Question 1

Tell us about yourself and why you want this post.

Accepted Answer

Thank you. I qualified in medicine overseas and worked for just over two years after my internship, mostly in a busy general medicine department where I clerked acute admissions, ran ward rounds with my registrar and covered nights on my own for a block of wards. Last year I passed PLAB 2, gained GMC registration and completed a clinical attachment in an acute medical unit here in the UK, which I found really useful. What I bring is that I'm used to being the first doctor to see an unwell patient. I'm comfortable taking a history at three in the morning, examining properly, putting a plan together and knowing when it needs a senior. I've also learned, especially during my attachment, how much I still have to learn about the way things work here. Things like NEWS2 escalation, electronic prescribing, the role of the hospital at night team and how much decisions are shared with patients were all different from what I was used to. I want this post because it's a ward based job with good supervision, a clear induction and real exposure to acute medicine. I'd like to settle into NHS practice properly, build my portfolio with supervised learning events and an audit, and then apply for core training. I read about your trust's induction programme for doctors new to the NHS and your teaching sessions, and that matters to me, because I'd rather start somewhere that supports new doctors well than somewhere I'm just filling a rota gap. On a personal level, I'm a calm person on a busy…

Question 2

You are the FY1 on a medical ward at night. A nurse calls to say a patient's NEWS2 score has risen and he looks unwell. What would you do?

Accepted Answer

The first thing I'd do is ask the nurse a couple of quick questions on the phone using SBAR, so I know who the patient is, why he's in, what the observations are and what's changed. If he sounds unwell I'd ask her to repeat a full set of observations, check a blood glucose and get the notes and drug chart ready, and I'd go straight there. A rising NEWS2 plus a nurse saying he looks unwell is enough for me to see him in person, not plan over the phone. At the bedside I'd use an ABCDE approach. I'd check his airway, look at his breathing, saturations and respiratory rate, and give oxygen to the right target, being careful if he has COPD. For circulation I'd check pulse, blood pressure, capillary refill and urine output, get a cannula in, send bloods including a lactate and cultures if I suspect infection, and do a venous or arterial gas. I'd check his conscious level and glucose, then expose and examine for things like a tender abdomen, a swollen leg or a source of sepsis. I'd look at his notes for his background and whether there's a treatment escalation plan or ReSPECT form. While I'm doing that I'd start the treatments I'm confident with, such as fluids if he's hypotensive and dry, and if sepsis is likely, I'd follow the trust sepsis pathway and get antibiotics in promptly. Then I'd escalate. If he's not improving, or his score has crossed the trust's threshold for urgent review, I'd call my registrar or the hospital at night team using SBAR and say clearly that I'm…

Question 3

You are on ward cover and you get four bleeps within a few minutes. How do you prioritise?

Accepted Answer

I'd answer each bleep and get just enough information to triage it. I'd ask who the patient is, what the problem is, the latest observations and how worried the nurse is. Then I'd sort the jobs by how quickly the patient could come to harm. Say the four calls are a patient with chest pain, a fluid prescription that's run out, a request to re-site a cannula for IV antibiotics, and a family who want an update. The chest pain comes first. I'd ask the nurse to do an ECG and a set of observations while I'm on my way, and I'd go and see that patient straight away. Next would be the cannula, because a delayed antibiotic dose in someone with an infection matters. The fluids depend on the patient. If they're nil by mouth and dry, that's more urgent than it sounds, so I'd check the observations and might be able to prescribe on the electronic system quickly between tasks. The family update is important but not urgent, so I'd let the nurse know I'll come later or that the day team can speak to them in the morning. What I try to do is close the loop with each nurse. I'd tell them roughly when I'll get to their job and ask them to call back if anything changes, because the priority can shift in a moment. I keep a written jobs list on my handover sheet with times, and I tick things off, so nothing gets lost when it's busy. If the jobs keep coming and I can't safely get to an unwell patient in good time, I'd tell my registrar or the hospital at night coordinator honestly. Asking for help,…

Question 4

Tell us about a mistake you made and what you did about it.

Accepted Answer

During my first year after graduating, I prescribed a regular dose of an anticoagulant to a patient who had already been given a dose that day in the emergency department. It was a busy post take round, I copied the plan from the notes, and I didn't check the administration record on the system. The nurse noticed before the second dose was given and called me, so the patient didn't receive it. I'll be honest, my first feeling was a sinking one. But I went straight to the ward, corrected the prescription, and checked the patient was well with no signs of bleeding. I told my registrar what had happened, and we agreed I'd speak to the patient. I explained simply that I'd made an error on her drug chart, that it had been caught before she received an extra dose, that she hadn't come to harm, and I apologised. She was actually very gracious about it. I documented the conversation in the notes and completed an incident report. Even though it was a near miss, I think being open mattered. Doctors have a professional duty to be honest with patients when something goes wrong, and an apology isn't an admission of liability. If there had been harm, the organisational duty of candour would also apply, and there'd be a formal process for that. I'd always involve my senior and follow the trust's policy, which can differ slightly between England, Scotland and Wales. What I changed was simple but it's stuck. I now check the administration record before I prescribe any time critical or high…

Question 5

How do you know when to ask a senior for help, and can you give an example?

Accepted Answer

For me there are a few clear triggers. If a patient is deteriorating despite what I've done, if I'm not sure what's going on, if a decision is outside my competence or my role, like a treatment escalation decision or a procedure I haven't been signed off for, or if I've got too many sick patients at once, I call. And honestly, if my gut tells me I'm worried, that's a reason in itself. One evening in my last post, I was covering surgical wards. An elderly man a day after bowel surgery had a slightly low blood pressure and a raised heart rate. His NEWS2 wasn't dramatically high, and I'd given a fluid bolus which helped a little. But his abdomen was more tender than I expected and he just looked grey. I didn't have a diagnosis, but I knew he wasn't right. I called the surgical registrar and said, using SBAR, who he was, what operation he'd had, what I'd found and done, and then I said clearly, I'm worried he might have an anastomotic leak and I'd like you to see him now. She came within twenty minutes, and he went for a scan that night. I learned that being specific about what I want from the senior gets a much better response than just reading out numbers. Where I trained before, there was sometimes a feeling that calling a consultant at night reflected badly on you. I've had to unlearn that a bit. In the NHS, escalation is expected and supported, and the GMC is clear that we should work within our competence. I'd much rather make a call that turns out to be unnecessary than…

Question 6

Which NHS value is most important to you as a junior doctor, and how have you shown it?

Accepted Answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. They all overlap, but the one I think about most as a junior doctor is compassion, because it's the one that slips first when you're tired and have a list of twenty jobs. On a respiratory ward I looked after a woman in her eighties with end stage lung disease who had been moved to a side room. On a busy afternoon I went to take bloods and found her upset because she hadn't seen her daughter, who couldn't get to the hospital because of work. The bloods were for a routine check. I asked the nurse if they could wait an hour, sat down, and asked her what was worrying her. It turned out she was frightened about dying alone at night. I let the nurse in charge know, we arranged for her daughter to stay over with open visiting, and I asked the palliative care team to review her symptom plan the next day. It took perhaps fifteen minutes out of my afternoon. It didn't cure anything, but she was settled that night and her daughter was there the following week when she died. That's what compassion means for me in practice. It's noticing the person behind the job on my list and then doing something practical about it. I'd also say compassion includes my colleagues. On a bad night, offering to take a bleep for the FY1 who's been stuck with a sick patient, or checking a nurse is okay after an arrest, is part of the same value.

Question 7

A nurse asks you to review a patient you saw earlier and is unhappy with your plan. How do you work with nurses in situations like this?

Accepted Answer

I'd start by listening properly, because nurses spend far more time with patients than I do and often pick up a change before the observations show it. In practice, I'd ask what she's noticed and what she's worried about, and I'd go back and see the patient again rather than defending my plan over the phone. Something like this happened to me on a care of the elderly ward. I'd reviewed a lady with a urinary infection in the afternoon, and my plan was oral antibiotics and fluids. A couple of hours later, the nurse called and said she was much sleepier than usual and wasn't herself, even though her NEWS2 had only gone up by one. My honest first reaction was that I'd only just seen her. But I went back. She was more drowsy, her blood pressure was lower than earlier, and her lactate came back raised. I changed the plan to IV antibiotics under the sepsis pathway and called my registrar. Afterwards I thanked the nurse and said she'd been right to push. I think that matters, because if a nurse ever feels I'll be dismissive, she might not call next time. I also made sure she knew she could escalate to my registrar or outreach if she ever felt I hadn't listened, and that's exactly what I'd want her to do. Martha's Rule in England has made that kind of escalation even more explicit for families as well as staff. If, after reviewing, I genuinely still disagreed, I'd explain my reasoning, agree what would change my plan, and ask a senior to give a second opinion if she remained…

Question 8

While clerking an older patient, you notice unexplained bruising on her arms and she seems frightened of her son, who is her carer. What would you do?

Accepted Answer

The first thing is to make sure she's safe right now and that she gets proper medical care for any injuries. I'd examine her carefully, document the bruising accurately, including site, size, colour and pattern, using a body map if the trust has one, and think about medical explanations too, like anticoagulants, falls or a low platelet count. Then I'd try to speak with her on her own, in a quiet space, perhaps when the son has gone for a coffee. I'd ask open questions such as, how are things at home, and do you feel safe? If she has difficulty with English I'd use a professional interpreter, never the son. I'd listen, not lead her, and I'd write down what she says in her own words. I wouldn't promise to keep things secret, but I'd explain that I want to help and might need to share concerns with others to keep her safe. I'd tell my registrar or consultant and the nurse in charge, and follow the trust's adult safeguarding policy, which usually means contacting the safeguarding team and making a referral to the local authority under the Care Act. I'd also think about her capacity. If she has capacity and doesn't want action taken, her wishes matter a lot, but that doesn't stop a referral if others may be at risk or there's a serious crime. If there's any immediate danger, for example if she can't go home safely, the team needs to plan for that before discharge. What I wouldn't do is confront the son or try to investigate myself. That's not my role and it could make things…

Foundation Programme & Clinical Fellow (Generic) Interview Questions & Answers

About this NHS interview question bank

Free NHS interview questions and model answers

Question 1: Tell us about yourself and why you want this post.

Question 2: You are the FY1 on a medical ward at night. A nurse calls to say a patient's NEWS2 score has risen and he looks unwell. What would you do?

Question 3: You are on ward cover and you get four bleeps within a few minutes. How do you prioritise?

Question 4: Tell us about a mistake you made and what you did about it.

Question 5: How do you know when to ask a senior for help, and can you give an example?

Question 6: Which NHS value is most important to you as a junior doctor, and how have you shown it?

Question 7: A nurse asks you to review a patient you saw earlier and is unhappy with your plan. How do you work with nurses in situations like this?

Question 8: While clerking an older patient, you notice unexplained bruising on her arms and she seems frightened of her son, who is her carer. What would you do?

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