A clinical-grade prep platform for UK Higher Specialty Training interviews. Score your portfolio against the PHST framework, simulate 22-minute stations under pressure, and rehearse with consultant-style mark schemes.
75-year-old presents with sudden breathlessness and chest pain. CTPA confirms saddle PE with right heart strain. Walk us through your acute management.
Situation: haemodynamically borderline PE with RV strain
Background: hormone therapy, recent immobility post-op
Assessment: high-risk PE — sPESI 2, troponin positive
Recommendation: ICU, anticoagulate, consider thrombolysis
Why StepUp ST4
Engineered with registrars who have sat — and passed — the panel. No recycled MCQs. Real stations, real frameworks, real timing.
Interactive self-assessment across all six portfolio domains. Dynamic totals as you select between local poster vs national oral, single-cycle audit vs closed-loop QI.
Mirror the real online interview format. Strict countdown timer, tabbed sub-stations, and a recording surface so you rehearse under genuine time pressure.
Every clinical answer scaffolded with SBAR for handover and SPIES for ethical dilemmas — the exact structures interviewers listen for.
Reveal what the panel is looking for after each attempt — early escalation, red-flag identification, structured management — and self-grade against it.
The interview format
The PHST ST4 interview runs on Qpercom as two stations with two examiners each. Every station is split into two ~7–8 minute sub-stations covering a distinct domain.
Two back-to-back sub-stations with the same panel. Examiners assess acute clinical reasoning and your commitment to the specialty.
Unseen vignette: acute presentation, differentials, immediate management, escalation and safety-netting.
Why this specialty, evidence of commitment, achievements, audit/QI, teaching, research and reflection.
Opens with a 1-minute prepared suitability presentation, then a structured ethics / professionalism scenario.
1-minute pitch on why you'll be a safe, effective medical registrar — followed by structured questions on leadership, teamwork, QI and NHS structure.
Capacity, consent, confidentiality, raising concerns, candour and GMC Good Medical Practice — structured with SPIES / four-pillar ethics.
Specialties covered
Clinical stems are mapped to each specialty curriculum. Portfolio, management and ethics stations are shared because panels ask them universally.
Run a full 22-minute mock interview right now — clinical stem, portfolio probe, ethical dilemma, mark scheme.