Preparing for the Specialised Foundation Program (SFP) interviews can be both exciting and nerve-wracking. This year, some medical schools might be doing interviews for the Pathway 1 SFP application process to shortlist people, but for Pathway 2 I do not believe there is an interview process so double check. The SFP is a competitive pathway that allows you to gain valuable experience in specific areas of medicine including research, education, and leadership (see full blog post on what the SFP actually is here). A strong interview performance is crucial to securing a position. Here’s what I used to rank in the top 30 of all UK applicants for the SFP and secure my 1st choice job in London:
Understand the format
The new SFP recruitment process this year involves the following:
Pathway 1: One-third of the SFP in England will be allocated to current final year medical school students in England, who will be selected by their medical school via a locally defined process (which may involve an interview).
Pathway 2: The remaining two-thirds of programmes will be allocated to eligible applicants for the 2025 foundation programme via preference-informed allocation.
The interviews I did last year (for London and Oxford/Thames Valley Deanery) consisted of 2 parts: academic and clinical. Please check if this is the same this year.
Clinical: Scenario that will require you to run through A to E assessment (verbally, as these interviews are conducted online) +/- an ethics element as well as your understanding of the FY1 role (knowing when to escalate to a senior).
Academic: personal questions, data interpretation, critical appraisal of an abstract you have never seen before (you'll be given a few minutes to read it and make notes).
The clinical interview
For this part of the interview, learn a script and always be logical and systematic!
Diagnosis and management plans: Be ready to discuss your approach to specific clinical cases.
Ethical dilemmas: Prepare for questions that challenge your ethical reasoning.
Below is an example:
Patient safety is my absolute priority, so I will follow ALS principles and undertake an ABCDE assessment.
Airway -
If patient vocalises in full sentences, airway is patent.
Otherwise, I would look, listen, and feel. I'd look inside the mouth for secretions which may be suctioned, as well as for rash/angioedema. I'd listen for stridor or gurgling. I'd feel for expired air at the nose/mouth.
If airway is not patent, I would secure the airway with chin life or jaw thrust manoeuvre, and use adjuncts such as oropharyngeal/nasopharyngeal airways.
If the airway is still not patent, I would put out a peri-arrest call. If there is stridor, I would FAST bleep anaesthetics/ENT registrars and give 0.5ml 1:1000 adrenaline IM. * It's a bonus to remember dosages (I was asked in my interview!) but do not say it if you're not 100% sure. Patient safety remember!
Breathing -
I would ask a nurse to help with basic observations, focusing initially on respiratory rate and pulse oximetry. * It shows that you have been on the wards and are efficient if you say WHO you would involve and why! Remember close-circuit communication. Make sure anything you have asked someone to do is reported back to you.
I would provide high flow oxygen with a non-rebreathe mask (15L) if required.
I would then assess effort, efficacy, and effect of breathing. I would look for evidence of respiratory distress such as use of accessory muscles/nasal flaring/tracheal tug.
I would then look, listen, and feel. I'd look for symmetrical chest expansion, listen on auscultation for equal air entry or wheeze, feel for central trachea, chest expansion, and equally resonant percussion. I would reassess airway before moving onto C. *Always reassess if something is abnormal (they will give you the values) but make sure you get through the WHOLE of A to E slick and in the time frame given.
Circulation -
I would inspect the patient's appearance (pink/blue/mottled) and do a fluid assessment (does the patient look euvolemic or pale/haemdynamically unstable?)
I would check pulse rate, rhythm, and volume. If no pulse felt, systolic BP may be below 80mmHg. I would check BP in both arms and measure capillary refill time peripherally (and centrally if peripherally shut down).
I would then listen to heart sounds. If any abnormalities, I would request a 12-lead ECG.
I would also establish IV access via wide-bore cannulae in the antecubital fossae bilaterally and send bloods such as an FBC, U&E, CRP, coagulation, cross-match, cultures, and troponin. If respiratory problem, consider ABG and also do a VBG for quicker results than the aforementioned.
If patient is hypotensive, I would assess response to a leg-raise and consider 500ml saline bolus.
I would repeat fluid challenge if necessary and call for senior help if there is no response. If there is blood loss, I would consider initiating the haemorrhage protocol (call 2222).
Disability - I would assess consciousness using the Glasgow coma scale; if under 8 (equivalent to AVPU=P), I would call anaesthetist to consider intubation (GCS 8 = intubate - a rhyme I find helps me remember). I would then obtain capillary glucose level, check if pupils are equal and reactive to light. IIf there is time, I'd conduct a neuro examination and consider antidotes to any obvious toxicity (common scenarios include opioid and paracetamol overdose).
Exposure - I would check patient's temperature, look for injuries and rashes, check calves for deep vein thrombosis and check for any indwelling catheters. I would check abdomen is soft and non-tender. I would then re-assess and alert my senior, using SBAR as a format for communication.
What I have bolded are the types of things that will score you almost full marks compared to most candidates.
The academic interview
The academic interview relates to the same subjects as the white-space questions you answered on Oriel so use your already-written answers to prepare you. Each Specialised Foundation Program may have different focuses and expectations. Research the specific programs you are applying to and think about what you may be asked and practice replying:
Why AFP?
Why [Deanery]? e.g. Clinical specialties offered, Deanery program values and goals, study budget, networking value, current connections.
Why academic medicine?
What challenges do you envisage?
What are your strengths and weaknesses?
How will you approach the programme?
Oxford even asked if I had reached out to anyone to start project planning so it can help you even more to do so but not a requirement.
Critical appraisal
You may be given an abstract (usually a randomised controlled trial but it could be any type of study so make sure you're practicing with a variety). I regularly practiced critically appraising abstracts that my friends had chosen at random from popular journals like New England Journal of Medicine and The Lancet.
The Critical Appraisal Skills Programme (CASP) Checklists can be really helpful to have open on your screen to tick off as you go along when critically appraising a study. The following should be covered in your responses to the interviewers, I used:
QR PICOK RAMBOS RP FEC
Summary of abstract: QR = question and relevance, PICOK = main summary
· Population
· Intervention
· Controls
· Outcomes
· Key findings
RAMBOS = internal validity
· Recruitment
· Allocation
· Maintenance
· Baseline
· Blinding
· Outcomes
· Statistical analyses
RP = external validity
· Resources
· Population
FEC = Funding, ethics, conclusion.
Find my official SFP cheat sheet to download below
List of SFP resources I used
I hope this helped! Good luck!
Shout out to Dr Tatiana Hamakarim - who helped me massively during my interview practice and is currently doing an SFP too!
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