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StepUp ST4

About

Built for the panel you'll actually sit in front of.

StepUp ST4 is a focused interview preparation resource for UK doctors applying to ST4 Higher Specialty Training in the medical specialties.

Who writes this

The question bank and model answers are written by a UK internal medicine registrar who has been through PHST recruitment — MBBS, MRCP(UK), currently working at registrar grade in acute internal medicine. Every clinical answer is written against current NICE, Resuscitation Council UK and specialty society guidance and dated where the guidance matters; every recruitment figure on the site is taken from the published NHS England and PHST sources and cited on the page it appears.

What that means in practice: this is one clinician's account of what a good answer sounds like, not a Royal College publication and not an official mark scheme. It is written to be useful rather than authoritative, and where the official guidance and this site disagree, the official guidance is right.

How it is kept current

  • Competition ratios and recruitment dates are checked against the published NHS England and PHST pages at the start of each recruitment round.
  • Clinical content is reviewed against current national guidance each round, and re-reviewed whenever a major guideline changes mid-round.
  • Corrections are welcome and acted on — email Vitalcaredx@gmail.com. If something here is wrong, we would rather hear it from you than from a candidate who repeated it to a panel.

Content last reviewed 18 September 2026.

What's inside

  • 157 questions across the four standard panel stations: clinical, portfolio, management and ethics.
  • Specialty-specific clinical stems for Acute Internal Medicine, General Internal Medicine, Cardiology, Respiratory Medicine, Gastroenterology, Endocrinology & Diabetes, Neurology, Renal Medicine, Geriatric Medicine, Medical Oncology, Stroke Medicine and Genitourinary Medicine.
  • A timed mock interview that mirrors the format and pacing of an HST panel.
  • Model answers and the explicit key points panels score against.

How to use it

Rehearse out loud. Read the question, set the timer, deliver your answer as if the panel is watching, then reveal the model answer and the key points. Note the gaps. Repeat the station until the structure is automatic.

Disclaimer

Educational content only. This is not a substitute for clinical judgment or current NICE, BNF and local trust guidelines. We are not affiliated with the NHS, NHS England, HEE or any Royal College, and no outcome at interview is guaranteed.

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