ENT (Otolaryngology) Interview Questions & Answers

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About this NHS interview question bank

To prepare for an ENT (otolaryngology) NHS interview, expect questions on ENT emergencies such as epistaxis, post-tonsillectomy bleeding and airway compromise, tracheostomy and laryngectomy safety, the head and neck cancer pathway, consent, safeguarding in paediatric ENT and how you manage on-call from home. Build short spoken answers around real cases from your practice, and know GMC Good Medical Practice, the NHS values and how the department you are applying to runs its emergency clinic and theatres.

This bank contains 40 original practice questions with first-person model answers for doctors applying to ENT posts in the NHS, pitched mainly at Clinical Fellow and Specialty Doctor level, with a selection aimed at those stepping up towards consultant. It covers the ENT emergency clinic, the wards, theatres, on-call from home and the head and neck multidisciplinary team, and every answer is built around a realistic, non-identifying scenario. Each question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the guidance worth reading, so you can practise answers that sound like an experienced, safe ENT doctor rather than a textbook.

 

What this question bank covers

• Motivation for ENT
• NHS values and GMC Good Medical Practice
• Epistaxis
• Post-tonsillectomy haemorrhage
• Airway compromise and supraglottitis
• Quinsy and deep neck infection
• Foreign bodies and button batteries
• Tracheostomy and laryngectomy emergencies
• Head and neck cancer pathway and MDT
• Sudden sensorineural hearing loss
• Consent and Montgomery
• Paediatric ENT and safeguarding
• Domestic abuse and adult safeguarding
• On-call from home and supervising juniors
• Deaf awareness and accessible information
• Confidentiality and clinical photography
• Incidents, PSIRF and duty of candour
• Quality improvement, teaching and career development

 

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 ENT, and why at this stage of your career?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine reason for choosing ENT that goes beyond liking surgery or the variety. They are listening for an honest understanding of what the job is really like, including emergencies at night, busy clinics and patients living with long-term conditions, and for evidence that you have tested your interest in practice.

 

Model answer

What drew me in was a night as a junior doctor when I was asked to help with a man in his seventies who'd been bleeding from his nose for hours. He was frightened, his wife was frightened, and the emergency department had done everything they could. The ENT registrar arrived, sat him upright, calmly explained what she was going to do, found the bleeding point and controlled it within about twenty minutes. I remember thinking how much difference one person's skill and calm made to that room.

Since then I've realised that's what ENT is like most of the time. You can have a toddler with a bead in their nose, someone with a neck lump who's terrified it's cancer, and a patient with a tracheostomy who suddenly can't breathe, all on the same shift. The airway sits at the centre of a lot of what we do, and I like that it demands real calm and good teamwork with anaesthetists and nurses.

I also love the outpatient side, which people sometimes underestimate. Helping someone hear their grandchildren again after a hearing aid referral, or giving a child good sleep after years of obstructive symptoms, changes daily lives.

I'll be honest that I've seen the hard parts too. Emergency clinics are busy, on-call from home can mean being woken several times a night, and head and neck cancer conversations are some of the hardest I've had. That hasn't put me off. My time in ENT so far has confirmed it, and at this point I want a post where I can consolidate my emergency and clinic skills, build my operative experience under supervision and contribute properly to the department.

 

Why this answer works

The answer starts with a specific memory rather than a cliche, which makes it believable. It shows a realistic understanding of the breadth of ENT, emergencies, clinics and cancer care, and links motivation to what the candidate wants to do next.

 

Key points to include

• A specific moment that sparked or confirmed your interest
• Understanding of the breadth of ENT: emergencies, clinics, theatres, cancer
• Awareness of the airway and multidisciplinary working
• Honesty about the demanding parts of the job
• Why this post fits your stage of career

 

Common mistakes to avoid

• Saying you chose ENT because it is a lifestyle specialty
• Only talking about operating
• Giving a generic answer that could fit any surgical specialty
• Ignoring the emotional side of cancer and emergency work

 

NHS values and standards

Compassion; Improving lives; Commitment to quality of care; GMC Good Medical Practice: knowledge, skills and development

 

Further reading

• GMC Good Medical Practice
• ENT UK resources on careers and training
• NHS Constitution for England

 

 

Question 2: Which NHS value matters most to you in ENT practice, and can you give an example of living it?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel is checking that you know the NHS values and can show them in ordinary ENT work, not just recite them. They want a concrete example and some reflection on why that value matters with ENT patients in particular.

 

Model answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. The one I think about most in ENT is respect and dignity, because so many of our patients can't easily speak up for themselves. They might have a tracheostomy, a laryngectomy, profound hearing loss, or they might be a child.

I looked after a man after a laryngectomy who communicated with a whiteboard while his voice prosthesis was being sorted. On a ward round, I noticed the team were talking across him to his daughter, and he'd started to give up writing anything. It wasn't anyone being unkind, just a busy round. So I crouched down to his level, gave him the board, asked him directly how his night had been and waited. It took longer. He wrote that his biggest worry wasn't the stoma, it was that he couldn't call for help at night because he couldn't shout.

That changed what we did. We made sure his call bell was always within reach, spoke to the nurses about checking him regularly, and the speech and language therapist brought forward her review. Afterwards I mentioned it gently to the team, and we agreed to always address laryngectomy patients directly and give them time to write or use their device.

What stayed with me is that dignity often comes down to small, practical things, like patience and eye contact. In ENT, where speech, hearing and breathing are what we treat, those are easy to lose and hugely important to the patient.

 

Why this answer works

It names the values accurately and then picks one with clear relevance to ENT patients. The example shows a small action with a real impact on safety and dignity, and the candidate brought the learning back to the team without blaming anyone.

 

Key points to include

• Name the values correctly
• Choose one and link it to ENT patients specifically
• Give a concrete, believable example
• Show what changed for the patient
• Reflect on what you learned and shared

 

Common mistakes to avoid

• Listing all six values with no example
• Choosing a value without explaining why it matters in ENT
• Telling a story where you criticise colleagues harshly
• An example with no outcome for the patient

 

NHS values and standards

Respect and dignity; Compassion; Everyone counts; GMC Good Medical Practice: patients, partnership and communication

 

Further reading

• NHS Constitution for England
• GMC Good Medical Practice
• National Tracheostomy Safety Project resources on laryngectomy care

 

 

Question 3: How would you break the news to a patient that their biopsy has confirmed laryngeal cancer?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel wants to see a structured, compassionate approach to breaking bad news within the head and neck cancer pathway. They are looking for preparation, checking what the patient knows, clear language, silence, involving the clinical nurse specialist and a plan, and for awareness that the patient may struggle to speak.

 

Model answer

I'd start before I walk into the room. I'd make sure I know the histology, what imaging has been done, whether the case has been to the head and neck MDT, and what the likely next steps are, so I'm not guessing. I'd book a quiet room with enough time, and I'd ask the head and neck clinical nurse specialist to be with me, because she'll be the patient's key worker afterwards. I'd also check in advance whether the patient wanted someone with them.

I'd sit down, introduce everyone and start by asking what they understand so far. Many patients have already worried about it since the biopsy. Then I'd give a warning shot, something like, 'I'm afraid the results aren't what we'd hoped for,' and pause. Then I'd say it plainly: 'The biopsy has shown a cancer in your voice box.' I'd use the word cancer, because softer words cause confusion.

After that I'd stop talking. The silence is uncomfortable, but people need it. If they want to talk, I'd follow their lead. Some people ask straight away about survival and others ask whether they'll lose their voice. I'd be honest that the team will discuss the best treatment with them, and that treatment for laryngeal cancer can include radiotherapy, surgery or both, depending on stage. I wouldn't give figures I can't stand behind in that first meeting.

With laryngeal cancer, patients are often hoarse, so I'd give them time and paper if speaking is tiring. Before they leave, I'd summarise, give written information and the nurse specialist's contact number, explain what happens next and roughly when, and check how they're getting home. I'd also mention support for stopping smoking and drinking if relevant, but gently, not as a lecture on that day.

Afterwards I'd write a clear note of exactly what was said, and make sure the GP is informed promptly so they aren't caught off guard.

 

Why this answer works

The answer follows a recognised structure for breaking bad news without sounding mechanical. It is specific to head and neck cancer, involving the CNS and MDT, acknowledging voice and speech, and avoiding premature statistics, and it ends with safety netting and documentation.

 

Key points to include

• Prepare: know the results and MDT plan, private room, time
• Involve the head and neck clinical nurse specialist
• Find out what the patient knows and give a warning shot
• Use clear language and allow silence
• Agree next steps, written information and a contact
• Document and inform the GP

 

Common mistakes to avoid

• Using euphemisms like 'growth' or 'abnormal cells' only
• Giving survival statistics too early or inaccurately
• Breaking the news in a busy clinic room with no time
• Leaving without a plan or named contact

 

NHS values and standards

Compassion; Respect and dignity; Working together for patients; GMC Good Medical Practice: communicate effectively and support patients

 

Further reading

• GMC Decision making and consent
• NICE guidance on cancer of the upper aerodigestive tract
• NHS England guidance on cancer key workers and holistic needs assessment
• GMC Good Medical Practice

 

 

Question 4: A nine-month-old baby is brought to the emergency ENT clinic with a nosebleed and no clear explanation. What would you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

This tests whether you recognise that epistaxis in an infant is unusual and can be a sign of physical abuse or attempted smothering. The panel wants to see that you treat the baby safely first, stay curious without accusing, involve paediatrics and safeguarding, and document carefully.

 

Model answer

My first priority would be the baby. I'd check that they're well, look at their colour, breathing and alertness, check the bleeding has stopped, and look for signs of significant blood loss. Most infant nosebleeds stop on their own, and if this one hadn't, I'd escalate to my senior and paediatrics straight away.

Once the baby is stable, I'd be aware that nosebleeds are uncommon in babies who aren't yet mobile. It can have innocent causes, like a clotting problem, an infection or a recent minor injury that's well explained. But it's also recognised as a possible sign of physical abuse or attempted suffocation, so I wouldn't just treat it and send them home.

I'd take a careful history in a calm, open way. When did it start, who was there, has it happened before, any bruising, any family history of bleeding. I'd ask about the baby's feeding, development and general health. I'd examine fully, including the skin, mouth, frenulum and ears, not just the nose, and I'd document exactly what parents say in their own words.

Then I'd discuss the baby with the paediatric team, because an unexplained bleed at this age needs a paediatric assessment, which may include blood tests and further investigations under their child protection procedures. I'd also tell my ENT senior and follow the trust's safeguarding policy, which normally means contacting the named or on-call safeguarding team and making a referral to children's social care if there's concern. I'd check whether the child is already known to services.

With the parents, I'd be honest without accusing. I might say, 'Nosebleeds are unusual in babies this young, so we always ask the children's doctors to have a look and do some checks.' Most parents accept that when it's framed as standard care.

If I was unsure, I'd still ask. In safeguarding, it's better to raise a concern that turns out to be nothing than to miss something.

 

Why this answer works

The answer shows the candidate knows a specific ENT safeguarding red flag. It balances immediate clinical safety with curiosity, proper examination, documentation and referral to paediatrics and safeguarding, and it handles the conversation with parents honestly.

 

Key points to include

• Assess and stabilise the infant first
• Recognise infant epistaxis as a possible safeguarding red flag
• Detailed history and full examination, documented verbatim
• Involve paediatrics and follow trust child protection procedures
• Be honest with parents without accusing them
• Escalate to your ENT senior and seek advice when unsure

 

Common mistakes to avoid

• Treating it as a routine nosebleed and discharging
• Accusing the parents or interrogating them
• Examining only the nose
• Not documenting what was said and seen

 

NHS values and standards

Everyone counts; Compassion; Working together for patients; GMC Protecting children and young people

 

Further reading

• Working Together to Safeguard Children (England)
• GMC Protecting children and young people
• Children Act 1989 and 2004
• Royal College of Paediatrics and Child Health child protection resources
• Your trust's safeguarding children policy

 

 

Question 5: You are in theatre for a child's grommet insertion, and you notice the consent form and the theatre list disagree about which side. What would you do?

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel is assessing whether you would stop and resolve a discrepancy before proceeding, even under time pressure. They want to see knowledge of the WHO surgical safety checklist and NatSSIPs, respect for the team, and openness about recording and learning.

 

Model answer

I'd stop. Wrong-site surgery is entirely preventable, and in ear surgery it's easy to get wrong because both sides look similar on the list and the child can't tell you. I'd say clearly at the sign in or time out, 'Before we go any further, the consent form says right and the list says left. Can we pause and check?'

Then I'd go back to the source. I'd look at the clinic letter and the latest audiogram and tympanometry in the notes, and check whether the site was marked on the ward. I'd speak to the parents if the child hadn't yet been anaesthetised, because they will usually know which ear the problem is in. If the child was already asleep, I'd contact the consultant who listed them and wouldn't proceed on a guess.

If it turned out to be a typing error on the list, I'd make sure the list was corrected and the site was confirmed by the whole team before we carried on. If the consent form was wrong, that's more serious, because the consent itself might not be valid for the procedure we were about to do. In that case we'd need to wake the child, re-consent properly with the parents and reschedule, even though that's disappointing for the family.

Afterwards I'd complete an incident report. Under PSIRF the aim isn't to blame anyone, but to understand how two documents ended up different. In my experience that kind of discrepancy often comes from transcribing at listing or a change after clinic. I'd also be open with the parents about what happened and why we paused.

I know stopping a list causes delays, but I'd much rather explain a delay to the parents than explain why we operated on the wrong ear.

 

Why this answer works

The answer is decisive about stopping and gives a sensible, ordered way to resolve the discrepancy. It distinguishes between a listing error and an invalid consent, and it shows a no-blame approach to reporting and openness with the family.

 

Key points to include

• Stop and speak up clearly at sign in or time out
• Verify against primary sources: clinic letter, audiology, site marking
• Do not proceed on assumption
• Re-consent if the consent form is wrong
• Report the incident and be open with the family

 

Common mistakes to avoid

• Proceeding because the surgeon 'remembers' the side
• Not speaking up because of hierarchy
• Quietly correcting paperwork without reporting
• Forgetting the child cannot confirm the side

 

NHS values and standards

Commitment to quality of care; Working together for patients; Respect and dignity; GMC Good Medical Practice: patient safety

 

Further reading

• WHO Surgical Safety Checklist
• National Safety Standards for Invasive Procedures (NatSSIPs)
• Patient Safety Incident Response Framework (PSIRF)
• GMC Decision making and consent

 

 

Question 6: You are called to the emergency department about a 78-year-old on anticoagulation with a nosebleed that has not stopped despite pressure. Talk us through your management.

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel wants a safe, systematic approach to adult epistaxis that starts with resuscitation and moves through a stepwise escalation. They are listening for attention to anticoagulation without reflex stopping it, sensible use of cautery and packing, recognition of posterior bleeds, and when to call a senior.

 

Model answer

I'd start with an ABCDE assessment, because the real risk with an older patient is blood loss and aspiration, not the nose itself. I'd sit them up and leaning forward, ask them to spit rather than swallow, and get firm pressure on the soft part of the nose, with ice in the mouth if it helps. I'd look at their observations and NEWS2, get IV access, and send a full blood count, clotting, renal function and a group and save, with crossmatch if they've lost a lot of blood or are unstable. If they were shocked, I'd start fluid resuscitation and get senior help immediately.

Next I'd take a focused history: how long, which side, any previous bleeds, blood pressure, and exactly which anticoagulant and why. I wouldn't stop anticoagulation on reflex. A patient with a metallic valve is very different from one on it for a single previous clot. If reversal seemed necessary, I'd discuss it with my senior and haematology, following the trust protocol.

Then I'd examine with a headlight, after clearing clots and applying topical local anaesthetic with a vasoconstrictor. If I can see an anterior bleeding point, usually on the septum, I'd use silver nitrate cautery carefully to a small area, one side only. If that fails or I can't see the source, I'd insert an anterior nasal pack, whichever type the department uses, and admit them for observation.

If blood is still running down the back of the throat despite a good anterior pack, I'd think posterior bleed. That's when I'd call my registrar or consultant, because it may need a posterior balloon or catheter, and ultimately theatre for endoscopic ligation, or interventional radiology. Some units also use tranexamic acid as part of their protocol, so I'd follow local guidance there.

Throughout, I'd keep the patient and family informed, because a heavy nosebleed is genuinely frightening. And I'd document clearly, including any pack type and when it's due to come out, so it isn't forgotten.

 

Why this answer works

This answer is ordered in the way a safe ENT doctor actually works: resuscitate, history, examine, escalate stepwise. It handles anticoagulation thoughtfully, recognises posterior bleeding as the trigger for senior input, and remembers patient communication and documentation of packs.

 

Key points to include

• ABCDE first: position, pressure, observations, IV access, bloods including group and save
• Careful anticoagulation history; no reflex stopping, discuss reversal
• Headlight examination, topical anaesthetic and vasoconstrictor
• Stepwise: cautery, anterior pack, then posterior options
• Escalate early for posterior or uncontrolled bleeding
• Document pack type and removal plan

 

Common mistakes to avoid

• Going straight to packing without assessing the patient
• Stopping anticoagulants without considering the indication
• Bilateral septal cautery in one sitting
• Not escalating a posterior bleed

 

NHS values and standards

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

 

Further reading

• ENT UK guidance on the management of epistaxis
• NEWS2 (Royal College of Physicians)
• Your trust's epistaxis and anticoagulation reversal protocols
• NICE Clinical Knowledge Summary on epistaxis

 

 

Question 7: A ward nurse calls you because a patient with a tracheostomy is in respiratory distress. What would you do?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel is testing whether you know the National Tracheostomy Safety Project emergency approach and can apply it calmly. They want to hear you check whether the patient has a patent upper airway, apply oxygen correctly, assess tube patency in the right order, and call for expert help early.

 

Model answer

I'd ask the nurse to put out an emergency call, including anaesthetics, and to apply high-flow oxygen to both the face and the tracheostomy while I come. I'd also ask her to check the bedhead sign, because I need to know immediately whether this patient has a tracheostomy with an upper airway or is a laryngectomy patient who only breathes through the neck.

When I arrive, assuming it's a tracheostomy, I'd follow the NTSP algorithm. I'd look, listen and feel at both the mouth and the tracheostomy, and put on waveform capnography if it's available, because that tells me whether there's airflow through the tube. If there's a speaking valve or cap, I'd remove it. Then I'd remove the inner tube, because a blocked inner cannula is common and easy to fix. I'd try to pass a suction catheter. If it passes easily and the patient improves, I'd suction, reassess and continue assessment.

If the catheter won't pass, I'd deflate the cuff. If the patient still isn't improving, the tube may be displaced or blocked, and the next step is to remove it. Then I'd oxygenate via the face and the stoma, and if needed use standard oral airway manoeuvres, covering the stoma, or attempt oxygenation through the stoma. Anaesthetics would lead on oral intubation if needed, with a plan for the stoma.

If it were a laryngectomy patient, it's different, because there's no connection between the mouth and the lungs. Oxygen goes to the stoma only. I'd remove any stoma covers or HME, check for a laryngectomy tube and suction through the stoma. Trying to intubate through the mouth won't work.

Once the patient was safe, I'd look at why it happened, check that the bedside emergency equipment was present, document clearly and report it as an incident if equipment was missing. Tracheostomy emergencies are rare enough that people forget the steps, so I make a point of practising them.

 

Why this answer works

The answer follows the NTSP algorithm in the correct order and highlights the critical difference between a tracheostomy and a laryngectomy. It also shows teamwork, early help from anaesthetics, and learning after the event, which is exactly what panels want to hear.

 

Key points to include

• Call for help, including anaesthetics, early
• Check bedhead sign: tracheostomy or laryngectomy
• Oxygen to face and tracheostomy; laryngectomy to stoma only
• Remove speaking valve, then inner tube, then try suction catheter, deflate cuff
• Remove the tube if still not improving; oxygenate via face or stoma
• Check bedside equipment and report gaps

 

Common mistakes to avoid

• Forgetting to call anaesthetics
• Giving oxygen to the face only in a laryngectomy patient
• Trying to reinsert a tube blindly as the first step
• Not knowing whether the patient has a patent upper airway

 

NHS values and standards

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

 

Further reading

• National Tracheostomy Safety Project emergency algorithms
• NCEPOD report On the right trach?
• Your trust's tracheostomy and laryngectomy care policy
• Resuscitation Council UK guidance

 

 

Question 8: ENT on-call from home can mean disrupted nights followed by a full day of clinic. How do you look after yourself and stay safe to practise?

Professional Development question  ·  Professional Development

 

What the interview panel is assessing

The panel wants to know you understand fatigue as a patient safety issue, not just a personal one. They are listening for realistic strategies, honesty about limits, willingness to ask for help and an awareness of trust support services.

 

Model answer

I've learnt that fatigue isn't something you just push through. A tired ENT doctor making decisions about an airway or a bleeding child at four in the morning is a patient safety risk, so I treat looking after myself as part of the job.

Practically, on an on-call week I try to protect my sleep in between calls. I keep my phone loud, my notes and the department's protocols to hand, and I make my telephone decisions properly the first time, documenting them, so I'm not lying awake worrying. If a call needs me in, I go in rather than trying to manage something I can't see. I also make sure I eat properly and I take a break in the day, even if it's short.

After a bad night, I'm honest with my consultant. There was one night when I was in from midnight until five with a post-tonsillectomy bleed and then a quinsy. I had an emergency clinic the next morning. I told the consultant, and we rearranged so I took a later start and someone else covered the first slots. Nobody minded, because it was safer for patients.

Driving is something I think about too. If I'm too tired to drive home safely after a night in, I'll rest in the on-call room first.

Beyond the practical side, some cases stay with you. After a difficult night with a child who bled heavily, I found it really helped to talk it through with my supervisor. I also know my trust has staff wellbeing services and I'd use them. Looking after myself means I can keep doing this job well for a long time.

 

Why this answer works

The answer frames fatigue as a safety issue and gives specific, believable strategies tied to ENT on-call. It shows the candidate is willing to be honest with seniors, uses support and reflects on emotionally difficult cases.

 

Key points to include

• Fatigue is a patient safety issue
• Practical strategies for on-call from home
• Being honest with seniors and rearranging work when needed
• Safe driving after nights in
• Using debriefs, supervision and wellbeing services

 

Common mistakes to avoid

• Claiming you never get tired
• Implying you would carry on regardless
• Only mentioning hobbies with no link to safety
• Not mentioning asking for help

 

NHS values and standards

Commitment to quality of care; Working together for patients; GMC Good Medical Practice: look after your own health

 

Further reading

• GMC Good Medical Practice
• BMA guidance on fatigue and rest facilities
• NHS England staff health and wellbeing resources
• Your trust's on-call and rest policy

 

 

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