This guide will enable you to understand the interview procedure, preparation material and the interview structure. The aim is to simplify the process of Interview and give a direction specifically to the ‘International Medical Graduates’ in order to prepare for the Interview smartly.
The IMT interview consists of 2 Rounds. Applications for round 1 start in the late second half of the year whereas round 2 applications begin in the early months of first half of the year. Training year starts in August for both round 1 and round 2 applicants. It Is very important to consult the IMT recruitment website before preparing for the interview as it will give a detailed insight on the interview procedure and details. Below is the link.
https://www.imtrecruitment.org.uk
Interview Structure
The Interview is structured and designed in a very balanced manner. The interview contains 3 stations, 10 mins each preceded by 5 mins of waiting time. Subsequently the entire interview procedure takes 40-45 mins (exclusive of registration time). All stations comprise of two panelists. You may find a third panelist in the room which is either a Lay representative (to monitor IMT interview) or a third clinical panelist to assist with checking/review of your documentation. To begin with, it is vital that you dress smartly and formally like in all other interviews.
Station -1: Portfolio Station
The portfolio station can be the simplest one if your application is scoring high on the basis of your portfolio. The best way to prepare for the portfolio station is to go through your entire portfolio or evidence folder a day before the interview. If you have completed a research it is important to go through the research paper as the panelists may ask you questions on your research. A simplest example of that can be ‘your role in the research/data collection, how did you manage to collect the data, was it a retrospective/prospective study, how do you define the term research’ etc. Likewise if you have performed any audit, teaching or have demonstrated a leadership project, it is important to be able to fully explain all details on the specific topic. The portfolio station begins with the following simplest question.
‘Please introduce yourself’
You can easily spend 3 to 4 mins of your interview talking about yourself and this is the time where you can summarise your entire portfolio in one answer. The easiest way is to start off with medical school, year of graduation, foundation year rotations and clinical experience. As an IMG you are most likely to take the PLAB route, therefore you can mention PLAB exams and subsequently your NHS job. After explaining your clinical experience, you can summarise your academic achievements. You can continue describing your teaching experience, audit, presentations or anything you are scoring on however, realistically the panelists will proceed to their next question as you would already be 3-4 minutes through to the interview by this time.
After this question, you can be asked anything based on your portfolio. Likely question would be regarding your high scoring content. The panelists would be curious to know how you scored high therefore it is imperative that you put good explanation in order to justify the score you claimed. Teaching experience, presentation in conference, quality improvement, research and leadership projects etc will be asked depending on the choice of the panel which is likely to be influenced by the evidence provided in your portfolio.
‘Have you shown any commitment to the speciality’
Here you can discuss your experience in Medicine. The clinical rotations you have had till date, any clinical attachments, taster weeks, Advance life support course, work based assessments such as Case based discussions, mini clinical evaluation exercises, direct observation of procedural skills or Acute care assessment tools etc. You can talk about MRCP wether you have attempted or preparing, teaching experience, audits/quality improvement and any prizes or achievements you have in medicine.
Some other commonly discussed topics are:
- definition of audit
- difference between audit and clinical governance
- MRCP
- what made you choose medicine or speciality of choice
- how do you describe a leader
- role in leadership project
- role in research project
- where do you see yourself in 10 years time
- feedback/team assessment of behaviour
Portfolio station is the easiest as long as you remember your contribution in your projects, definitions and good understanding of the important pillars of your career. I always refer to Quality Improvement, research, teaching, presentation and leadership as the 5 important pillars of your career in NHS and it is imperative that you work on these on top of the MRCP exams for a progressive career in the NHS.
Station 2 – Clinical Scenario
Clinical scenarios are generally simple however sometimes you can be asked speciality specific questions such as scenarios on inflammatory bowel disease or atrial fibrillation. It is impossible to predict what can be asked therefore the best way to prepare is to consult the medical emergencies section in the Oxford handbook of Clinical Medicine.
You will be given 5 minutes to go through the scenario after which you will proceed to the station. Generally, the following approach towards any scenario is suggested.
- ABCDE
- History from patient/nurse/family/relative
- Clinical Examination
- Differentials
- Investigations
- Diagnosis
- Management – Hospital protocol/Trust policy
- Unwell patient -Escalation
- Discussion with senior (very important)
- Discussion with patient/ family (very important)
- Ceiling of Care – Ward based/ITU (very important)
- DNAR
One mark will be awarded to you based on your suggestions and responses to the clinical scenario . The second mark will be on the communication skills. This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers at the station -(IMT recruitment).
The important thing is to remain calm, consider yourself in a Hospital setting (NHS) and go through the basic protocol you practise everyday. The scenario is testing your medical knowledge but is more importantly testing your approach towards a sick patient, whether or not you can identify a deteriorating patient, whether or not you would escalate or discuss with senior. Always ensure that you involve your senior if you are dealing with an unwell patient.
Station 3: Ethical Scenario
The ethical scenario is the most important in terms of preparation as it is based on Medical ethics, professionalism and governance. The Ethical scenario contains two separate scenarios. The former assesses your moral, ethical and legal approach towards any Hospital/ward based situation. The later tests the understanding and demonstration of professional and clinical governance. The most important way to prepare for this is to go through these two important and handy tools.
- GMC Good Medical Practice guideline (GMP)
- Medical Interviews by ISC Medical
The GMC GMP explains medical ethics, professionalism and clinical governance in adequate detail. This is very helpful in getting a basic understanding of the principals and policies that one needs to refer to during any sensitive situation while working in the NHS.
The ISC Medical is a very handy book that gives insight into the entire interview with detailed focus on the medical ethical scenarios. As this is scenario based, going through this book will cover important 15-20 important ethical scenarios. Some of the common ethical scenarios are described below:
- You are the only Doctor in a stroke ward on an On-Call. Your Consultant calls you over phone and tells you that the Hospital beds are in red-alert state and suggests you to discharge home a patient quickly who recovered from stroke. You are approached by a physiotherapist who says that he is concerned about the discharge as the patient is unsteady on legs and has history of falls. What will you do.
- You have reviewed a patient in the morning round. Later on the mother of the patient complains about you and says that you were abrupt and did not give her enough time to speak and question. What will you do.
- You return from work and find that your colleague has posted an update on his day in the ward along with some pictures of a patient on facebook. What will you do.
Scenario 1:
identifying the issue
Consultant wants you to discharge a patient whereas the physiotherapist has raised a concern regarding his safety at home.
Patient safety
Patient safety is an issue here. No matter it is important to create beds for sick patients, this particular patient is at risk of falls as described by the physiotherapist therefore is not a safe discharge for home.
Action
- Re-assess patient for discharge, full examination, medical notes, involve OT and physio, Stroke Nurse
- Discuss situation with a senior or another Consultant if possible as you think this patient is unsuitable for discharge home.
- Discuss with staff involved in direct care of the patient. This includes the ward Nurses, Stroke Nurse and HCAs.
- If no remaining medical issue, consider Community bed, rehabilitation.
- Inform the Consultant you may not be able to discharge home patient due to the concerns raised by the Physiotherapists as it is a patient safety issue and patient is at risk of falls. However there is a bed available in rehabilitation and you are considering to transfer patient there until the mobility issue is resolved, patient gains full recovery and necessary arrangements regarding his safety and mobility are addressed at home by the social services.
It is important to note that approach to an ethical scenario may vary however the principal approach revolves around patient safety at all times. The above mentioned answer may not be the best description of an approach however does not compromise on patient safety. Seeking information, identifying issue, initiating action and escalation are other tools to remember while approaching a scenario. The ISC Medical states various handy pneumonics for approaching an ethical scenario like SPIES Structure etc.
The other important thing to remember is the pathway of escalation if you want to raise a concern in the NHS. This can be frequently asked during any ethical scenario.
Your Consultant > Other Consultant/Clinical Supervisor > Clinical Director > Medical Director > CEO > GMC.
Note: All details furnished above are only based on experience of an individual and are not official. The IMT recruitment website should be consulted for precise details on any topic related to the Interview process and for most updated information. Thank you.
PLAB Exams and Journey to General Medical Council, UK 