before starting a systemic immunosuppressant. No interpreter has been booked. Her adult son is present and offers to translate. The clinic is full and the next interpreter slot is in three weeks.

  Communication · Communicator · Culturally Responsive Practitioner · Professional

• The consultant who says it's viralMMIpredicted

  You are a first-year dermatology registrar. You have assessed an inpatient with a widespread painful eruption two weeks after starting allopurinol, with mucosal involvement and systemic upset. You are concerned about a severe cutaneous adverse reaction and want the drug ceased immediately and the patient escalated. Your consultant, over the phone, is dismissive: "It's a viral exanthem, I've seen a hundred of these. Just chart some emollient and I'll see them tomorrow."

  Disagreement with a senior · Medical Expert · Professional · Communicator