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ST4 interview FAQ

The questions candidates actually ask, answered from the published recruitment guidance rather than from rumour.

Source: PHST Recruitment . Always confirm against the official guidance for your own round.

When are the ST4 interviews?

For the round recruiting to February–April 2027 posts, interviews run in October and November 2026. They are held virtually on Qpercom. Exact dates are released by the recruiting office and vary by specialty, so check your Oriel account and the PHST specialty page for your own window.

How is the ST4 interview scored?

Each specialty assesses four, five or six domains. Every domain is scored independently by two interviewers on a 1–5 scale, and the total of those marks is your Raw Interview Score (RIS). Five domains, for example, means ten marks and an RIS range of 10–50.

What makes a candidate appointable?

Three conditions must all be met: no score of 1 out of 5 in any domain, no more than two scores of 2 out of 5, and an RIS at or above the threshold for your number of domains — 24 for four domains, 30 for five, or 36 for six. Failing any one of the three makes you non-appointable regardless of the others.

Do I need full MRCP to apply for ST4?

You need MRCP(UK) Part 1 at the time of application and the full MRCP(UK) diploma by the offer date. Holding the full diploma at application is listed as desirable and scores in the self-assessment, but it is not essential to apply.

How much experience do I need?

At least 36 months of medical specialty experience, of which a minimum of 18 months must include the care of acute medical inpatients. You also need evidence of Internal Medicine Stage 1 capabilities.

Which physician specialty is most competitive?

In the 2025 round, standalone General (Internal) Medicine ST4 was the most competitive at 11.24 applications per post, largely because only 17 posts were advertised. Among the larger specialties, Endocrinology & Diabetes was 4.96:1 and Acute Internal Medicine 4.43:1. Geriatric Medicine was the least competitive of the major routes at 2.06:1.

Does the interview score carry over from my portfolio self-assessment?

No. The self-assessment determines whether you are shortlisted for interview. Once you are at interview, your ranking is driven by the interview score itself — which is why a strong portfolio does not rescue a weak interview.

Can I apply to more than one specialty?

Yes. Applications are made per specialty through Oriel, and you may apply to more than one, but each has its own application, interview and offer process. Be realistic about how many interviews you can prepare for properly.

What happens if I am not appointed?

You can apply again in a subsequent round. Applicants who are not appointed are given their scores, which is the most useful information available for deciding whether the gap was the portfolio or the interview.

How early should I start preparing?

Portfolio evidence — teaching, audit and QI, leadership, publications — takes months to accumulate and must exist before the application closes. Interview preparation is more compressible, but candidates who start six to eight weeks out consistently sound more structured than those who start two.

Recruitment rules change between rounds. Everything here reflects the current published guidance, but the official PHST and NHS England pages for your specialty and round are the only authoritative source.

Knowing the process is not the same as being ready for it

Interviews are October–November 2026. The practice libraries cover every domain the panel scores — clinical scenarios, registrar capability, ethics, portfolio and the presentation — with model answers and the Score-5 anchors.

Browse the specialty libraries

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