Interview themes and top tips for HST (18 Jan 2023)

SPEAKER_01 0:00

If you enjoy listening to career conversations, why not become a member of the Royal College of Physicians of Edinburgh? Our membership provides you with access to the RCPE educational portal, the live evening medical updates, and you have options to view the symposia both in person or online. If you would like to learn more about this, please go to the Royal College of Physicians of Edinburgh website. I'm delighted to be back with Dr. Hannah Preston. She will be going through the interview tips and tricks for higher specialty training applications. My name is Dr. Marilena Gianudi and I'm a member of the TMC. So, Hannah, welcome. Welcome back. Thank you. So obviously, we discussed about getting the application started, and hopefully, most of our listeners will now have been invited to interview. So, can you just talk us through the interview process, please?

SPEAKER_00 1:05

Yes, so the interview process, which occurred last year and is occurring this year, is online. So that is different to previous years and obviously has evolved out of COVID. And definitely for this year, the whole interview process is going to be online. I can't tell about years ahead, but that's something that we can talk about because you're probably some of your preparation is going to be different to what it may have been otherwise. And you need to think of different logistics to what you might have done to an in-person interview. So I think it's worth thinking about the interview prior to you getting shortlisted for interview. And I think you should maybe have in your mindset the preparation that you are going to be chosen for interview so that if it's quite a last-minute thing, then you've already done that prep work. And I think there's definitely, you know, bits and bobs that you can do to help yourself on the day.

SPEAKER_01 2:05

And obviously, in the old format, I gather that we'd be walking around different sections, different parts of the interview hall as such, and it would be split up into academic or portfolio clinical. How does it work when it's online? Is it all just one interview with the same interview panel?

SPEAKER_00 2:24

Yeah, so online it's obviously going to be different. So you're going to be in either the comfort of your own home or somewhere that you know has got reliable, good internet and connectivity. And I think that's really important. And then you can therefore book a time slot on the website for a part in the day within the interview timeline that suits you. So you might be a morning person or you might be an afternoon person, for example, and you can kind of pick your time slot. And then it is the same panel that interviews you throughout the stations, which is different to how an interview would structure if you were doing it in person. So personally, I had two panel members who were independent from separate areas as the panel, and alongside that had a person from recruitment to help with the kind of logistics and the admin side of things. So they weren't involved with the interview itself, but helped with the kind of online interview process and they would talk you through how it runs and just oversee anything in case there were any potential little glitches along the way. I was lucky and didn't have any technical issues, but you know, they're there for technical support, which is useful.

SPEAKER_01 3:36

Okay, and how was the interview set up? So could you tell that you were going through the different stations, or was it all just very organic and one question led to another?

SPEAKER_00 3:47

No, we had time set aside for each section. So it's important that you use the higher specialty recruitment website to look at the general format of the interview. Each specialty may have slight nuances or variations to the interview, so it's really important that you look at the specialty's page and go through that in your preparation. But that was okay, let's do this question, talk about that question, wrap up, and move on to the other section. And we can talk about the different sections of the interview, but it was kind of segmented into those areas.

SPEAKER_01 4:23

Okay, so how many sections were there in total?

SPEAKER_00 4:27

For my interview, I had a section on medical registrar suitability, and that was a new question last year that took place, which I guess gathers information on the whole about how well suited you are to be a medical registrar, and you can, I guess, apply that question in a different way, but it might be using cases or scenarios about how it encompasses leadership and time management and all the things that you need to be a medical registrar. Some interviews have presentations needed for that. I personally didn't have to do that. I was quite lucky about, but I had a clinical scenario, and that will be specialty specific. So again, you'll be asked a leading question or a STEM, and then you'll need to describe your process through working that clinical scenario, and you might get more information along the way from the interviewers as they kind of feed it in and as you ascertain more detail. And then question two was the medical registrar suitability one, which I've mentioned, which is a new area. Question three was then an ethical scenario, again, specialty specific and talking through a case and bringing up different ethical points. So that's definitely something that you can go and revise and scrub up your knowledge on all the ethical aspects of medicine. And then question four was about suitability and commitment to specialty. So this could have a variety of different questions, but would generally ascertain how you've demonstrated commitment to specialty so far, what you like about the specialty that you want to go into, how you feel that you are suitable. So again, looking at stuff from the person specification would be useful, commenting on your attributes, how you feel that you would work in that department or that specialty, and then kind of what you've done so far, or it may well be about, you know, where you see that specialty heading in the future. So I guess that looks into your commitment to specialty because you've looked into where the specialty might be going, or what difficulties it's having at the moment, or where you see research going. So those were the questions or the topics that I got in my interview set. And then you also get marks for communication. So it's not actually a question per se, but within each question area, there are scores specifically for communication skills that you've used. So that might be how you communicate in the clinical scenarios. So you need to bring in aspects of the patient, of the colleagues, of the multidisciplinary team, and then how you communicate with the interviewers throughout the whole interview process, which is quite challenging, or it brings a lot of different communication skills being online compared to in person, and you just need to think about how you come across in an online setting. For some people, that might be better suited to them because obviously being in person for an interview can bring a whole different set of nerves to being online, and it's definitely going to play to some people's strengths and it's going to play to some people's weaknesses, but ultimately we know this is going on and we just need to embrace it and perhaps practice at how we can communicate best in an online setting.

SPEAKER_01 7:59

And I think kind of moving on from that, it's really important that any candidate takes the time to actually practice talking online, using their web camera, seeing, you know, that it's all set up where it needs to be, that they're in frame, that they're, you know, maintaining good eye contact. Because the things that we find important in face-to-face communication still apply online. And sometimes you need to work that bit harder to get that across.

SPEAKER_00 8:24

Absolutely. I think, as you said, making sure that your room is set up, thinking about what you've got behind you or what type of camera you've got, if you know how the microphone's working, if you can practice a practice interview or a chat online, that could be really helpful. When you're in person, you can bring across those non-verbal communication skills. And I think it's still important to do that in an online setting. But as you said, you might just need to not exaggerate it, but you need to think about different ways to bring across your like warmth and enthusiasm, which might feel a little less natural when you're talking to a computer rather than a group of people directly in front of you. And I think if you can setting up a practice interview, be that in person or online with colleagues, people in department, people that you know, or equally people that you don't know, but you've managed to set up something with, or previous registrars or trainees that have been in a similar boat, just so that you can be put under that, I guess that different type of pressure, because it's all well and good kind of talking to a wall about what you might do in a scenario, or you might have kind of prepped questions written down, but to be put on the spot in a mock interview. I found my mock interview more daunting than the actual interview, which I think is useful to get some of those nerves out of the way before the real thing.

SPEAKER_01 9:47

And I think there's so much importance on having that mock interview, as you said, because you can almost treat this like an exam, like a test. We tend to, before any exam, do practice questions and try and get ourselves, you know, prepared for that. And so it's really important to actually go through that process. And for different people, doing it with someone that they know may be more stressful because they don't want to embarrass themselves equally, it might be with someone that they don't know, but it's just taking that time to find someone who can go through the process with you.

SPEAKER_00 10:16

Definitely. And it's not something that we as medics do a lot at all. You know, we don't apply for jobs maybe as often as other people might do, or we don't have a kind of string of interviews together. It's kind of a you've got one chance, go for it. And so therefore, I think the practice is really important because, well, yeah, certainly for me, an interview isn't a natural thing that we maybe get practice or teaching with. And I think it's an aspect which, you know, it's got a heavy scoring in your whole application process. That total score of your interview is significantly more than your pre-interview score. So it's really important that you prepare for it as best as you can because the weighting is so heavy.

SPEAKER_01 10:57

And just if you don't mind us, just talking through a couple of the different stations that you mentioned. So their portfolio station, obviously, in the olden days, back in my day, you would have your portfolio, your file that you would take with you, and the examiners could kind of look through that. How does it work online? Have you already uploaded everything before and they can ask you about it, or did they ask you specific questions and then you don't necessarily even need to prove something with, you know, a certificate?

SPEAKER_00 11:24

Yeah, so your portfolio per se, you have already uploaded. You haven't uploaded everything, you've just uploaded really the stuff that gains you the maximum points. And actually, some of that might not be relevant. So I think it's important to have. I had a paper portfolio by my side in case something came up and I don't know, I decided to like hold it up against the screen. I actually didn't, but I felt it quite, I don't know if comforting's the right word, but I felt it useful to have that portfolio by me in case you could utilize it. And some of that portfolio stuff might come up in the suitability and commitment section. That's probably the point where it's most used. I guess you could maybe use some of your portfolio stuff within the medical registrar suitability, where you're talking about managing an MDT, communication, leadership, things like that. So I think they're the two sections where you might be able to utilize and bring in some of your portfolio, but it's not necessarily used in the same way as it was previously.

SPEAKER_01 12:32

Okay. And with regards to the clinical station, I can imagine that that's actually the most nerve-wracking. Like, what are they going to ask me? How complicated is it gonna be? The way I've interpreted the interviews is that actually the people that are applying should have PACE's level of knowledge. So even though it's specialty specific, your knowledge should be at the level of you completing MRCP. You're not gonna be a finished, you know, ST7, respiratory, cardiology, renal reg. So it's just about making sure that what you answer is safe and at the level of knowledge that's really expected of you at that time. Is that something that you found when you went through the process? Or do you think actually you do need to read up a little bit more for that extra little bit of specialty knowledge?

SPEAKER_00 13:17

Yeah, so I think definitely what you said, you know, you are going in at a junior specialty registrar level. So you therefore need to think about how you would assess the patient in this kind of hypothetical clinical situation, what information you might gather, what treatments and investigations you might ascertain. At that point, you should be thinking you're not the highest up the chain, as you said. So thinking about when would you discuss this with your senior? I guess this could be an outpatient or an inpatient scenario. So, you know, do you need to discuss with anyone about bringing the patient in? Do they need any other specialty input? Do you need to communicate with any other people? So I guess the patient, the patient's family, colleagues, etc. So you definitely need to talk about it at the level that you are, if that makes sense. You're not jumping to be a consultant and you don't have all of the answers for this. So you definitely need to bring that across in answering your question that they give you. But I think if you're interested in that subject, knowing some of the things that might come up in a common, theoretically common or potentially uncommon situation for that specialty. So thinking about topics or themes that come up for that specialty probably will then put you one foot ahead when assessing that situation, if that makes sense. So cardiology, what might come up, things about chest pain, arrhythmias, hypertension, for example, renal, what might come up, a new AKI, CKD, line issues, for example, respiratory shortness of breath, issues with COPD or asthma, for example. So, you know, the theme is going to run along your specialty. So you need a sense of knowledge about that. But regardless, every clinical situation can be pulled apart in the same way.

SPEAKER_01 15:07

Yeah, definitely. And I think if you ever get stuck, you just go back to basics.

SPEAKER_00 15:11

Definitely. And that's what you need as well in an interview, especially when nerves are heightened. Having that basic structure, that basic approach, which is kind of generic and not necessarily specialty specific, will hold you in good stead.

SPEAKER_01 15:25

Yeah. And I think we can apply that to the ethical scenario as well. So everyone knows about the four ethical principles. And if you ever get stuck, you can always just say, well, the four ethical principles of this, I think this case relates to it with this, this, and this. And obviously, knowing about, you know, GNC guidance and any recent things that have been in the news, which may also be ethically implicated, is really good. But if you ever get stuck, those four ethical principles are what you must always go back to.

SPEAKER_00 15:53

Yeah, definitely. And I think basing your answers around those principles and about focusing it on the patient and things like capacity and assessments and MDTs, the GMC website has actually got some really useful scenarios and guidance on that within their kind of duties of a doctor pages, and they've got scenarios that you can run through. You know, you just need to use buzzwords, but also have an understanding around them and thinking about what you do in a day-to-day level, and probably everyone's had scenarios which have big ethical considerations, which at the time you might not necessarily think about, but actually, if you reflect on them, you think, oh, yeah, I remember that time when I needed to deal with a capacity or consent and things like that. And it'll bring stuff to the forefront of actually when you've used your ethical principles before.

SPEAKER_01 16:41

Yeah. And again, like you said before, when you're preparing, if you think about the main things that may come up, just like you would in your clinical stations. So I guess capacity, mental health act, and consent, those are probably your three main things that could come up.

SPEAKER_00 16:57

Yeah, and then you've also got to think about, I guess, autonomy and patient choice and decisions to treat and stuff like that. So lots of things can come up, but if you just go back to fundamentals, I think that's the most important thing with the whole part of the interview. If you just take it back to basics and then kind of layer it up from there, it doesn't necessarily need to be as overwhelming as it then feels because you need to do the basics right because you've then got to add on the nerves and things that you might have on the day. Yeah, definitely.

SPEAKER_01 17:26

So if there was one piece of advice that you could give to anyone preparing for this stage of the application process, what would it be?

SPEAKER_00 17:34

Oh, if I could give one piece of advice, it would be do a preparation interview. So have a kind of mock interview, definitely. Yeah, I I completely agree with that, to be honest. You know, you've got time. We know the interview window is actually very, very wide. It runs from the 3rd of January to the 18th of April. So I guess if now you start to pencil in a date for a practice, but you will be told, you know, with enough time to organize that. And I guess you also need to think about your rotor as well and letting whoever organises your rotor that you might have an interview around this time and thinking about when you're going to book into your interview, because the window might be three or four days wide for your specialty-specific interview. So thinking about, you know, when were you last on a late shift or a night shift and how that might factor in. But I guess the pro of an online interview is that you don't need to worry about organising transport and accommodation and things like that.

SPEAKER_01 18:32

Yeah, definitely. And I think if anyone wants more information, then the Physician House Specialty Training Recruitment website has a little bit more information about the interview setup and how you can prepare. And we'll obviously put a link to it on our podcast page. And as you mentioned, Hannah, I think it's really important to keep going back to that person's specification for the job because ultimately they will be seeing if you can tick the boxes that they need. So if you have that in front of you while you're preparing, then that will help you be able to practice answering potential questions whilst making sure that you're ticking those boxes.

SPEAKER_00 19:10

Yeah, definitely. The person spec is really useful. As you said, the website is really useful. And then within the website, going on to the specialty page to find out how each specialty will be slightly different. Some specialties might have presentations that you need to do, some specialties will use different questions slightly differently and potentially have different weightings. So it's really important to look at your specific area, especially if you're applying to multiple specialties, because they might not all be the same.

SPEAKER_01 19:40

Definitely. I think that's me and asking all my questions. Do you have any last comments for our listeners?

SPEAKER_00 19:47

Um, no, I guess just a good luck to anybody that's applying. Just give it your best shot, but go in prepared and bring across that warmth and enthusiasm that you have, because the interviewers will be able to get that vibe from you. And I guess if you have any further questions, then we're able to be contacted through the trainees and members committee, you know, the social media channels or email. And yeah, just a massive good luck to everybody. And if it doesn't go well, if it's not your day, that is hard. But you know, there are other options, there's other rounds, you know, don't give up, keep going.

SPEAKER_01 20:22

Definitely. And it will all be worth it in the end. Whenever that end is for you, it will all be worth it.

SPEAKER_00 20:27

Yeah.

SPEAKER_01 20:28

So good luck, everyone. Thank you for listening to us today.