NHS INTERVIEW GUIDE

ST3 Medical Registrar Interview Questions: Stations, Examples and Preparation

How higher specialty training interviews in the medical specialties usually work, the questions to expect at each station, a worked suitability answer, common mistakes and a preparation plan.

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

Quick answer

What questions are asked at an ST3 medical specialty (registrar) interview?

Expect portfolio and suitability questions on audit, teaching, leadership and commitment to the specialty, a clinical scenario where you act as the registrar managing an acutely unwell patient, and questions on running the acute take, teamwork and communication. Interviews are short, online and scored against the person specification. Many physician specialties now recruit at ST4, so check the current applicant guide.

Key takeaways

Many medical specialties now enter at ST4 after IMT
Stations usually cover portfolio, clinical scenario and registrar readiness
Clinical answers: assess, resuscitate, escalate, communicate
Use STAR with measurable results for portfolio questions
Evidence every self-assessment point you claim

At an ST3 or ST4 interview for a medical specialty such as gastroenterology, cardiology, respiratory, renal or geriatric medicine, you are usually asked three kinds of question: portfolio and suitability questions about your achievements and commitment to the specialty, a clinical scenario where you act as the registrar managing an acutely unwell patient, and questions that test communication, teamwork and leading the acute medical take. Interviews are currently held online, are short and tightly timed, and are scored by trained panel members against set criteria.

This guide explains the usual structure in general terms, gives example practice questions with a specialty flavour, works through one answer, and lists common mistakes and a preparation plan. Formats, entry points and scoring change between recruitment rounds and differ between specialties, so always read the current applicant guide and person specification from the official recruiting body for your specialty before you prepare.

In this guide

Is it an ST3 or ST4 interview for medical specialties?
What is the format of an ST3 or ST4 medical specialty interview?
What do ST3 and ST4 interview panels look for?
What questions are asked at an ST3 medical registrar interview?
How do you answer a GI bleed scenario at an ST4 gastroenterology interview?
What is a good example answer to a portfolio or suitability question?
What are the most common mistakes at a medical registrar interview?
How should I prepare for an ST3 or ST4 medical interview?
Where can I find ST3 medical interview practice questions?

Is it an ST3 or ST4 interview for medical specialties?

For many physician specialties it is now ST4. Since Internal Medicine Training became a three year programme, specialties that train alongside general internal medicine (often called Group 1, including gastroenterology, cardiology, respiratory, renal and geriatric medicine) generally recruit at ST4, while some other medical specialties still recruit at ST3.

Doctors still commonly say "ST3 interview" or "registrar interview" for all of these, and the question themes are very similar. Check the entry level, eligibility and any transitional arrangements for your chosen specialty on the national recruitment pages, because they are set each year.

What is the format of an ST3 or ST4 medical specialty interview?

Most medical specialty interviews are a short online panel split into a small number of stations, each with two scoring interviewers. Official national recruitment guidance says interviews are held digitally, you need photo ID, you may be asked to show your room on camera, and any notes must be on paper.

The exact stations vary by specialty and round, but most combine some of the following:

Portfolio, suitability and commitment: questions drawn from your application about audit and quality improvement, teaching, research, leadership and why you want this specialty.
Clinical scenario: a brief case where you are the registrar and must assess, prioritise, treat safely and escalate.
Medical registrar suitability: running the acute take, prioritising referrals, supporting juniors, working with the multidisciplinary team and discharge planning.
Communication or professionalism: some specialties use a structured discussion or role play, such as breaking bad news, handling a complaint or a colleague concern.
Short presentation: some specialties ask you to present a case or recent development, then answer questions on it.
Application score: many specialties also use a verified self-assessment of your portfolio, where you must upload evidence for every point you claim, and combine it with your interview score.

What do ST3 and ST4 interview panels look for?

Panels score you against the person specification, so they want evidence that you are safe and ready to step up as a registrar. Strong candidates usually show:

Clinical safety: a structured approach, sensible priorities and early senior escalation.
Insight and honesty: knowing your limits and reflecting on errors without defensiveness.
Leadership: coordinating a busy take and supporting less experienced colleagues.
Genuine commitment: specific, evidenced reasons for choosing the specialty.
Improvement mindset: audits and projects with a measurable outcome and a closed loop.
Communication: clear, empathetic explanations for patients, families and colleagues.

What questions are asked at an ST3 medical registrar interview?

Expect a mix of portfolio, clinical, registrar-readiness and professionalism questions. The examples below are original practice questions, not questions from any real interview.

Why do you want to train in gastroenterology rather than another medical specialty?
Talk us through a quality improvement project you led and what changed as a result.
Tell us about your teaching experience and how you know it was effective.
You are the gastroenterology registrar. A patient on the ward has vomited blood and looks pale and clammy. How would you manage this?
An older patient with chronic liver disease is newly confused. What are your priorities?
A patient with suspected acute severe colitis is referred to you overnight. How do you approach the referral and initial plan?
It is a busy take with several unseen patients and an ED referral queue. How do you prioritise and delegate?
A cardiology patient deteriorates on the ward with new chest pain while you are covering the take. What do you do?
A patient with breathlessness and known COPD is not improving on ward treatment. When and how would you escalate?
How would you approach a conversation with a family about limits of treatment for a frail older patient?
A junior doctor tells you they feel overwhelmed and made a prescribing error. How do you respond?
Tell us about a time you disagreed with a senior's plan. What did you do?
How do you plan a safe discharge for a patient with complex needs?
What do you see as the biggest challenges facing your chosen specialty over the next few years?

How do you answer a GI bleed scenario at an ST4 gastroenterology interview?

Answer as a safe registrar: assess and resuscitate first, risk stratify, involve the right people early and communicate clearly. Panels are usually assessing your structure, priorities and teamwork, not detailed doses or numbers.

At principle level, a strong answer would cover:

Immediate assessment: an ABCDE approach, recognising shock and calling for help early.
Resuscitation: secure access, send appropriate bloods including group and save or crossmatch, and follow your trust's major haemorrhage protocol if needed.
History and risk factors: medications such as anticoagulants, liver disease and alcohol, previous bleeding.
Risk stratification: use a validated scoring tool as your local guideline recommends to judge urgency.
Escalation: involve your consultant, the endoscopy team and critical care or interventional radiology where appropriate, following local pathways.
Communication: keep the patient and family informed, hand over clearly and document your decisions.

What is a good example answer to a portfolio or suitability question?

Use the STAR structure: describe the situation briefly, your task, the actions you personally took and the measurable result, then add what you learned. Keep it concise because time is tight.

Worked answer: "Tell us about a quality improvement project you led."

Situation: On the gastroenterology ward during IMT, I noticed that patients admitted with alcohol related liver disease were not consistently being screened for withdrawal risk or offered referral to the alcohol care team.

Task: As the resident doctor leading the project, I wanted to improve consistent screening and referral using our trust's existing guideline.

Action: I audited a sample of admissions against the guideline, shared the findings at the department meeting, and worked with the alcohol specialist nurses and ward pharmacist to add a prompt to the admission proforma. I taught the change at resident doctor induction and re-audited after the next rotation.

Result: Screening and referral rates improved on re-audit, and the prompt was adopted on a second ward. I learned that small system changes, agreed with the people who use them, last longer than reminder emails. That experience is one reason I want to develop leadership in quality improvement as a gastroenterology registrar.

What are the most common mistakes at a medical registrar interview?

Most lost marks come from structure and timing rather than lack of knowledge.

Jumping to investigations: skipping assessment, resuscitation and escalation in a clinical scenario.
Acting beyond your role: not mentioning your consultant or the wider team.
Vague portfolio claims: saying "I did an audit" without your role, outcome or re-audit.
Generic commitment answers: reasons that could apply to any specialty.
Overrunning: long answers that leave no time for the panel's follow-up questions.
Unverified self-assessment: claiming points you cannot evidence, which can reduce your score and raise probity concerns.
Neglecting the online setup: poor connection, lighting or a cluttered room on the day.

How should I prepare for an ST3 or ST4 medical interview?

Start with the official applicant guide and person specification, then practise out loud under timed conditions. A simple four week plan:

Week 1: read the current applicant guide, person specification and self-assessment criteria; gather and redact your evidence.
Week 2: write short STAR notes for your audit, teaching, leadership, research and a mistake you learned from.
Week 3: practise common acute scenarios in your specialty aloud, using a clear structure with escalation and communication built in.
Week 4: do timed practice with registrars, consultants or peers who have recently been through selection, and test your camera, audio and room.
Throughout: follow your specialty's royal college and specialist society for current issues, and use BMA or deanery interview resources where available.

Where can I find ST3 medical interview practice questions?

The most reliable sources are free: the official national recruitment pages, your supervisors and consultants, recent successful trainees, royal college and specialist society materials, and any interview sessions run by your deanery, trust or the BMA. Practising with colleagues who give honest feedback is especially valuable.

Healthcare Interview Prep is a self-study option. It covers 471 NHS roles with original practice questions and full model answers, with the first questions for each role free to read. It is not live coaching and does not run mock interviews, so pair it with spoken practice with colleagues.

Frequently asked questions

How long is an ST4 medicine interview?

Most higher specialty interviews in the medical specialties are short, often well under an hour in total, split into a small number of tightly timed stations. Each answer may only have a few minutes, so concise, structured responses matter. The exact length, number of stations and timings are set for each specialty and round, so check the current applicant guide and any interview information you are sent before the day.

Is the ST3 medical interview online or face to face?

National recruitment guidance currently states that interviews are held digitally on an online platform. You will usually need photo ID, a quiet private room you can show on camera, a reliable connection and paper notes only. Arrangements can change between recruitment rounds, so read the latest instructions from the recruiting body and test your equipment well before the interview date.

What clinical scenarios come up at a gastroenterology ST4 interview?

Practice scenarios often include acute upper gastrointestinal bleeding, decompensated liver disease, acute severe colitis, acute pancreatitis and a deteriorating patient on the take. Panels usually look for a structured approach: assess and resuscitate, risk stratify, follow local guidelines, escalate to your consultant and relevant teams, and communicate clearly with the patient and family. They are generally testing safe registrar thinking at the expected level, not specialist detail.

How is the ST4 medicine interview scored?

Each station is usually marked by two trained interviewers against set criteria from the person specification, and the scores are combined, often with weighting. Many specialties also add a verified self-assessment or application score to reach a final ranking, and there may be minimum standards to be appointable. The current applicant guide for your specialty explains the scoring, so read it rather than relying on older forum advice.

How do I show commitment to a medical specialty at interview?

Use specific evidence rather than enthusiasm alone. Mention relevant rotations or taster days, audits or quality improvement in the specialty, teaching, conferences, courses, specialist society membership and research or case reports. Explain what you learned and how it shaped your choice. Link your answer to the realities of the specialty, including the acute medical workload, to show you understand what training will involve.

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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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