Prepare for the 2026 Geriatric Medicine ST4 Interview with Structured, Specialty-Specific Practice Questions

Geriatric Medicine ST4 Interview Questions built for doctors preparing for the 2026 national selection interview. The bank covers every station of the online PHST panel, from clinical scenarios and reflective practice to communication and non-clinical domains, and is written by high-scoring registrars with recent experience of the selection process.

“I was successful at interview and the scenarios were very similar to those on the Medibuddy website. The information on Medibuddy was really useful for interview preparation.”

“I wanted to say thank you for your wonderful site. I got my top ranked post and I scored highly in all stations.”

Updated for 2026

What to Expect from the Geriatric Medicine ST4 Interview

Geriatric Medicine ST4 recruitment is coordinated nationally by the Physician Higher Specialty Training (PHST) office on behalf of JRCPTB, with applications submitted through Oriel. Competition sits at 2.06:1 for the 2025 round (323 applications for 157 posts, NHS England), up slightly from 1.75:1 in 2024. The specialty remains less oversubscribed than most physician routes, but with published appointability thresholds the interview itself is where posts are won or lost.

Interviews have been conducted online in recent cycles through the national PHST process; confirm the current-year delivery format with the PHST Geriatric Medicine guidance. Two framings of the interview appear in official sources: the British Geriatrics Society describes approximately four questions of 5–10 minutes each with an overall communication mark, while more recent PHST guidance describes a two-station format with each station scored by its own pair of consultant interviewers. These are two descriptions of the same online interview, and total interview time is typically around 30–40 minutes. A third clinician occasionally joins to share questioning. Station detail below reflects PHST guidance and candidate-reported experience; treat it as directional and confirm the current-year specifics with your deanery briefing.

Clinical Station

You’ll be given a hypothetical clinical scenario involving a complex older patient and asked to talk through your assessment, prioritisation and management. This station tests clinical reasoning against the Comprehensive Geriatric Assessment framework: acute medical management, frailty, multimorbidity, functional and social context, and MDT decision-making. Scoring is on a 1-5 scale per assessment area, contributing to the Raw Interview Score.

Professionalism, Ethics and Commitment to Specialty Station

The second station covers professionalism, governance and ethics alongside your motivation for geriatric medicine. Expect scenarios involving capacity, DNACPR, safeguarding, or managing a colleague’s behaviour, together with questions on why you have chosen the specialty, your relevant experience, and your plans within dual GIM and geriatrics training. Each assessment area is again scored 1-5 by the paired interviewers.

Communication

Communication isn’t a separate role-play station but is scored across the interview as a whole. Interviewers mark clarity of thought, empathy, structure when discussing families and MDT colleagues, and how you handle ethically loaded material. Given the specialty’s emphasis on complex conversations with patients, carers and teams, this domain carries real weight in the final ranking.

What the Panel Is Looking For

Based on published PHST guidance, ten individual 1-5 scores across the two stations produce a Raw Interview Score out of 50, which is then weighted to produce a Weighted Interview Score reported as being out of 80. This is combined with an Application Score (out of 40, halved to 20) to give a Total Score out of 100. Confirm current-year weightings on the PHST Geriatric Medicine specialty page. To be appointable you need no 1/5 in any domain, no more than two 2/5 scores, and a minimum RIS of 30. Across every station the panel is assessing the same underlying attributes set out in the person specification: sound clinical judgement in older patients, empathy, MDT working, probity, and a credible, evidenced commitment to geriatric medicine.

The Medibuddy 2026 Geriatric Medicine ST4 Interview Question Bank

We’ve built the question bank around the actual shape of the Geriatric Medicine ST4 interview: the PHST two-station format, within which the British Geriatrics Society describes roughly four questions of 5–10 minutes each covering clinical, ethical and governance, and portfolio-linked reasoning in turn. It covers every station comprehensively, including the reflective and significant-event discussion, capacity and DNACPR ethics, end-of-life and ceiling-of-care decisions, safeguarding, and the clinical scenarios that come up repeatedly in older-patient care. Every question and model answer is written by high-scoring geriatric medicine registrars who recently sat the interview, and the bank is updated each year using feedback from that year’s candidates.

What’s Included in the Geriatric Medicine ST4 Interview Question Bank

How to Prepare for the Geriatric Medicine ST4 Interview

Preparation for the PHST Geriatric Medicine ST4 interview isn’t about learning stock answers. It’s about understanding what each of the two stations is scoring, then rehearsing your material until you can deliver it precisely within the time each interviewer pair gives you.

Understand the format before you start practising

The interview has been delivered online through the national PHST process in recent cycles as a two-station structured panel, with a separate pair of interviewers scoring each station. Total interview time typically falls in the 30 to 40 minute range, split across roughly four questions of 5 to 10 minutes each with an overall communication mark layered across the whole encounter. Before you rehearse a single answer, read the current PHST Geriatric Medicine page and the 2026 person specification so you know exactly which domains (clinical, professionalism and governance, commitment to specialty, communication) sit in front of which interviewer pair. Working through the question bank in parallel with the person specification is the most efficient way to translate those criteria into rehearsed answers; practising blind against a generic "med interview" format wastes time.

Focus on knowledge and delivery equally

Strong clinical content delivered as an unstructured monologue scores poorly, and a slick structure with thin geriatrics knowledge is caught immediately by consultant interviewers. We recommend treating knowledge and delivery as two separate workstreams. Build your underlying content (frailty syndromes, falls, delirium, dementia, continence, end-of-life decision making, capacity, and the acute general medical topics you’ll be expected to handle as a dual-accredited registrar) using the 2022 JRCPTB curriculum, BGS guidance (including the Silver Book), and relevant NICE guidelines. Then use timed question practice against the bank to turn that knowledge into structured, spoken answers that fit the 5 to 10 minute window.

Build preparation around each station

Station 1 (clinical). Rehearse acute geriatric and acute general medical scenarios out loud: the frail patient with delirium and sepsis, the falls admission with an atypical presentation, the polypharmacy review, the MDT decision on ceiling of care. Use a clear framework, work through assessment, differential, immediate management and MDT/discharge planning, and practise finishing inside the question window.

Station 2 (professionalism, governance, ethics and commitment to specialty). Prepare for capacity and best-interests scenarios, DNACPR and ReSPECT conversations, safeguarding, complaints, colleague behaviour and clinical governance. Alongside this, expect commitment-to-specialty and motivation questions: why geriatrics, why now, what your taster experiences, QI work and teaching tell them about your fit for a four-year dual GIM programme.

Practise under timed conditions

The 5 to 10 minute question window is the constraint most candidates underestimate. In real interviews, strong answers get cut off mid-flow and weak ones sprawl. We recommend practising with a visible timer from your very first mock: 60 seconds to think, then a structured answer that lands its main points inside the window and closes cleanly. Record yourself, listen back, and cut filler.

Start earlier than you think

We recommend beginning focused interview preparation around eight to twelve weeks before your interview date, alongside continued portfolio and self-assessment work. That gives you time to build clinical content, run at least two full mock cycles across both stations, and refine your commitment-to-specialty narrative. Candidates who start in the final fortnight typically know the material but haven’t rehearsed delivery, and it shows in the communication mark that sits across the whole interview.

Practise deliberately with the question bank

Reading through model answers isn’t practice. The bank is designed to be worked through out loud, timed, station by station, so that by interview day the format feels familiar and your answers land inside the window. Rotate between clinical scenarios and Station 2 material rather than drilling one domain in isolation, and revisit weaker questions until the structure is automatic.

Frequently Asked Questions

What does the Geriatric Medicine ST4 interview involve?

The interview has been delivered online in recent cycles through the national Physician Higher Specialty Training (PHST) recruitment process as a structured multi-station panel, with two scoring interviewers per station. Stations cover clinical scenarios, professionalism and ethics, and commitment to specialty, with communication assessed throughout. Total interview time typically runs around 30 to 40 minutes.

How competitive is Geriatric Medicine ST4?

Competition is moderate compared with most physician specialties. NHS England’s published figures show 323 applications for 157 posts in the 2025 round, a ratio of 2.06:1, up slightly from 1.75:1 in 2024. The specialty has historically been undersubscribed, but rising applicant numbers mean interview performance still decides who ranks where and who secures their preferred region.

What topics come up in the Geriatric Medicine ST4 interview?

Expect clinical scenarios rooted in older people’s medicine: delirium, falls, frailty, deteriorating patients, and ceiling-of-care decisions. Professionalism and ethics questions cover consent, capacity, safeguarding and end-of-life discussions. You’ll also be asked about your commitment to the specialty, a significant clinical event you were involved in, and questions drawing on your portfolio, teaching, quality improvement and leadership experience.

Does the question bank cover every station?

Yes. The bank is built around the PHST two-station format used for Geriatric Medicine ST4, with practice questions across clinical scenarios, ethics and professionalism, motivation and commitment to specialty, and reflective significant-event discussion. Each question includes a model answer and marking guidance mapped to the domains interviewers actually score, so you can rehearse the full interview rather than isolated topics.

When should I start preparing for the Geriatric Medicine ST4 interview?

We recommend starting around eight to twelve weeks before your interview date. That gives you time to work through clinical scenarios covering the core geriatric syndromes, refine a structured approach to ethics and professionalism questions, prepare portfolio and motivation answers, and rehearse a reflective significant event. Candidates who begin only in the final fortnight rarely have time to move from knowing content to delivering it clearly under timed conditions.

Start Preparing for the Geriatric Medicine ST4 Interview

Most candidates prepare by reading broadly across geriatric syndromes and hoping it translates on the day. Strong candidates prepare differently. They practise the exact stations they’ll face, rehearse structured answers under time pressure, and align their preparation to how the ST4 interview is actually assessed.