The cardiology ST3 interviews are a highly competitive process which understandably cause considerable anxiety for candidates. However, there are several things that you can do help you perform at your best. The aim of this article is to outline the interview process and to give some advice based on our personal experience and opinion. We’ve also produced our Cardiology ST3 Interview Question Bank to help you prepare.
The interview comprises of three stations. They can take place in any order, depending on the circuit that you are in. Each station will last about 20 minutes with a short break (5-10 minutes) in between, which will give you time to prepare for the next station. Usually there are three separate rooms for each of the stations and interviews occurs on a rotational basis, so that the candidates, not the interviewers, move around the circuit. There are ushers on hand who will guide you to your stations and each room usually has chairs outside where candidates sit and wait to be called in.
The portfolio station comprises of the opportunity to answer the question: “Why are you the ideal candidate for cardiology training?” The question varies slightly each year and is released before the interview when interview details are sent out. Despite the changes in wording, every year its essence is the same and it is an opportunity for you to sell yourself and outline why you are suitable for cardiology training. The interviewers will be sat a table and once you have entered the room, they will likely recite the question back to you and give you the opportunity to talk without interruption. You will usually be asked to answer the question in the form of a presentation. This is done without the use of aids, such as powerpoint slides etc. It is best to consider it as a four-minute opportunity to sell yourself. It is unlikely that you will be asked to stand to present.
Most candidates will have very similar curriculum vitae: publications, presentations, audits/QIPS, research, clinical cardiology rotations during foundation or core medical training, cardiology specific courses (e.g. echocardiography courses), MRCP (or pending). Whilst it’s important to mention these in the presentation, the point of this station is not to simply list your achievements or experiences as you did in your written application. You must qualify your achievements and relate them to cardiology, explaining how they will make you a better cardiology registrar.
- What did you do on your cardiology rotation that makes you suitable for cardiology? Did you manage outpatient clinics?
- What clinical skills did you practice or are competent in that are cardiology-specific?
- If you attended an echocardiography course, have you practiced this on the ward, and are you able to acquire basic images?
- Did you spend time in the catheter lab, understanding coronary physiology, the practical aspects of angiography, and managing the complications associated with interventional cardiology?
- What did you learn from your research projects, or when writing or publishing your research? What skills did you acquire through these processes, and importantly, how will that be helpful to you in cardiology training?
- What audits or QIPs have you completed, and what will you be able to bring to the teams that you will join as a cardiology registrar?
You will appreciate from the questions above that the four-minute slot should not be spent simply listing your experiences or achievements. It is imperative that you relate it to cardiology training, clearly demonstrating what you have learned and most importantly how you will be able to apply it to your specialist training.
Four minutes is a very short time in which to do this. You must be economical with your words and make each one count for something. Try not to waffle. Similarly, it is important not to appear too rehearsed. For this reason, we recommend that you don’t write down your “speech” and read it out to the interviewers.
Ensure that you make eye contact, smile (even though you will be nervous) and come across as positive and enthusiastic, but not overly confident or arrogant. Remember, the interview is an opportunity for your future consultants to judge whether or not they would want you to work alongside them, so it’s important come across well.
After you have made your case for being a cardiology registrar, they will ask you three or four predetermined questions relating to your portfolio. These questions will be the same for all candidates to ensure that the interview is fair. They may ask about research, audit or organised teaching events. Again, the same principles apply: outline what you did, what you learned and how you will apply it to cardiology training. We would suggest that you limit your answers to no more than two minutes, and ideally aim for about one and a half minutes. This should be sufficient and will ensure that you do not ramble on, which can be boring for the interviewers and reduce the time that they have to ask you other questions. You should ensure you know your written application inside out and can qualify and explain everything in it.
The second station consists of clinical scenarios. There will be two clinical scenarios, likely related to cardiology, and the details of these will be provided to you approximately 5-10 minutes before the station begins. You should use this time wisely to gather your thoughts, apply clinical principles and pre-empt the questions that examiners may ask. Remember, this is not an opportunity to tell the interviewers everything that you think you know about cardiology. During the station, you must listen carefully to their questions and answer them concisely, ensuring you don’t deviate too far away from what they have asked. It is acceptable to ask for more information but be specific about what you want to know and remember there will be a limit to how much they can help you.
In one of the scenarios there is a good chance you will be expected to take a history and examine a patient. However, if the history and examination findings are already provided to you beforehand, don’t waste too much time repeating these. On the day it is important you adapt to whatever scenario they present you with.
The most important point for you to remember is to start with the basics and be safe. They want to know that you are competent and will work within the confines of your knowledge, without trying to do something that you are not yet trained to do. There is nothing wrong with suggesting investigations that you cannot perform, but we’d advise you to start with the basics. Try to put yourself in the scenario and say what you would do in real life. The station is designed to test your clinical acumen and judgement, so saying that you would do a coronary angiogram or insert a pericardial drain as your first response is unlikely to score you many points.
Instead, start by saying you would take a history and examine the patient, managing them in a systematic and organised fashion. Your first priority would be to stabilise the patient and ensure basic tests are done (blood tests, ECG, urine dip, chest xray, ensuring there is vascular access and a cardiac monitor). You would then inform other members of the team to organise specialist tests and management. The point here is to emphasise that you are able to manage acutely and chronically unwell patients presenting with cardiovascular illnesses. You will be expected to have some knowledge of managing cardiology specific scenarios, for example post-angiography or post coronary syndrome complications, however, you should aim to demonstrate this knowledge once you have first covered the basics.
You should be aware of the NICE and ESC guidelines for common presentations such as stable angina, coronary syndromes, heart failure, hypertension, tachy- and brady-arrhythmia, syncope. You should also be aware of the cardiology specific investigations eg. echocardiograms, stress tests, CT coronary angiography, angiography and angioplasty, cardiac MRI etc. However, due to time limitations there are unlikely to ask you detailed questions about these so a general overview should suffice. You goal should be to demonstrate you have knowledge of guidelines and are able to apply them to an unwell patient.
Remember, in order to score highly you need to answer the questions concisely, start with a basic management plan and then move to more complex tests and investigations. You must then demonstrate that know when to escalate for help and can think laterally about the patient’s problems, ideas, concerns, and expectations.
Clinical Governance/Management and Ethics
The third station is for clinical governance/management and ethics. Unlike the clinical scenarios, the scenarios in this station are notoriously difficult to pre-empt. Our advice here would be to ensure that you understand clinical governance and the various activities that comprise this umbrella term (eg. teaching and training, audit, information technology etc.). Have examples of activities that you have been engaged in that demonstrate your understanding and participation in clinical governance. Again, it is important to not just list what you have done, but to explain your learning and how you would apply it to cardiology training.
I would also be recommend reading GMC guidelines for doctors, including best practice, consent, confidentiality and mental capacity. Having some knowledge about the role of indemnity organisations like the MPS and may also be helpful. It is possible that there will be scenarios similar to the situational judgement test (SJT) taken by final year undergraduates and GP trainees during their application process. Irrespective of the scenario, your goal should be to demonstrate that you are sensible and safe, aware of guidance and can quote some references (for example GMC guidelines).
We hope that the above has been useful in outlining the interview process and has given you an insight into what you may expect. Of course, interview formats and their content can change year on year, and your own experiences may differ to those noted above. But you can be confident that the same principles will apply to your interview and hopefully you will find our advice informative and useful.
You can see our other cardiology resources here.