NHS INTERVIEW GUIDE

IMT Interview Questions: Format, Clinical Scenario and How to Prepare

How the IMT interview usually works, the kinds of questions asked at each station, a principle-level approach to the clinical scenario, common mistakes and a preparation plan.

Last updated 24 October 2026 · Created by a practising NHS doctor · Independent of the NHS

Quick answer

What happens at the Internal Medicine Training (IMT) interview and what questions are asked?

The IMT interview is a short, structured, multi-station interview, held online in recent rounds, for applicants shortlisted on their portfolio self-assessment. Stations typically cover your achievements and suitability for IMT, an ethics or professionalism dilemma, and an acute clinical scenario with a handover, with communication scored throughout. Formats change, so check the current IMT applicant handbook.

Key takeaways

Shortlisting relies on your portfolio self-assessment.
Stations cover achievements, suitability, ethics and a clinical case.
Use ABCDE, escalate early and hand over with SBAR.
Communication is marked across every station.
Check the current applicant handbook every year.

The Internal Medicine Training (IMT) interview is a short, structured, multi-station interview, held online in recent rounds, that you reach after your portfolio self-assessment scores highly enough for shortlisting. Stations typically cover your achievements and suitability for IMT, an ethics, professionalism or governance question, and a clinical scenario with a handover, with communication marked throughout. The exact format, timings and scoring can change each year, so always check the current IMT applicant handbook.

This guide explains each stage in general terms, gives example practice questions for every station, walks through a principle-level approach to the clinical scenario and finishes with common mistakes and a preparation plan. The questions here are original practice material, not real or leaked interview questions.

In this guide

What happens at the IMT interview?
How does the IMT self-assessment and portfolio scoring work?
What questions are asked at the IMT interview?
How do you approach the IMT clinical scenario?
How do you answer IMT ethics and suitability questions?
What are interviewers looking for at the IMT interview?
What are the most common IMT interview mistakes?
How should I prepare for the IMT interview?
Where can I find IMT interview practice questions?

What happens at the IMT interview?

In recent rounds the IMT interview has been a brief online interview split into timed stations, usually with two interviewers, testing whether you are ready to work as a core medical trainee.

Recent formats have broadly covered the following, though the official recruiters have said the format may be reviewed:

Portfolio and achievements: often a short opening summary of what you have done that is relevant to IMT, followed by questions on it.
Suitability for IMT: why medicine, what the job involves, your understanding of the training pathway and what you would bring.
Ethics, professionalism and governance: a dilemma such as consent, capacity, confidentiality, probity, raising concerns or a colleague's conduct.
Clinical scenario: brief reading time, then questions on assessment, investigation, management and escalation of an acutely unwell patient.
Handover: a short structured handover of that patient to an interviewer playing a colleague.
Communication: scored across the stations, so how you talk matters as much as what you say.

How does the IMT self-assessment and portfolio scoring work?

The self-assessment is a set of scored questions on your application, covering areas such as postgraduate exams, teaching, quality improvement, presentations, publications and commitment to the specialty, and it is used to decide who is invited to interview. The domains, scores and rules change between rounds, so read the current applicant handbook carefully before you answer.

In some rounds you upload evidence and claimed scores may be checked, and the official recruiters have discussed changes to the self-assessment. Only claim what you can prove, and check the handbook for how self-assessment and interview scores are combined for ranking.

What questions are asked at the IMT interview?

Questions usually test three things: your record and motivation, your judgement on professional dilemmas, and your safe approach to an acutely unwell patient. These practice questions cover the main themes:

Take two minutes to tell us about your achievements that make you suitable for IMT.
Why internal medicine rather than another specialty?
What do you understand about the structure and demands of IMT?
Tell us about a quality improvement project you led and what changed as a result.
What would you find hardest about the medical registrar role, and how would you prepare for it?
A colleague appears to be under the influence of alcohol at the start of a shift. What do you do?
A patient with capacity refuses a treatment you think they need. How do you approach this?
A relative asks you for test results but the patient has not consented to sharing them. What do you do?
You realise you made a prescribing error yesterday that caused no harm. What happens next?
A patient on the ward becomes acutely breathless overnight. Talk us through your approach.
Hand over this patient to the night medical registrar.

How do you approach the IMT clinical scenario?

Use a clear, systematic structure: recognise the patient is unwell, assess and treat at the same time, involve seniors early and keep the patient and team informed. Panels want safe reasoning in an organised order, not every possible diagnosis. The example shows the shape of a good answer at principle level.

Worked approach: an acutely unwell patient on the ward

Scenario (practice only): you are the doctor on call and a nurse asks you to review an older patient who has become confused and has worsening early warning scores.

Step 1, first impressions: I would go promptly, check the observations and their trend, and ask the nurse what has changed.

Step 2, structured assessment: I would assess using an ABCDE approach, treating problems as I find them and following local sepsis and deterioration pathways where relevant.

Step 3, history and review: I would take a focused history, review the notes, drug chart and results, and check the treatment escalation plan.

Step 4, differentials: I would give a short, prioritised list of likely causes, most common and most dangerous first, and the investigations that would help.

Step 5, escalation: I would escalate early to my registrar using SBAR, and involve critical care outreach if the patient was not responding.

Step 6, communication and documentation: I would explain the situation to the patient and, with consent, their family, document clearly, and set a time to reassess.

Handover: a concise structured handover covering the situation, background, assessment, actions taken, outstanding tasks and clear escalation triggers, then check understanding.

How do you answer IMT ethics and suitability questions?

For ethics questions, show calm reasoning anchored to patient safety and professional guidance; for suitability questions, link specific evidence to what IMT demands.

A simple ethics structure is: clarify the facts, put immediate patient safety first, consider the people involved and the relevant principles (such as autonomy, capacity, confidentiality and honesty), act within local policy and professional guidance, escalate or seek advice where appropriate, and reflect. Mental capacity and consent law differs across the UK nations, so describe the principles and say you would follow the framework where you work.

For suitability questions, use concrete examples in a STAR shape (situation, task, action, result) and finish with what you learned. Pick two or three achievements and explain why they matter rather than reciting your CV.

What are interviewers looking for at the IMT interview?

Interviewers generally want a safe, organised, self-aware doctor who communicates well and understands IMT. Descriptors vary by round, but strong answers usually show:

Patient safety first in every station, including the ethics question.
Structure: a clear order you can explain, such as ABCDE or a stepwise ethics approach.
Early, appropriate escalation and knowing your limits.
Honest reflection on what you learned, not just what you did.
Clear communication: plain language, signposting and checking understanding.
Realistic insight into on calls, the medical take and the training pathway.

What are the most common IMT interview mistakes?

Most marks are lost through disorganised answers and unsafe gaps rather than lack of knowledge.

Jumping straight to a diagnosis in the clinical scenario before assessing the patient.
Forgetting to escalate, or escalating vaguely without a structured message.
Running out of time on the opening achievements summary because it was not rehearsed.
Claiming self-assessment points you cannot evidence or explain.
Giving a one-sided ethics answer that ignores the patient's views or safety.
A rambling handover with no clear outstanding tasks or escalation plan.
Poor online set-up: unstable internet, noisy room or looking away from the camera.

How should I prepare for the IMT interview?

Start with the official applicant handbook and your portfolio, then practise each station aloud under timed conditions. A four-week plan suits many applicants:

Week 1: read the current applicant handbook and person specification, check your self-assessment evidence and list your three strongest achievements.
Week 2: draft and time your achievements summary, and practise suitability questions using STAR.
Week 3: practise acute medicine scenarios and handovers aloud with a colleague, using ABCDE and SBAR, and review common ethics themes against professional guidance.
Week 4: run full timed mock stations with peers or a supervisor, and test your online set-up.
Throughout: ask supervisors for feedback and use deanery or trust teaching sessions where offered.

Where can I find IMT interview practice questions?

Your best free sources are the official IMT recruitment website and applicant handbook, your educational supervisors, colleagues who recently went through IMT recruitment, and resources from the royal colleges and the BMA. Peers who can play patients, nurses and registrars are especially useful for the clinical and handover stations.

Healthcare Interview Prep is one self-study option: it is an independent site covering 471 NHS roles, each with practice questions and full written model answers, plus free guides on topics such as the STAR method and interview practice for doctors. It does not run live coaching or mock interviews, so pair any written practice with speaking your answers aloud.

Frequently asked questions

How long is the IMT interview?

In recent rounds the IMT interview has been short, made up of a small number of timed stations held online, so the whole process takes well under an hour. Each station has a strict time limit and interviewers will move you on when time is up. Timings and the number of stations can change between rounds, so check the current IMT applicant handbook for the exact structure before you start practising.

Is the IMT interview online or face to face?

Recent IMT interviews have been held online using a video interview platform, with candidates joining from home or work. You will usually be sent joining instructions and a time slot in advance. Make sure you have a quiet private room, a reliable connection and your camera at eye level. The format can change, so confirm the delivery method in the current applicant handbook and in your interview invitation.

How do I get shortlisted for an IMT interview?

Shortlisting for IMT has relied on the self-assessment score you submit with your application, based on areas such as postgraduate exams, teaching, quality improvement, presentations and publications. Higher scores make an interview invitation more likely. Read the scoring guidance in the current applicant handbook carefully, only claim points you can evidence, and keep your evidence organised in case it is checked.

What clinical scenarios come up in the IMT interview?

IMT clinical scenarios usually involve an acutely unwell medical patient on a ward or in the emergency department, the sort of situation a junior doctor meets on call. Panels want a structured assessment, a prioritised differential, sensible investigations, early escalation and a clear handover. Practise common acute medicine presentations aloud using ABCDE and SBAR, and follow local guidelines rather than quoting doses or thresholds.

Do I need MRCP to get an IMT interview?

Postgraduate exams such as MRCP parts have typically earned points in the IMT self-assessment rather than being a strict requirement for applying, but rules can change between rounds. Having passed an exam part can strengthen your score, while not having one does not automatically exclude you. Check the eligibility criteria and scoring tables in the current IMT applicant handbook and person specification for your round.

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Healthcare Interview Prep is an independent NHS interview preparation website. It is not affiliated with, endorsed by or connected to the NHS. Example questions and answers are original practice material, not official or leaked interview questions.

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