How to Prepare for Medical School Interviews

Preface

Do you come from a medical family? is a question that any medical student or junior doctor will empathise with.

I’m unsure why, but medics have traditionally seemed to breed medics, and they make fantastic doctors.

However, I am a passionate believer that those who don’t come from medical families make equally fantastic doctors. Not better. Not worse. Equally fantastic.

And it was with that equality in mind that I and twenty equally fantastic medics set about creating this book. I’ve worked with some absolutely wonderful medical students and doctors from almost every medical school in the UK. Our aim was to consolidate the conversations, tips and preparation advice that anyone could have if they chatted to a consultant physician or surgeon about applying to medical school. Some applicants know those people. Some don’t. But whether you are the son or daughter of a brain surgeon, engineer, plumber, psychiatrist, GP or shop assistant I hope this book helps provide that information.

Whether your mum or dad are phenomenally well connected, or you no longer know them, if you want to apply to medical school you should do it. It doesn’t matter what background you’re from. If you have the skill, ability and caring nature to be a doctor, you should be a doctor. I sincerely hope that this book can help demystify the process of getting there, and put you on an equal footing to be an equally fantastic doctor.

Good luck and believe in yourself.

#WideningParticipation

#WideningAccess

Philip McElnay

@phil_mce

March 2016

Chapter 1 |

Applications and interview preparation

Applying to medical school is a slightly different process to applying to study most other subjects. Applications are made through UCAS but almost all medical courses have an earlier deadline for submission: start planning well in advance! Depending on which courses you apply to, you may have to take the UK Clinical Aptitude Test (UKCAT – www.ukcat.ac.uk

), BioMedical Admissions Test (BMAT – www.admissionstestingservice.org/for-test-takers/bmat/

) or both. These tests are designed to distinguish between the best applicants in the country and have an unusual format, so preparation is essential.

The majority of medical schools will then consider your application and create a shortlist to invite for interview. Offers will be based on all the information that they have received: exam grades, UKCAT/BMAT results, personal statement and interview scores. There are some important exceptions, which do not routinely interview UK school leavers. This is always subject to change and we recommend you read the online prospectus of your chosen universities well in advance.

Each medical school puts different weighting on certain aspects of the application. Some choose candidates entirely on the basis of the UKCAT, some use a GCSE grade cut-off and some interview almost everyone. They are transparent about their interview selection procedure and it is worth working out the aspects of your application that are strongest and choosing universities that rate them highly.

Personal statements are important for two reasons. Firstly, they form the only really individual part of your electronic application (most medical school applicants have broadly similar grades and test results). Secondly, during your interview you can expect to be asked about specific details and must be prepared to defend, elaborate upon or discuss them.

Interviews vary widely between medical schools, ranging from a scientific cross-examination to a 15-minute chat about empathy and motivation. Many universities are employing a new format of interview with multiple stations including short traditional interviews as well as tasks and challenges. These are termed Multiple Mini Interviews (MMIs). Once again, whether your chosen university uses this format can usually be gleaned from the internet.

Offers are usually sent in letter or email form. They can arrive late in the day: don’t let this stress you out! Some medical schools will invite offer holders to a second open day, which can help you to decide where to rank each offer.

Graduate applicants

Graduate applicants to medicine come from a variety of backgrounds.

One of the biggest barriers to graduates attending medical school may be financial, but support is out there. National student finance agencies have a range of funding options and there are charities, loans, scholarships and bursaries that can assist graduates.

A number of institutions offer accelerated four-year programmes for graduates. This allows for the completion of the course in a shorter, but more intense, timeframe. Traditional five- or six-year courses also still accept graduates.

Applications are also processed through UCAS and institutions still employ a variety of entrance exams including the UKCAT and BMAT.

Anecdotally, graduates may perform better at interview but expectations are high. A variety of interview techniques are also utilised, from traditional panel interview to a multiple mini interview format.

About the Multiple Mini Interview (MMI)

Questions in MMI format are indicated by ‘(MMI)’ beside the question number in this book.

What are MMIs?

MMI stations are designed to test a range of skills. They involve a number of different, short interviews or role-play scenarios. For example, you may be given one minute to read a set of instructions outside a room. A whistle may then be blown and you will enter the room to perform the task. You will be given a set amount of time to perform the task, e.g. 7 minutes. At the end of the 7 minutes (often with a warning whistle at 6 minutes) a whistle may be blown again and you will rotate to the next station, having one minute to read the brief outside the station again. This will continue for multiple stations, e.g. ten stations. There will be interviewers who will mark your performance in each station and a decision will be taken on your overall performance. Often there will be a number of staff outside the interview rooms to guide you around the circuit.

The stations will often involve challenging and unfamiliar scenarios. Interviewers are eager to assess whether you will be able to communicate effectively in a range of situations, as well as being able to follow instructions, rationally consider complex problems and display a range of technical skills.

The questions may require a small amount of medical knowledge (i.e. enough to demonstrate that you have an interest in medicine) but on the whole they are designed to allow you to demonstrate the range of skills described above without being a medical expert. After being given a written or verbal brief before the station you will often be asked to communicate with an actor or the interviewer in the station.

How do I practise?

The key to success in these scenarios (and in traditional interviews!) is to practise frequently before the interview – you can use this book as a starting point. Pair up with a friend or family member. Ask them to be the actor/interviewer in the scenario and to read the answer in order to develop the situation appropriately. You, as the candidate, should read the brief provided in the question (and no more!) and then speak to your friend as if you are in the real interview. Allow them to develop the scenario as described in the answer. Ask them to provide feedback to you.

Some key tips

If you are asked to communicate with someone in station there are some key concepts that will be common to each scenario. Whilst we don’t have room to mention them each time in the answer you should consider doing each of the following things if the station asks you to talk to someone:

Introduce yourself – the brief will often tell you who you are playing: Hello, my name is John and I am a medical student.

Start with open questions – Can you tell me a little bit about why you are here today? as opposed to closed questions such as Where is your pain?

Summarise your conversation at the end of the station – Just to check I have got everything clear in my mind – your computer broke last week, you brought it to us for repair and you are unhappy with the service we have provided.

Conclude the conversation – Thank you for coming to see me today; I will raise what we have discussed with my supervisor and come back to you today with a solution. See you soon. Perhaps offer a handshake, if it feels comfortable!

About the traditional interview

Questions in traditional format are denoted by ‘(T)’ beside the question number in this book.

Many medical schools across the UK have embraced the MMI format to conduct their interviews. There are a number, however, that still conduct a single, formal ‘across the table’-style interview, with applicants being asked questions by a number of interviewers. Sometimes this format of questioning is used in an MMI station too (and some of the content from the MMI questions contained in this book can also find their way into traditional-style interviews) – don’t forget to prepare both styles of questions.

The questions asked might range from queries about extra-curricular activities to something you mentioned in your UCAS personal statement. The interviewers may debate medical politics with you, delve into your reasons for applying or seek to test your scientific knowledge. Regardless of the strength of your application, preparation for this style of interview is important. In fact, both MMI and traditional interview preparation is likened in quantity and intensity to that for an exam!

TOP TIPS

•Start preparing early – get a friend or family member to ask you questions from this book and answer them as if you were in an interview.

•Speak to junior doctors, consultants, GPs, current medical students (especially those at the medical school to which you are applying) – ask them about the things they love about their job (or the course), but also quiz them about the challenges. Don’t forget to mention to the interviewer that you have done this.

•At least a week before, prepare what you are going to wear. Unless your invitation to interview tells you otherwise, you must look impeccable. Despite male doctors infrequently wearing ties now, males should still wear a shirt, suit and tie. Don’t forget to polish your shoes.

•Arrange/book your travel well in advance and allow some contingency time in case of road works, train delays, poor weather, etc.

•Smile! And practise smiling! By demonstrating that you are approachable and friendly you will make a much better impression than if you appear glum and nervous. It might be difficult to smile, and you will be nervous, but smiling can actually give you confidence and may even make the interviewer smile back, which will give you even more confidence!

•Arrange work experience – find out if medicine is for you. Speak to hospitals, GP practices, private hospitals, nursing homes; people will want to help you. If at first you find it difficult to arrange work experience, keep trying – you may need to be persistent but always be very polite!

•If you have been invited to interview: congratulations! This is a huge achievement in itself and you have clearly impressed the medical school already. Medicine needs a huge variety of people and you should believe in your own abilities without being arrogant. Good luck!

Chapter 2 | Applying to Oxford or Cambridge

Applying to Oxford or Cambridge may be daunting but if you’d like to go you should definitely apply! Have the courage to believe that you could get in no matter how remote a possibility it might feel.

Start thinking early about how to structure your personal statement, as this often guides the interviewers’ questions. Before your interview, research areas of interest that you can talk about fluently and articulately – for example, the Ebola outbreak or new breakthroughs in Alzheimer’s disease research – as you may be asked if there’s a topic you’d like to discuss during the interview.

Cambridge and Oxford both use a college-based university system and it is worth reading about this online before your interview. Often colleges set up one academic and one non-academic interview, so don’t forget to brush up on your answers to the common non-academic questions listed in this book. Some colleges are in higher demand than others and the competition ratios can vary. Oxford and Cambridge have different systems to combat this effect and ensure that the best students get a place at the university no matter which college they apply to. In Oxford you will be allocated an interview at a second college. If you get offers from both colleges, then the college you originally applied to gets priority. In Cambridge you only interview for the college you apply to, but the highest-ranking unsuccessful candidates are placed in a ‘pool’ and can be selected by other colleges that year. The colleges that select out of the pool can either give an offer straight away or interview the candidate again.

Be prepared to be unprepared. Up until now, it is likely that you will have entered exams and similar scenarios with a pretty good idea of what is likely to come up. However, the whole basis and aim of the Oxbridge interview is to take you outside your comfort zone and encourage you to really think. I can almost guarantee that there will be questions to which you don’t know the answer and have never even considered before. The vital thing here is to accept this before you go to interview, and not to let it intimidate you. It will be the same for every other interviewee. The interview is not a simple knowledge test, but rather an opportunity for you to demonstrate how you are able to apply basic principles in unfamiliar scenarios and handle pressure: both are vital skills for any future doctor. Have a look at Chapter 10 to gain more experience of how to answer very unfamiliar questions.

Finally, be enthusiastic! Oxbridge academics meet their students regularly for small tutorials, so they use the interviews to decide whether they feel you would benefit from this sort of interaction and if you would fit in. Your interviewers may ask questions on the subjects that most interest them and if you clearly enjoy discussing and learning about science it will go a long way. Practise spontaneous and stretching conversations about science with your science teachers or friends.

Believe in yourself, and good luck.

Chapter 3 | Questions about you

This is a question asking you to outline the skills that you possess. It is a good idea to start an answer to skills-based questions with a broad sentence such as:

I believe I would be an active and effective member of a PBL group for a number of reasons:

and then, giving three or four skills in a structured manner makes you sound considered and logical, i.e. Firstly,… Secondly,… and finally,….

When describing a skill you possess, back it up with an example and explain how it would make you an ideal medical student. For example:

"Firstly, I have very good time management skills so would be able to plan my week carefully to ensure I could do the appropriate PBL preparation whilst also attending lectures, dissection sessions and clinical skills sessions. I’ve demonstrated my time management skills already in my role as a prefect at school and by organising the publication of my school yearbook whilst also performing well in my school exams and working in a local care home in my spare time.

Secondly, I learn well by discussing new topics and ideas. This would mean I would actively participate in a PBL group and encourage others to do the same. I’ve demonstrated my communication skills by debating on the school debating team.

Thirdly, I am aware of my limits, and so would be very open about asking questions when I don’t understand something. This is very important in PBL because it facilitates conversation and will ensure I cover issues in enough breadth to make me a safe clinician. I have demonstrated this by asking for help in my coursework at school when necessary."

Don’t forget to finish well:

I believe these skills would help me function well in a PBL group.

Some positive attributes of PBL group members:

•Not afraid to ask questions

•Listen carefully to others’ points of view

•Encourage quieter members to get involved

•Well-prepared

•Motivated

•Disciplined enough to study alone

•Pragmatic – you know what information would be important to know in a given situation

This question aims to indirectly expose your inner disposition and determine your level of commitment. You should still provide an answer for the alternative career but its values should be congruent with the values of a doctor. If your reasons for studying medicine include altruism, scientific interest and working in a team, a possible different career path would be to become a Physician Associate. Physician Associates are a new and expanding profession in the NHS and their primary role is to support junior doctors. What is more, in using Physician Associates in your answer, you are also demonstrating an awareness of changes within the NHS.

Answer in three parts:

1. Make it clear you are very committed to a career in medicine

I am exceptionally committed to pursuing a career in medicine; however, if after numerous attempts I remained unsuccessful, I would still like to combine my passion for science, altruism and teamwork in another caring profession.

2. Explain your alternative career plans

I would consider becoming a Physician Associate. Physician Associates work with junior doctors, clerk patients, order tests and diagnose patients. They work in different specialties and have become an established member of the medical team. Their training involves learning core sciences and physical examination skills, both of which deeply interest me. As a Physician Associate, I would be able to apply my knowledge in challenging circumstances. Their work closely complements that of a junior doctor.

3. Tell the interviewer why you are choosing medicine instead

However, there are reasons why the role of Physician Associate is not my first career choice. The Physician Associate qualification currently allows for limited career progression. I really enjoy science, and medicine also offers a more rigorous training in science. I enjoy practical tasks and am quite dexterous, so I would like the opportunity to develop my practical skills and be able to perform a wider range of procedures. Medicine offers an opportunity to apply a combination of deep scientific knowledge and procedural skills to help people, which is why I want to become a doctor.

Other potential career choices:

•Nursing

•Medical relief worker

•Basic sciences

•Voluntary work

•Allied healthcare professional

This question is seeking an example. For any question that asks for an example, you can answer using the ‘BARL’ technique:

Background (i.e. set the scene)

Action (what YOU did to demonstrate the skill asked about in the question)

Result (what were the positive results of your actions?)

Link to medicine (why is the example relevant to your medicine application?)

Firstly, consider what the key qualities of a good leader are. A good leader is one who is fair, decisive, encouraging of the development of members in the group, diplomatic, organised, approachable and dependable. The example you choose should demonstrate some of these qualities. Think about the last time you had more input or decision-making responsibility than other team members in a group, whether in your part-time job, or during a school project. You must relate this to how the qualities you demonstrated in previous leadership roles have taught you how to be a good leader in future. This requires a degree of self-reflection: what did you do that worked well as a leader? Was there anything problematic that happened during your leadership, and if so, how did you resolve it? Being a good leader includes being able to keep those positive attributes in stressful situations.

A good example would be:

Background: I was a part-time salesperson at a vintage clothing shop, and had been working there for three years. On one of my Saturday shifts, the manager approached me, saying she had to leave immediately to deal with a family emergency. The manager asked me to tend to the shop and lead the rest of the team, consisting of four other workers. I had never done this before, and it was a particularly busy day for the shop but I agreed to do so. The pace in the shop quickly picked up and the workers were really stretched.

Action: I strategically placed one worker at the door to greet customers, two on the sales floor and one by the cashier’s till. I floated around the shop assisting the workers as much as possible. Later, I noticed a customer arguing with the worker who was on cashier duty. Seeing the look of panic on the cashier’s face, I quickly went over and talked sensitively with the customer. The customer seemed reassured and happily made her purchase. At the end of the day, I played an equal part in cleaning up and ensured that everything was in order before closing the shop.

Result: The other staff commented on how supportive I had been and how I had clearly given direction throughout the day.

Link to medicine: I believe this ability to work alongside others will allow me to function well as a leader in a medical team.

It may seem counterintuitive to talk about your weaknesses in an interview, but it is the role of the interview panel to judge your suitability for their medical course and a future career in medicine. This can only be done effectively if your weaknesses, as well as your strengths, are properly explored.

Needless to say, if you are reluctant to work in a team or unwilling to deal with uncertainty and risks, this would not benefit your chances of successfully demonstrating your suitability for medicine. However, presenting one or two weaknesses that would not preclude you from a career in medicine, and using these effectively to show evidence of personal insight, self-reflection, and, most importantly, the initiative to take appropriate steps to deal with them, demonstrates that you possess what are highly sought-after qualities in medicine. On the other hand, if you were to say you had no weaknesses you would come across as either dishonest or someone who lacks insight.

The value of insight and reflective practice cannot be overstated. Working within the limits of one’s competence is one of the duties of a doctor. Mindful of this, the following would be a suitable answer:

I have very high expectations of myself, which means I can sometimes be quite self-critical if I make a mistake.

Now explain how this might affect your ability to perform in the role of a doctor, e.g.:

If not dealt with appropriately, this might cause me to become easily frustrated with myself, which could add unnecessary stress to what is already a stressful job.

Finally, show that you have reflected on your weakness and taken the initiative to overcome it, e.g.:

I have therefore taken the opportunity to reflect on this and realise that mistakes, especially within a safe learning environment, form an essential component of the learning process as they enable me to identify key areas that may require more practice, a different approach, or additional support.

The following is a good example for graduate applicants:

I do not come from a science degree background, which means I may require more time to grasp some of the new concepts presented to me during the course. However, I have reflected on this and feel that my ‘A’ in A level Biology combined with 1st class honours in my Bachelors degree demonstrates that I have the ability to do well. Moreover, I have spoken with similar students at the medical school and feel that the combination of the excellent support they receive and my characteristic determination will enable me to excel.

Even the brightest student will not do well in medicine if they have poor coping strategies, and it is likely they will perform unexpectedly on at least one assessment during their time in medical school. It is important to remember that a career in medicine is a marathon, not a sprint, and there are a few things to keep in mind when answering this question. How have you dealt with poor results in the past? Perhaps on your mock A level or UKCAT exams? Alternatively, when have you been in a position where your expectations of yourself have not been met? Interviewers will be looking for the following:

•Your ability to accurately reflect on the situation in which you have failed

Reflection has become a very important part of the undergraduate and postgraduate medical curriculum, and in practice doctors are expected to appraise themselves critically. As such, routinely looking through your performance and assessing yourself is a good habit to form early in your medical career. Reflecting involves critically thinking about your development, what your learning needs are, and how you can meet them. A good medical student would reflect on why they think they performed poorly, how it makes them feel, and what they should be doing in order to do better on the next exam.

•Your resilience in being able to put aside your disappointment in order to understand what went wrong

Perhaps you would take a break by playing a game of rugby, or relaxing with a friend before returning to the situation and re-analysing it. It is important to mention this, as you cannot simply say you wouldn’t feel upset. This is a good opportunity to show your coping