Clinical Radiology Interview Questions & Answers

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About this NHS interview question bank

To prepare for a clinical radiology NHS interview, expect questions on vetting and protocolling requests, IR(ME)R justification, communicating urgent and unexpected findings, learning from discrepancies, out-of-hours CT reporting, contrast and MRI safety, and how you work with radiographers and referring teams. Build short spoken answers around real reporting lists, on-calls and MDTs, and know GMC Good Medical Practice, the relevant RCR standards and the pressures on imaging services before you walk in.

This bank contains 40 original practice questions with first-person model answers written for doctors applying for clinical radiology posts in the NHS, pitched mainly at Clinical Fellow and Specialty Doctor level, including internationally trained radiologists new to UK practice, with a selection that steps up towards Consultant. It covers vetting, radiation protection, reporting and communication of results, discrepancy and learning meetings, contrast reactions, MRI safety, interventional radiology consent, teleradiology, safeguarding, information governance and the sensible use of AI tools. Every question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the frameworks worth reading, so you can practise answers that sound like you rather than a textbook.

 

What this question bank covers

• Motivation for clinical radiology
• NHS values in an imaging department
• Vetting and protocolling
• IR(ME)R justification and radiation protection
• Communicating urgent and unexpected findings
• Discrepancies and learning meetings
• Reporting backlogs and outsourcing
• Out-of-hours CT reporting
• Contrast reactions and contrast safety
• MRI safety
• Interventional radiology consent and complications
• Working with radiographers and sonographers
• Teleradiology
• AI tools in radiology
• Safeguarding children and adults
• Equality and reasonable adjustments
• Confidentiality and PACS
• Teaching and quality improvement
• FRCR, portfolio pathway and development
• Resilience and wellbeing

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why have you chosen clinical radiology, and what keeps you in it?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine, specific reason for choosing radiology that goes beyond liking images or wanting to avoid the wards. They are listening for an understanding that radiologists are clinicians whose decisions change patient pathways, and for realism about the pressures of the specialty.

 

Model answer

What first pulled me towards radiology was a night as a medical registrar's junior, years before I chose the specialty. We had an elderly man with vague abdominal pain and normal bloods, and everyone was a bit stuck. The on-call radiologist looked at the CT, picked up subtle mesenteric ischaemia and rang us directly. The way she explained it, calmly and clearly, completely changed that patient's night. I remember thinking that she'd never met him, yet she'd made the single most important decision in his care.

That's still what I value most. Radiology sits in the middle of almost every pathway, from the two-week-wait patient waiting to hear about a lung nodule to the trauma call at three in the morning. I enjoy the problem-solving of a hard case, but I also like that my job doesn't end when I click 'verify'. A good report answers the clinical question, and a good radiologist makes sure the right person actually hears it when it matters.

I'll be honest about the harder side too. The volume is relentless, the backlogs are real, and the work can be isolating if you sit in a dark room all day without talking to anyone. I've learnt that I'm a better radiologist when I'm out in MDTs, on the phone to referrers and helping radiographers with a tricky protocol. That contact keeps me connected to the patients behind the images.

What keeps me in it is that I'm still learning every week. Every discrepancy meeting, every case a consultant walks me through, makes me a bit safer, and I like a specialty where getting better is so visible and so directly linked to patients.

 

Why this answer works

The answer opens with a specific clinical memory instead of a cliche, which makes it believable. It shows the candidate sees radiology as a clinical, patient-facing specialty, acknowledges workload and isolation honestly, and ends with a commitment to learning that suits a Clinical Fellow or Specialty Doctor.

 

Key points to include

• A specific moment or experience that drew you to radiology
• Radiology as a clinical specialty that shapes patient pathways
• Communication with referrers, not just image interpretation
• Honesty about workload, backlogs and isolation
• What you do to stay connected and keep learning

 

Common mistakes to avoid

• Saying you chose radiology to avoid patients or on-calls
• Talking only about technology and machines
• Giving an answer that could fit any specialty
• Sounding unaware of the pressure on imaging services

 

NHS values and standards

Commitment to quality of care; Improving lives; Working together for patients; GMC Good Medical Practice: knowledge, skills and development

 

Further reading

• GMC Good Medical Practice
• Royal College of Radiologists curriculum and guidance on the role of the clinical radiologist
• NHS Constitution for England

 

 

Question 2: Which NHS value matters most to you as a radiologist, and how have you shown it?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel is checking that you know the NHS values and can connect one of them to real behaviour in an imaging department, where patient contact can be brief or indirect. They want an example, not a definition.

 

Model answer

The six NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. The one I come back to most as a radiologist is commitment to quality of care, because so much of what I do is invisible to the patient but has a huge effect on them.

A good example was a routine outpatient CT chest I was reporting on a busy afternoon list. The request was for follow-up of a known small nodule, and the nodule was stable. It would have been easy to answer the question and move on. But reviewing the whole scan, I noticed a lytic lesion in a rib that hadn't been there on the previous study. It wasn't what I'd been asked about, and the patient wasn't under a cancer team. I described it clearly, put it in the conclusion rather than burying it in the body of the report, made a recommendation for further assessment and then used our unexpected findings alert pathway so the referrer would be prompted to act. I also rang the referrer's secretary to make sure the team knew to look for it.

For me, quality is about that discipline: looking at every image even when you're under time pressure, writing a report that a busy GP can act on, and closing the loop rather than assuming someone else will.

It also links to everyone counts. That patient was one of dozens on my list, and they were no less important than the trauma CT waiting for me later. I try to give every study the same attention, and when I can't because I'm tired or overloaded, I say so and ask for help rather than rushing.

 

Why this answer works

The candidate names all the values accurately, then chooses one and shows it through a realistic radiology scenario. The example demonstrates thorough review, a clear conclusion, use of an alert pathway and closing the loop, all of which reflect safe reporting practice.

 

Key points to include

• Name the NHS values accurately
• Choose one and give a concrete radiology example
• Show what you actually did, including closing the loop
• Link to safe reporting habits such as reviewing every image
• Admit when workload threatens quality and ask for help

 

Common mistakes to avoid

• Reciting the values with no example
• Choosing compassion but giving no patient-facing detail
• Implying incidental findings are someone else's problem
• Overclaiming heroics rather than everyday good practice

 

NHS values and standards

Commitment to quality of care; Everyone counts; Working together for patients; GMC Good Medical Practice: safety and quality

 

Further reading

• NHS Constitution for England
• Royal College of Radiologists standards for interpretation and reporting of imaging investigations
• Royal College of Radiologists standards for the communication of radiological reports and fail-safe alert notification
• GMC Good Medical Practice

 

 

Question 3: You are reporting an outpatient CT and find an unexpected suspected malignancy. How would you communicate it?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel wants to know that you understand the radiologist's responsibility does not end with the written report. They are looking for clear, timely communication to the right person, use of local alert systems, documentation, and awareness of how the patient will eventually hear the news.

 

Model answer

The first thing I'd do is make sure I'm right, or as right as I can be. I'd review the whole study carefully, compare with any previous imaging and, if I'm uncertain, ask a consultant or the relevant subspecialty colleague to look at it with me. An unexpected finding of suspected cancer changes a patient's life, so I want my description and my level of confidence to be accurate.

Then I'd write a report that makes the finding impossible to miss. I'd describe it clearly, put it at the top of the conclusion, say what I think it most likely is and make a specific recommendation, such as referral on the appropriate urgent suspected cancer pathway or a particular further test. I'd avoid vague phrases that leave a GP or junior unsure what to do.

The written report alone isn't enough for something like this. I'd follow our trust's urgent and unexpected findings policy, which usually means flagging the report through the electronic alert system and also speaking directly to the referrer or a responsible member of their team. If it's an outpatient scan requested by a GP, I'd phone the practice and make sure a doctor knows, not just the receptionist. If I can't reach anyone, I'd escalate through our department's process rather than leave it. I'd document who I spoke to, when, and what was agreed, in the report addendum or wherever the local policy says.

I'd also think about the patient. Usually it isn't my role to break that news over the phone, and it's better coming from the team who'll manage them, but sometimes the patient asks me directly in the department. In that case I'd be honest that we've seen something that needs further tests, without guessing at a diagnosis, and make sure they know who will contact them and when.

Afterwards I'd check the alert was acknowledged, because closing the loop is where things most often go wrong.

 

Why this answer works

This answer covers accuracy, a clear report with an actionable conclusion, direct verbal communication, the trust's alert pathway, documentation and follow-up. It shows awareness that fail-safe systems exist because written reports can go unread, and it handles the patient conversation sensitively and within role.

 

Key points to include

• Check your interpretation and seek a second opinion if unsure
• Clear conclusion with a specific recommendation
• Direct verbal communication plus the trust's alert or fail-safe system
• Document who was told, when and what was agreed
• Close the loop and check acknowledgement
• Be honest but appropriate if the patient asks you

 

Common mistakes to avoid

• Assuming the written report will be read in time
• Burying the finding in the body of the report
• Leaving a message with someone who cannot act on it
• Telling the patient a diagnosis you are not certain of

 

NHS values and standards

Commitment to quality of care; Working together for patients; Compassion; GMC Good Medical Practice: communication, partnership and teamwork

 

Further reading

• Royal College of Radiologists standards for the communication of radiological reports and fail-safe alert notification
• GMC Good Medical Practice
• NICE guideline on suspected cancer: recognition and referral
• Your trust's urgent and unexpected findings policy

 

 

Question 4: How do you build a good working relationship with radiographers?

Teamwork question  ·  Teamwork

 

What the interview panel is assessing

The panel wants to see that you value radiographers as skilled professionals and partners in patient safety, not as technicians who simply follow instructions. They are listening for respect, accessibility, shared learning and how you handle disagreement.

 

Model answer

I think the honest answer is that radiographers make me a safer radiologist, and I try to act like I know that. They're the ones with the patient on the table, they understand the scanner far better than I do, and they often spot that something isn't right before I've seen a single image.

In practice, the first thing is being approachable. When a CT radiographer rings me out of hours with a question about a protocol or a patient who can't lie flat, I try to answer promptly and never make them feel they've bothered me. If I'm short or dismissive once, they'll think twice about calling next time, and that's how safety issues get missed.

The second thing is giving clear instructions. When I protocol a request, I write it so that it can't be misread: the phase, the coverage, whether contrast is needed and anything specific, such as checking renal function or allergy status first. If I've changed what the referrer asked for, I explain why.

The third thing is learning from each other. On a previous rotation, a radiographer pointed out that my protocols for a particular MRI request were making the scan far longer than necessary for the clinical question. She was right. We sat down with the lead radiographer and agreed a shorter protocol, which helped the patients who struggled to keep still and freed up slots on the list. I also try to give back by talking through interesting cases and offering to help with their reporting or CPD sessions.

If we disagree, for example about whether a scan is justified, I talk it through respectfully and, if needed, involve a senior colleague. Most of the time those conversations end with us both understanding the patient better.

 

Why this answer works

The answer treats radiographers as expert colleagues and gives practical behaviours: accessibility, clear protocols and two-way learning. The example shows the candidate accepting challenge and turning it into a service improvement, which panels value highly.

 

Key points to include

• Respect radiographers' expertise and role in safety
• Be approachable and responsive, especially out of hours
• Write clear, unambiguous protocols
• Show two-way learning with a real example
• Handle disagreement respectfully and escalate if needed

 

Common mistakes to avoid

• Describing radiographers as there to carry out your instructions
• Giving no concrete example
• Ignoring the safety role of radiographers, for example in IR(ME)R and MRI checks
• Implying you never get things wrong

 

NHS values and standards

Working together for patients; Respect and dignity; Commitment to quality of care; GMC Good Medical Practice: communication, partnership and teamwork

 

Further reading

• GMC Good Medical Practice
• Ionising Radiation (Medical Exposure) Regulations 2017 (duty holder roles)
• Society and College of Radiographers and Royal College of Radiologists joint guidance on team working in clinical imaging
• HCPC Standards of proficiency for radiographers

 

 

Question 5: An emergency department registrar insists on a CT that you do not think is justified. What do you do?

Conflict question  ·  Conflict

 

What the interview panel is assessing

The panel is testing your understanding of justification under IR(ME)R, your ability to stay patient-focused under pressure, and how you handle disagreement with a colleague without becoming obstructive or simply giving in.

 

Model answer

I'd start by remembering that we both want the same thing, which is the right outcome for the patient. A registrar who's pushing hard usually has a reason, and sometimes that reason isn't in the request form.

So the first thing I'd do is ask rather than refuse. I'd say something like, 'Help me understand what you're worried about and what the scan will change.' Often I'll learn something important, for example that the patient's on an anticoagulant, or there's a new neurological sign. If that information makes the scan justified, I'd be glad to approve it and ask them to update the request so the record reflects the reasoning.

If I still don't think it's justified, I need to explain why clearly. Under IR(ME)R, as the practitioner I'm responsible for justifying the exposure, meaning the expected benefit must outweigh the radiation risk. I'd talk through the evidence, perhaps referring to iRefer or our local pathway, and I'd suggest what might help more, such as a different test, ultrasound, a period of observation or a senior review. I'd keep it collaborative and never make it personal.

If we still disagree, I wouldn't let it turn into a standoff while the patient waits. I'd involve my consultant, or the on-call consultant radiologist out of hours, and I'd encourage the registrar to involve their consultant too. A quick senior-to-senior conversation often resolves it. I'd document the discussion and the decision.

Looking back on situations like this, the ones that went badly were where someone felt dismissed. The ones that went well were where I treated the request as a clinical conversation, not a gate to guard. And I'd always keep in mind that a scan declined in good faith can still be the wrong call if the picture changes, so I'd make it easy for them to come back to me.

 

Why this answer works

The answer shows curiosity before refusal, correct understanding that the IR(ME)R practitioner justifies the exposure, and a range of alternatives. It escalates to senior colleagues rather than letting conflict delay care, and it emphasises documentation and keeping the door open.

 

Key points to include

• Seek to understand the clinical concern first
• Explain justification under IR(ME)R as the practitioner's responsibility
• Offer alternatives such as another modality or senior review
• Escalate senior to senior if disagreement continues
• Document the discussion and decision
• Keep the patient, not the argument, at the centre

 

Common mistakes to avoid

• Refusing outright without asking questions
• Approving everything to avoid conflict
• Letting the disagreement delay an unwell patient
• Making it personal or criticising the referrer to others

 

NHS values and standards

Working together for patients; Commitment to quality of care; Respect and dignity; GMC Good Medical Practice: working collaboratively with colleagues

 

Further reading

• Ionising Radiation (Medical Exposure) Regulations 2017
• Royal College of Radiologists iRefer referral guidelines
• GMC Good Medical Practice
• Your trust's IR(ME)R employer's procedures

 

 

Question 6: While reporting a chest radiograph on an infant, you notice findings that could suggest non-accidental injury. What would you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel wants to know that you recognise the radiological signs that can raise concern about physical abuse in children, and that you act promptly and appropriately through safeguarding processes. They are also checking that you stay objective, seek senior and specialist input, and do not investigate or accuse.

 

Model answer

The first thing I'd do is pause and look carefully, because this is a situation where both a missed finding and an overcalled one can cause real harm. Say I saw healing posterior rib fractures in a small baby. That's a finding that should always prompt concern, because there are very few innocent explanations in an infant who isn't yet mobile. I'd review previous imaging, the clinical details and the history given.

I wouldn't sit on it or wait for the morning. I'd speak to the consultant radiologist straight away, ideally one with paediatric experience, and if our trust doesn't have a paediatric radiologist available, I'd follow the local arrangement for specialist opinion, which might be through a regional network.

Then I'd make sure the clinical team responsible for the child knows today, by speaking directly to the paediatric consultant or registrar. It's their job, with the safeguarding team, to take things forward, and children's social care may need to be involved. My job is to describe what I see objectively and factually in the report: the findings, their likely age where that can be estimated with appropriate caution, and the fact that they raise concern for non-accidental injury and need further assessment in line with national guidance, which usually includes a skeletal survey and other investigations.

I'd be careful not to speculate about who might be responsible, and I wouldn't discuss my concerns with the parents myself. I'd also make sure I documented who I spoke to and when.

Finally, I'd talk to the safeguarding lead if I was at all unsure about the process, and I'd make use of supervision afterwards. These cases can stay with you, and talking them through helps.

 

Why this answer works

The answer shows understanding of a classic radiological sign of concern, prompt senior and specialist involvement, direct communication with the responsible paediatric team, and an objective report. It respects role boundaries and refers to national guidance on imaging in suspected physical abuse without overstating detail.

 

Key points to include

• Recognise findings that raise concern and review carefully
• Involve a senior or paediatric radiologist promptly
• Speak directly to the responsible paediatric team the same day
• Write an objective, factual report recommending appropriate further imaging
• Follow local safeguarding procedures and document everything
• Do not accuse, speculate or confront parents

 

Common mistakes to avoid

• Waiting for a routine report to be read
• Speculating in the report about who caused the injury
• Discussing concerns directly with the parents
• Acting alone without senior or specialist input

 

NHS values and standards

Everyone counts; Compassion; Working together for patients; GMC Good Medical Practice and GMC guidance Protecting children and young people

 

Further reading

• Working Together to Safeguard Children (England, or the equivalent in Scotland, Wales and Northern Ireland)
• Royal College of Radiologists and Society and College of Radiographers guidance on the radiological investigation of suspected physical abuse in children
• GMC Protecting children and young people: the responsibilities of all doctors
• Children Act 1989 and 2004

 

 

Question 7: Tell us about a discrepancy in your reporting and what you learnt from it.

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel wants honesty and insight. They are looking for an understanding that discrepancies are part of radiology practice, that you engage with learning meetings, and that you are open with patients and colleagues when harm may have occurred.

 

Model answer

A case I still think about was an out-of-hours CT abdomen I reported as a fairly new fellow. The clinical question was appendicitis, and the appendix was normal. I said so, mentioned a bit of free fluid and moved on. The next morning the consultant reviewing the overnight work noticed a small area of subtle bowel wall thickening with some surrounding stranding in the small bowel that I hadn't commented on. It turned out to be relevant to the patient's pain.

My first feeling was a horrible sinking one. But I went straight to the consultant to understand what I'd missed and why, and then we made sure the surgical team had an addendum and a phone call. Thankfully the patient was still in hospital and was being reviewed, so the delay didn't change their management, but it could have.

When I reflected on it, I realised I'd fallen into satisfaction of search. I'd answered the question I'd been asked and relaxed. Since then I've used a deliberate checklist approach for every abdominal CT, especially at night, and I re-review the bowel loop by loop before I finalise, even when I've found the answer.

The case also went to our radiology events and learning meeting. I'll admit I was nervous about that, but it was anonymised, supportive and focused on learning. Several colleagues said they'd made similar misses, and we discussed search patterns for subtle bowel pathology, which helped everyone.

I've come to see discrepancy as part of being a radiologist, not a sign that you're a bad one. What matters is being open, making sure the patient and team know where it matters, following duty of candour if harm has occurred, and learning from it. I include those reflections in my appraisal portfolio too.

 

Why this answer works

The answer is honest, specific and non-defensive. It shows immediate action to protect the patient, insight into a recognised cognitive error, a concrete change in practice and positive engagement with learning meetings. It also references duty of candour and appraisal, which shows professional maturity.

 

Key points to include

• Choose a real, appropriately sized example
• Describe immediate action to protect the patient
• Identify the cause, such as satisfaction of search
• Explain a concrete change in your practice
• Show engagement with learning meetings and duty of candour where relevant
• Reflect without being defensive or self-punishing

 

Common mistakes to avoid

• Claiming you have never had a discrepancy
• Blaming the request form or the radiographer
• Choosing an example with no learning
• Describing an error that suggests unsafe practice without showing insight

 

NHS values and standards

Commitment to quality of care; Improving lives; GMC Good Medical Practice: honesty and openness; Professional duty of candour

 

Further reading

• Royal College of Radiologists standards for radiology events and learning meetings
• GMC and NMC Openness and honesty when things go wrong: the professional duty of candour
• Patient Safety Incident Response Framework (England)
• GMC Good Medical Practice

 

 

Question 8: Talk us through how you vet and protocol an imaging request.

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel wants to see a safe, structured approach to vetting: checking the request answers a real clinical question, justification under IR(ME)R, choosing the right test and protocol, and spotting safety issues before the patient reaches the scanner.

 

Model answer

I think of vetting as the first clinical act of the scan, not admin. Done well, it protects patients from unnecessary radiation and makes sure the scan actually answers the question.

I start with the clinical information. Is there a clear question, and will the answer change management? If a request just says 'abdominal pain, ?pathology', I'll look at the electronic record or ring the referrer. Usually a two-minute conversation gives me what I need.

Next is justification. For anything involving ionising radiation I'm acting as the IR(ME)R practitioner, so I weigh the expected benefit against the risk, thinking about the patient's age, previous imaging and whether another test without radiation, like ultrasound or MRI, would answer the question as well. iRefer and our local pathways help, but I still apply judgement to the individual patient.

Then I choose the protocol. For a CT that means the area covered, which contrast phases are needed and whether oral contrast helps. For MRI it means the sequences, whether gadolinium is needed and the right coil. I try not to add phases 'just in case', because each one adds dose and time.

Alongside that, I look for safety flags. For contrast I'm checking previous reactions, renal function where our policy requires it, and medicines that need thought. For MRI I'm looking at implants, pacemakers or anything that needs MRI safety screening. For women of childbearing age I make sure the radiographers know if pregnancy status will be particularly important. I'll also note urgency and any practical needs like a hoist, an interpreter or a learning disability that means we should offer adjustments.

Finally I write the protocol clearly so the radiographer can't misread it, and if I've changed the test or declined it, I tell the referrer why and suggest what would help instead. If I'm unsure, I ask a consultant. It's much better to check before the scan than to discover the wrong protocol afterwards.

 

Why this answer works

This answer gives a clear, logical structure covering clinical question, IR(ME)R justification, protocol choice, safety screening and communication. It shows awareness of dose optimisation, contrast and MRI safety and patient needs, and it demonstrates appropriate escalation for a Clinical Fellow or Specialty Doctor.

 

Key points to include

• Treat vetting as a clinical decision
• Clarify the clinical question and seek more information if needed
• Justify the exposure as IR(ME)R practitioner, considering alternatives
• Choose a protocol that answers the question with the lowest reasonable dose
• Screen for contrast, MRI and pregnancy safety issues
• Communicate changes or refusals clearly and ask for help if unsure

 

Common mistakes to avoid

• Treating vetting as a box-ticking exercise
• Approving vague requests without clarifying the question
• Forgetting MRI or contrast safety checks
• Changing or declining a test without telling the referrer

 

NHS values and standards

Commitment to quality of care; Working together for patients; Everyone counts; GMC Good Medical Practice: safety and quality

 

Further reading

• Ionising Radiation (Medical Exposure) Regulations 2017
• Royal College of Radiologists iRefer referral guidelines
• Royal College of Radiologists guidance on contrast administration
• MHRA Safety guidelines for magnetic resonance imaging equipment in clinical use

 

 

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