STRUCTURE OF THE ST INTERVIEW
ST interviews normally last 30 to 40 minutes and are made up of three or four stations, each with a different theme. The exact duration, the number of stations and the themes will depend on each specialty, but are usually 10-12-minute long. Note that, as always, there are exceptions as some candidates have had interviews that included one single 30-minute station (more or less alongside the format of the “old” SHO or SpR interviews).
The type of stations vary from specialty to specialty, and in fact also from deanery to deanery. For example, some anaesthetics candidates in London have had almost exclusively clinical scenarios, whereas in Manchester the interviews were more balanced.
Globally speaking you are likely to have three or four stations taken from the following types:
This normally includes a range of clinical scenarios (e.g. emergencies) that you would normally be expected to handle. Some of the scenarios are straight forward, but others may be stretching you a little (i.e. you may not have met such situations in the past, but the interviewers would expect you to have a good educated guess).
In some specialties, candidates may be asked to demonstrate practical procedures (e.g. intubating a dummy in anaesthesia, or suturing a tomato in ophthalmology). There is absolutely nothing that you can do to prepare for this station. Either you know or you don’t. Practical stations tend to be reserved for surgery-related specialties.
General, Motivation & Teaching station
A number of deaneries and specialties have stations that are designated for generic questions. These tend to relate to your interest in the specialty and the deanery, together with your career plans and the manner in which you have developed your interest in the specialty. Usually the general station also deals with teaching skills.
Academic & Clinical Governance station
Most interviews will have an academic station. In some interviews, there can actually be two academic stations (e.g. one specifically on Research and Audit, and another one on other topics such as Teaching and Risk Management.
Academic stations take the form of a traditional question and answer session. For example you may be asked to talk about your most interesting audit. The interviewers will then dig into the detail of your experience e.g. how you selected the standard, what you role was, what changed as a result, etc.
Other questions will include your experience of Research, what you understand about research principles, questions on the importance of Research etc. Such questions can be daunting at first, but if you are well prepared, you can really shine.
Critical Appraisal station
In several specialties (e.g. ophthalmology, general surgery), candidates have been asked to critically appraise a paper, at all ST levels, including ST1.
Preparation time varied between 20 and 40 minutes, followed by a 5 to 10 minute presentation. As part of a critical appraisal station, you are expected to demonstrate an understanding of how critical appraisals should be approached and you should also be able to answer any questions that the interviewers have on the paper that you have just read. This could include questions of a clinical nature, based on the topic being discussed; it also often includes questions on research principles such as “What is a p-value?” or “What are the ethical issues involved in this paper?”.
Experience of research is a definite advantage to succeed in this station. Having said that, attendance at journal clubs is also a good way of preparing yourself for it, particularly at the lower ST grades.
In some specialties, role play has been introduced. Role play was already an integral part of SpR interviews for some specialties such as Obs & Gynae but it has been extended to other specialties in some of the deaneries, including psychiatry (e.g. dealing with a father who wants some news on his over-18 admitted daughter), ophthalmology (e.g. breaking bad news and counselling a patient on glaucoma) and several others.
In many ways, role-play stations are similar to those used for the recruitment of GP trainees. Their main aim is not to test your clinical skills & knowledge (this is achieved in others ways in proper clinical stations) but to test your approach towards patients and your communication skills. The clinical content of the role play section is therefore limited as they concentrate instead on your empathy, your listening skills, your ability to summarise information in a simple language, your ability to deal with anger and conflict calmly and sensibly, and your ability to build a rapport with a patient in sometimes difficult circumstances.
The role play stations usually include actors who have been briefed accordingly. Having said that, the role is sometimes played by an interviewer. There have been occasions where role-play was introduced unexpectedly in a normal clinical station, or an ethics station. The station would start normally with a few general question such as “How would you deal with a patient who …”. Half-way through the station one of the interviewers will tell you that he is now the patient and that he wants you to act your answer out. This can be somewhat disconcerting and you should therefore be prepared for the worst, even if you have not explicitly been told that you will have a role play station.
TIP 4: Organise your answers
Many candidates’ answers are made up of a long list of ideas, most of which are irrelevant or not backed up. There is no point putting across 20 ideas if the average human being can only remember 3 or 4 ideas at a time. You will just drown your interviewers in a mass of information they can’t digest. As a result they will either lose interest and start looking through the window, or they will get a headache trying to make sense of it all. Put yourself in their shoes! They have been sitting there listening to the same old answers from everyone. Make their job easy, don’t make them think too much, organise the information for them. In our experience, those who get the jobs are not those who have an absolutely flawless content in their answers. They are those who have a good structure and make them personal, even if they only have 70% of the expected content.
TIP 5: be personal
For each question, there are a number of points that can be raised. Most people who have prepared will automatically come up with these points and, in order to make a difference, you will need to personalise your answers otherwise you will sound the same as everyone else. Depending on the question that you have been asked, this can be achieved in different ways.
If the question is about your interpersonal skills, try to bring in a few examples that
demonstrate your experience. For example when discussing team playing, describe
situations where you gained experience of team work. You should not go into too much detail but be specific enough to be credible.
Steer clear of definitions and grand statements. An interview is a conversation, not a speech or a verbal essay. You need to appear natural and confident in what you say. Do not be scared of expressing your ideas in your own words. For example, when is the last time you used the word “flourish” at home or at work? So why insist in using it in your description of Clinical Governance? Too many people try to explain simple ideas using pompous words because they feel it makes them sound better. In reality it makes them sound vague, theoretical and, sometimes, confused … the interviewers are confused too.
Don’t be afraid of expressing how you feel, what you liked, why you enjoyed it, etc. They want to recruit human beings, not clones. Also, talking about feelings helps being out your enthusiasm and passion for what you do. No one has ever sounded passionate talking about.
TIP 6: Stop obsessing about your body language
There is little point in worrying about how you cross you fingers or your legs if what comes out of your mouth makes no sense. Body language is not part of the marking sheet interviewers have. In fact most people will ignore your body language unless it is really bad, in which case it most probably means that you have very little confidence and therefore that your answers are also very bad.
Most people have a normal body language and interviewers will make allowances for the fact that you are a bit nervous. If you spend the time preparing well for your interview, you will gain much more confidence in yourself and your body language will follow naturally. The more you think about your body, the less you are able to think about your answers.
TIP 7: Do not spend month learning about the minutia of NHS issues
There is always a danger in knowing too much about one subject: they can ask you for more detail until you fall on your own sword. At our last count, there were over 95 possible NHS issues you could be asked at an interview. Even if you spend just 20 minutes on each, it would still take you over 30 hours of work. And that’s just for the basics.
Instead concentrate and spend some proper time on 5 or 6 key issues of importance either because they are of actuality or because they are of close concern to your specialty. But do not confine yourself to learning the basic facts otherwise you will go back to the realm of ready-made answers. At ST interviews, you will be expected to show an understanding of the issue but also of it consequences and practical applications. So spend your time wisely by discussing the issues with colleagues and debating them. You will then start thinking about those issues in different ways and will gain a personal understanding of them that will enable you to discuss them freely at a medical interview.