The consultant interview: secrets to success

Authors: Robert Ghosh 

Publication date: 18 Mar 2008

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Robert Ghosh, consultant physician and director, intensive care, at Homerton University Hospital, London, shares some tips for would-be consultants

Philosophy

Although the application and interview process for junior doctors seems to be in constant flux, the consultant interview remains a fixed point and the potential pinnacle of a doctor’s career. Meticulous preparations by the prospective interviewee are essential. This article will hopefully provide you with useful guidance and pointers.

Preparation before application

All candidates must feel prepared. Exemplary clinical skills need to be underpinned by leadership and management expertise, along with an awareness of the multifactorial components of clinical situations and a particular regard for ethics and time management.

You should confirm that the appointment criteria are consistent with your credentials. Any discrepancies and embellishments in your CV should be reassessed—the details should not only be truthful but also sit comfortably in preparation for grilling during the interview. If you do not have clinical experience in the trust to which you are applying, you will need to ensure that it meets your requirements and you should therefore research relevant information and consider visiting it before the shortlisting takes place.

Preparation after selection

Selection will hopefully instil pride and excitement. Organise appointments with the chief executive, the medical director, the clinical director, and the lead clinician, and during the visit confirm the qualities and features of the trust that prompted your application. Ask about the department’s clinical interests, clinical shortfalls, ongoing problems, and future direction. The value of interview practice, with the help of consultant colleagues, cannot be overestimated. Although there is no dress code, you should appear formal and smart.

The interview: first impressions and frame of mind

An interview panel is likely to include the:

• chair 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, PowerPoint is usually used. The topic will be predetermined by the trust and may relate to the benefits you can bring to the department, your vision for the department or trust, and how you can help the trust to develop.

In the oral interview, calmness and confidence are essential to encourage interviewers to warm to you—being nervous can make interviewers wary. You should assume that you are at least on a par with your competitors, as internal candidates may not necessarily be preferred, or they may interview very badly.

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 will give the interviewer the impression that you are a good problem solver who will be an asset to their department. 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 be prepared 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 currently working (for example tertiary services, background of the medical director) shows dedication and enthusiasm. You may be asked about your attributes (achievements, strengths and weaknesses, reaction to stress, an example of a difficult case with a description of the resolution).

You may also be asked to demonstrate your understanding of common concepts such as team working, effective communication, clinical governance, and risk assessment or management. Frequently, candidates are asked about personal experience or about their knowledge of the value of audit, research, and teaching. Definitions may also be explored—for example, “What is the difference between leadership and management?” or “What is the difference between (re)validation and appraisal?”

As a bare minimum you should have a working knowledge of these:

• NHS Plan

• Department of Health

• Healthcare Commission

• National service framework

• Patient-led NHS

• Payment by results or activity

• European Working 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 that are often discussed are those of Ara Darzi,[1] Wanless,[2] Kennedy,[3] Alder Hey,[4] and Caldicott.[5]

Questions of opinion

These are commonly answered badly. They are chiefly about wisdom and pragmatism, and they rarely identify a right or wrong answer. Examples are, “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

These could include witnessing a colleague performing a criminal act or seeing them 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 to qualify or 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 before the interview. If this is the case, it would be advisable to mention it. In no circumstances should annual leave or salary requirements be brought up at the interview—this should be discussed at the appropriate time with the human resources department.

Make a graceful exit

Even if you are nervous, it is 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 (0800 612 1135; www.Apply2.co.uk; info@apply2medicine.co.uk), and is the author of Succeeding at your Consultant Interview, currently in preparation.

Robert Ghosh consultant physician mailto: Homerton University Hospital, London

irghosh@aol.com