235 practice prompts

NHS interview questions by specialty

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Cross-cutting interview questions anyone can start with. 110 questions.

  1. Portfolio · FreeTell us about yourself
  2. Motivation · FreeWhat drew you to this specialty, and can you point to a specific experience that confirmed your interest?
  3. MotivationWhy have you applied to this hospital and this department specifically?
  4. MotivationThis is a non-training post. How does it fit into your longer-term career plans?
  5. MotivationWhat is the achievement you are most proud of, and why does it matter to you?
  6. MotivationWhat is it about this area of medicine that keeps you motivated day to day?
  7. MotivationWhat aspect of this specialty do you find most difficult to deal with?
  8. MotivationWhere do you see your career in five years, and how does this role contribute to that?
  9. PortfolioIf we spoke to your most recent consultant, what would they say are your main strengths?
  10. MotivationWhy should we offer you this post?
  11. MotivationWhat do you understand are the current priorities or challenges for this department, and how could you contribute?
  12. PortfolioWhat should we know about you that we cannot learn from your CV or application form?
  13. PortfolioWhat experience have you gained so far that is directly relevant to this post?
  14. MotivationIs there anything about the job description that you feel less confident about, and how would you address that?
  15. Communication · FreeYou are about to break unexpected bad news to a patient whose first language is not English and whose family are not present. Talk us through your approach.
  16. LeadershipYour consultant tells you after a clinic that several patients found you "a bit abrupt." You thought the clinic went well. How do you handle this?
  17. Ethics · FreeIt is 4pm on a Friday. You have a sick patient to review, three discharge summaries that must go out today, a medical student waiting for scheduled teaching, and you have just been asked to consent a patient for a Monday procedure. What do you do?
  18. LeadershipTell us about a project or clinical episode whose success depended entirely on how well your team worked together.
  19. LeadershipYou believe a management plan agreed on the ward round is not in the patient's best interest. The consultant has already moved on to the next patient. What do you do?
  20. LeadershipWhen have you had to step into a leadership role you were not expecting? What did you learn about yourself?
  21. MotivationA patient's relative complains that nobody has explained what is happening with their mother's care, despite your team seeing her daily. What might have gone wrong and how would you address it?
  22. Quality Improvement · FreeYou notice the same problem keeps recurring on your ward but nobody seems to be addressing it. Walk us through how you would go from identifying the problem to implementing a solution.
  23. LeadershipReflect on a time when your actions, or inaction, negatively affected the dynamics of a team you were part of.
  24. LeadershipSome doctors say "medicine is a team sport." Others argue that the best clinical decisions are made by individuals thinking independently. Where do you stand?
  25. PortfolioWho is the best leader you have worked with in medicine, and what specifically did they do that you try to emulate?
  26. MotivationTell us about a change you have driven that initially met resistance from others. How did you bring people on board?
  27. LeadershipCan you think of a situation in your clinical experience where good management was present but leadership was lacking, or vice versa? What was the impact?
  28. MotivationA patient keeps missing follow-up appointments despite having a serious chronic condition. The usual approach has been to send letters. What would you do differently?
  29. MotivationA patient agrees to everything you suggest during a consultation but you have a nagging feeling they are not really on board. How do you explore this?
  30. CommunicationTell us about a time when the standard approach to a clinical or workplace problem was not available to you, and you had to find another way.
  31. EthicsWalk us through a clinical situation that did not go as you expected. What would you do differently with the benefit of hindsight?
  32. PrioritisationHave you ever been in a situation where doing the right thing professionally came at a personal cost to you? What happened?
  33. MotivationA colleague confides in you that they made a prescribing error last week that did not harm the patient, and they decided not to report it. What would you say to them?
  34. MotivationMedicine is a career with high rates of burnout. What do you do proactively to protect yourself, and how would you know if it was not working?
  35. CommunicationTell us about a time when you were out of your depth. What did you do?
  36. EthicsIf we asked your closest colleague to describe what you are like on a bad day, what would they say?
  37. CommunicationDescribe a shift or clinical episode that tested your limits. What kept you going and what would you change about how you handled it?
  38. CommunicationA patient's medical treatment is going well, but they are not getting better. What might you be missing?
  39. EthicsA patient tells you they have been reading about their condition online and want to try an alternative treatment instead of the one you have recommended. How do you respond?
  40. CommunicationYou notice that a colleague who recently returned from sick leave seems to be struggling. They have not said anything to you. What, if anything, do you do?
  41. PortfolioWhat three qualities make you the right fit for this role, and what is your evidence for each?
  42. CommunicationIf we asked your educational supervisor for one area where you need to develop, what do you think they would say?
  43. LeadershipA new FY1 on your team is struggling with a practical procedure you are competent in - for example, lumbar puncture or ascitic tap. How do you approach helping them?
  44. MotivationYou receive feedback from a junior colleague that your departmental teaching sessions are "too fast and assume too much knowledge." How do you respond, and what changes would you make?
  45. MotivationYour department has a weekly teaching slot that nobody attends. Your clinical lead asks you to revive it. What would you do?
  46. Quality ImprovementA patient on your ward receives ten times the intended dose of insulin due to a prescribing error. Fortunately, it is caught before serious harm occurs. Walk us through the systems that should exist to prevent, detect, and learn from this kind of event.
  47. MotivationYour consultant asks you to lead a departmental audit on venous thromboembolism (VTE) prophylaxis compliance. Describe the steps you would take from start to finish, including what happens after you present the results.
  48. MotivationA colleague proposes studying whether a new wound dressing reduces infection rates on your surgical ward. They plan to compare outcomes before and after introducing the dressing and call it an "audit." Do you agree with this classification? Why or why not?
  49. MotivationIf you were given six months of protected time and a modest budget to conduct a research project relevant to your specialty, what would you study and why?
  50. LeadershipA consultant on your team routinely uses a treatment that you believe is not supported by the current best evidence. How do you approach this situation?
  51. Quality ImprovementYour department has had three serious incidents involving the same type of error in the past six months. Individually, each was investigated and recommendations were made, but the problem keeps recurring. What would you do differently?
  52. Quality ImprovementA senior colleague tells you: "I have been doing this for twenty years and I do not need a protocol to tell me how to manage my patients." What are your thoughts?
  53. Quality ImprovementYour hospital receives a CQC inspection report rating your department as "Requires Improvement." As a junior member of the team, what role can you play in responding to this?
  54. PortfolioDescribe how you use reflective practice in your day-to-day work. Give us a specific example of something you reflected on and what changed as a result.
  55. Quality ImprovementA new landmark trial is published that contradicts the way your department currently manages a common condition. How do you go about integrating new evidence into your practice?
  56. MotivationYou are presenting at journal club and a colleague has selected a meta-analysis showing that a commonly used drug is ineffective. Some consultants in the room are sceptical. How do you facilitate a balanced critical appraisal?
  57. MotivationYou witness a colleague make a clinical error that does not result in patient harm. They do not report it. What do you do?
  58. MotivationYou are asked to teach a group of foundation doctors about acute kidney injury. You could deliver a lecture or design an interactive session. Make the case for the interactive approach.
  59. Quality ImprovementWhat is the difference between a clinical audit and a quality improvement project? When might you choose one over the other?
  60. EthicsA pharmaceutical company approaches your department offering to fund a study of their new drug. What factors would you consider before agreeing to participate?
  61. PrioritisationYou notice a senior colleague's clinical judgement seems impaired during a busy on-call - they are making unusual decisions and their speech seems slightly slurred. What do you do?
  62. LeadershipAfter raising your concern about the impaired colleague, the on-call consultant thanks you but says they will "have a quiet word in the morning" and takes no further action that night. What do you do?
  63. MotivationThe impaired colleague takes you aside and tearfully explains they are going through a divorce and have been relying on prescription sedatives to cope. They beg you not to report it, saying they will stop immediately. What do you do?
  64. MotivationA fellow SHO has been calling in sick on most of their weekend shifts over the past two months, leaving the remaining team significantly stretched. How do you handle this?
  65. LeadershipYou overhear two colleagues in the coffee room discussing that a registrar in your department has been self-prescribing controlled medications from the hospital system. What do you do?
  66. MotivationYou discover that a consultant you work closely with has been listing procedures on their logbook that were actually performed by registrars. A colleague shows you the evidence. What do you do?
  67. LeadershipYou are working a night shift and your on-call consultant, who is at home, repeatedly does not answer their phone when you need clinical guidance on acutely unwell patients. What do you do?
  68. LeadershipA senior colleague routinely takes credit for your clinical ideas in MDT meetings and dismisses your contributions in front of the wider team. How do you address this?
  69. PrioritisationDuring a theatre list, the operating consultant publicly berates the scrub nurse for a minor error, causing visible distress. You are the surgical assistant. What do you do?
  70. LeadershipYou have been in your post for three months and have had no induction, no clinical supervision meetings, and no opportunity to discuss your professional development. What do you do?
  71. EthicsYou discover that a colleague has been accessing patient records of family members and acquaintances without any clinical reason. What do you do?
  72. LeadershipA patient tells you in confidence that during a home visit by your colleague, the colleague made comments about the patient's appearance that made them uncomfortable, and asked for their personal phone number. What do you do?
  73. LeadershipTwo consultants in your department are in an ongoing personal dispute that is now affecting how they communicate about shared patients during handover. What do you do?
  74. LeadershipA colleague confides in you that they have been diagnosed with a serious mental health condition and are not currently receiving treatment. They are still seeing patients. What do you do?
  75. MotivationYou witness a consultant make a racially insensitive comment to an international medical graduate colleague during a departmental meeting. What do you do?
  76. EthicsA 55-year-old patient with end-stage renal failure, who is fully competent, tells you he has decided to stop dialysis. His family are distraught and beg you to "talk him out of it." How do you approach this situation?
  77. EthicsYou are the on-call medical registrar and the last ICU bed has just become available. Two patients need it: a 40-year-old mother of three with severe pneumonia and a good prognosis, and a 78-year-old man with advanced COPD and a less certain outcome. How do you think about this decision?
  78. EthicsA patient's employer telephones the ward and says they need to know the diagnosis urgently because "it affects workplace safety." How do you handle this call?
  79. EthicsA patient with newly diagnosed epilepsy tells you he intends to continue driving his lorry because he cannot afford to lose his licence. What are your obligations?
  80. EthicsThe police arrive on the ward and ask you to provide the medical records of a patient who is a suspect in a serious assault. They do not have a court order. What do you do?
  81. EthicsA colleague from another specialty asks you for detailed information about a shared patient "for a clinical audit they are running." The patient has not been told their data will be used in this way. Is it appropriate to share the information?
  82. EthicsYou are asked to consent an 82-year-old patient with mild dementia for an urgent hip repair after a fracture. She is in pain and seems confused. Walk us through how you would assess whether she has capacity to consent to this procedure.
  83. EthicsA 35-year-old Jehovah's Witness is admitted with a massive gastrointestinal haemorrhage and refuses a blood transfusion. Her haemoglobin is 52 g/L and falling. The surgical registrar says: "She clearly doesn't understand what she's saying - she'll die without blood. We should just transfuse her." How do you respond?
  84. EthicsA patient is about to undergo an elective laparoscopic cholecystectomy. She asks: "What do I need to know before I sign the consent form?" What information are you legally and ethically obliged to share, and how has the law on consent changed in recent years?
  85. EthicsA 70-year-old man with severe Alzheimer's disease is admitted with a bowel obstruction. He cannot participate in decisions about his care. His daughter holds lasting power of attorney for health and welfare and says: "Dad would never have wanted an operation - please just keep him comfortable." The surgical team believes surgery could save his life. How do you navigate this?
  86. EthicsYou are the on-call doctor and a patient is brought in unconscious after a cardiac arrest. The paramedics hand you a document that appears to be an advance directive refusing resuscitation and all "invasive treatment." The patient is 45 years old and otherwise well. What do you do?
  87. EthicsA family is upset because they have discovered that a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) form has been placed in their mother's notes without their knowledge. They say: "No one discussed this with us - we want it removed." How do you handle this?
  88. EthicsA 14-year-old girl presents to your clinic requesting the oral contraceptive pill. She does not want her parents to know. How do you approach this consultation?
  89. EthicsA 15-year-old boy with acute appendicitis is refusing surgery. He says he is "terrified of operations" and "would rather take his chances." His parents want him to have the operation. What do you do?
  90. EthicsA 13-year-old boy attends the emergency department with bruising to his arms and torso. He says he fell off his bike, but the pattern of injuries is inconsistent with this explanation. He begs you not to tell his parents he is here. What do you do?
  91. EthicsA patient on your ward has been confirmed as brainstem dead following a catastrophic intracranial haemorrhage. The specialist nurse for organ donation approaches you about discussing organ donation with the family. The family is from a cultural background where they are likely to find the concept distressing. How do you approach this?
  92. EthicsThe family of a patient on long-term ventilation in the ICU asks you: "Is switching off the ventilator the same as killing him?" How do you answer?
  93. EthicsYou discover, through a patient's blood results that you processed, that a colleague who had blood tests done on the ward has been diagnosed with a blood-borne virus. They have not disclosed this to occupational health and continue to perform exposure-prone procedures. What do you do?
  94. EthicsA consultant surgeon asks you to "go and consent Mrs Jones for her total knee replacement tomorrow morning." You have never performed or assisted in a total knee replacement. Should you do it?
  95. EthicsYou have just received biopsy results confirming pancreatic adenocarcinoma for a patient who specifically told you last week, "I don't want to know if it's bad news - just treat me." The oncology MDT needs a decision on treatment within 48 hours. How do you proceed?
  96. EthicsA patient's adult son confronts you in the corridor, visibly distressed, shouting: "My mother came in walking and now she can't move her legs - what have you done to her?" Other patients and visitors are watching. How do you handle this?
  97. EthicsA 34-year-old woman with a pulmonary embolism diagnosed six hours ago, currently on a heparin infusion, tells you she is leaving hospital immediately because she has no childcare and her two young children are home alone. She is putting on her coat. What do you do?
  98. EthicsA 17-year-old with severe post-operative anaemia (haemoglobin 42g/L) is deteriorating. His parents, who are Jehovah's Witnesses, have refused consent for blood transfusion. When you are alone with the patient, he whispers, "I'd take the blood if it were up to me." What do you do?
  99. Quality ImprovementA patient who is herself a solicitor has written a formal letter of complaint about you, alleging that you dismissed her symptoms and that your "negligent delay" in ordering a CT scan caused her appendix to perforate. You recall the consultation and believe your clinical decisions were reasonable. How do you respond?
  100. EthicsYou are looking after an 89-year-old man with end-stage heart failure, advanced dementia, and recurrent aspiration pneumonia. You believe a DNACPR decision is appropriate, but his daughter insists that "everything must be done" and says she will "sue the hospital" if CPR is withheld. The patient lacks capacity. How do you manage this?
  101. LeadershipA 52-year-old woman with motor neurone disease, still cognitively intact, tells you during a ward round: "I've looked into Dignitas. I want to end my life before I lose the ability to swallow. Will you help me?" How do you respond?
  102. PrioritisationYou are working in the emergency department. A 3-year-old is brought in by his mother with a scald to both feet in a "stocking" distribution. The mother says he climbed into the bath, but the child is withdrawn and the burn pattern looks symmetrical and well-demarcated. What do you do?
  103. EthicsA 28-year-old woman presents to the acute medical unit with a rib fracture. She says she fell down the stairs, but you notice finger-shaped bruising on her upper arms and she becomes tearful when her husband steps out of the room. She has presented three times in six months with minor injuries. What do you do?
  104. EthicsWhile suturing a laceration in the emergency department, you sustain a needle-stick injury from a hollow-bore needle. The patient is an intravenous drug user with unknown HIV and hepatitis status. What do you do?
  105. MotivationYou need to obtain consent for a hip replacement from an elderly Sylheti-speaking woman. Her adult son, who is interpreting, keeps answering questions on her behalf and appears to be minimising the risks you are explaining. You are not confident the patient understands what she is consenting to. What do you do?
  106. EthicsIt is a winter evening and the hospital is at full capacity. You have one remaining monitored bed on the acute medical unit. Two patients need it: a 78-year-old with an NSTEMI who needs cardiac monitoring, and a 45-year-old with diabetic ketoacidosis who needs hourly observations and an insulin infusion. Both are clinically unstable. How do you decide?
  107. MotivationA patient's wife pulls you aside before your ward round and says, "Please don't tell my husband he has cancer. In our culture, we don't tell people they're dying - it will destroy him. Let me decide what he needs to know." The patient has capacity and has not expressed a wish to avoid information. How do you handle this?
  108. Quality ImprovementDuring a night shift, you realise that a patient has been receiving ten times the prescribed dose of methotrexate for three days due to a prescribing error by a colleague. The patient is currently asymptomatic but is at risk of serious bone marrow suppression. What do you do?
  109. PrioritisationYou are called to see a post-operative patient who was expected to be discharged today. She has developed sudden-onset breathlessness and hypotension, and you suspect a massive pulmonary embolism. Her husband and teenage daughter are at the bedside expecting to take her home. How do you manage the situation?
  110. EthicsA 55-year-old man with a ruptured abdominal aortic aneurysm, fully conscious and oriented, calmly tells you he does not want surgery. He says he has "lived long enough" and that his wife died last year. The vascular surgeon is standing by. The patient will die without an operation. What do you do?

Emergency Medicine

Acute prioritisation, handover, and high-pressure communication. 20 questions.

  1. Leadership · FreeA 35-year-old man presents to the ED with severe central chest pain and a systolic blood pressure of 78 mmHg. He is diaphoretic and looks unwell. His ECG shows ST elevation in leads II, III, and aVF. Talk me through your management.
  2. Quality Improvement · FreeA 70-year-old woman is brought to the ED by ambulance. She has a temperature of 39.8° C, heart rate 132, blood pressure 80/45, respiratory rate 28, and a GCS of 13. The paramedics report she has been increasingly confused over the past 24 hours. How do you assess and manage this patient?
  3. Prioritisation · FreeA polytrauma patient is brought to the ED by ambulance following a high-speed road traffic collision. The paramedics hand over using ATMIST and report that the patient was the unrestrained driver, the car rolled, and extraction took 45 minutes. Talk me through your approach from the moment of arrival.
  4. PrioritisationA 5-year-old child is brought to the ED with a fever, a non-blanching rash, cold peripheries, and increasing drowsiness. How would you assess and manage this child?
  5. Quality Improvement · FreeA 68-year-old man is brought to the ED with sudden-onset right-sided weakness and expressive dysphasia. His wife says symptoms started approximately two hours ago. How do you assess and manage this patient?
  6. Clinical · FreeA 25-year-old woman presents to the ED with acute onset of wheeze, urticarial rash, facial swelling, and difficulty breathing. She ate a meal containing shellfish 20 minutes ago. Her oxygen saturations are 89% and she is becoming increasingly distressed. How would you manage this?
  7. EthicsA 19-year-old woman is brought to the ED by her flatmate after taking an overdose of paracetamol tablets two hours ago. She says she wants to die and is refusing all treatment, wanting to leave the department. How do you manage this situation?
  8. PrioritisationYou are the team leader for a cardiac arrest call in the resuscitation bay. A 55-year-old man has been brought in by ambulance in cardiac arrest with an initial rhythm of ventricular fibrillation. Walk me through how you would lead this resuscitation.
  9. PrioritisationWhat do you understand about triage systems in a UK Emergency Department, and how does the Manchester Triage System work?
  10. MotivationWhat do you know about the 4-hour ED target? Do you think it is a useful measure?
  11. EthicsThe ED is extremely busy. There are patients in corridors, ambulances are queuing outside, and the waiting room is full. As the senior doctor on the shop floor, what would you do?
  12. PrioritisationYour hospital has been declared a receiving hospital for a major incident. What do you understand by this, and what is your role as an ED doctor?
  13. CommunicationHow would you manage a patient who is intoxicated and becoming increasingly aggressive and violent towards staff in the ED?
  14. CommunicationA patient arrives in the ED in cardiac arrest. Resuscitation is unsuccessful and the patient dies. The family have just arrived. How do you break the news?
  15. Quality ImprovementA patient is attending your ED multiple times per week, often in the early hours of the morning. Each time, they present with vague symptoms and are usually discharged. The nursing staff are frustrated. How would you approach this?
  16. EthicsA patient who has been assessed in the ED and advised that they need admission is refusing to stay. They want to self-discharge. How do you manage this?
  17. PrioritisationYou are working in the ED and a 6-year-old boy is brought in with a painful swollen forearm after an alleged fall from a sofa. The history given by the two carers is inconsistent and the child seems frightened. How do you proceed?
  18. MotivationWhat do you see as the biggest challenges facing Emergency Medicine over the next five to ten years?
  19. MotivationWhy Emergency Medicine? What is it about this specialty that appeals to you?
  20. PortfolioWhat unique skills, experience, or qualities would you bring to this Emergency Department?

Internal Medicine

Ward leadership, escalation, and safe decision-making under ambiguity. 20 questions.

  1. Quality ImprovementA 40-year-old woman is brought to the acute medical unit. She is febrile (39.4° C), tachycardic (HR 128), hypotensive (BP 82/50), and confused. Her lactate is 4.2 mmol/L. Talk me through your management.
  2. LeadershipA 58-year-old man develops central chest pain radiating to his left arm. His ECG shows ST elevation in leads V1 - V4. Talk me through your management.
  3. Quality ImprovementA 72-year-old woman presents with acute breathlessness, pleuritic chest pain, and haemoptysis. Her heart rate is 110, oxygen saturations are 91% on air, and she has a swollen left calf. What is your approach?
  4. Quality ImprovementA 78-year-old man is brought by ambulance with sudden-onset left-sided weakness and slurred speech. Symptoms started 90 minutes ago. How would you assess and manage this patient?
  5. Quality ImprovementA 65-year-old man with known liver cirrhosis presents with large-volume haematemesis. His heart rate is 130, BP is 88/52, and he appears pale and clammy. How do you manage this?
  6. Quality ImprovementA 24-year-old woman with type 1 diabetes is brought in drowsy, with Kussmaul breathing and a capillary blood glucose of 32 mmol/L. Her venous blood gas shows pH 7.1 and ketones 5.8 mmol/L. How do you manage this?
  7. ClinicalYou are called to see a 68-year-old man on the ward whose potassium has come back at 7.2 mmol/L. His ECG shows tall tented T waves. What do you do?
  8. Quality ImprovementA 55-year-old woman with known COPD presents to the acute medical unit with worsening breathlessness, productive cough, and wheeze over three days. Her oxygen saturations are 86% on air. She is using accessory muscles. How do you manage this?
  9. PrioritisationDescribe your experience leading or participating in a post-take ward round. How did you prioritise patients?
  10. EthicsHow would you decide which patients are suitable for the Same Day Emergency Care (SDEC) pathway rather than full admission?
  11. PrioritisationYou are the medical SHO on a night shift. You receive three simultaneous requests: a cardiac arrest call on ward 5, a patient with new-onset chest pain on ward 3, and a nurse asking you to re-write a drug chart on ward 7. How do you prioritise?
  12. EthicsHow would you manage a situation where there are medical outliers on surgical wards and bed capacity is critically short?
  13. CommunicationA nurse calls you because a patient's NEWS score is 7. Walk me through your response.
  14. Quality ImprovementHow would you assess and manage a frail 82-year-old patient admitted with a fall and new confusion?
  15. EthicsAn 85-year-old with advanced dementia, recurrent aspiration pneumonia, and a Clinical Frailty Score of 8 is admitted. The family want "everything done." How do you approach this?
  16. Quality ImprovementWhat is polypharmacy, and how would you approach a medication review in an elderly patient with multiple comorbidities?
  17. ClinicalTell me about a key scoring system or clinical decision tool that you use regularly in acute medicine and explain how it works.
  18. Quality ImprovementA medication error occurs on your ward - a patient receives ten times the intended dose of methotrexate. Walk me through what happens next.
  19. MotivationTell me about a NICE guideline relevant to internal medicine that you know well and how it influences your practice.
  20. MotivationWhat do you see as the biggest challenges facing acute medicine in the NHS today, and how would you contribute to addressing them in this role?

Surgery

Peri-operative judgement, teamwork, and operative professionalism. 23 questions.

  1. PrioritisationYou are the surgical SHO on call and are fast-bleeped to the ward because a patient has vomited approximately 500ml of fresh red blood. Describe your approach.
  2. ClinicalA 25-year-old female presents to A&E with a 12-hour history of right iliac fossa pain, nausea, and a low-grade fever. How would you assess and manage this patient?
  3. ClinicalA 65-year-old man presents with severe colicky abdominal pain, absolute constipation, distension, and vomiting. He had an open right hemicolectomy for colon cancer three years ago. How would you assess and manage him?
  4. ClinicalA patient is Day 4 post anterior resection and has developed worsening abdominal pain, tachycardia (HR 110), fever (38.8° C), and raised inflammatory markers. What is your concern and how would you manage this?
  5. ClinicalA patient presents to A&E with acute severe epigastric pain radiating to the back. How would you assess and manage this patient?
  6. Quality ImprovementYou are called to A&E to see a patient with generalised peritonitis. Describe your approach.
  7. ClinicalA patient is brought to A&E following a road traffic collision. They are haemodynamically unstable with a distended abdomen. Talk me through your approach.
  8. ClinicalA patient is Day 3 post right hemicolectomy and develops a temperature of 38.5° C. How would you assess and manage this?
  9. MotivationTell us about the WHO Surgical Safety Checklist. What are its three stages and why is it important?
  10. EthicsHow would you consent a patient for a laparoscopic cholecystectomy?
  11. ClinicalWhat is a never event? Can you give examples relevant to surgery, and what would you do if one occurred?
  12. Quality ImprovementWhat is the NCEPOD classification and how does it help you manage the emergency theatre list?
  13. EthicsHow would you consent a patient for an emergency laparotomy?
  14. ClinicalHow do you assess and manage VTE risk in a surgical patient?
  15. ClinicalWhat do you understand by Enhanced Recovery After Surgery (ERAS)?
  16. Quality ImprovementWhat is NELA and what measures improve outcomes in emergency laparotomy?
  17. Quality ImprovementWhat measures do you take to prevent surgical site infections?
  18. ClinicalYou are assisting with a laparoscopic appendicectomy and unexpected findings are encountered - the appendix looks normal but there is an inflamed Meckel's diverticulum. What principles would guide your response?
  19. LeadershipWhen would you convert a laparoscopic procedure to an open procedure?
  20. ClinicalA patient presents with equivocal right iliac fossa pain. The CT scan is reported as "possible early appendicitis but findings are not conclusive." The patient is not peritonitic. How do you manage this diagnostic uncertainty?
  21. PrioritisationYou are the surgical SHO on a busy on-call shift. You have three ward reviews to do, a new referral from A&E, and your registrar is in theatre. How do you prioritise?
  22. Quality ImprovementThere are bed pressures and your patient who had an emergency laparotomy with a predicted mortality of 12% cannot get an HDU bed. What do you do?
  23. MotivationWhy surgery, and why is this particular non-training surgical role a good fit for you? What would you bring to the department?

Paediatrics

Child health, safeguarding, and family-centred communication. 20 questions.

  1. Quality ImprovementA 3-month-old baby is brought to the emergency department with a temperature of 40°C. The parents are very worried. How would you assess and manage this child?
  2. Quality ImprovementA 6-month-old infant presents in winter with wheeze, increased work of breathing, and poor feeding. How would you assess and manage this child?
  3. ClinicalA 2-year-old is brought to the emergency department at 2am with a barking cough and noisy breathing. How would you assess and manage this child?
  4. ClinicalA 4-year-old is brought in fitting. The parents say the seizure has been going on for about 10 minutes. Talk me through your management.
  5. ClinicalA 10-year-old presents with vomiting, abdominal pain, deep rapid breathing, and confusion. Blood glucose is 28mmol/L. How would you manage this child?
  6. ClinicalA 5-year-old collapses at school after eating a peanut butter sandwich. The child is brought to the emergency department. How would you manage this patient?
  7. LeadershipYou are called to attend a delivery of a baby at 30 weeks gestation. The baby is born floppy, blue, and not breathing. Heart rate is 50 beats per minute. Talk through your initial management.
  8. Quality ImprovementA 7-year-old known asthmatic presents with worsening wheeze, breathlessness, and difficulty speaking in full sentences. How would you classify the severity and manage this child?
  9. EthicsYou are examining a 3-month-old with bronchiolitis and notice unexplained bruising on the chest and abdomen. How would you proceed?
  10. EthicsYou suspect that a parent may be fabricating or inducing illness in their child. The child has had multiple admissions with symptoms that resolve in hospital and recur on discharge. What would you do?
  11. EthicsA 15-year-old girl presents to you asking for contraceptive advice. She does not want her parents to know. How would you manage this consultation?
  12. EthicsA child discloses to you that they are being hurt at home. How would you respond?
  13. CommunicationYou need to tell the parents of a 2-year-old that their child has been diagnosed with leukaemia. How would you approach breaking this news?
  14. EthicsA 14-year-old with a ruptured appendix requires emergency surgery, but both parents need to consent and they disagree - the mother wants the operation but the father refuses. How would you manage this?
  15. EthicsA 14-year-old with a known chronic condition refuses a blood transfusion that the medical team considers necessary. The parents support the child's decision. What do you do?
  16. EthicsHow do you adapt your communication when seeing patients of different ages in paediatrics - for example, a toddler versus a teenager?
  17. ClinicalWhat is the Paediatric Early Warning Score (PEWS) and how does it help in recognising the deteriorating child?
  18. Quality ImprovementWhen is it appropriate to prescribe antibiotics to a child, and how do you approach antibiotic stewardship in paediatrics?
  19. MotivationWhat do you see as the current challenges facing paediatric services in the NHS?
  20. MotivationWhy paediatrics? What is it about this specialty that motivates you, and what do you bring to this role?

Obstetrics & Gynaecology

Labour ward emergencies, consent, and high-stakes communication. 20 questions.

  1. Quality ImprovementYou are called to see a woman who has just had a normal vaginal delivery. She is bleeding heavily and the estimated blood loss is already 1500mL. Talk me through your management step by step.
  2. Quality ImprovementA woman at 34 weeks of gestation presents with a blood pressure of 170/110mmHg, a severe headache, and visual disturbance. How do you manage her?
  3. Quality ImprovementYou have delivered the head at a vaginal delivery but the shoulders will not deliver. Talk me through your management of this shoulder dystocia.
  4. Quality ImprovementOn vaginal examination of a woman in labour, you feel a pulsating cord presenting ahead of the baby. What do you do?
  5. Quality ImprovementA woman at 35 weeks presents with sudden severe abdominal pain, a woody-hard uterus, and vaginal bleeding. What is your differential diagnosis and how would you manage this?
  6. ClinicalA postnatal woman on the ward is febrile at 38.8 degrees Celsius with a heart rate of 115 and has rigors. How do you assess and manage her?
  7. Quality ImprovementYou are shown a CTG trace with a baseline rate of 170 beats per minute, reduced variability of less than 5 beats, and late decelerations. How do you interpret this and what would you do?
  8. Quality ImprovementA 28-year-old woman presents to the emergency department with lower abdominal pain, vaginal spotting, and a positive pregnancy test. Her blood pressure is 90/60mmHg and her heart rate is 112. How do you manage her?
  9. Quality ImprovementA woman at 10 weeks of gestation presents with vaginal bleeding and cramping. Ultrasound confirms a missed miscarriage. How do you counsel her about the management options?
  10. EthicsWhat are the categories of caesarean section? A woman has a fetal bradycardia and needs an emergency caesarean. Talk me through your approach to consent.
  11. EthicsA woman in advanced labour with a pathological CTG is screaming and saying she does not want any intervention. Does she have capacity to refuse a caesarean section?
  12. Quality ImprovementWhat is the WHO Surgical Safety Checklist and how is it applied in obstetric theatres? How would you adapt it for a crash caesarean section?
  13. EthicsA Jehovah's Witness is having a massive post-partum haemorrhage and has a valid advance directive refusing all blood products. How do you manage this?
  14. EthicsWhat is your understanding of the legal framework for termination of pregnancy in England and Wales? How does conscientious objection work in practice?
  15. EthicsA woman attends your antenatal clinic and on examination you identify type 3 FGM. What are your responsibilities?
  16. LeadershipYou are the doctor on labour ward. The midwife tells you she cannot find a fetal heartbeat at 36 weeks. How do you manage this situation?
  17. Quality ImprovementWhat is the Saving Babies' Lives Care Bundle and what are its elements?
  18. Quality ImprovementWhat lessons should maternity services learn from the Ockenden and Kirkup reports?
  19. MotivationWhat do you see as the main challenges facing Obstetrics and Gynaecology as a specialty at the moment?
  20. MotivationWhy Obstetrics and Gynaecology?

Psychiatry

Risk assessment, legislation, and therapeutic communication. 22 questions.

  1. EthicsYou are the on-call junior doctor on a psychiatric ward. The nursing staff inform you that an informal patient wants to leave. They are very concerned about the patient's safety as she has been expressing suicidal thoughts. What do you do?
  2. MotivationWhat is the difference between Section 2 and Section 3 of the Mental Health Act? When would you use each?
  3. EthicsThe police bring a young man to A&E under Section 136. He was found on a bridge threatening to jump. What happens next?
  4. EthicsA patient on a Community Treatment Order is not complying with treatment in the community. What are your options?
  5. MotivationWhat is Section 117 aftercare? Who is entitled to it and why is it important?
  6. EthicsA patient with schizophrenia on your ward wants to leave against medical advice. The team is concerned about their safety. How do you assess their capacity to make this decision?
  7. EthicsAn elderly patient with moderate dementia is being cared for in a care home. The staff are concerned that the level of supervision amounts to a deprivation of liberty. What do you understand by Deprivation of Liberty Safeguards and how would you approach this?
  8. EthicsA patient with dementia is refusing to be discharged to a care home. Her family and the team believe she cannot manage at home safely. How do you approach this?
  9. Quality ImprovementA 22-year-old man is brought to A&E by his family. Over the past three weeks he has become increasingly withdrawn, is talking to himself, and believes MI5 are monitoring him. This is his first presentation. How would you assess and manage him?
  10. EthicsYou are called to A&E to see a 30-year-old woman who has taken an overdose of paracetamol. She says she wants to die and does not want treatment. How do you approach this?
  11. EthicsA severely emaciated 16-year-old girl with anorexia nervosa is brought to A&E by her parents. She is refusing to eat and refusing any medical intervention. How do you manage this?
  12. Quality ImprovementA patient on the psychiatric ward becomes acutely agitated and aggressive, threatening staff. De-escalation has been attempted but has failed. What do you do?
  13. ClinicalA patient on lithium presents with vomiting, coarse tremor, and drowsiness. How do you recognise and manage lithium toxicity?
  14. ClinicalWhen would you consider starting clozapine? What monitoring is required and when might you need to withhold it?
  15. EthicsA patient detained under Section 3 with paranoid schizophrenia is refusing all medication. When can you treat without their consent?
  16. EthicsA patient with a diagnosis of emotionally unstable personality disorder frequently presents to A&E following episodes of self-harm. The team are finding it difficult to balance patient autonomy with the duty to protect. How do you approach this?
  17. EthicsA patient with schizophrenia tells you in confidence during a consultation that he is planning to harm a specific individual. What do you do?
  18. MotivationCan you describe how community mental health services are structured? What is the difference between a Community Mental Health Team and a Crisis Resolution and Home Treatment Team?
  19. EthicsWhen is seclusion justified on a psychiatric ward? What safeguards must be in place?
  20. MotivationWhat do you see as the biggest challenges currently facing psychiatry as a specialty in the NHS?
  21. MotivationWhy psychiatry? What is it about this specialty that appeals to you?
  22. EthicsA patient on your ward has been prescribed medication above the BNF recommended maximum dose and subsequently develops an adverse reaction. How do you deal with this?