Tell me about a key scoring system or clinical decision tool that you use regularly in acute medicine and explain how it works.
- NEWS2: 6 parameters (RR, SpO2, systolic BP, HR, consciousness, temperature) + supplemental O2. Aggregate scores: 0 - 4 low, 5 - 6 medium, 7+ high risk. Single parameter of 3 = urgent review.
- CURB-65: Confusion, Urea >7, RR >30, BP systolic <90 or diastolic <60, age >65. Score 0 - 1 = home treatment, 2 = consider admission, 3 - 5 = severe pneumonia (consider ICU if 4 - 5).
- Wells score for PE: Clinical signs of DVT (+3), PE most likely diagnosis (+3), HR >100 (+1.5), immobilisation/surgery (+1.5), previous DVT/PE (+1.5), haemoptysis (+1), malignancy (+1). PE likely if >4.
- Glasgow-Blatchford score: Used for upper GI bleeding. Incorporates Hb, urea, systolic BP, HR, melaena, syncope, hepatic disease, cardiac failure. Score of 0 = very low risk, may not need admission.
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How to approach this Internal Medicine interview question
This clinical question is common in Internal Medicine NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "Tell me about a key scoring system or clinical decision tool that you use regularly in..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.
What the panel is testing
A strong clinical answer sounds safe before it sounds clever. Use a structure such as initial assessment, immediate management, differential diagnosis, escalation, and reassessment. Mention guidelines only where they help the decision in front of you. For internal medicine, show safe ward or acute-take judgement. Make escalation, diagnostic uncertainty, prescribing safety, discharge planning, and multidisciplinary working part of the answer where relevant.
- Start with immediate safety, ABCDE assessment, senior support, and escalation thresholds.
- Name the likely diagnoses or risks, but show how you would keep reassessing as new information arrives.
- Close with documentation, handover, follow-up, and patient or family communication where relevant.
How to structure your answer
For a clinical prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.
- Open by naming the main issue in the question.
- Give a structured response rather than a memorised script.
- End with escalation, documentation, learning, or follow-up.
Common mistakes to avoid
The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.
- NEWS2: 6 parameters (RR, SpO2, systolic BP, HR, consciousness, temperature) + supplemental O2. Aggregate scores: 0 - 4 low, 5 - 6 medium, 7+ high risk. Single parameter of 3 = urgent review.
- CURB-65: Confusion, Urea >7, RR >30, BP systolic <90 or diastolic <60, age >65. Score 0 - 1 = home treatment, 2 = consider admission, 3 - 5 = severe pneumonia (consider ICU if 4 - 5).
- Wells score for PE: Clinical signs of DVT (+3), PE most likely diagnosis (+3), HR >100 (+1.5), immobilisation/surgery (+1.5), previous DVT/PE (+1.5), haemoptysis (+1), malignancy (+1). PE likely if >4.