ST and CT Interview Tips
ST interviews have underground significant change over the last few years. This has been as a result of the MMC process and MTAS Medical Training and Application System disaster. The National MTAS process received significant criticism not just for its structural failure and also the objective failure of not being able to select the most appropriate candidates.
The national recruitment process was abandoned and selection handed down to each of the deaneries. It has been said that it is no different from the previous application system where candidates would apply to individual deaneries however the ST interview process has inherited many attributes from the initial MCAS and MMC national recruitment process.
Over the last 10 years objective methods of assessment have become very popular within medicine. A prime example is the OSCE which stands for Objective Structured Clinical Examination. The reason behind this is mainly because this process has been validated and shows a high sensitivity and specificity for the task of selecting the most appropriate candidates. The ST interview process also follows a similar formal structure.
A station based approach is therefore employed whereby a predefined set of skills, knowledge or attributes are required to pass each station. It has the added advantage of there being a structured marking system which therefore allows for accurate assessment of the candidates with little variability in the scores given by different examiners.
The ST interview is therefore a structured process and can be highly predictable. Candidates can also be coached on the more common aspects that are found within the ST interview process and therefore can dramatically increase the rank that they achieve during their assessment. Come on one of our courses to find out more.
The ST interview process is not the same in each deanery. Hwever a common application structure is found in many deaneries. Typically there are three or four separate stations each of which will be looking at a set of different characteristics. The stations include the following
General and portfolio review station:
This station serves a very broad function. It is present to globally review your training and your application. You will be expected to bring along your portfolio which contains all the documentation relating to clinical training, previous work experience, audits, teaching, courses, and other aspects of your clinical and professional development. You may be asked about why you want to work in that deanery, why you want to work in that speciality, and why you were better or worse than any other candidate.
Clinical scenario station:
Don't forget that during the ST interview they are not looking for the complete finished article. However what they will be looking for other key skills and attributes that are required in order to you to be trained successfully to become a consultant. You will typically be given a clinical scenario or clinical case which requires multiple aspects of management. The clinical aspects of management are just one part. The others such as thinking on your feet, prioritising the current problems, using your initiative, working well in a team, using effective communication skills, knowing where to call for help, having insight into the limitations of the system and environment and also having insight into what own personal limitations are.
A difficult question to answer on the spot but once you have been told and shown once what the assessors are looking for you want make a mistake.
Clinical governance station
Clinical governance is a large area and incorporates various aspects of clinical and non-clinical management. You will be expected to have a reasonable knowledge of how clinical governance works and more importantly be able to demonstrate you have consistently participated in it. You may be asked to give examples of how example you manage your risk, of how well you communicate and work in a team, of how you keep yourself up-to-date and maintain your CPED activity. Not a particularly difficult station. It really only shows up the poorly prepared candidates. This is an area where it is difficult to discriminate between the best candidates.
Academic teaching research and audit station:
Naturally there is a reasonable degree of crossover among the topic content within this station and that of the clinical governance station. There is a vast scope for questioning in this area. Can you critically appraise a paper, can you give an example of a paper that has changed your practice, can you tell me the different types of research methodology, where is funding secured, and the various advantages and disadvantages of different study designs?
How do you like being taught who is your best teacher and why? What are the characteristics that make a good trainer? Other aspects of medical education such as curriculum design and theory of adult learning have also been previously explored.
Audit is a classic area. Knowledge of the key buzzwords within the audit process will be present on the scoring system and you will need to give examples from your own personal audits to satisfy the examiners.
Other stations:
Role-play: Please don't worry too much about role-play stations. Because of the advantages of the objective structured ST interview process not many deaneries have started to use the role-play assessment. This are several reasons for this and it is probably beyond the scope of this particular article. If you are applying to the GPVTS-GPST entry scheme then this is an integral part during the assessment.
ST Presentations: Presentations are becoming common in the ST interview process. Typically there are two types of presentation. Pre warned and on the spot presentations. Firstly you may get advance notice and given a topic to prepare in a particular format such as PowerPoint or on a set of acetates. You'll be given 5 to 10 minutes to present following which you will be required to answer questions on the topic area. Some deaneries are asking the topics to be other non-clinical subject matter. Remember when selecting your topic you want to keep the topic on you and your application. Concentrate on America of your strengths and maybe a unique selling point that you have compare to other applicants.
If you get an on the spot presentation you may have 20-30 minutes before your interview, a pen and an acetate to make your presentation. I personally prefer this form of presentation as it is easier to separate the candidates into the exceptional and the rest. The keys here are your time management, verbal presentation, engage the audience, great content, thought provoking questions and if you are very good a little sprinkle of humour. Every candidate will be in the same boat and pressure as you.
Resuscitation: Cardiopulmonary resuscitation (CPR) stations using models commonly found on an ALS course are starting to creep into the ST interview process. We have heard numerous stories whereby basic and advanced life-support techniques have been checked at various stations across the United Kingdom. It is probably sensible to spend five minutes reading up the latest resuscitation guidelines prior to your interview.You will either know it or you wont.
Can you tell me a bit more about the marking system?
As mentioned previously the ST interview process is now very structured across many of the deaneries within the United Kingdom. Typically there will be two assessors one of which will be asking questions and one of which will be marking your responses. They will swap over halfway during the ST interview station. Each station typically takes approximately 10 minutes therefore with four stations your entire ST interview will take 40 minutes.
Because the interview is now structured a preset list of answers will have been prepared. As you give your response to the question the consultant who is not asking the questions simply ticks off from the list the answers which you give. At the end of the interview a score can be numerically calculated and the scores from each station can added together so that you will receive a global score your interview. This will allow the candidates to be ranked so that the highest scoring doctors get offered the posts first. Please remember that the highest scoring candidates get the pick of the jobs not the best doctor however the system would like the sensitivity of the interview process to be very high ( ie ability to spot 100% of the true positives).
It is important not to get bogged down on any particular question and certainly not let a poor answer in one aspect or one section of the interview affect your performance during the rest. There may be several questions that will be asked during that station. If you don't know the answer to the first question simply say-so and move on and putt it behind you. Focus on delivering a high quality and effective answer to the next question. Poor candidates tend to get flustered and try to give an answer to every question when it may be better just to move on.
Top 5 tips for ST interview preparation
- 1: Structure your answers
Many candidates underperform simply because they don't know how to structure their answers appropriately. If you don't have a structure you answer /content may be sprayed around. You'll look as if you can't prioritise information ( a simple task that is very important for our daily jobs). You may fall into the trap of giving your opinion before any factual information. ST interviews are structured and they do have a structured assessment process however there is still a very large subjective component. You need to convince the assessor that you are the person for the job you have the right sets of skills and attributes that they are looking for. Giving a response in a wishy-washy unstructured manor is the best way not to do your self justice.
- 2: Limit your content
A very good research paper published in 1968 looked at communication skills. 7% of what you communicate is actually your content. That's not to say that it's not important. It is vitally important. If I asked you a question I would expect you to respond for approximately 60 to 90 seconds. You are welcome to respond for 7 minutes if you wish. You may score the full three points that we are looking for however you won't get to answer any remaining questions during your 10 minutes and as a result you won't score very highly.
You need to limit your content and deliver it in a hierarchical structure. Tell me the most important point first. Tell me the second most important piece of factual information next. In order to deliver your content in this manner you will naturally have had to think about it beforehand. Thinking on your feet during the heat of your interview is not the time to be developing the thought process on which piece of information is more important than the other. Therefore preparation is vitally important. Once again processing information is a key skill that we take for granted but actively looked for during your interview.
- 3: Work on your communication skills
Most deaneries use a four point marking system. When I asked a consultant colleague of mine who was interviewing how he decided what marks he gives he decided to give me his own version.
Four points= I want you to work to me, nobody else. This guy is good
Three points= I am happy to work with you but you better off working from my consultant colleague.
Two points= I could work with you if I had to but you will find the deanery down the road would suit you best.
One point= Please try another speciality
I've decided that I would publish this marking system because it highlights some really important points.
What does it take for me to decide that I want you to work for me? Well it is very subjective and ultimately comes down to the rapport that we make during our interview. Naturally this is a very subjective area and simple things such as being able to communicate well, smile, for a rapport, make me feel comfortable that you will do the best things for my patients all comes into account.
- 4: Don't start poorly
When we interview within 90 seconds we have a very good idea of how we are going to score you. This decision is often sub-conscious and we will often then spend the rest of the interview trying to prove that this initial assessment is correct.
Make sure that you start well. Brush all the cob webs off prior to the interview. When did you ever see a pro golfer hit his first shot of the day off the first tee and when did you see a sprinter have his first run during the actual race? Attention to detail helps.
- 5: Handling pressure?
The whole interview process is about ranking the candidates and separating the very best from the rest. Each deanery and each consultant wants the very best doctors working for them and their patients. They will interview more people than they have positions.
It may be the case that during your interview that you are pushed and placed under pressure. This is a simple process that is not personal. It simply means that you are being pressed to the limits of your abilities so that the interviewer can get an opinion of where you are in the field of candidates.
