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

This page covers our Palliative Medicine ST4 Question Bank, and includes relevant interview questions that have been written and refined by recently appointed registrars who scored highly at national selection. Built for doctors preparing for the 2026 national selection interview, the question bank covers every station you’ll face on the day, from portfolio and commitment-to-specialty discussion through to clinical and communication scenarios drawn from real palliative practice.

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Updated for 2026

What to Expect from the Palliative Medicine ST4 Interview

Palliative Medicine ST4 recruitment is coordinated nationally through the Physician Higher Specialty Training (PHST) process, with interviews delivered as a video interview rather than in person. Competition has climbed sharply in recent cycles: NHS England’s Medical Hub reported a ratio of 1.04 in 2022, 1.55 in 2024 (101 applications for 65 posts), and 2.34 in 2025 (136 applications for 58 posts). You’re now competing against more than twice as many applicants per post as candidates were three years ago.

The interview runs as two 15-minute stations, roughly 40 minutes in total. Each station has two scoring interviewers (occasionally a third clinician helps with questioning), and each pair scores its station independently against defined domains. Each station carries two questions. The raw interview score (RIS) is weighted to /80 and combined with the verified self-assessment score (weighted to /20) to give a total out of 100. The four assessed sections below sit across these two stations and reflect the most recent official and Association for Palliative Medicine guidance; specifics can shift year on year.

Suitability and Commitment

Assessed in Station 1. The panel explores why you’ve chosen Palliative Medicine, the experiences that took you there, and the commitment you’ve shown beyond the mandatory curriculum: audit, teaching, research, hospice exposure and relevant courses. Expect to evidence specific, credible examples rather than general enthusiasm. Each interviewer scores you on a 1 to 5 anchored scale.

Medical Registrar Suitability

Also assessed in Station 1, reflecting the dual pathway with Internal Medicine Stage 2. Expect questions on acute medical decision-making, escalation, prioritisation, and your readiness to function as the on-call medical registrar.

Ethical and Communication Scenario

The core of Station 2 is scenario-led. You’ll work through complex symptom control (pain, breathlessness, agitation, terminal restlessness), end-of-life decision-making, and acute problems in palliative patients. Communication is assessed inside the scenario through breaking bad news, advance care planning, DNACPR conversations, and family or team conflict, rather than as a separate role-play.

Ethics, Professionalism and Governance

Station 2 also carries a dedicated ethics, professionalism and governance question: capacity and the Mental Capacity Act, withdrawal of treatment, the distinction between palliative sedation and euthanasia, consent at the end of life, and requests for hastened death. Scoring uses the same 1 to 5 scale.

What the Panel Is Looking For

To be appointable for Palliative Medicine you cannot receive any score of 1/5, you can receive no more than two scores of 2/5 across the ten interview marks, and your RIS must reach the published threshold (30 for Palliative Medicine in recent rounds, though this figure can be revised annually). Across both stations, panels are weighing the same threads: structured clinical reasoning grounded in the 2022 JRCPTB Palliative Medicine curriculum, holistic multi-professional thinking, ethical and legal literacy, calibrated communication (frameworks such as SPIKES score well when delivered with warmth rather than recited), and a credible, specific account of why this specialty and why now.

The Medibuddy 2026 Palliative Medicine ST4 Interview Question Bank

We’ve built the question bank around the real structure of the Palliative Medicine ST4 national interview and the sections it assesses: Suitability and Commitment, Medical Registrar Suitability, the Ethical and Communication Scenario, and the dedicated Ethics, Professionalism and Governance question. Coverage is comprehensive across every section, with scenarios mapped to the 2026 person specification and GMC end-of-life care guidance. We update the question bank each year using feedback from candidates who’ve just sat the interview, and every question is written and reviewed by high-scoring Palliative Medicine registrars who recently went through selection themselves.

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

How to Prepare for the Palliative Medicine ST4 Interview

Strong preparation for Palliative Medicine ST4 requires structure. The interview is short, specialty-specific and scored by two separate pairs of consultants. The candidates who do well treat it as two distinct assessments rather than one long conversation, and they start working on each well before the invitation lands.

Understand the format before you start practising

You’re preparing for a short, structured video interview delivered through the national selection process. The format is two 15-minute stations, each with two questions and a different pair of scoring interviewers. One station focuses on commitment to palliative medicine and your readiness to function as a medical registrar; the other works through clinical scenarios where ethics and communication are typically embedded rather than tested separately. There is no extended pre-reading bay between stations (any reading time sits inside the station) and notes are permitted during the interview. Knowing this shapes everything else: you’re rehearsing tight, structured answers under a hard clock, not building 20-minute monologues.

Focus on knowledge and delivery equally

The Palliative Medicine ST4 interview rewards both clinical substance and the way you deliver it. Knowing the ethical framework for withdrawal of treatment isn’t enough if you can’t structure it in 90 seconds for a consultant panel. The reverse is also true: a confident delivery style won’t carry an answer that misses the symptom-control specifics or the medical registrar judgement the station is testing. We recommend building your underlying knowledge in parallel with your interview practice, then using timed question practice to sharpen the delivery.

Build preparation around each station

For Suitability and Commitment and Medical Registrar Suitability (Station 1), work through structured answers on why palliative medicine, what you’ve done to demonstrate that commitment (taster weeks, hospice exposure, APM involvement, palliative-focused audits and teaching), and how you’ll function as the on-call medical registrar. Have specific examples ready. The panel will probe.

For the Ethical and Communication Scenario and the Ethics, Professionalism and Governance question (Station 2), drill end-of-life decision-making, symptom control crises, family conflict, capacity and best interests, error disclosure and candour, and the medical registrar scenarios involving deteriorating patients. Practise voicing your thinking out loud against a clock. The scenarios reward a clear structure (information gathering, clinical management, ethical reasoning, escalation and communication) far more than a memorised script.

Practise under timed conditions

Each question gives you only a few minutes to answer, and the difference between candidates is rarely the content; it’s the structure under pressure. Practise to the actual station length with a partner playing interviewer, ideally on a video call to mirror the real format. The small Palliative Medicine ST4 applicant pool means informal practice partners are easy to find through APM networks and trainee groups, and a Reddit-organised partner is better than no partner.

Start earlier than you think

We recommend giving yourself at least eight to twelve weeks of focused interview preparation, and longer if your clinical exposure to palliative medicine has been limited. The format is narrow but deep, and the consultants interviewing you will probe quickly past a rehearsed surface answer. Starting early also gives you time to arrange a taster week or join a hospice MDT, both of which give you genuine material to draw on in the commitment station.

Use the question bank to pull it all together

The principles above only work if you practise them on the right material. Our Palliative Medicine ST4 question bank is structured around the two-station format, with timed scenarios for each station and model answers that show the structure consultants are scoring against. Work through it alongside your knowledge revision, then run timed mock stations with a partner in the final fortnight.

Frequently Asked Questions

What does the Palliative Medicine ST4 interview involve?

The interview is delivered online through the national recruitment process, as two 15-minute stations, each scored by a separate pair of clinician interviewers. One station explores commitment to the specialty and your portfolio; the other centres on a clinical scenario where ethics, communication and end-of-life decision-making typically arise within the case.

How competitive is Palliative Medicine ST4 in 2026?

Competition has risen sharply. NHS England’s Medical Hub recorded a ratio of 1.04 in 2022 (53 applications for 51 posts), 1.55 in 2024, and 2.34 in 2025 (136 applications for 58 posts). Applicant numbers have more than doubled in three cycles, so a strong interview performance now carries more weight than it did even a year or two ago.

What topics come up in the Palliative Medicine ST4 interview?

Expect questions on commitment to palliative medicine, your suitability for the medical registrar role, and clinical scenarios drawn from symptom control, complex prognostication and multidisciplinary working. Ethical issues around withdrawal of treatment, capacity, error disclosure and family conflict are routinely embedded in the scenarios, alongside reflective discussion linked to the specialty’s reflective practice requirement.

Does the question bank cover every station?

Yes. The question bank is built around the current interview format and covers all four assessed sections: Suitability and Commitment, Medical Registrar Suitability, the Ethical and Communication Scenario, and the dedicated Ethics, Professionalism and Governance question. Each section has its own dedicated set of scenarios so you can rehearse the format you’ll actually face.

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

We recommend starting at least eight to twelve weeks before your interview date. Palliative Medicine ST4 interviews for 2026 are scheduled for 16–17 March, so building in time for structured scenario practice, mock stations and refining your reflective cases well before invitations land gives you room to fix delivery issues rather than just learn content.

Start Preparing for the Palliative Medicine ST4 Interview

Most candidates prepare by reading broadly across symptom control, ethics and service issues. Strong candidates prepare differently. They rehearse against the actual station format, time their answers, and refine how they communicate under panel conditions, which is how the Palliative Medicine ST4 interview is genuinely assessed.