IMT Interview Guide 2024

So, you’ve decided to apply for IMT, nailed your application, and have been shortlisted for an Internal Medicine Training (IMT) interview.

What next?

In this guide, we’ll run you through the IMT interview process, including sections of the interview and how to maximise your interview score.

Updated 16th October 2023 for IMT 2024 Round 1 Information.

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Hints and Tips by Dr Nikhil Ahluwalia

Hello MedCourse readers,

I’m Nikhil- a cardiology registrar in London. Of greater relevance, I am one of more than a dozen medical registrars who have come together to share our strategies, experiences and advice to help applicants prepare for their medical interviews through our courses, videos and mock circuits.

We’ve worked with hundreds of applicants and is really proud to have had top-ranking applicants coming through our programme- many scoring full marks at interview.

This year, we’re able to offer all of this to applicants to IMT. We’ve worked with top-ranking IMTs to design OptimiseIMT, the most comprehensive ‘start-to-finish’ prep package available online. Check out everything we have to offer, including our free videos at Optimise Interviews.

Below, I share some of the secrets of success I’ve seen in the most successful candidates I’ve worked with.

The Internal Medicine Training (IMT) Interview

When you have been shortlisted and it’s confirmed that you are eligible for an interview, you will receive an email with an invitation to book your interview on Oriel.

When you get the IMT interview invite email – stop what you’re doing and get booking! The booking is on a first-come, first-served basis, so if you don’t get in there quickly you might end up with a date that doesn’t suit your level of preparation.

All IMT Interviews for 2024 will be held online.

When face-to-face interviews return it’s even more important to book early, as otherwise you might be forced to travel the length of the country to interview – face-to-face interviews don’t have to be in the region you’re applying to.

IMT Interview Timeline

While face-to-face interviews previously had a 3-station format, virtual interviews were changed to a single 25-minute session with four main question areas. The question areas roughly follow the original format, so you can prepare for 2024 IMT interviews the same way – we will keep this page updated!

How to Prepare for Your IMT Interview

As a medic, the IMT interview might be the first time you have had an interview since medical school – a good few years ago! However incredible you are on the wards, in the clinic, or on the pages of your portfolio, you need to be able to convey this information in a calm and confident way to your interviewers.

If you have a few months to prepare for your interview, you should first focus on maximising your application score. Many of the domains that score well in your application will also go down well in the “suitability and commitment” and “application and training” sections of the interview.

In the weeks before your interview, you need to get ready to answer the questions you’ll be asked at the interview. The clinical and ethical scenarios are important to prepare for, but it’s likely you’ll feel more comfortable discussing a medical scenario than talking about how completely amazing you are.

With that said – the key to smashing your IMT interview is to really nail your interview skills. If you can give your interviewers the impression that you are a confident, competent, and calm candidate who would be a delight to work with, you’re 90% of the way there.

Medical Interview Courses

Having all the answers is great, but it doesn’t mean much if you don’t possess the skills to relay them to an interview panel. This is a pricier option, and if you’re confident in your skills or don’t mind which hospital or rotation you are given it might not be worth it.

However, if you’re really worried about how well you’ll come across in interviews or want to learn directly from the experts, an IMT interview course might be for you.

One example of a medical interview course specific to IMT is the OptimiseIMT – IMT Interview Video Library. You can also learn from a course aimed at CT/ST applications in general from providers such as Oxford Medical and ISC Medical.

If you want to see a full range of course events, filter by price and location, and book your course in a few clicks, search our course calendar for medical interview courses.

Search Interview Courses

Medical Interview Books

I’m sure you could find thousands of generic interview skills books, but a book that comes highly recommended is A comprehensive guide to CT, ST & Registrar Interview Skills by ISC Medical. You’ll find many rave reviews for this book among medical trainees, for good reason.

The book goes through medical interview questions, tactics, and techniques. Through this book, you’ll prepare a small number of scenarios you have faced as a doctor which relate to multiple types of questions so that you’re prepared for whatever question is thrown your way.

Medical Interview Question Banks

Interview question banks, such as the Medibuddy Internal Medicine interview resource, are a great way to practice for the IMT interview. Medibuddy has all four question groups of the interview covered and will give you questions and model answers for all the most common questions you can face.

If you prefer online learning to flipping a page, this is a great alternative to an interview book. It’s better to give your answers out loud, so grab a friend to help you practice these interview questions.

Practice with a Friend

It’s no secret that many of us find ourselves within the “medic bubble” and have medical friends on hand to help for interview prep. With a set of interview questions from a question bank or book to hand, you can prep for interview even if your friend isn’t medical.

You need to find a middle-ground between answering like you haven’t got a clue and giving an answer that seems rehearsed. Don’t give yourself 100 different scripts to reel off for each question, get your head around a smaller number of scenarios that apply to multiple categories, and work out how to present those scenarios differently depending on what has been asked.

IMT Interview Tips

Everyone gets nervous during interviews, it’s inevitable. You’re going to forget things, mess up your lines, and think you’ve done a terrible job. Interviewers know this! They want you to do well and will make allowances for your nerves.

The marking scheme for each question is vague and relies on the interviewers’ own definition of how an FY2 doctor should perform. Your interviewer will be considering a few things when coming up with a grade:

• Is this candidate safe?
• Would I trust this candidate’s management plan?
• Would this candidate be pleasant to work with?
• Will patients have confidence in this candidate?

You should try to make things easy for yourself on the day of the interview. Give yourself plenty of time, get all your paperwork and equipment ready, and do whatever it takes to manage the on-the-day stresses of the interview.

IMT Interview Questions

In 2024, all interviews will be held virtually, consisting of three main question areas. The interview will last roughly 25 minutes, with each section lasting between 5 and 9 minutes. If you have dyslexia, you should update this on your personal page so that your reading time can be increased.

The interview panel is made up of two interviewers who will ask questions based on three question groups:

Question 1 – Application and Suitability for IMT

Question time: 6 minutes

The initial question group is split into two sections:

Section 1: Presentation – 2 minutes

In the first part of the interview, your interviewers will ask “Give an overview of your achievements to date which are most relevant to your application to be a trainee in internal medicine”, giving you a 2-minute time limit to present this information.

This is a chance to show off any impressive feats which show that you’re a great fit for IMT. This is the one part of the interview where you should know exactly what you’re going to say.

You cannot use a visual aid such as a PowerPoint presentation, but you can use notes. If you make notes, ensure that you’re using them as a reference rather than reading off the page.

Focus on your headline achievements in this section. These might be things like quality improvement projects which made a change to practice, research projects you have been involved in, awards, or anything else which got you plenty of points in your application.

The interviewers will have read your application form prior to the interview – there’s no point just trying to fit in all the information they already know about, instead focus on areas where you’ve gone above and beyond the minimum requirements. With a 2-minute time limit, you should aim to be brief when describing these achievements – once you are finished the examiners can ask further questions.

You should try to practice this section ahead of time to make sure your presentation is clear and well-structured. The interviewers are assessing your communication skills during the interview, so aim to show that you can present information well.

Use your achievements to demonstrate any skills or talents that make you an excellent candidate for medical training. This can include achievements outside of medicine in which you can demonstrate transferrable skills. Read the IMT 2023 person specification “selection criteria”. If you have achievements which meet the desirable criteria, make sure to include them here.

This is a good time to show that you have the skillset, values, and mindset that make a good medical trainee. Try to demonstrate that you are a hardworking, knowledgeable, and competent trainee who can communicate well with both patients and colleagues.

Section 2: Questions – 4 minutes

In this section, it’s time to back up all of the things you’ve just been talking about with more information, as guided by your interviewers. The panel will ask you questions about your achievements, why you are pursuing a career in medicine, which higher medical specialities you are interested in, and what you have done to show commitment so far in your career.

You may be asked more about information from your application form and your previous training. The focus is on what you’ve learned from experiences in medicine and other specialities, and what you have achieved so far in your career.

This is also a chance to show interviewers that you can learn from challenges and understand how your training thus far has helped with your personal and professional development.

One key interview question you may be asked is “why internal medicine?”. For this question, you must have a good understanding of what the job entails, including what your ward and on-call duties are. You can get more information on how IMT works in our ultimate guide to IMT.

Core training and higher medical speciality training can be incredibly rewarding if you enjoy hospital medicine, managing both acute and chronic conditions, and working through the diagnosis and treatment of medical admissions.

The interviewers are not looking for a stock answer – think about why you specifically are choosing medicine as a career path. Don’t talk about why internal medicine is great, discuss why the job matches well with your personality and attributes. If you have a subspeciality in mind, talk about what appeals to you about the consultant job in this speciality.

Nikhil’s Tips – Portfolio Presentations

Many of you will be expected to give a pre-prepared presentation as part of your interview. There are obviously different expectations that come with something that is pre-prepared versus a scenario that is sprung on you without notice.

Finding the balance between being authentic (so that your response sounds Genuine, non-robotic and has intonations) and being prepared (so you don’t forget your content, have a mind blank or jumble your words) is really tough.

It is even harder in the virtual setting, where you don’t have the benefit of hand gestures, body, language, or proximity.

Take inspiration from outside of medicine from great public speakers, such as Barack Obama with his passion and tone of voice, or Steve Jobs with his pauses, facial expressions, and narrative.

These speeches were highly rehearsed but came across as spontaneous and engaging to draw you in.

Authenticity can be prepared, by building in variations, the pace of speech, tone, sentence length, and presentation style. Importantly, you should also look like you are enjoying what you are talking about – it is clear when someone is reciting facts or reading off a note card versus someone who is having a conversation about something they are passionate about.

Question 2 – Clinical Scenario and Patient Handover

Question time: 12 minutes

• 3 minutes reading time
• 8 minutes of clinical questions
• 1-minute handover to a colleague

In the clinical scenario question group, you will be given a clinical scenario to read. This will be on common medical conditions such as sepsis, diabetes, and myocardial infarction.

Here’s an example, which we will discuss in “patient handover”:

You should expect discussions around the following sections:

What Your Next Steps Should Be

The scenario is likely to start with the interviewers asking you to discuss what you’ve read in the scenario text and how you would approach it. While it doesn’t have to be structured like in a handover, SBAR is a useful tool for discussing what information you have, what conclusions this leads you to, and what your next steps are.

You might not have the full information available, so once you’ve discussed what your next steps are, the interviewer will either move on to another question or will reveal a bit more information and ask you what you would do next.

Your Differential Diagnosis

After discussing the information, you have been given, the interviewer might ask what your differential diagnosis is. You don’t have time to go through a 20-page list of differentials here. Instead, you should focus on the most likely differential and the most serious or life-threatening differentials.

It’s important to remember that the interviewers aren’t expecting your answer to be 100% correct. Interviews are nerve-wracking and you won’t be performing at your best. The main concern for the interviewer here is that you can evaluate information under pressure, present information clearly, and practice safely by ruling out serious conditions.

Potential Treatments

You might not be able to discuss treatment until later in the scenario when you know or highly suspect a diagnosis. Prior to this though, it’s important that you consider early treatment for serious conditions.

For example, if the scenario is about someone who meets the criteria for sepsis or myocardial infarction, tell your interviewers that you’d like to initiate treatment as soon as you would in practice.

Again, you don’t need a perfect explanation of which antibiotic would target the likely organism, or which trials support P2Y12 receptor antagonists – the interviewer wants to know that you know when to initiate treatment and that your management plan is safe and appropriate. 

Further Information Gathering

When you are given the initial scenario, you won’t have the full information. In your next steps, try to include information you still require and who you might be able to get it from. Try to put yourself in the scenario and consider what you would be doing in practice.

This is an imaginary scenario so you can be creative. If the scenario is about an elderly housebound person, you could ask to get information from a relative or carer. If the scenario mentions someone who is attending with the patient, that’s a big clue that they could be a source of information.

Don’t forget the patient themselves – if you need to ask questions to rule out alternative diagnoses, ask!

Communicating to Others

Communication is one of the six scoring sections of the interview, and that can include how you communicate with patients and relatives. Once you have most of the information, interviewers might ask you to explain to the patient or their relative what the problem is, and what the next steps are.

There might also be colleagues involved in the scenario, and the interviewer may ask you to communicate information to them also, including during the patient handover. Practice this section with a friend and give yourself a structure to fall back on so that you can carry on talking even if you’re feeling flustered.

Patient Handover

This is a separately scored section in the clinical scenario and is very important. You can practice this beforehand by taking cases from your work and presenting them to friends or colleagues. You will be asked to hand over the case to a colleague.

You only have a minute to present this information concisely using the SBAR format:

Situation

“John Smith is an 85-year-old man with COPD, who was admitted 3 days ago for non-infective exacerbation of COPD”

This is the headline where you need to capture the attention of your colleague and give them a brief summary, so they know what information they need to focus on for the next minute

Background

“He has been struggling with shortness of breath, wheeze, and a non-productive cough for 5 days. He was admitted to the hospital 3 days ago and was treated with a course of prednisolone and regular salbutamol nebulisers.

I was called to the ward this evening because he was acutely short of breath and had a new oxygen requirement. His COPD is usually stable and managed with just a salbutamol inhaler. He has no other significant past medical history”.

In this section, you should give a bit more information on how this patient presented to the hospital, recent significant events including why you were asked to see them, and relevant aspects of their medical history.

Assessment

“When he initially presented his oxygen saturations were 83% on room air, which improved to 98% on a 28% venturi mask, with a respiration rate of 28. His other vital signs are stable.

On examination he appeared dyspnoeic with widespread wheeze and crepitation’s in the right lower zone of his chest on auscultation. 

His arterial blood gas confirms type 1 respiratory failure after 30 minutes on oxygen, and I have sent bloods and requested a chest x-ray”

This is your opportunity to deliver the salient information of your patient assessment. The interviewer isn’t interested in you reading back the text of the scenario back to them, you should focus on positive findings and important negatives, which lead you to your recommendations.

Recommendation

“My differential diagnosis includes infective COPD exacerbation and Pneumonia, though I would like to review this following blood results and x-ray findings.

I would suggest giving salbutamol and ipratropium nebulisers, continue oral steroids, oxygen aiming for saturations >94%, antibiotics according to hospital antimicrobial guidelines, and VTE prophylaxis.”

In your conclusion, you should give your differentials (including any serious differentials you still need to rule out!) and what your next steps are including your initial management plan.

Question 3 – Ethical, Professionalism, and Governance

Section time: 5 minutes

The ethical question section is shorter than the clinical scenario. You will be asked to discuss ethical issues around a situation involving a patient or colleague. The questions cover topics like ones you may have come across in the Situational Judgement Test. In this section, you will not have time in advance to read the scenario.

Here are some common ethical issues which you should do some reading on before the interview:

• Do not resuscitate orders – legal issues, how you would explain it to a patient or relative, and what to do if it is refused.
• Confidentiality, what you can tell relatives when the patient does not have capacity, and when you can break confidentiality.
• Conflict with patients, relatives, and colleagues.
• Legal issues including capacity, sectioning, and discharging against medical advice.
• Issues with colleagues not practising in line with guidelines or GMC Good Medical Practice.
• Personal issues with colleagues, how you should approach this, and when you should escalate it.

A common medical ethics scenario involves blood transfusions and Jehovah’s Witnesses. A patient who is a Jehovah’s Witness might refuse a life-saving blood transfusion, but if they are unconscious, do not have an advanced directive, and the next of kin is telling you that you can not give this lifesaving treatment, it becomes more complex. You should read more on this before your interview.

IMT Interview Scoring

There are six areas of assessment in the IMT interview. Your two interviewers will each give you marks out of 5 for each section, using the following frameworks:

Question 1 – Application and Achievements Scoring

General Scoring for All Other Questions and Communication

Interview scoring will vary from person to person, but the main focus is on avoiding scores of 1 or 2, as these can result in you being found not appointable.

The raw interview score and individual scores are used to determine whether you are considered appointable. If you fail to meet all three of the below criteria, your application will be classed as “not appointable”.

Your score is calculated from six categories, which include the three question groups as well as a mark for communication across the interview. Each score is then multiplied by the weighting score to give a total interview score.

Your total interview score is the number that determines your overall IMT ranking. If your application is classed as appointable during the interview, your score will be used to give you a rank out of all the appointable candidates. This is what will be used to decide whether you get your preferred programme, so if you’re aiming for a competitive region you should aim to score as high as possible!

Read more about rankings and choosing your preferences in our IMT application article.