Core & ACCS Anaesthetics Interview Guide 2027

The Core & ACCS Anaesthetics CT1 Interview Process

The core anaesthetics interview is the final hurdle for trainees hoping to start their careers via either the Core OR ACCS anaesthetics pathways, with both of these pathways recruiting via a single application and interview process.

If you’re still undecided at this point whether you’d prefer to join the core training or ACCS pathway, you still have time to decide before you choose your preference. For more information, check out our Ultimate Guide to ACCS Training.

All CT1 Anaesthetics interviews will be held online in 2027 - NHS England states "All online interviews will be a two-station format performed online via Qpercom" - with no suggestion that this will change.

Shortlisting for the interview is done via the MSRA exam, whereby candidates who achieve the required MSRA score will be invited to interview. New for 2027: "A cut off score will be implemented for the MSRA which will be effective from Round 1 2027 onwards" (the value has not been published), and invitations also depend on agreed interview slot capacity. You will be invited via an email with instructions on how to book your interview on Oriel.

When invited to interview, you will be allocated to an online interview in the cluster you chose during the application process. Clusters include:

Scotland
Northern Ireland
England & Wales (applicants must choose one nation to be considered for at this stage)

You will only receive one interview, in your chosen cluster, and you will only be considered for placements in the cluster you have chosen.

Online interviews are booked on a first-come; first-served basis, so if you have an idea if you’d prefer an early or late interview you should try to book your interview as soon as possible.

Anaesthetics Interview Timeline

NHS England has published the 2027 timeline for the August 2027 intake (MSRA results, interview invitations and sub-preference dates are still "To be confirmed"). Last year's dates follow as a guide to the gaps.

Previous Year's Dates (2025/26)

Applications open	Thursday 23rd October 2025 at 10am
Applications close	Thursday 20th November 2025 at 4pm
MSRA window	Tuesday 6th January - Monday 19th January 2026
Invitation to Interview	Tuesday 17th February 2026
Interview window	Wednesday 25th February - Friday 13th March 2026
Initial Offers out	By Tuesday 24th March 2026
Hold deadline	Thursday 2nd April 2026 at 1pm
Upgrade Deadline	Wednesday 8th April 2026 at 4pm

Jaimin's Tips - When Should I Start Preparing?

Start practising early! As soon as you know you have an interview start practice with whoever is available, it doesn’t even have to be from the medical field.

Try an attend courses (such as The London Anaesthesia Course!), practice with colleagues and approach anaesthetic trainees at your local hospital who may be willing to help too! We are a friendly bunch.

Have a look at the interview domains and scoring guidance on NHS England's site (ANRO's old scoring matrix has been withdrawn), it gives you an idea of how they score these interviews. This will allow you to tailor your practice to ensure you get the most amount of points from your answers.

The CT1 Anaesthetics Interview Format

Each of the two stations – a clinical scenario and a general interview – lasts 15 minutes, and NHS England says "the whole process should take 50 minutes. This includes ID checks prior to interview, 5 minutes reading for the clinical judgement station, and 5 minutes waiting prior to the general station." You won’t be given any questions in advance of the interview day, but both sections use a scoring guideline which gives us an idea of the questions that might be asked.

Interview Day – Performing at Your Best

Interview day is full of indomitable nerves and last-minute crises, with a sprinkling of self-doubt. To prevent a complete breakdown on the day you need to prepare in advance:

Get Your Sleeping Pattern Right

It will already be difficult to sleep on the night before the interview, and with a poor sleeping pattern, it may become nigh-on-impossible. Set a regular alarm and bedtime and stick to it for at least a week before the exam.

Book some leave.

A last-minute night shift will mess up both your interview preparation and your sleep cycle. Try to book some leave in the days leading up to the interview.

Don’t wear yourself out.

Your mental state can turn a decent interview into a car crash – don’t burn yourself out by fitting incessant revision and practice around your work! Book a spa day, chill out in the bath, or do something else that relaxes you – there is such a thing as too much prep.

Prep your tech.

Remember all of the zoom-based shenanigans during early-lockdown teaching days? This might be amusing to zoom-room full of foundation docs but is less so to interviewers. Make sure your webcam, microphone, and internet are all running smoothly on the day.

For each section, you will have two assessors, so four in total. Each assessor marks your interview separately and will give you a global rating in addition to the other scoring domains.

Let’s go through the two sections of the interview and the potential questions.

Section 1 – Clinical Scenario

Section time: 15 minutes

The clinical scenario section assesses your knowledge and ability to problem-solve. You will be given 5 minutes of preparation time to read and digest the clinical scenario (you may take notes) and consider how you might answer questions, after which the interview will officially start.

You will then have 15 minutes in which to answer questions about the clinical scenario from your assessor, discussing how you would approach your assessment, investigation, and management of the patient.

This section of the interview is looking at the “Clinical skills – clinical knowledge and expertise” part of the CT1/ACCS anaesthetics person specification, which includes:

Your ability to apply sound clinical knowledge and judgement to problems.
Your ability to prioritise clinical needs.
Your ability to maximise safety and minimise risk.
Your recognition of, and ability to undertake the initial management of, an acutely ill patient.

You are not expected to have detailed knowledge of anaesthetics when applying, so the clinical scenario is likely to be a common situation or emergency that a foundation year 2 doctor should be able to deal with.

The point of the clinical scenario is to assess your clinical judgement and decision-making, reflective practice, and working under pressure – note these domains are not entirely dependent on your clinical knowledge. (Team working is now scored in the general interview station.)

Your assessors are trying to work out whether their patients are in safe hands and whether you will function well as a core anaesthetic trainee:

Is your approach to an emergency safe and systematic?
Can you initiate management appropriately?
Are you able to judge when to escalate to a senior?
Will you stay calm in an emergency?

An ABCDE approach to the scenario is advisable but regardless of your approach, you should always have a structure to fall back on. Losing your head due to nerves and adrenaline is a common experience, but if you have a structure in place to fall back on you will always have somewhere to start again.

Here’s an example of an emergency scenario that you might be expected to answer:

Example Clinical Scenario

“You are a Foundation Year 2 doctor working out-of-hours as the overnight on-call surgical SHO. A staff nurse from the general surgical ward calls to inform you that he is concerned about one of his patients.

He tells you that his patient is a 57-year-old female who underwent an emergency laparotomy earlier in the day for small bowel perforation. He reports that his patient is drowsy and looks unwell, pale, and clammy.

Please explain how you would approach this scenario.”

In the above scenario, you have been called to an acutely unwell patient and must demonstrate to your interviewers that you can make sensible treatment and escalation decisions. This is a roleplaying exercise, and you must imagine what you would do in this situation.

As a first step, it may be wise to gather further information on the scenario. To prioritise your jobs, you must ascertain how unwell this patient is. Pertinent questions might include what the patient’s observations are, whether there were any complications during their procedure, and what the patient’s GCS is.

Once you have your answers, you must decide how urgent treatment should be. You could consider:

Is there anything you should ask the nurse to do while on the phone (such as further observations or interventions such as cannulation)?
Are there any immediate interventions which need to happen (such as a cardiac arrest 2222 call or fast-bleep to a senior)?
How should you prioritise attending the surgical ward?

As you go along in this scenario, your interviewers will try to give you the requested information and provide further prompts as you work your way through the diagnosis, investigation, and treatment of the patient. Scenarios are likely to be familiar to anyone who has worked as a foundation doctor.

Further questions that your interviewer might ask as you go through the scenario include:

“How would you assess the patient?”
“What is your differential diagnosis?”
“Are there any immediate treatments you would start at this point?”
“What investigations would you request?”
“Would you like to contact anyone at this stage?”
“How would you explain the situation to the patient?”
“How would you prioritise this compared to X and Y?”

The potential questions on this are limitless, but you can see that most of these questions will be related to your everyday practice. You should aim to answer these questions calmly, concisely, and with structure.

Jaimin's Tips - Clinical Scenario

The amount of anaesthetic knowledge they will expect of you will be negligible. They want to know you are a safe pair of hands, sensible and know your limitations.

The A-E approach will always come in handy. Make sure you practice this and can recite this in your sleep!

Other all-time favourites will be questions on managing workload, prioritising cases, and dealing with emergency situations. Come up with examples of when you have been a part of these situations.

Remember in your experience where these scenarios worked well and not so well? Think through why they did they worked. This will give you a lot of material on how to answer these questions.

They want to see you can stay calm and not panic under questioning. When was the last time you went to an arrest and saw an anaesthetist flap and panic?!

Section 2 - General Interview

The general interview section of the interview also lasts 15 minutes, and is essentially the “portfolio station”. For 2027 your interviewers score three domains in this section:

Communication
Commitment to Specialty
Teamwork

Expect questions about your training to date and commitment to the specialty, your experience of working in and leading teams, and your wider knowledge of the NHS and its influence on anaesthesia. Your teaching, quality improvement, audit and research are no longer separate scored domains, but they remain your best evidence of commitment.

Each section is an opportunity to shine, emphasising anything you’re particularly proud of and helping to demonstrate that you are a well-rounded doctor. Each of these scoring domains is marked by both assessors out of 5 (for a total of 10 points).

When preparing for the interview, go through your portfolio to eke out your most impressive achievements. While you should avoid reeling off a list, it’s still important to be concise in your answers, as there is a lot to cover in this section.

There is no portfolio or self-assessment score in the 2027 process – selection is longlisting, then the MSRA, then the interview, with offers made on your unique rank and preferences – but the old self-assessment criteria can still guide you to which of your experiences might prove more valuable to discuss in detail.

Jaimin's Tips - General Interview

Remember these questions are ones you would have come across in your practice so keep calm and cool!

As I previously said make sure you have a different example for each domain they assess in the interview. It shows how good a CV you have as well as how well you can answer the question. Two birds with one stone!

Think early about how you can answer the standard questions such as ‘Why anaesthetics’ differently. You want to stand out from the crowd and have a unique answer that the interviewers will remember... In a good way!

Finally, 40 of the 100 marks are global ratings (10 per assessor in each station) - So being nice, and polite and having well-structured and confident answers go a long way!

Interview Scoring

The total interview score is out of 100, with each station worth 50: three domains scored out of 5 by each of two assessors (30 marks) plus a global rating out of 10 from each assessor (20 marks).

The minimum score required to be considered appointable is 60/100. If you score below this, you will not be considered appointable and will not be considered for a training post.

If you are given a global rating of 1 by each assessor in one station you may be vetoed: the assessors discuss it with the Clinical Lead, whose decision is final, and two 1s do not automatically mean a veto. You can score above the national cut-off and still be vetoed for serious concerns about behaviour, performance or dangerous decisions, and vetoed applicants are not considered for appointment in any region.

The scoring for each station is as follows:

Clinical Scenario Scoring (50 marks)

Three scoring domains, scored out of 5 by both assessors (10 marks per domain, 30 in total), plus a global rating out of 10 from each assessor (20 marks)

Clinical Judgement & Decision Making
Reflective Practice
Working Under Pressure

Clinical Judgement & Decision Making

5 Points

o   Comprehensive understanding of the needs of the situation.
o   Seeks team input, asking for appropriate help.
o   Always alert to signs and symptoms which might destabilise the patient.
o   Regularly reviewed the situation and prioritised tasks appropriately.
o   Excellent planning and took decisive and appropriate action.

3 Points

o   Good understanding of the needs of the situation.
o   Noticed significant changes to the clinical situation.
o   Regularly reviewed the situation.
o   Some evidence of structured thinking and planning.
o   Firm idea of appropriate solutions to problems.

1 Point

o   Poor understanding of the needs of the situation.
o   Lack of urgency and decisive action.
o   Failed to notice significant changes in the clinical situation.
o   Disorganised approach to patient assessment.
o   Lack of forward planning and structured thinking.
o   Unable to suggest workable solutions to the problem.

Scores of 2 or 4 are given for candidates who fit somewhere between these descriptions.

Team Working (scored in the general interview station from 2027)

5 Points

o   Ensured team capabilities matched task, escalating appropriately.
o   Always confirmed understanding and instructions.
o   Clear communication of plans.
o   Sympathetic and considerate of other team members.
o   Showed leadership with authority and justification.
o   Always participative with a non-confrontational approach.

3 Points

o   Showed awareness of team capabilities, escalating appropriately.
o   Negotiated and compromised with team members.
o   Good rapport with team.
o   Delegated tasks appropriately.
o   Maintained non-confrontational approach.

1 Point

o   Lack of awareness of team capabilities.
o   No understanding of the needs of team members.
o   Rude, confrontational, or critical of team members.
o   Failed to delegate tasks or show leadership.
o   Failed to escalate appropriately, undertaking tasks outside level of competence.

Scores of 2 or 4 are given for candidates who fit somewhere between these descriptions.

Working Under Pressure

5 Points

o   Relaxed and comfortable with the situation.
o   Responded quickly to unexpected changes.
o   Always maintained perspective.
o   Flexible and open in manner when challenged.
o   Aware of personal limitations and of when tasks are outside their level of competence.
o   Effectively dealt with other’s opinions and questions.

3 Points

o   Remained calm for most of the scenario.
o   Took decisive action.
o   Maintained perspective.
o   Some flexibility when challenged.
o   Insight into personal limitations.
o   Listened and responded to other’s opinions and questions.

1 Point

o   Tense and agitated.
o   Hesitant to take decisive action.
o   Focussed on immediate worries without maintaining perspective.
o   Rude or offensive when challenged.
o   Unable to adapt to changing situations.
o   Disregarded other’s opinions and questions.

Scores of 2 or 4 are given for candidates who fit somewhere between these descriptions.

Reflective Practice

5 Points

Educational Appraisal
o   Evidence of regular educational appraisal with clear outcomes from meetings.
o   Gives examples of how these appraisals affected professional development.

Risk Management
o   Describes engagement in reducing risk in the workplace through critical incident reporting or meetings.
o   Shows insight into the impact of non-technical skills on the delivery of service in the NHS and mitigation of recognised issues.

Personal Development Plans (PDPs)
o   Accounts for the content of Foundation Personal Development Plans in curriculum and other outcomes.
o   Shows how PDPs enable career planning and demonstrate commitment to speciality.

Assessment Tools
o   Describes a minimum of 2 workplace assessments and evidence of how these have been used for practice and personal development.
o   WPA’s include TAB/MSFs, education supervisor meetings, self-audit, mini-CEX, case-based discussion (CBD), procedure logs, DCTs, and reflections.

Feedback
o   One or more examples of feedback which resulted in behavioural change, improved outcomes, or career development.

3 Points

Educational Appraisal
o   Describes how educational appraisals have been used in professional development.

Risk Management
o   Describes personal non-technical skills role in clinical risk management.

Personal Development Plans (PDPs)
o   Accounts for content of Foundation Personal Development Plans in curriculum and other outcomes.

Assessment Tools
o   Describes workplace assessments and how these have been used to change personal clinical practice.

Feedback
o   One or more example of feedback which resulted positive professional change.

1 Point

Educational Appraisal
o   Unable to give examples of how educational appraisal has affected professional development.

Risk Management
o   Limited description and understanding of clinical risk management and personal non-technical skills.

Personal Development Plans (PDPs)
o   Limited evidence of appropriate PDPs.
o   Unable to link these to professional development.

Assessment Tools
o   Limited description of how WPA’s were used to enhance professional development.

Feedback
o   Little evidence of feedback used to change practice or improve outcomes.

Scores of 2 or 4 are given for candidates who fit somewhere between these descriptions.

General Interview Scoring (50 marks)

Three scoring domains, scored out of 5 by both assessors (10 marks per domain, 30 in total), plus a global rating out of 10 from each assessor (20 marks)

Communication
Commitment to Specialty
Teamwork (see the Team Working descriptors above)

Qualifications, teaching, QI, audit and research are no longer separate scored domains for 2027, but the descriptors below still show what assessors value when you talk about your training to date and commitment to the specialty. The official domain descriptions are on NHS England's interview domains and scoring guidance page.

Qualifications and Experience

5 Points

o   Excellent description of the below.
o   Meets qualifications required in person specification.
o   Additional qualifications related to anaesthesia (PGCert/Dip, additional degrees).
o   Good experience relevant to anaesthesia such as taster days and placements.

3 Points

o   Adequate description of the below.
o   Meets qualifications required in person specification.
o   Some experience relevant to anaesthesia.

1 Point

o Unable to describe suitable qualifications and experience.

Scores of 2 or 4 are given for candidates who fit somewhere between these descriptions.

Teaching, Audit, Quality Improvement, and Research

5 Points

o   Excellent description of the below.
o   Significant teaching experience and/or teaching qualifications.
o   Clear insight into the role of the anaesthetic trainee as educator.
o   Major involvement in QI, research, and/or audit with significant change made.

3 Points

o   Adequate description of the below.
o   Some teaching experience and/or teaching qualifications.
o   Some insight into the role of anaesthetic trainee as educator.
o   Involvement in QI, research, and/or audit with limited change made.

1 Point

o Limited description of suitable teaching, QI, audit, or research experience.

Scores of 2 or 4 are given for candidates who fit somewhere between these descriptions.

Commitment to Speciality

5 Points

o   Excellent knowledge of the anaesthesia/ACCS training programme.
o   Career plan with clearly defined strategy to maximise training opportunities.
o   Good evidence demonstrating intention to follow career in anaesthesia.

4 Points

o Good knowledge of the anaesthesia/ACCS training programme & how to maximise training opportunities.
o Some evidence of intention to follow career in anaesthesia.

3 Points

o Some knowledge of the anaesthesia/ACCS training programme & how to maximise training opportunities.

2 Points

o Limited evidence of knowledge of the anaesthesia/ACCS training programme
o Limited insight into a career in anaesthesia.

1 Point

o No evidence of knowledge of the anaesthesia/ACCS training programme.
o No insight into a career in anaesthesia.

To hit maximum points and show excellent evidence of knowledge in these domains, you should aim to demonstrate:

Commitment to speciality - give evidence of experience in anaesthesia, such as on undergrad/postgrad placements, taster days, and career days.
Insight into anaesthesia – demonstrate that you understand what a career in anaesthesia looks like, and what your role as an anaesthetic trainee will be.
Knowledge of the anaesthesia / ACCS training programme – show that you know how the core anaesthesia or ACCS training schemes work and that you know about the career progression to ST4.
Career development – Demonstrate that you have put thought into how you will use the training programme to learn new skills, add to your CV, and start to create the blueprints for your future career.

Reflective Practice

From 2027 this is scored in the clinical scenario station - see above for marking.

Global Rating (40 marks)

Each assessor gives you a mark out of 10 in each station, based on their overall impression - 10 marks × 2 assessors × 2 stations = 40 of the 100 marks. A global rating of 1 from each assessor in a station triggers the veto discussion described above.

Core & ACCS Anaesthetics CT1 Interview Guide 2027

Hints and Tips by Dr Jaimin Arya

Key Documents

The Core & ACCS Anaesthetics CT1 Interview Process

Anaesthetics Interview Timeline

Previous Year's Dates (2025/26)

Jaimin's Tips - When Should I Start Preparing?

The CT1 Anaesthetics Interview Format

Interview Day – Performing at Your Best

Get Your Sleeping Pattern Right

Book some leave.

Don’t wear yourself out.

Prep your tech.

Section 1 – Clinical Scenario

Section time: 15 minutes

Example Clinical Scenario

Jaimin's Tips - Clinical Scenario

Section 2 - General Interview

Jaimin's Tips - General Interview

Interview Scoring

Clinical Scenario Scoring (50 marks)

Clinical Judgement & Decision Making

Team Working (scored in the general interview station from 2027)

Working Under Pressure

Reflective Practice

General Interview Scoring (50 marks)

Qualifications and Experience

Teaching, Audit, Quality Improvement, and Research

Commitment to Speciality

Reflective Practice

Global Rating (40 marks)

Related Topics

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August 2027 Start Date (Round 1)