Internal Medicine Training: The Interview

Arguably the most important part of your entire internal medicine training recruitment process, you need to be very well prepared for the interview. Hopefully you’ve been long-listed and then shortlisted, and finally received an email asking you to choose a location and date for your interview. Try and be as prompt as possible when you’re responding to the email regarding available dates and locations so that you can get a day that works with your schedule. Often times they will try and add extra dates or locations, but it’s not a good idea to risk waiting until the last second.

If you are working the day you wish to attend an interview, ask your hospital about applying for ‘special leave’, which is separate from annual and study leave. Make certain you are well-rested and prepared the day of your interview, so try not to book it soon after nights. If you have to travel a bit to get to the nearest interview location, try and travel the night before so that you can decrease your nerves.

How should I dress?

Dress professionally but keep comfort in mind. This is not the day to break in a new pair of shoes or heels that you’ve not worn before and then you’re stuck suffering through an interview with painful feet. You don’t need to adhere to NHS regulations regarding rolled up sleeves or no ties, so go ahead and put together an outfit that exudes sophistication.

You may also be wondering about any luggage or bags you may be carrying (especially if you are traveling just for this interview). Many centers have a place you can keep your bags during the interview, but it’s always best to contact the local center you will be attending to be sure that they will not have any issues with you keeping your things with them for the duration of your interview.

What can I expect the day of my internal medicine training (IMT) interview?

First and foremost, DO NOT BE LATE. Get to the interview center as early as possible. The IMT website recommends arriving at least 30 minutes before your booked slot. When you get there, you will be asked to submit your portfolio, and someone will check your identity. You will need to bring your passport with you, as well as a photocopy of the following pages of your passport:

  • outer cover
  • inside front cover
  • photo and signature page (if your passport has the photo and signature on different pages, these are both needed)
  • any additional pages of relevance within the passport (such as giving information on immigration status)

You’ll also need to show proof of GMC registration (download the certificate from your GMC online account) if you have obtained it by the time of the interview. You do not need GMC registration to apply for IMT, but you must have it by the time the training post starts.

How is the Internal Medicine Training (IMT) interview structured?

There are 3 stations,

  • an ethical one,
  • a clinical scenario, and
  • a portfolio station.

You will have 5 minutes between each station and 10 minutes inside. The entire process should take 45 minutes. There will be two clinical interviewers who will assess different areas of your skills, knowledge, and experience. So overall, you will be assessed and scored by six different interviewers.

You, along with two other interviewees, will be called in, sat down in front of 3 rooms, and from there (after the general rules and procedures are explained), your 5 minutes will start. Aside from the portfolio station, in those five minutes, you will have a cue card to read that will cover the scenario you will face inside. When the five minutes are up, you will be informed, and you can enter the room.

How to prepare for the interview?

If you’re already working in the NHS, especially if you’re in an acute setting or doing on-calls, you shouldn’t have much trouble with the clinical scenarios that you may face. That being said, you can review basic approaches towards common medical emergencies such as:

  • Sepsis
  • Stroke
  • Diabetic ketoacidosis
  • Acute exacerbation of asthma/COPD
  • Electrolyte imbalances

You can go through the “EMERGENCIES” in the Oxford Handbook of Clinical Medicine.

For the ethical scenarios and questions you could potentially be asked in the portfolio station, the book Medical Interviews: A comprehensive guide to CT, ST, and Registrar Interview Skills. Give yourself at least 1 month to really understand how questions are presented in this book and how you would ideally respond in your interview. Don’t just try and memorize the example responses given in the book, as it can come across as stale.

It’s a good idea to find someone to practice with so that when the time comes you feel comfortable talking about what you’re asked. Try and limit the length of your responses so that you don’t ramble (which can often happen if you’re nervous!).

During the portfolio station, the interviewers will have your portfolio in front of them. Make sure you are comfortable speaking about the audits, QIPs, courses, or any other information that you’ve mentioned in it. Don’t embellish or go beyond what is asked of you.

Check our article regarding Internal Medicine Training (IMT) : Planning your portfolio

Do I need to do any course for IMT interview

From my personal experience and from the experiences of many, if you follow the above guideline and read that interview book, there is NO NEED to pay for any particular course for IMT.

For the clinical scenarios, always remember ABCDE and your threshold to seek for help. Any clinical scenerio should follow the following steps which we all learnt in medical school:

  • History
  • Examination
  • Investigation
  • Management

Medicine that we learnt back home is different in the UK, it is only how it is practiced. So, do not fear about the clinical scenario station.

After the interview

You will be given your portfolio back at the end of your 3 stations. You’ll then be escorted out, and you may be asked to complete a quick survey about how everything was during the interview. Please refrain from discussing the stations and questions you faced in your internal medicine training interview. Before submitting your application to Oriel, and before the interview itself, you will be asked if you agree to maintain the integrity of the entire process by not sharing the questions, and as it is a grave matter of probity of you break this, do not risk your GMC registration by talking about what went on during your interview.

You will get an email informing you about ranking and preferences (which we will discuss in our next post), but in the meanwhile, you will have to wait to hear back about your results from your interview and your overall marks.

How is the IMT interview scored?

In each station, you will face 2 interviewers. They may split the time between themselves and ask you questions according to how you’ve been responding, or they may even begin a new line of questioning. You will be graded on a scale of 1-5. This will be seen against an overall assessment of 6 aspects. For each aspect, you will get 2 marks (one from each interviewer), leaving you with the potential of getting 12 marks. If you were to get all the marks awarded, it would leave you with a maximum total of 60. This is the raw interview score (RIS), after which weighting will be applied.

To be classed as ‘appointable’, you must meet all 3 criteria:

  • None of your 12 interview scores can be 1/5
  • No more than two of your 12 interview scores can be 2/5
  • Your RIS must be 36 or above.

If you are deemed appointable, you will then progress onwards for the ranking process. If unfortunately you are found to be unappointable, your application will not proceed any further.

All of this will be added to your application score, giving you a total score which will then be used to determine your ranking.

Hopefully you’ve gotten a better understanding of how to prepare for and appear in the interview, as well as what you can understand from your scores at the end. Good luck!