The Consultant Interview: Secrets to Success

Dr Robert Ghosh, Consultant Physician and Director, Intensive Care, Homerton University Hospital, London

The Philosophy

Whereas the application and interview process for junior doctors seems to be in constant flux, the Consultant Interview remains a fixed point, the potential pinnacle of a doctor’s career. This fact is given due respect by those conducting the interview, and there should be no doubt that meticulous preparations should be made by the prospective interviewee. Although by no means comprehensive, this article will hopefully provide you with useful guidance and pointers.

Preparation Prior to Application

Any candidate must feel ready. Exemplary clinical skills need to be underpinned by leadership and management expertise, and an awareness of the multifactorial components of clinical situations, with particular regard for ethics and time management. Confirm that the appointment criteria are consistent with your credentials. Discrepancies and embellishments in your CV should be reassessed; the facts should not only be truthful but also sit comfortably, in preparation for ‘grilling’ during the interview. If you have not had clinical experience in the Trust to which you are applying, you will need to ensure that it meets your requirements. You should therefore research relevant information for the Trust, and consider visiting prior to shortlisting unless this is refused.

Preparation After Selection

Hopefully selection will instil pride and excitement. Organise appointments with the Chief Executive, Medical Director, Clinical Director and Lead Clinician. During the visit, if you are not known to them, it would be reasonable to confirm the qualities/features of the Trust which prompted your application, and enquire about the department’s clinical interests, clinical shortfalls, perennial problems and future direction. The value of interview practice, with the help of Consultant colleagues, cannot be underestimated. Although there is no ‘dress code’, one should appear formal and smart.

The Interview: First Impressions and Frame of Mind

An interview panel is likely to include the following:

• The Chairman of the Trust (who will also chair the interview)
• Chief Executive
• Medical Director
• Clinical Director
• External College Representative
• Lead Clinician/colleague
• University Representative (for academic appointments)
• Human Resources representative
• Key personnel from other sites in split site appointments

If a presentation is required, this should usually be delivered using PowerPoint. The topic will be pre-determined by the Trust, and may relate to benefits you can bring to the department, your vision for the department/Trust or how you can help the Trust develop.

In the oral interview, calmness and confidence are essential to encourage interviewers to warm to you, while nervousness will make them wary of you. Candidates should assume that they are at least on a par with their competitors. Any ‘internal’ candidates may not be preferred, or may interview very badly. Indeed, there may be no preferred candidate. When answering questions, you should remember that the interviewer wants to get to know you. Most candidates recall successful interviews as a series of conversations, rather than an interrogation. Well thought-out and articulate answers to difficult questions should give the interviewer the impression that you are a good problem-solver, which would be an asset to the department. Ensuing questions may be split into those relating to fact (seeking an explanation or understanding), opinion or approach (scenario-based). Be advised, if you volunteer expertise in a particular field (for example research), you should prepare for in-depth cross-examination.

Questions of Fact

You may be asked about future challenges or controversies within your chosen specialty. A detailed knowledge of the Trust in which you are presently working (for example tertiary services, background of the Medial Director) implies dedication and enthusiasm. You may be asked about attributes specific to you (achievements, strengths and weaknesses, reaction to stress, an example of a difficult case with a description of the resolution). You may be asked to demonstrate your understanding of common concepts such as team working, effective communication, clinical governance and risk assessment/management. Frequently, candidates are asked about personal experience or knowledge of the value of audit/research and teaching. Definitions may also be explored: ‘What is the difference between “leadership” and “management”?’, ‘What is the difference between (re)validation and appraisal?’.

A working knowledge of the following should be seen as a bare minimum:

• NHS Plan
• Department of Health
• Health Care Commission
• National Service Framework
• Patient-led NHS
• Payment by results/activity
• European Work Time Directive
• Patient-led service
• Modernising medical careers
• Hospital at night
• Foundation Trusts
• Primary Care Trust
• Strategic Health Authority
• NHS Direct
• National Project for Information Technology
• Choose and Book
• Electronic Patient Records

Seminal reports often discussed include those of Ara Darzi, Wanless, Kennedy, Alder Hey, and Caldicott.

Questions of Opinion

These are commonly answered badly. They are chiefly about wisdom and pragmatism, and rarely identify a right or wrong answer. Examples of questions of opinion include ‘What do you think of MTAS?’, ‘What do you think about the future for Consultants?’ and ‘Does the GMC have a future?  Interviewers are looking for you to identify the advantages and disadvantages, and arrive at a pragmatic conclusion. Remember, for every protagonist on the panel, there will be an antagonist of equal force.

Scenarios

This category of question could include witnessing a colleague performing a criminal act, acting unprofessionally or performing below standard. Other examples include unusual requests, patients refusing treatment and equipment failure. ‘Patient safety’, ‘ethics’ and ‘process’ are key words when answering scenario questions.

‘Do you have any questions for us?’

When the panel invite you to ask questions, the main challenge is not to undo all of your good work! You can take this opportunity to rectify mistakes or imperfect answers from previous questions, or qualify/amplify a previous point. It is perfectly acceptable, even desirable, not to have any questions. It may well be that all queries have been answered during your informal visit to the Trust prior to interview. If this is the case, it would be advisable to mention it. Under no circumstances should annual leave or salary requirements be brought up at the interview - this should be discussed at the appropriate time with Human Resources.

And Finally…

Despite nervousness, it would be prudent to exit at the appropriate door, and not the broom cupboard. Best of luck!

Conflict of interest: Dr Ghosh delivers courses on Consultant Interview Skills on behalf of Apply2Medicine (info@apply2medicine.co.uk), and is the author of the book ‘Succeeding at Your Consultant Interview’, currently in preparation.