General Internal & Acute Medicine Interview Questions & Answers

← All NHS Medical and Dental interview questions

About this NHS interview question bank

To prepare for a general internal and acute medicine NHS interview, expect questions on assessing the acutely unwell patient, prioritising on the medical take and on nights, escalation, ceilings of care and DNACPR conversations, consent and capacity, prescribing safety and discharge. Panels also ask about GMC Good Medical Practice, safeguarding, teamwork and how you will settle into an NHS medical team, so build calm, structured spoken answers around real cases from your own practice.

This bank contains 40 original practice questions with first-person model answers written for doctors applying to general internal medicine and acute medicine posts, pitched mainly at Clinical Fellow and Specialty Doctor level, including international medical graduates starting their first NHS job, with a selection aimed at Specialist and Consultant interviews. It covers the medical take, post-take ward rounds, AMU and same day emergency care, nights, sepsis and the deteriorating patient, ReSPECT and DNACPR, death certification and the medical examiner system, incidents and Duty of Candour, teaching, audit and the portfolio pathway. Every question explains what the panel is really assessing, the points to hit, common mistakes and the guidance worth reading.

 

What this question bank covers

• Motivation for acute and general medicine
• The medical take and post-take ward round
• The acutely unwell patient, ABCDE and NEWS2
• Sepsis
• Prioritising bleeps on nights
• AMU and same day emergency care
• Discharge and patient flow
• Escalation to seniors, outreach and ICU
• Ceilings of care, ReSPECT and DNACPR
• Consent and the Mental Capacity Act
• Prescribing safety
• Death certification and the medical examiner system
• Safeguarding adults and children
• Confidentiality and record keeping
• Incidents, PSIRF and Duty of Candour
• GMC Good Medical Practice
• Teaching, audit and quality improvement
• Portfolio pathway (CESR) and career progression
• IMGs in a first NHS post
• Wellbeing and rota pressures

 

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 do you want to work in general internal and acute medicine?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine reason rooted in real clinical experience, not a general wish to help people. They are listening for an understanding of what the job actually involves, including the take, nights, frailty and flow, and whether you will stay motivated when it is busy.

 

Model answer

The honest answer is that I like the front door. I like not knowing who's coming through next and having to work it out from first principles. In my last post I was on a medical take where, within a couple of hours, I saw an older man with a fall who turned out to have complete heart block, a young woman with breathlessness who had a pulmonary embolism, and a gentleman with confusion whose real problem was hypercalcaemia from a cancer nobody had found yet. Each of those started as a vague referral, and each needed careful history taking and clear thinking to get right.

What I value about general medicine is that it doesn't let you hide in one organ. Most of the patients I see on the take have three or four things going on at once, alongside frailty, polypharmacy and a social situation that has quietly fallen apart. Getting someone well is only half of it. Getting them home safely, with the right support and a plan their GP understands, is the other half, and I find that genuinely satisfying.

I'm also realistic. Acute medicine is busy, the nights can be relentless and the pressure on beds is real. I've done a full on-call rota and I know what a heavy night feels like. What keeps me going is the team, the variety and the fact that a good decision at two in the morning can change the whole course of someone's admission.

Longer term, I want to build my skills on the take, take on more responsibility in running the medical team at night and contribute to teaching and improvement work. This post feels like the right place to do that.

 

Why this answer works

The answer uses specific, believable cases to show the breadth of acute medicine rather than just claiming to enjoy it. It shows an understanding of multimorbidity, frailty and discharge, and it is honest about the pressures without sounding put off by them.

 

Key points to include

• A specific memory or case that shows why the take appeals to you
• Understanding of multimorbidity, frailty and the whole patient
• Awareness that discharge and flow are part of good medicine
• Honest realism about on-call and nights
• Where you want to develop next

 

Common mistakes to avoid

• Saying you like variety without giving any real example
• Talking only about rare diagnoses and ignoring frailty and social care
• Sounding as if general medicine is a fallback because training posts were competitive
• Ignoring the team and the nursing staff

 

NHS values and standards

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

 

Further reading

• GMC Good Medical Practice
• NHS Constitution for England
• Royal College of Physicians and Society for Acute Medicine information on careers in acute and general medicine

 

 

Question 2: You are bleeped by a ward nurse about a patient with a NEWS2 score of 7. Talk us through what you would do.

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel is checking that you treat a high NEWS2 as a medical emergency, use a structured ABCDE approach and escalate early. They want to hear safe, practical actions, clear communication with the nurse and an understanding of when to involve the registrar, outreach and critical care.

 

Model answer

A NEWS2 of 7 is in the range that calls for an emergency response, so I'd treat it as one. While I'm on the phone I'd ask the nurse for a quick SBAR: who the patient is, why they were admitted, what's changed, and the full set of observations. I'd ask them to stay with the patient, put them on high flow oxygen if they're hypoxic, and call critical care outreach if the trust policy triggers that at this score, which in most places it does. Then I'd go straight there.

At the bedside I'd use ABCDE. I'd check the airway is patent, then look at breathing: respiratory rate, saturations, work of breathing, and I'd listen to the chest. I'd want a blood gas early. For circulation, I'd feel the pulse, check the capillary refill and blood pressure, get two large bore cannulas in, send bloods including cultures and lactate, and give a fluid bolus if they're hypovolaemic and there's no reason to be cautious. For disability I'd check their conscious level and a capillary glucose. For exposure I'd look for a source, a rash, bleeding or a swollen calf, and check the drug chart and fluid balance.

As I go, I'd be thinking about sepsis, because a deteriorating medical patient with a high score often has it. If I suspect it, I'd start treatment on the trust sepsis pathway without waiting for results.

I'd call my registrar early, not at the end. If the patient isn't responding, or I'm worried about their airway or their blood pressure, I'd want outreach and the critical care team involved, and I'd check whether there's a treatment escalation plan or ReSPECT form so we know what the patient would want.

Finally I'd document clearly, agree how often observations should be done, and make sure the nurse knows exactly when to call me back. Then I'd return to review the response to treatment rather than assuming it's worked.

 

Why this answer works

The answer is structured, safe and practical, and it shows the candidate acts immediately rather than waiting for results. It includes early senior and outreach involvement, considers sepsis and ceilings of care, and closes the loop with documentation and re-review.

 

Key points to include

• Recognise a NEWS2 of 7 as an emergency response score
• Ask for an SBAR handover and give interim instructions by phone
• Structured ABCDE assessment with treatment as you go
• Consider sepsis and act on the trust pathway
• Escalate early to the registrar, outreach and critical care, and check for a ReSPECT form or escalation plan
• Document, set an observation plan and return to reassess

 

Common mistakes to avoid

• Saying you would review the patient after finishing your current task
• Listing investigations without treating anything
• Escalating only at the very end or not at all
• Forgetting to check the patient's wishes and ceiling of care

 

NHS values and standards

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

 

Further reading

• Royal College of Physicians National Early Warning Score (NEWS2)
• Resuscitation Council UK ABCDE approach
• NICE guideline on suspected sepsis
• Your trust's deteriorating patient and sepsis policies

 

 

Question 3: It is 2am. You are the only medical doctor on the wards and you have four bleeps waiting. How do you prioritise?

Operational Scenario question  ·  Operational Scenario

 

What the interview panel is assessing

The panel wants to see that you can triage by clinical risk rather than order of arrival, gather the right information quickly and know when to call for help. They also want to know you communicate honestly with nurses about when you will arrive.

 

Model answer

The first thing I'd do is not answer them in the order they came in. I'd ring each ward back quickly and get the same core information every time: the patient's name and ward, why they're in, what the problem is and the latest set of observations with the NEWS2 score. That usually takes a minute per call and it gives me a picture of the whole night rather than just the next job.

Let's say the four are a patient with chest pain, a patient who needs a cannula for IV antibiotics, a request to rewrite a drug chart, and a patient who's had a fall. I'd go to the chest pain first, unless the observations suggested the faller had hit their head on anticoagulants or was now drowsy, in which case they'd move up. On the phone I'd ask the nurse to get an ECG and set of observations for the chest pain straight away so I can act as soon as I arrive.

Next would be the fall, with neurological observations started. The cannula matters because a missed antibiotic dose is a real risk, so I'd ask whether a nurse or the night practitioner team can site it, and if not I'd do it next. The drug chart rewrite I'd do last, unless a time critical medicine like insulin or a Parkinson's drug was due.

I'd tell each nurse honestly where they are in the queue and ask them to call me back if anything changes. That way nobody's left wondering. I'd also keep a written list so nothing gets lost when I'm interrupted.

If more than one patient is genuinely unwell at the same time, I don't try to be a hero. I'd call my registrar, and for the sickest I'd involve critical care outreach. Being honest about capacity is safer than quietly falling behind.

 

Why this answer works

This answer shows a repeatable system for triage based on risk, not on who shouts loudest. It uses realistic night-time examples, delegates appropriately, recognises time critical medicines and makes clear that the candidate will call for help when overwhelmed.

 

Key points to include

• Triage by clinical risk using observations and NEWS2, not order of arrival
• Ring back quickly and gather the same core information each time
• Give interim instructions such as ECGs or neuro observations
• Use the wider night team and delegate appropriately
• Tell nurses honestly when you will arrive and ask them to call back if things change
• Escalate to the registrar or outreach if more than one patient is unwell

 

Common mistakes to avoid

• Answering bleeps one by one and heading off to the first ward that called
• Treating routine jobs and sick patients as equally urgent
• Not considering time critical medicines
• Trying to cope alone rather than escalating

 

NHS values and standards

Commitment to quality of care; Working together for patients; Everyone counts

 

Further reading

• Royal College of Physicians NEWS2
• GMC Good Medical Practice
• Your trust's Hospital at Night and escalation policies

 

 

Question 4: How would you approach a conversation with a patient and their family about a DNACPR decision and ceilings of care?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel is checking you understand the legal and ethical basis for DNACPR and ReSPECT decisions and can hold these conversations with honesty and kindness. They want to hear that you involve the patient wherever possible, that DNACPR does not mean no treatment and that you know when to involve a senior.

 

Model answer

I'd start by making sure I'm the right person and it's the right time. These conversations are best done with a senior decision maker involved, and on the post-take ward round that's usually the consultant. I'd want to know the patient's background, their frailty, what's happened on this admission and whether there's already a ReSPECT form or an advance decision.

I'd find a quiet room, take a nurse with me if I can, and turn my bleep over to a colleague. I'd begin by asking the patient what they understand about how they are, and what matters most to them. Very often an older patient will tell me plainly that they don't want to be on a machine, and that makes the conversation much easier and more respectful.

I'd explain honestly what CPR actually involves and how unlikely it is to work for someone with their level of illness. I'd be very clear that a DNACPR decision is only about CPR. It doesn't mean we stop treating them, and it doesn't stop antibiotics, fluids or a review by the outreach team. I'd then talk through the wider plan: what treatments we would offer, whether ward based care is the right ceiling, and what we'd do if they got worse.

The law in England expects us to involve patients in these decisions, unless doing so would cause them physical or psychological harm, and if someone lacks capacity we should consult those close to them. That doesn't mean the family decides. If CPR wouldn't work, it isn't offered, but I'd explain that gently and give them time. If there's a disagreement, I'd involve my consultant and offer a second opinion.

Afterwards I'd document who was there, what was discussed, the patient's views and the decision clearly on the ReSPECT form or the trust equivalent, and make sure the nursing team knows.

 

Why this answer works

The answer is legally accurate, shows respect for the patient's voice and is clear that DNACPR is not a withdrawal of care. It includes senior involvement, careful preparation and documentation, which panels look for in this high-risk area.

 

Key points to include

• Prepare: know the patient, check for existing ReSPECT forms or advance decisions
• Involve a senior decision maker and plan a private setting
• Explore the patient's understanding and what matters to them
• Explain that DNACPR is about CPR only, not about stopping treatment
• Involve patients, and consult those close to them if the patient lacks capacity, but families do not demand treatment
• Document clearly and communicate the plan to the team

 

Common mistakes to avoid

• Implying the family makes the decision
• Using vague language like we won't do anything heroic
• Making a DNACPR decision alone at night without involving a senior where one is available
• Forgetting to discuss the wider treatment escalation plan

 

NHS values and standards

Compassion; Respect and dignity; Working together for patients; GMC Good Medical Practice

 

Further reading

• Resuscitation Council UK, BMA and RCN joint guidance on decisions relating to CPR
• ReSPECT process documentation
• GMC Treatment and care towards the end of life
• Mental Capacity Act 2005
• Human Rights Act 1998

 

 

Question 5: Tell us about a prescribing error you made or nearly made. What did you learn?

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel wants honesty, insight and evidence that you acted to protect the patient, reported the error and changed your practice. They are wary of candidates who claim never to have made a mistake, and they want to hear about systems, not just personal blame.

 

Model answer

On a busy take a few years ago, I clerked an older lady with a chest infection and wrote up her regular medicines from the GP list. She was on a direct oral anticoagulant, and I also wrote up prophylactic low molecular weight heparin from the admission bundle without noticing the overlap. I'd been interrupted twice while doing the drug chart.

Thankfully the ward pharmacist spotted it the next morning before the second dose was given. One dose had already gone in. I'll be honest, my stomach dropped when she rang me. I went to see the patient straight away, checked for bleeding, reviewed her bloods and discussed it with my registrar. She came to no harm.

I told the patient what had happened and apologised. It was a short, honest conversation, and she was very gracious about it. I completed an incident report, because even though there was no harm it was exactly the kind of thing the team needed to learn from.

What I learned changed how I work. I now do a deliberate final check of every drug chart before I sign off a clerking, looking specifically for duplicate anticoagulants, interactions and doses that need adjusting for kidney function. I don't let myself be pulled away halfway through a chart if I can help it, and if I am, I go back to the start.

It also made me think about systems. With the pharmacist, I raised it at our department safety meeting and we suggested a prompt on the venous thromboembolism assessment asking whether the patient is already anticoagulated. That's the part I'm proudest of, because it helps the next tired doctor as well as me.

 

Why this answer works

The candidate owns the error without excessive self-blame, puts the patient first, shows openness with the patient and reporting, and demonstrates concrete learning at both a personal and a system level. This is what the GMC and panels expect.

 

Key points to include

• Choose a real and appropriate example, without minimising it
• Describe immediate action to check and protect the patient
• Be open with the patient and inform a senior
• Report the incident through the trust system
• Explain what you changed personally and at a system level

 

Common mistakes to avoid

• Claiming you have never made a prescribing error
• Choosing an example so trivial it shows no learning
• Blaming the pharmacist, nurse or system without owning your part
• Forgetting to mention telling the patient

 

NHS values and standards

Commitment to quality of care; Respect and dignity; GMC Good Medical Practice: safety and quality; professional duty of candour

 

Further reading

• GMC Good Medical Practice
• GMC and NMC guidance on the professional duty of candour
• Patient Safety Incident Response Framework (PSIRF)
• British National Formulary

 

 

Question 6: Which NHS value is most important to you in acute medicine, and how have you shown it?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel wants to know you are familiar with the NHS values and can link one of them to real behaviour on the take or the wards. They are looking for an example, not a definition, and for a connection to the pressures of acute medicine.

 

Model answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. In acute medicine the one I hold onto most is respect and dignity, because it's the first thing to slip when the department is full.

I remember a night when AMU was completely full and we had patients waiting on trolleys in the corridor of the emergency department. One of them was an elderly man with advanced dementia who'd been there for hours. When I went to clerk him, he was distressed, his pad needed changing and he'd been talked about over his head several times. It would have been easy to rush the history from his daughter on the phone and move on.

Instead I asked a healthcare assistant to help me find a side room in the department for ten minutes. We got him cleaned and comfortable, I spoke to him directly even though his answers didn't always make sense, and I examined him properly with the curtains drawn. I rang his daughter, who told me he'd been a bus driver for thirty years and liked the radio on. That one detail made a difference, because the nurse found him a radio and he settled.

It didn't fix the corridor, and I don't want to pretend it did. What it did was remind me that dignity isn't about the building, it's about what each of us does at the bedside. I also escalated to the site team about corridor care for frail patients, because I think we have a duty to raise it as well as to cope with it.

 

Why this answer works

The answer names the values accurately, then focuses on a single believable example of protecting dignity under real pressure. It avoids pretending the individual solved a system problem and shows the candidate also escalates concerns.

 

Key points to include

• Know the six NHS values
• Choose one and show it with a specific example
• Link it to the real pressures of acute medicine
• Show you treat the patient as a person, including those with dementia or delirium
• Recognise when to raise system concerns as well as act individually

 

Common mistakes to avoid

• Reciting the values without an example
• Picking a value and describing it in abstract terms
• Implying corridor care is acceptable or inevitable
• Overclaiming that you single-handedly solved the problem

 

NHS values and standards

Respect and dignity; Compassion; Everyone counts; GMC Good Medical Practice

 

Further reading

• NHS Constitution for England
• GMC Good Medical Practice
• NHS England guidance on dementia care in hospital

 

 

Question 7: You are clerking an 84-year-old woman admitted with a fall. You notice bruises of different ages on her arms and she seems frightened of her son, who is with her. What would you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel is checking that you recognise possible adult abuse and know how to act safely and proportionately under the Care Act 2014. They want to hear that you speak to the patient alone, assess capacity, document carefully and involve the safeguarding team, without jumping to conclusions.

 

Model answer

First I'd make sure she's medically safe, because a fall in an 84-year-old needs a full assessment for its cause and for injuries. But I wouldn't let the bruising go unexplained. Bruises of different ages on the arms, in a pattern that could fit gripping, and a patient who seems frightened of the person with her are both things I'd take seriously.

I'd find a reason to see her alone, which is usually easy on a ward because I can say I need to examine her. I'd ask open, gentle questions: how things are at home, who helps her, whether she feels safe. I'd look at whether there are other medical explanations too, like anticoagulants, a low platelet count or steroid skin, because I want to be fair to everyone involved.

I'd also think about capacity. If she can tell me what's happening and has capacity, her wishes really matter, although if there's a risk to others or a crime may have been committed, I can still share information. If she lacks capacity for this decision, I'd act in her best interests.

I'd document exactly what she said in her own words, describe the bruises with size, colour and site, and ideally use a body map. I'd discuss it with my registrar or consultant and contact the hospital adult safeguarding team. Under the Care Act, a concern can lead to a safeguarding referral to the local authority, and the team can guide me on that. If she's in immediate danger, I wouldn't discharge her home until it's been looked at.

Throughout, I'd stay professional and calm with the son. It isn't my job to accuse anyone. It's my job to notice, to listen to her and to pass it to the people who can investigate.

 

Why this answer works

The answer balances medical assessment with safeguarding, considers alternative explanations and is accurate about capacity and information sharing. It shows calm, non-accusatory behaviour and clear use of the safeguarding team and local authority processes.

 

Key points to include

• Treat the fall medically but do not ignore the injury pattern
• Speak to the patient alone and use open questions
• Consider medical causes of bruising to be fair and thorough
• Assess capacity and respect the patient's wishes, while recognising when you can share without consent
• Document accurately and refer through the hospital safeguarding team under the Care Act 2014
• Do not discharge into immediate danger

 

Common mistakes to avoid

• Confronting or accusing the son
• Ignoring the bruises because the admission is about a fall
• Asking leading questions
• Not documenting the patient's words and the injuries clearly

 

NHS values and standards

Respect and dignity; Compassion; Everyone counts; GMC Good Medical Practice

 

Further reading

• Care Act 2014 and the Care and Support Statutory Guidance
• Mental Capacity Act 2005
• GMC Confidentiality guidance
• Your trust's adult safeguarding policy

 

 

Question 8: This would be your first NHS post. How will you adapt to working in an NHS medical team?

Professional Development question  ·  Professional Development

 

What the interview panel is assessing

The panel wants to know that an international medical graduate understands the differences in systems, culture and expectations, and has a realistic plan to settle in safely. They are listening for humility, a willingness to ask questions, and knowledge of induction and support.

 

Model answer

I'll be honest, I'm excited and a little nervous, and I think both are healthy. Clinically, I've spent several years managing acutely unwell medical patients, running wards and doing on-calls, so the medicine itself won't be new. What I know will be new is the system around it, and that's where I've focused my preparation.

I've read GMC Good Medical Practice carefully and done the GMC's Welcome to UK Practice session. Some things are quite different from where I trained. Patients here expect to be partners in decisions, so consent conversations are more detailed and I need to explain material risks properly. Nurses work with a lot of autonomy, and they'll challenge me, which is a good thing. And documentation, prescribing and escalation all follow structures like SBAR, NEWS2 and electronic prescribing that I want to learn quickly.

In my first weeks I'd make the most of induction and shadowing, ask the ward pharmacist to look over my prescribing and get to know the local guidelines for sepsis, anticoagulation and alcohol withdrawal. I'd ask for an educational or clinical supervisor early and arrange to meet them regularly, even though a non-training post doesn't always require it.

I'd also be careful about my limits. On nights, I'd escalate early, especially in the first months while I'm still learning how things work here. I know asking for help isn't seen as weakness in the NHS, it's expected.

Finally, I'm aware that settling into a new country is a lot. I've thought about my own wellbeing and I'd use support like the trust's IMG network. A doctor who's supported and settled is a safer doctor.

 

Why this answer works

The answer is honest about strengths and gaps, names concrete UK-specific differences and shows a realistic plan for induction, supervision and escalation. It reassures the panel that the candidate will be safe while they learn the system.

 

Key points to include

• Acknowledge strengths and the specific differences in UK practice
• Mention GMC Good Medical Practice and the Welcome to UK Practice programme
• Describe concrete steps: induction, shadowing, pharmacy, local guidelines
• Seek supervision and feedback early
• Escalate early and know your limits
• Think about wellbeing and peer support

 

Common mistakes to avoid

• Saying nothing will be different because medicine is the same everywhere
• Sounding anxious without a plan
• Underestimating the importance of shared decision making and consent
• Forgetting to mention supervision and support

 

NHS values and standards

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

 

Further reading

• GMC Good Medical Practice
• GMC Welcome to UK Practice
• NHS Employers guidance on supporting international medical graduates
• Your trust's induction and local clinical guidelines

 

 

Unlock 32 more NHS interview questions

You have read the free questions. The full bank adds 32 premium questions for this role, each with a model answer, what the panel is assessing, key points and common mistakes.

One-off payment of £2.99 for 12 months' access. No subscription. Use the Unlock button at the top of this page.