SJT Textbook: Maintaining Professional Boundaries
Maintaining Professional Boundaries MSRA SJT
This maintaining professional boundaries MSRA SJT guide explains how GMC boundary rules are tested in ranking and Best-of-3 scenarios and how to avoid low-scoring traps.
🎥 Video Lesson (YouTube)
🎧 Podcast Lesson (Spotify / Apple / Amazon)
🎯 THE CORE PRINCIPLE
Professional boundaries are the limits that keep healthcare relationships appropriate, fair, and focused entirely on patient welfare. Breaches erode trust, create conflicts of interest, and risk GMC investigation.
In the SJT, you score for:
• declining risky interactions early,
• using appropriate professional channels, and
• documenting objectively.
Maintaining professional boundaries MSRA SJT questions frequently involve gifts, secrecy, or personal contact.
⚡ HIGH-YIELD ACTIONS (What Scores Points)
1. Politely decline high-value gifts, personal contact, or social invitations.
2. Explain the reason (professional guidance, fairness, avoiding influence).
3. Redirect patients to safe, official channels (clinic line, PALS, formal feedback).
4. Escalate persistent, pressuring, or unsettling behaviour to a senior or safeguarding.
5. Document neutrally: who, what, when, your advice, and any impact on care.
6. Use chaperones, formal communication routes, and organisational policies.
7. Maintain boundaries consistently — no exceptions, even with “nice” patients.
8. Seek senior advice if a colleague breaches boundaries.
9. Protect confidentiality and use only secure, approved communication systems.
• Requests for personal phone numbers, email, or social media connection
• Invitations to private meetings, meals, or social events
• Dual roles (clinical + personal/romantic/financial)
• Repeated testing of boundaries or behaviour causing discomfort
• Any request for secrecy (“keep this between us”)
Even one “small exception” is still a boundary breach.
💬 MODEL PHRASES (Use These in SJT Logic)
* “Thanks for the gesture. I can’t accept gifts of this value — it could be seen to influence care.”
* “To keep things appropriate, please contact us through the clinic line rather than my personal account.”
* “I’m concerned this might cross professional boundaries, so I’ll follow our local policy and speak with my supervisor.”
* “I understand the intention, but I need to maintain clear professional boundaries for both our protection.”
Redirect • Explain • Decline • Offer safe alternative • Communicate & record
A fast way to remember the correct sequence: decline early → stay professional → document.
Decline politely but firmly.
Explain why (professional guidance + fairness).
Redirect to safe, official channels.
Escalate if persistent or coercive.
Document factually.
Maintain confidentiality throughout.
Seek senior help if unsure.
📋 QUICK FAQ
Can I accept a gift?
Token, low-value gifts may be acceptable if policy allows and recorded; decline expensive items, cash, or anything that could appear influential.
Can I connect with a patient on social media?
No — keep all communication via professional channels.
What if a colleague crosses a boundary?
Prioritise safety, seek senior advice, follow policy, and document.
Should I ‘declare and keep’ an expensive gift?
No. Declaration does not remove perceived influence.
Do former patients count?
Yes — especially if recently discharged or vulnerable. Always seek advice.
Boundary breaches are consistently low-scoring in maintaining professional boundaries MSRA SJT scenarios.
📚 GMC ANCHOR POINTS
• Maintain appropriate personal and professional boundaries (GMC GMP 2024, paras 54–57).
• Use social media professionally: keep to professional channels, protect confidentiality.
• Identify and manage conflicts of interest, including gifts and bequests (GMC COI guidance).
• Raise concerns about colleagues who breach boundaries.
• Document and act transparently.
Social media traps are common in maintaining professional boundaries MSRA SJT questions.
💡 MINI PRACTICE SCENARIO
A patient brings you an expensive bottle of wine and asks you not to tell anyone.
Best action: Politely decline, explain professional guidance, and offer an alternative (e.g., written team feedback).
Why: Protects trust, avoids conflicts of interest, and aligns with GMC policy.
Requests to “keep things private” test maintaining professional boundaries MSRA SJT judgement directly.
🎯 KEY TAKEAWAYS
✓ Boundaries protect patients and maintain trust
✓ Decline high-value gifts and personal/social contact
✓ Use professional channels only
✓ Redirect → escalate → document
✓ Never conceal or “bend the rules once”
Persistent patient behaviour is a classic maintaining professional boundaries MSRA SJT red-flag theme.
🔗 RELATED TOPICS
* → Honesty & Candour
* → Conflict of Interest
* → Social Media & Digital Professionalism
* → Raising Concerns
* → Confidentiality
📖 FULL PRACTICE QUESTIONS
Example SJT — Best of 3 (8 options; choose three)
A patient you’ve seen for several months brings you an expensive bottle of wine and says “keep it — just between us.”
Options:
A. Accept to avoid offence
B. Accept and declare later
C. Politely decline and explain it’s against guidance
D. Suggest alternatives (team feedback or charity donation in their own name)
E. Document the interaction objectively and inform your supervisor
F. Give your personal email “to thank them properly”
G. Ask a colleague and leave the wine in the office
H. Post in the staff WhatsApp group for advice
Correct three: C, D, E
• C: Safest — clear refusal aligned with guidance.
• D: Preserves rapport via safe alternatives.
• E: Ensures transparency and continuity.
Why others are weaker/wrong:
• A/B: Accepting = perceived influence.
• F/H: Breach of confidentiality/professional channels.
• G: Avoids responsibility and blurs ownership.
Example SJT — Rank 5 (best → worst)
A grateful patient invites you to an expensive restaurant as thanks.
Options:
A. Politely decline; explain guidance; suggest written feedback
B. Accept to avoid offence and keep it private
C. Accept but declare it later
D. Offer to meet for coffee instead
E. Decline abruptly in front of others
Ideal order: A (1) > C (2) > D (3) > E (4) > B (5)**
A: Safest — protects boundaries and suggests a professional alternative.
C: Transparent but still accepting → boundary risk.
D: Social meeting still inappropriate.
E: Maintains boundary but unnecessarily rude.
B: Concealment + acceptance = high-risk.
Decline high-value gifts immediately
No personal numbers or social media contact
Redirect to professional channels only
Document clearly and escalate if persistent
Protect trust and fairness
Expensive gifts or cash
Requests to “keep it secret”
Invitations to social events
Dual roles or repeated testing of boundaries
- GMC — Maintaining personal and professional boundaries
https://www.gmc-uk.org/professional-standards/the-professional-standards/maintaining-personal-and-professional-boundaries - GMC — Using social media as a medical professional
https://www.gmc-uk.org/professional-standards/the-professional-standards/using-social-media-as-a-medical-professional/using-social-media-as-a-medical-professional - GMC — Identifying and managing conflicts of interest
https://www.gmc-uk.org/professional-standards/the-professional-standards/identifying-and-managing-conflicts-of-interest/identifying-and-managing-conflicts-of-interest - NHS England — Conflicts of interest: Gifts & hospitality policy
https://www.england.nhs.uk/2017/02/coi-guidelines/