Question 1

Why have you chosen a career in paediatrics?

Accepted Answer

I'll start with the honest answer, which is that I didn't plan it. As a junior doctor I rotated through paediatrics expecting to find it stressful, and on my second week I was asked to see a six-month-old on the assessment unit whose mum said he just wasn't himself. His observations were only mildly off, but he was quiet in a way that didn't feel right. My registrar listened to my worry, took it seriously, and within the hour we were treating him for sepsis. He went home well a week later. That taught me something I still carry: in children, the history from a parent and your own sense that something is wrong can matter as much as the numbers. What keeps me in paediatrics is the range of it. In one shift you can be at a delivery, then reassuring the parents of a toddler with a febrile convulsion, then sitting down with a fifteen-year-old to talk about how she's really coping with her diabetes. You have to change the way you speak every half hour, and I enjoy that. I also like that children usually recover well when you get the basics right, early. I'm not naive about the harder side. I've been involved in safeguarding cases that stayed with me, and I've seen a family lose a child. Those experiences didn't put me off. They made me want to be the kind of paediatrician who is calm, notices the small things and is a steady presence for parents on the worst day of their lives. That's the doctor I'm working to become, and this post is the right next step for that.

Question 2

You are the resident on call overnight and a nurse tells you a two-year-old's PEWS score has risen from 2 to 6 over the last hour. Talk us through what you would do.

Accepted Answer

A rise like that over an hour is a trend, and trends worry me more than any single number, so I'd go and see the child straight away rather than giving advice over the phone. On the way I'd ask the nurse a few quick questions: why the child was admitted, which parameters have changed, whether she or the parents are worried, and whether there's a current weight and any treatment plan or ceiling of care documented. At the bedside I'd do an ABCDE assessment and start treating as I go. I'd look at work of breathing, saturations and whether oxygen is needed, then heart rate, capillary refill, blood pressure and how warm the peripheries are. I'd check conscious level using AVPU or the paediatric GCS, and always a blood glucose. I'd look at the fluid balance, temperature and the skin for any rash. I'd also ask the parents directly whether their child seems different to them, because a parent saying this isn't my child is a red flag in its own right. Depending on what I find, I'd act on it immediately: oxygen, IV or IO access, bloods including a gas, lactate and cultures, and if sepsis is a possibility, antibiotics within the hour according to the trust sepsis pathway. Fluid boluses would be weight-based and given with reassessment after each one. Whatever the cause, a score that has jumped like this means I'd call my registrar or the consultant on call early, and I'd ask for help from the outreach or resus team if the child is not responding. I'd rather call too soon than too…

Question 3

A four-month-old baby is brought to the paediatric assessment unit with a cough, and you notice a small bruise on the cheek. The parents say they are not sure how it happened. What would you do?

Accepted Answer

The first thing I'd say is that a four-month-old can't roll into things or cruise round furniture, so any bruise in a baby who isn't independently mobile is significant. It doesn't mean someone has harmed this child, but it does mean I follow the trust's bruising in non-mobile infants protocol rather than deciding on my own whether it looks innocent. A small bruise can be the only visible sign before a much more serious injury. I'd still manage the reason they came in. I'd assess the cough properly, because the baby may be unwell and that matters too. Then I'd fully undress the baby and examine all of the skin, including behind the ears, inside the mouth and the frenulum, and the genital area, with a nurse present. I'd document the bruise on a body map with size, colour and site, and record exactly what the parents said in their own words, with the time. I'd tell my registrar or the consultant straight away, because the protocol usually needs senior review and a referral to children's social care, and I'd check whether the child or siblings are known to services or have a child protection plan. The consultant would usually lead the child protection medical, and investigations normally include a skeletal survey, neuroimaging when indicated, bloods to look for a bleeding disorder, and an eye examination, all decided by the senior team and local guidance. With the parents, I'd be honest and calm. I'd explain that whenever we see a bruise on a young baby we follow the same…

Question 4

A father is angry because his daughter was sent home from the emergency department yesterday and has come back today much sicker. He says nobody listened. How would you handle this?

Accepted Answer

My first priority would be the child, so I'd make sure she's being assessed and treated before anything else. If I was the one seeing her, I'd tell her dad that I wanted to hear everything but that I'd like to check her first, and then I'd come back and sit down with him properly. Most of the time, a parent's anger comes from fear, and the best way to settle it is to show him straight away that his daughter is being taken seriously now. Once she was stable, I'd find somewhere quiet and let him talk without interrupting. I'd say something like, I can hear how frightening this has been, and I'm sorry you feel you weren't listened to yesterday. That isn't admitting blame for something I don't know about, it's acknowledging his experience. I wouldn't criticise my colleagues, because I wasn't there and I don't know what she looked like at the time. Illnesses in children can change quickly. But I also wouldn't brush his concern aside. I'd explain clearly what we think is happening now, what we're doing and what he should expect over the next few hours, and I'd check he understood. I'd ask him what he's most worried about, because often it's something specific I can answer. I'd also make sure he knows he can ask for an urgent review if he's worried at any time, and I'd tell the nurse in charge so the whole team is aware. Afterwards, I'd let my consultant know, because a return visit with deterioration may need reviewing as a patient safety event under the trust's PSIRF approach.…

Question 5

Which of the NHS values matters most to you as a paediatrician, and can you give an example of it in practice?

Accepted Answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives and everyone counts. In paediatrics, the one I keep coming back to is everyone counts, because children can't always speak up for themselves and some families find it much harder than others to be heard. An example that stays with me was a boy of about eight with a learning disability and autism who came to the assessment unit with abdominal pain. He was very distressed, wouldn't let anyone near him, and I could hear a colleague say he was just being difficult. His mum told me he only behaved like that when he was in real pain. I asked what usually helped, and she said a quiet room, his tablet and a simple picture explanation of what would happen. We moved him to a side room, the play specialist helped, and I examined him slowly with his mum holding his hand. He had clear right iliac fossa tenderness, and he went on to have an appendicectomy. What I took from that is that everyone counts isn't about treating every child the same. It's about making reasonable adjustments so every child gets the same quality of care. If we'd treated his distress as behaviour, we could have missed something serious. Since then, I always ask parents of children with additional needs what normal looks like for their child, and I check whether there's a health passport or communication plan.

Question 6

How do you make sure your prescribing is safe for children, and what would you do if you realised you had made a tenfold dosing error?

Accepted Answer

Children's prescribing is riskier because almost everything is weight-based, the volumes are small, and a misplaced decimal point can mean a tenfold error that would be obvious in an adult but can look plausible in a baby. So I have habits I stick to every time. I use a weight that has actually been measured on this admission, and I write it on the chart. I calculate the dose from the BNF for Children or the local formulary, check it against the maximum, which is often the adult dose for older children, and then check my answer roughly in my head. If I'm prescribing an infusion, I use the trust's standard concentrations rather than making something up. I write micrograms in full, never use a trailing zero, and avoid abbreviations. For high-risk drugs like gentamicin, insulin, opioids or anything given as an infusion, I'm happy for the nurses and pharmacists to challenge me, and I actually thank them when they do. On night shifts when I'm tired, I slow down rather than speed up. If I realised I'd made a tenfold error, the first thing would be the child. I'd stop or hold the drug, go and assess the child, and tell my registrar or consultant straight away. I'd get pharmacy advice on the effects and any antidote or monitoring needed, and if there was any sign of harm I'd escalate urgently. Then I'd be honest with the parents. I'd explain what happened, apologise, tell them what we're doing about it, and document the conversation. That's both the professional duty of candour…

Question 7

A 14-year-old attends clinic on her own and asks for contraception. She does not want her parents to know. How would you approach this?

Accepted Answer

I'd start by making her feel safe to talk. Fourteen-year-olds often find it hard to come in on their own, so I'd thank her for coming and explain early on how confidentiality works: what she tells me stays private, unless I'm worried that she or someone else is at risk of serious harm, in which case I'd talk to her first about who I'd need to tell. Then I'd assess whether she's Gillick competent for this decision. That means checking she understands what contraception involves, the options, the risks and benefits, and the alternatives, and that she can weigh that up and make her own choice. For contraception specifically, the Fraser guidelines apply. I'd want to be satisfied that she understands the advice, that I can't persuade her to tell her parents or let me tell them, that she's likely to have sex anyway, that her physical or mental health would be likely to suffer without contraception, and that it's in her best interests. I'd gently encourage her to involve a parent or another trusted adult, but I wouldn't make that a condition. Alongside that, I'd use a HEADSS-style conversation to understand her life, and I'd ask sensitively about the relationship: how old the partner is, whether she feels pressured, whether there's alcohol or drugs involved, whether she's been given gifts or money. A big age gap, coercion or any sign of exploitation would be a safeguarding concern, and I'd discuss it with the safeguarding team. I'd also remember that sexual activity under 13 is…

Question 8

Tell us about a time you worked closely with the wider team to care for a sick child.

Accepted Answer

One night on the paediatric assessment unit, we had a three-year-old with severe acute asthma who wasn't responding to back-to-back nebulisers. I was the resident, my registrar was in the neonatal unit with a sick baby, and the consultant was on the way in from home. It was a moment where the team mattered far more than any one of us. The nurse in charge took control of the room. She allocated one nurse to the child, another to observations and the drug chart, and she asked the play specialist, who was still on the unit late that evening, to sit with the child's older brother so mum could stay at the bedside. I focused on the assessment and the treatment plan, and I said out loud what I was doing so everyone could hear and challenge me. I phoned the registrar early and agreed on IV treatment, and the on-call pharmacist helped me check the magnesium dose and the infusion concentration, which on a busy night I really valued. What made it work was that people spoke up. At one point the nurse said, I don't think his chest is moving as much as it was, and she was right. It was a sign he was tiring, and that led to an earlier call to the anaesthetist and the regional paediatric critical care transport service. He improved enough not to need a transfer in the end, but we were ready. Afterwards, we had a short debrief and I thanked everyone by name. I learned that being a good doctor in a team isn't about knowing everything. It's about creating a room where a nurse feels…

Paediatrics Interview Questions & Answers

About this NHS interview question bank

Free NHS interview questions and model answers

Question 1: Why have you chosen a career in paediatrics?

Question 2: You are the resident on call overnight and a nurse tells you a two-year-old's PEWS score has risen from 2 to 6 over the last hour. Talk us through what you would do.

Question 3: A four-month-old baby is brought to the paediatric assessment unit with a cough, and you notice a small bruise on the cheek. The parents say they are not sure how it happened. What would you do?

Question 4: A father is angry because his daughter was sent home from the emergency department yesterday and has come back today much sicker. He says nobody listened. How would you handle this?

Question 5: Which of the NHS values matters most to you as a paediatrician, and can you give an example of it in practice?

Question 6: How do you make sure your prescribing is safe for children, and what would you do if you realised you had made a tenfold dosing error?

Question 7: A 14-year-old attends clinic on her own and asks for contraception. She does not want her parents to know. How would you approach this?

Question 8: Tell us about a time you worked closely with the wider team to care for a sick child.

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