The interview is the single biggest factor you can influence.

Many strong candidates already bring a portfolio interviewers value. Typical strengths include:

• NHS registrar experience in Acute Medicine
• MRCP (UK)
• Quality improvement work with closed-loop cycles
• Teaching experience with feedback
• National poster presentation
• Peer-reviewed publication
• Leadership roles (rota, trainee rep, committee)
• Additional professional development (e.g. Level 7 diplomas) — frame relevance honestly

The key is presenting these experiences effectively — focus on impact and learning, not a list of activities.

Although the format can change each year, higher physician specialty interviews commonly assess:

• Clinical judgement
• Specialty commitment
• Communication
• Leadership and management
• Quality improvement and patient safety
• Professionalism and ethics
• Reflection
• Motivation for the specialty

Interviewers are looking for someone who thinks like a future medical registrar and future consultant. Instead of:

“I would refer to gastroenterology.”

Say:

“My priorities are recognising severity, initiating resuscitation, involving the appropriate multidisciplinary team early, and ensuring definitive management while maintaining patient safety.”

They want structured reasoning, not a referral.

Expect scenarios such as:

• Upper GI bleed
• Decompensated cirrhosis
• Acute severe ulcerative colitis
• Acute pancreatitis
• Ascending cholangitis
• Liver failure
• Dysphagia and oesophageal obstruction
• Severe diarrhoea
• GI oncology pathways

For every case, use the same framework:

• ABCDE assessment
• Immediate investigations
• Initial management
• Escalation
• Communication
• Safety-netting
• Reflection

Every achievement should be ready to discuss. For your QIP, be prepared to explain:

• Why you identified the problem
• Baseline measurements
• PDSA cycles
• Results
• Challenges
• Sustainability
• What you learned

Similarly, rehearse: audits, publications, posters, teaching programmes — interviewers explore impact and personal learning, not just what you did.

For leadership or behavioural questions, use STARR:

• Situation
• Task
• Action
• Result
• Reflection

Reflection is frequently what distinguishes stronger answers.

Have thoughtful answers to:

• Why this specialty?
• Why this specialty over others?
• What excites you about it?
• Where do you see yourself in 10 years?

For Gastroenterology, discuss: endoscopy, hepatology, IBD, nutrition, GI bleeding, cancer pathways, long-term patient relationships, research and service improvement. Avoid generic statements like “I enjoy procedures.”

• Patient safety
• Duty of candour
• Human factors
• Clinical governance
• Quality improvement
• Resource stewardship
• Equality, diversity and inclusion
• NHS Long Term Plan
• Multidisciplinary team working

Expect scenarios involving:

• Breaking bad news
• Managing an angry relative
• Capacity and consent
• DNACPR discussions
• End-of-life care
• Complaints
• Difficult colleagues

Show empathy, active listening, and clear explanations.

Read recent guidance and updates in your specialty: national guidelines, endoscopy quality standards, liver disease, IBD, upper and lower GI bleeding. You don't need to memorise everything — you should be aware of current best practice.

Many candidates know the content but lose marks because they become disorganised. Practice:

• Speaking for 5–7 minutes on common topics
• Answering with a timer
• Receiving challenging follow-up questions
• Staying calm when interrupted

Recording yourself or rehearsing with colleagues is very useful.