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Colleague impairment — MCCQE Part 1 MCQ

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HardEthics & ProfessionalismColleague impairmentMCCQE Part 1

Resident physician presents with notices a colleague smelling of alcohol before procedures. The colleague asks them not to say anything. Which of the following is the most appropriate next step?

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Correct answer: C — Escalate immediately to protect patients while supporting the colleague through appropriate channels

Escalate immediately to protect patients while supporting the colleague through appropriate channels is best because patient safety overrides loyalty when impairment may endanger care. Breach confidentiality broadly without legal basis is suboptimal because disclosure must be limited to what is legally authorised or clinically necessary; Let family preference override a capable patient is suboptimal because capable patients direct their own care; Refuse to discuss the issue and document nothing is suboptimal because professional practice requires communication and clear documentation; Delay a mandatory report until certainty is absolute is suboptimal because statutory reporting thresholds are often suspicion or reasonable belief, not proof. The aim is safety and remediation, not punishment.

Reference: CMPA professional obligations guidance