Interview themes and top tips for IMT (19 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. Hello everyone and welcome to another episode of Career Conversations brought to you by the Royal College of Physicians of Edinburgh. My name is Dr. Marilena Gianudi, and I'm a member of the Trainee and Members Committee. Today I'm delighted to be joined by Dr. Georgia Baines, who's here to discuss her experience of the IMT interview process and hopefully give you tips as to how you can prepare for what can sometimes be considered a very daunting experience. So, Georgia, thank you so much for joining me. Thank you. So you applied for IMT last year. You're an IMT one now. Can you just talk us through the process of preparing for the interview? And after you submitted your application, how did that work?

SPEAKER_00 1:18

Of course. So, like everyone, I was quite nervous going into it because I didn't know masses of people that had also applied. So I went onto the sort of NHS website and reviewed the structure of the interview, I guess, and went through okay, so this is what we'd be doing for each section, and then kind of split it up into the clinical ethical and the application and suitability. And at the time I was lucky enough to be working as a locum. So I had quite a lot of free time with which to play with and did actually spend quite a lot of time providing for the interview, particularly sort of the clinical scenario, which I've actually found quite helpful anyway, that revision for working and for clinical practice. So I actually used an online interview question bank, which I did pay a little bit for, but it gave lots of different examples of sort of a sepsis scenario or a DKA scenario. And I worked through them and I also got my partner and my friends to quiz me on each one and to sort of act as the examiner or the assessor. So went through each of them for the clinical scenario. In terms of the ethical one, that mainly involved me looking through GMC's good medical practice. And I thought about questions that would be key and that could come up. So I guess questions relating to DNA C PR and management of patients and families and complaints. I just looked through exactly what the guidelines were for each one, because each one is just focused on good medical practice. So I just made sure that I knew and would be able to hit the points to cover each one of those. I think the one that I was most surprised by when revising was the complaints procedure. It wasn't something that I knew a lot about in great detail, but when I was looking at it, it was something that could definitely have come up. And in the past, they could ask you about things like the ombudsman and how complaints are escalated. So I was quite relieved that I'd looked into that in a bit more detail because I thought, well, I would have been a bit stumped, I think, if that had come up in my interview at the time. Then with regards to the application and suitability, I made sure that I knew my portfolio in detail, which sounds ridiculous because it's obviously about me. But I feel like it's very easy, particularly in the moment, to forget exactly what you've written. And also it's important to know which part of your portfolio you want to emphasize, because you know there's a lot of information in there. And I was a little bit tactical and I pulled out points that fit the HEU specialty person specification for IMT. So anything that I'd done that I felt that hit that in whatever way or hit a few points in that, I kind of pulled it out and I said, Oh, I've done this, which I feel covers these points. So I guess just clarifying that why each point of your portfolio is relevant for your work as an IMT, rather than just saying this is something I'm good at.

SPEAKER_01 3:55

And if we take each of those sections then, so you were quizzed on three sections. So it was clinical suitability and good medical practice. And that's something that will be similar this year, I gather. Was it an online interview for you last year?

SPEAKER_00 4:11

Yes, it was online. It was done, I think it was via Zoom or Microsoft Teams. So when I got the offer of the application, I was offered some slots and some times, and I just selected one of them. I understand that they do them sort of back-to-back, the interviews. So I had a time, which I think was around 11 o'clock, and I logged in at that time, and they were obviously busy doing other interviews. So they then didn't log into my link until 11:20, by which point I was very nervous.

SPEAKER_01 4:40

I guess that's really important to point out because I remember years ago when I did mine, we overran by an hour, and you were just sat in this waiting room waiting for an hour to be called in. So for anybody listening, I think it's very important to highlight that it's completely normal to be sat waiting. Try and keep calm and they will come to you. It's not that the link has broken or the, you know, they've forgotten about you. Interviews do just tend to overrun.

SPEAKER_00 5:06

Yeah. And I think at the time, you know, I'm not always the most IT savvy. So I did think that maybe I'd logged in incorrectly, but I agree. They did come to me and they were apologetic. But yes, you're exactly right. I've got myself a bit worked up, but I agree it's definitely best to stay calm.

SPEAKER_01 5:20

Yeah. So if we just briefly talk about the clinical station, and I think it's very important for us not to specifically highlight, you know, previous questions, because there's going to be set things that come up, such as, you know, you mentioned there's loads of question banks available. And I will make sure that we have as many resources as we can on the footnotes of this episode for our listeners. But how much detail were you asked about during the clinical scenarios? And was it just one or were you asked about two?

SPEAKER_00 5:49

So I was just asked about one clinical scenario. Like I said, I'm not going to obviously mention what my clinical scenario was, but it was actually a fairly basic scenario and something that definitely comes up in everyday practice. So although I'd revised a lot of things that were a bit more specialist or pertained to different specialties, actually, my one was basic and something that you'd see often in acute medicine or going down clerking in AE. And they essentially wanted an A to E assessment. And then they followed it up with some questions as to what further investigations would I want, what diagnostic tests would I make, what are my differentials. And actually the questions that I had were fairly simple. I understand that if you answer the early questions quickly, then I think they do get on to some more challenging questions and sort of things I guess relating to that topic, such as what would you do if the initial management hadn't worked, or if it was DKA for things like what would be the criteria for ICU admission and sort of just testing the upper limits of your knowledge. But all the initial questions were actually very simple and were the sort of thing that you would be expected to think about and to document if you were clerking.

SPEAKER_01 6:57

And I think it's very important again, just to highlight that, that you are applying for IMT. This is your core training. You're not expected to know everything, but you are just expected to be safe. And obviously, this is a disclaimer, it's not that I sit on the panel, but I can imagine that what is most important for somebody applying for a job like that is to have a thorough A to E assessment because that is what is required of somebody at that stage to be safe and to know how to fully assess a patient and escalate as appropriate.

SPEAKER_00 7:30

Yeah, for sure. And I think another thing that I learned a little bit, even when I was just practicing, is that probably quite often they want you to escalate to a senior at a point maybe before you might do in clinical practice. And I guess it's going back to sort of medical practice and basic guidelines and things. And actually, if you say, Oh, I'd let my senior know about this or I'd inform them, then they seem sort of happy with that and happy for you to then carry on with the ongoing management. But they seem to quite like it in the clinical scenarios. If you said quite early on, oh, now that I've done this and I've got some differentials, I'd let my senior know. I know that that wasn't a main point that a lot of people stumbled on, I think.

SPEAKER_01 8:06

Excellent. Okay, so that was the clinical scenario. And again, I think for anybody preparing, talk to people in your hospital, what they got asked, and think about what's the most common presentation that you see coming into the MAU that you need to be able to treat. So DKA is Georgia mentioned, sepsis. You know, it's those simple things that we see again and again and again that you really should know off the back of your hand. Yeah. So clinical, and then you mentioned about the ethical station.

SPEAKER_00 8:37

Oh, yeah, just quickly at the end of the clinical, there's a handover section.

SPEAKER_01 8:41

Okay.

SPEAKER_00 8:41

Where you have to do an S bar. And I understand that that carries quite a lot of points. Well, I don't think you have to do an S bar, but you can do. So there is a handover section, and I think just having a simple S-bar. I think we had two minutes, and everyone that I spoke to had a handover at the end of the clinical scenario. So I guess that that would be another thing just to make sure that people are smooth out.

SPEAKER_01 9:02

Yeah, it's important that we mention this. And again, S-bar is something that you can keep practicing at work or with your friends, loved ones. Make sure that it's short and snappy and you get them pertinent points across. So, as we mentioned, the question is ethical professionalism and governance. And again, were you just asked one question about this, Georgia?

SPEAKER_00 9:22

Mine was a scenario. So they explained the basis of a scenario to me, asked me how I'd respond to that. And then in answer to my response, then the scenario sort of continued on. They said, Oh, okay, well, now you've answered that, they want to know this. So mine was an ethical one, and it was yet again something very simple and something that we would use every day. But I guess they did use quite a lot of, and why would you do that? Are you sure that's how you would proceed? So I guess a lot of questioning why I was making those decisions as well and what my ethical basis for those would be. I think I was quite relieved to have had an ethics station. I understand that they can go down more of a clinical governance route that you were mentioning, and I had gone through like the seven pillars of clinical governance, but I guess I find it a little bit harder to communicate because there's sort of similarities between the pillars and things and getting that across. But yeah, so I just try to follow the good medical practice guidelines.

SPEAKER_01 10:15

And I think that's certainly something that all candidates should do, even in the IMT recruitment webpage, when it gives you advice on this ethical question, it clearly states your answer should be guided by GMC good medical practice. And I think if you use this as your basis for your revision and your preparation, and you can refer back to it and say, well, as per good medical practice, this is the reason for my decision, then no one can question that decision. Yeah, for sure. I agree. And then if we talk a little bit about the portfolio, then had you had to upload information before the interview?

SPEAKER_00 10:55

The application and suitability, there was a section on it at the end of the Oreo application for the portfolio. From what I can remember, that was an open text box scenario of is there anything else that you would like to add? How would you benefit IMT and how would IMT benefit you? So kind of both ways. And I guess in that you had the opportunity to document other things that weren't necessarily part of the structured portfolio, but that he felt helped you as a person or could help you to help others. And I just made sure that I had reviewed all of that and was clear on the points about that that I wanted to bring up. Another part of mine that they did bring up in the application process was some of the teaching and leadership things and the quality improvement projects that I'd been involved in in the past. Yeah. So we talked about the opportunity to discuss all of that in a little bit more detail.

SPEAKER_01 11:43

And is that something that was specifically asked to use straight off, or did you try and bring the conversation towards that so you could discuss it?

SPEAKER_00 11:52

So I'd always planned, I had in my head that I was going to make sure that I brought up my quality improvement project. And then they asked me straight out about it. So fortunately, I had a couple of ideas as to other points I wanted to discuss. So I certainly also wanted to discuss the teaching that I'd coordinated and other skills that I had outside of medicine. So they asked me outright about the QI project, but then I did have other things where if they said, Oh, is there anything else you want to discuss, which they did?

SPEAKER_01 12:17

And just going through what might be different for our listeners from what the IMT recruitment website states is that this year you'll be asked to give a presentation. And what it says is this will be a two-minute presentation giving an overview of your achievements to date and which are most relevant to your application to be a trainee in internal medicine. And there's quite thorough guidance on your presentation and how you will be scored. So, as I said, I will post the link on the footnotes, but I think it's very important that you do read that. And again, taking George's point on board, I think you can use the person specification guide as your base of what you talk about during that time, see what you've done and how you can fill as many boxes as possible of that person specification and use that to present your achievements.

SPEAKER_00 13:11

Yeah, for sure. I 100% agree. And even simple things, I guess, that you might think, oh, that doesn't particularly relate to medicine. So I can speak reasonable Spanish. But I sort of said, oh, so this helps me with my communication and understanding of other cultures and it is of benefit in demonstrating communication skills with others because it's an important part of learning the language to improve your communication skills. So I guess things that don't obviously pertain to medicine still can do.

SPEAKER_01 13:39

Of course. And you need to show you're a well-rounded person. I don't think anybody wants to hire somebody who eats, lives, breathes just medicine. You need to show that you do have skills outside of medicine. And it might be worthwhile. I don't know if this is something you did, Georgia, or if you even agree with. But you know, if you sit down when you're preparing and think about what are my hobbies, what are my skills, and how can I sell myself? And it feels very cringy, very inorganic to think, oh, I really need to sell myself. But ultimately, you have got 10, 15 minutes for a three-year job. So you do have to sell yourself to the maximum because if you don't, someone else will for themselves, and you don't want to miss out on a job because of that.

SPEAKER_00 14:25

Yeah, absolutely, 100% agree. I did have to sit down with a piece of paper and think, oh, what am I good at? And I think that medics are particularly critical of themselves and were very good at saying, oh, I didn't do that particularly well. But actually, that's not really what the IMT interviewers want to hear. And I guess the other thing is asking partners or friends or family or other people who might be a bit better at selling you and saying, well, what am I good at? I found that quite helpful.

SPEAKER_01 14:51

Definitely. And based on that, I think it's also really important that you ask for help, ask for people to question you, even under timed conditions, people that you like, people that you know you're quite scared of how they might judge your answers. You need to get yourself out of your comfort zone as many times as possible before your interview, so that when the interview time comes, you're already used to that environment. I don't know, Georgia, did you practice at all, you know, mock interviews over Zoom or was it all in person?

SPEAKER_00 15:22

So I didn't. I was lucky enough. Well, I lugged all my family and friends into practicing interview questions with me, which I'm sure they didn't thank me for. So I was lucky enough to have them to help me. But I guess for people who have family friends with little medical experience, because it does help if people are able to question why you've done things, and it does help if people have good medical experience as well. Then I guess Zoom interviews and things won't be of benefit. And I do understand that some trusts do organise medical interviews, and I think there are some other practice ones online, but it wasn't something that I personally was involved in.

SPEAKER_01 15:56

I think it's good even if you just practice your presentation online before you give it. I think a lot of communication can sometimes be missed over the screen. And it's so important that you have somebody saying to you, yes, actually, your eye contact is where you need to be, your camera's in the right place, you know, making sure that your internet is up to speed, because you don't want those extra little stresses on the day for something that, you know, it is out of your control. And I think the more times you practice online, the more comfortable you will feel.

SPEAKER_00 16:26

Yeah, those are really important points. Actually, not something that I'd considered in the past, but you're right, it is important.

SPEAKER_01 16:32

I mean, I think because we're all so used to COVID and working through the screen, but it's just when it comes to interviews, I think it's especially daunting to have to do it online.

SPEAKER_00 16:42

Yeah, for sure. It's not comfortable not being able to see people's body language. And in my interview, they weren't particularly smiling, which is fine, and I assume is part of everything, but it's quite hard to work off. So kind of essentially working off a blank screen, particularly when sort of discussing the clinical and the ethical scenarios, kind of thinking, oh, I don't know if I'm doing this right. You know, normally if you're talking to a consultant or a registrar, you'd be seeing sort of positive non-verbal feedback, even about what you were discussing, but I didn't really get that at all.

SPEAKER_01 17:12

Yeah, yeah, definitely. And I guess that's where it's important to stick to your guns. If you're happy with what you're doing, stick to your guns. Yeah, yeah, don't start questioning yourself. Exactly. So before we start wrapping things up, what would be your main piece of advice to anybody who is going to go forward and have their IMT interview in the next few weeks?

SPEAKER_00 17:33

I guess it would be just practice and structure, having a clear idea of exactly what you're going to do in each station and what you want to communicate to the interviewers. So for the clinical one, just making sure that you've got that A to E and that you're then already thinking about sort of the diagnosis and investigations. Similarly with the ethics, just knowing your good medical practice and with the application and suitability, knowing your portfolio and knowing exactly what you want to tell them about. So I just had one A four piece of paper in the end, which I boiled down everything that I wanted to make sure that I'd done for each section, and then I felt like I'd be happy with that. And I think having that structure in my head really helped me, particularly when I was getting a bit stressed.

SPEAKER_01 18:19

I guess my final question would be: I know that a lot of people who have either finished FTU or have done, you know, a locum F3 year may have applied for multiple different training programs. So now that you're almost halfway through IMT one, do you regret your decision? And what would you say to somebody thinking about whether IMT is the right thing for them or not?

SPEAKER_00 18:44

No, I don't regret my decision. IMT is not easy, you know, it's a hard training pathway, but I'm not sure anything is particularly easy in the NHS nowadays. I think that IMT is about getting a good basis in medicine and then learning so that you've got that structure in place for progression up through the hospital. And I guess it's just about seeing that long-term pathway of, you know, if you see the medical consultants and think, oh yeah, that's something I really want to do and something I think I would enjoy, then I guess that is the main thing. I think for myself, I've always wanted to work in a hospital and in a team environment, and I enjoy the stimulation of hospital medicine. So I guess it's more about seeing the long term. Like I say, it's not easy, but I don't think anything in the NHS is particularly easy.

SPEAKER_01 19:27

And I think the only thing that I would add to that is, because this is what I get told a lot, is I couldn't imagine being a medical registrar. And if I can encourage you, if you are thinking about doing IMT, but you're worried about what will come after that, IMT prepares you for being a medical registrar. And the knowledge that you get during IMT is what you need for being a medical registrar. And I think there is a lot of hype about it, but ultimately you're just the one that's had the training to be able to make the decisions that perhaps other people wouldn't not aren't trained to do, but you know, need that extra push to make. So please don't let the thought of being a medical registrar put you off doing IMT.

SPEAKER_00 20:13

Yeah, and I guess also, you know, I'm obviously still quite a way off and have a lot more left to learn, but you can already see that the progression in that. And I was always worried as well that being a medical registrar sort of meant that everything fell on you in the hospital, particularly at night. But I think that's definitely not the case, particularly nowadays in AEs and things, there's often the consultant there, there's other registrars around, and also, you know, in most hospitals, there's normally more than one medical registrar as well. So I guess there's also peers to look to and to support you. So it still seems a bit daunting to me, but I think I'll get there.

SPEAKER_01 20:48

As you said, everyone works as part of a team. So please, please don't worry about that. So thank you everyone for listening. We hope you found this useful. Please check out the footnotes of the podcast and good luck with your interviews. And Georgia, thank you so much for joining us today. No, thank you so much. All the best.