MDT common mistakes
MDT · Understand the traps and how to avoid them.
Answering 'what is the MDT?' by listing member disciplines only, and omitting terms of reference, quorum, chair accountability, decision rights, and the escalation route when consensus fails.
Candidates revise from induction packs and rota lists that show who attends, so membership feels like the whole answer; governance documents are rarely read cover to cover.
What to do instead
For every team you describe, rehearse five fixed headings: purpose and population served, membership and required quorum, who chairs and is accountable, what the team can decide versus recommend, and the escalation path. Practise saying it in 60 seconds.
Stating that 'the team obtains consent' or that any attending clinician can answer for a colleague's decision, without naming which professional holds legal accountability for that specific decision.
In real MDTs decisions are genuinely collective, so candidates carry everyday shorthand into an exam that tests individual professional accountability.
What to do instead
Use a two-column frame: 'team contribution' versus 'accountable professional'. For consent, capacity, prescribing, and referral, name the profession and registration body that carries the duty, and state how the team records its advice without absorbing that duty.
Describing delegation of a task (explaining prognosis, discussing a trial, completing a referral) to a colleague or unregistered staff member without stating competence assessment, supervision, and who remains answerable.
Workforce pressure makes task-shifting normal locally, so candidates describe what happens rather than what should be governed.
What to do instead
Answer delegation questions with four elements: task, required competence and how it is evidenced, supervision and escalation arrangements, and retained accountability of the delegating clinician. Anchor on the principle that accountability is not delegated, only the task.
Presenting a case as a chronological narrative of admissions and results, ending without stating the specific question the team must answer.
Candidates mirror ward-round storytelling and worry that omitting detail looks like poor preparation, so the clinical ask is squeezed out.
What to do instead
Draft the presentation backwards: write the one-sentence decision request first, then include only history, results, and patient priorities that change that decision. Use a fixed structure and close by restating the question and the options you want weighed.
Referring or presenting a case without the minimum dataset: no performance status, comorbidity, allergy status, staging or key result, current medications, and no record of the patient's own goals or preference.
Referrals are often written under time pressure by the most junior team member, and patient goals are assumed rather than elicited and documented.
What to do instead
Learn a pre-MDT checklist and apply it to every practice case: demographics and relevant history, diagnosis and staging, performance status and comorbidity, key results, current treatment, patient wishes, and the explicit question. If an item is genuinely unavailable, say so and state its impact on the decision.
Justifying a recommendation with 'the guidelines say so' or a single trial name, without stating the strength of evidence, its applicability to this patient, or why the plan departs from guidance.
Guideline familiarity is easier to revise than critical appraisal, and exam answers reward a confident recommendation over a qualified one.
What to do instead
Use a three-part formula: evidence source and strength, fit to this patient's characteristics and preferences, and the rationale for any deviation, documented in the plan. Practise stating explicitly when evidence is weak or extrapolated.
Writing the care plan as a list of interventions with no goals, named responsible clinician, timescale, contingency, or review date, and no reference to patient priorities.
The MDT output is often recorded as 'for chemotherapy' or 'for review', and candidates copy that shorthand as if it were a complete plan.
What to do instead
Write plans as a table: problem, goal agreed with the patient, action, owner, deadline, escalation trigger if not met, and review date. In practice answers, include one sentence on what would prompt the team to reconvene.
Documenting only the final decision, omitting the options considered, reasons for rejection, dissent within the team, and the patient's expressed view.
Minutes are written to record outcomes efficiently, and dissent feels awkward or disloyal to capture.
What to do instead
Use a decision-record template: options considered, evidence discussed, decision and rationale, minority or dissenting views, patient preference and involvement, information given, and next review. This is what makes a record defensible and usable at handover.
Treating identifiable patient information casually - using personal or unsecured email and messaging, over-sharing in open clinical areas, or assuming that being on the MDT implies consent to share.
Instant messaging is how teams actually coordinate, and 'need to know' is applied by habit rather than by stated principle.
What to do instead
State the principle explicitly: minimum necessary data, lawful basis and patient awareness, approved secure channel, and role-based access. When answering, specify what would be shared, with whom, by what route, and how the sharing decision is recorded.
Describing an audit as 'collecting data on our service' without a defined standard, sample, owner, action plan, and re-audit date, or labelling service improvement as research without addressing ethics and approval.
Audit is often taught as a data exercise and confused with both research and simple service evaluation.
What to do instead
Answer with the full cycle: standard or guideline being tested, measurable criteria, defined sample and period, named lead, findings compared against standard, actions with owners, and a scheduled re-audit. Explicitly distinguish audit, service evaluation, and research, and state when ethics review is required.