How To Improve Your CASPer Test Score For Canada: Tips For IMGs!

Sample Scenario: Your coworker Bob and his wife are preparing to be new parents. Bob has told you that he and his wife decided early on that he would take paternity leave so he could stay home to help his wife and bond with their baby. However, your boss just offered Bob a new position for more money. Bob will need to spend more hours at work. Bob tells you he could use the money, but he also wants to be with his family and doesn’t want to disappoint his wife. Bob confides in you that he does not know what to do and asks what you think.  

What would you tell Bob to do? 

State the main concern/issue and who/what is involved. This helps you focus on the problems and people to create a baseline or anchor for your thought process. It also let’s the rater know what you have understood from the information presented in the scenario. There is a different rater for each scenario, so don’t worry about using the same script repetitively. 

The anchor or summary sentence can be a critical thinking statement. 

“My coworker appears to be struggling with a decision to either take paternity leave or take a promotion to support his family financially. Bob asked for my advice.” 

You have identified the key person, the problem and your role. You have also demonstrated empathy and emotional intelligence because you use the words “appears to be struggling”, which were not in the prompt. With these words you have shown that you understand it “may” be a difficult decision for Bob, but you don’t want to assume anything. 

Critical Thinking and Analysis Sequence     

“If Bob asked for my advice on a private family matter, he seems to trust my judgement. I would like to help Bob make an informed choice by getting more information.” 

You have demonstrated that you understand this is a confidential issue and that Bob has a trusting relationship with you. You demonstrate your desire to support Bob but you want to ensure you help him get factual information before making a decision. 

“First, I would suggest we check the work policy on paternity leave to see if it is flexible or time sensitive.” 

Together, you are checking the rules at work to see if Bob has alternative options.

“Then, I would encourage Bob to discuss the choices with his wife, so they can prioritize their personal needs.”

You are encouraging Bob to communicate with his wife before making a decision that affects both their lives and their baby’s life. You are promoting shared-decision making and have clarified that it is a personal matter.

“I would also encourage Bob to talk to our boss about the new responsibilities and if he can work remotely some days to be closer to his family.”

You are encouraging Bob to talk to a higher authority to check if there are other options. This is a private family matter, so it is not in your role to talk to Bob’s wife or your boss. You are promoting communication and collaboration to elicit more factual information. 

Other common responses about giving advice or options could be:

State that your response depends on more information and you cannot take the situation at face value.  

“First, I must remain non-judgmental and gather more information.” 

“I must not jump to conclusions about (a, b, c) or place blame on anyone/thing.” 

State what you know and what you don’t know, based on the information given. 

These statements are OK, but it is much better to “show” rather than “tell” the reader you are non-judgemental, for example.

Ask others directly (or indirectly like in Bob’s situation). Involve perspectives other than your own. This depends on the situation, the people involved and privacy/confidentiality issues. Remember not to share or discuss personal or embarrassing information in front of other people in the situation. If you are in a role where there is a manager or higher authority, always remember to consult with them before you make a final decision. 

Check with any rules, regulations, policies that you must follow. You need to demonstrate that you can uphold the policies and integrity of the profession, while providing support. 

Communicate the new information to other people involved and demonstrate an effort to come to a shared decision or demonstrate your duty to inform or report  regarding your decision (if applicable). 

State the options and possible consequences based on evidence. This includes information learned from asking others and checking resources. How are the people involved affected, including you? 

To help you with ideas to explain your reasoning, think of consequences or options as: if/then statements, pro and con, benefits and risks/costs, positive and negative, helpful or harmful, proactive or reactive and so on. Think opposites.  

State your final decision. Describe the sequence or steps you would take to make an informed choice and why. On what evidence are you basing your final decision? You must have support for your choice. 

“If Bob and his wife agree that financial security is more important at this time than Bob taking paternity leave, I would support Bob’s decision to take the job promotion over staying home. Bob mentioned that family time is important to him. If Bob is not permitted to do his work remotely, I would also offer to work extra hours some days to relieve Bob from his duties so he could get home earlier to spend time with his family.”

Creating alternative solutions to support a colleague in need demonstrates professionalism, respect and compassion.   

End your responses with a follow-up

Follow-up solutions could include plans to prevent future conflicts, how to improve a process, show gratitude,  demonstrate how you are open to change, flexible, or willing to answer future questions. 

“At the next meeting, I would suggest a flexible schedule or role rotations. This could help all employees achieve a work/life balance with shared responsibilities while promoting collective/group accountability. We could also have bi-annual meetings to check-in on professional progress and personal well-being.” 

Suggesting a positive work culture like rewarding staff for supporting colleagues and participating in collaborative teamwork are examples that demonstrate how you would respond to colleagues in need. These suggestions show that you understand the benefits of a just work culture and the importance of psychological safety in the workplace (i.e. CanMEDS role of Professional based on CMA Code of Ethics and Professionalism).

Possible Follow-up Question:

Would you change your answer if Bob were in a same-sex relationship? Explain.

“I would not change my answer. The gender of Bob’s spouse or Bob’s sexual orientation does not change the fact that as a person living in Canada, Bob has the right to be a parent and take paternity leave. Also, “paternity” and “maternity” are outdated terms in policy and have been replaced with “parental” leave to include all persons regardless of gender, sexual orientation, or other discriminations. Research shows that the healthy development of a child depends on love, nurturing and safety. Gender or sexual orientation of a parent do not have negative effects on child development, according to science.” 

Your answer remains the same and you support it with reference to Canadian labour and human rights laws, in addition to policy terms and conditions. You add that there is science to support these laws regarding child development and safety. 

Using specific terms such as the updated term “parental” demonstrates you are informed of Canadian laws related to discrimination in the workplace and human rights. Your personal morality or beliefs are not included in the statement. All the support for your response is related to laws and science, in addition to the professional and ethical responsibilities of doctors in Canada. 

In this response, you have demonstrated professionalism, ethics, scholar and critical analysis based on objective evidence. What is being assessed is the manner in which you defend your claims using objective information, not personal subjective feelings. 

Keep in mind that the CASPer is not an essay or research paper. You don’t have time to cite or present empirical information. But, stating that you rely on science or that you are informed of laws and policies outside of the medical field (i.e. the social determinants of health), demonstrates you are a responsible, caring and prudent critical thinker. 

How to Improve Your CASPer Score: Ideas for a Script with Canada’s Public Health Ethics Framework 

This is another FREE resource! The 5 Steps Ethical Framework was created for Canadian public health professionals and policy makers as a guide to systemic analysis of ethical issues to support decision-making in the context of COVID-19. It’s a perfect sequence for CASPer questions!