IMT Interview Preparation Guideline (Old)

গতকাল Internal Medicine Training ইন্টারভিউ এর ranking প্রকাশিত হয়েছে। IMT Interview এর জন্যে কিভাবে ভালোভাবে প্রস্তুতি নেয়া যেতে পারে এই পোস্টে আমি তা লেখার চেষ্টা করবো এবং পোস্টের শেষের দিকে আমি নিজে কী কী করেছিলাম প্রস্তুতির জন্যে সেটা জানাবো।

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প্রথমে আপনাকে ইন্টারভিউর খুঁটিনাটি জেনে নিতে হবে। খুটিনাটি জানার জন্যে এই তিনটা মাধ্যম ব্যবহার করতে পারেন।

1. https://youtu.be/LwDr40nuiDU?si=ZiWpM4xZKEvuu5WU
2. https://www.imtrecruitment.org.uk/recruitment-process/interview/interview-structure-and-content
3. https://medcourse.co.uk/speciality-guide/imt-interview-guide/

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ইন্টারভিউ এর তিনটা মেইন পার্ট।

1. Application and Suitability for IMT
2. Clinical Scenario and Patient Handover
3. Ethical, Professional and Governance Question

প্রতিটা পার্ট থেকে আপনাকে এক বা একাধিক প্রশ্ন করবে। পুরো ইন্টারভিউ শেষ হতে আনুমানিক সময় লাগবে ২৫ মিনিট।

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Part 1: Application and suitability for IMT

এই অংশটা দুইভাগে বিভক্ত। সময় ৬ মিনিট।

1. 2 minute presentation
2. Questions related to your your application/CV/Portfolio and suitability to be a trainee in medicine

1. 2 minute presentation

প্রথম অংশে আপনাকে একটা ২ মিনিটের মোখিক প্রেজেন্টেশন দিতে হবে এই টপিকেঃ
“Give an overview of your achievements to date which are most relevant to your application to be a trainee in internal medicine”
এই প্রশ্ন দিয়েই আপনার ইন্টারভিউ শুরু হবে এবং উত্তর দেয়ার সময় ২ মিনিট।২ মিনিট শেষ হয়ে গেলে আর কথা বলার সুযোগ পাবেন না। এখানে কোন স্লাইড কিংবা পাওয়ারপয়েন্ট দেখাতে হবেনা।আপনি চাইলে কাগজে নোট রাখতে পারবেন।

2. Questions related to your your application/CV/Portfolio and suitability to be a trainee in medicine

Questions related to your your application/CV/Portfolio and suitability to be a trainee in medicine
দ্বিতীয় অংশে আপনি IMT তে ঢুকার জন্যে কতটুকু suitable সেটা দেখার জন্যে আপনাকে আপনার সিভি বা পোর্টফোলিও থেকে কিংবা এর বাইরের কিছু প্রশ্ন করা হবে, hence the name ‘Suitability for IMT’.
এই পার্ট এর জন্যে নিচের এই প্রশ্নগুলোর উত্তর তৈরি করবেনঃ

• Why do you want to get into IMT?
• What have you done so far to get into IMT/that shows your committment to get into IMT?How have you prepared yourself for IMT?
• What do you know about IMT curriculum?
• Tell us about your research experience
• Tell us about your quality improvement project
• Tell us about your publication
• Tell us about your teaching experience
• Why do you think teaching is important for an IMT?
• Why do you think research is important for an IMT?
• Why do you think quality improvement is important for an IMT?

Suggested Preparatory Materials for Part 1:

• Medibuddy
• Optimize Interviews

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Part 2: Clinical Questions and Patient Handover

প্রথম পার্ট শেষ হওয়ার পর আপনাকে তিন মিনিট সময় দেওয়া হবে একটা ক্লিনিক্যাল প্রশ্ন পড়ার জন্যে এবং উত্তর তৈরি করার জন্যে। তিন মিনিট পার হয়ে যাওয়ার পর আপনাকে এই ক্লিনিক্যাল সিনারিও থেকে কিছু প্রশ্ন করা হবে এবং আপনাকে এগুলোর উত্তর দিতে হবে। মোট ৮ মিনিট ধরে আপনাকে প্রশ্ন করা হবে।
প্রশ্নগুলো এমন হতে পারেঃ

• How will you assess and manage this scenario
• what next steps you would take, e.g. further investigations
• your differential diagnosis
• any potential treatments possible
• any further information you would gather
• how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario.

আট মিনিট শেষ হয়ে গেলে আপনাকে এক মিনিট সময় দেওয়া হবে এই রোগীকে হ্যান্ডওভার দেওয়ার জন্যে।
Can you hand this patient over to your colleague?

Suggested Preparatory Materials for Part 2:

• Oxford Handbook of Clinical Medicine
• Medibuddy
• Optimize interviews
• NICE Guideline

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You should be able to do the initial assessment, management and produce a list of necessary investigations and differential diagnosis of a patient coming with the following presentations:

Acute setting:

• Patient presenting with Shortness of Breath
• Patient presenting with Chest Pain
• Patient presenting with hematemesis/Malena
• Patient presenting with Headache
• Patient presenting with seizures
• Patient presenting with Confusion/Altered mental status
• Patient presenting with palpitation
• Patient presenting with low GCS
• Patient presenting with fever
• Patient presenting with fever, night sweats, weight loss
• Patient presenting with lew pain and/or swelling
• Patient presenting after a fall
• Patient presenting with diarrhoea +/- vomiting
• Patient presenting with poisoning
• Patient presenting with palpitations

OP setting:

• Deranged LFTs
• Asthma Patient presenting for annual review
• High Blood pressure in clinic

Diseases:

• Pneumonia+ CURB 65 Score
• Sepsis
• Acute Severe Asthma
• Acute exacerbation of COPD
• Tension Pneumothorax
• Pulmonary Embolism
• Acute Coronary Syndrome
• Paracetamol Poisoning
• Hypoglycemia
• Diabetic Ketoacidosis/HHS
• Acute Upper GI Bleeding
• Hyperkalemia
• Hyponatremia
• Anaphylaxis
• Cardiac Arrest (ALS Protocol)
• Tachycardia
• Bradycardia
• ECG interpretation (ST elevation, TWI, Hyperkalemia, SVT, Atrial Fibrillation, Heart Block)
• X-Ray interpretation (Pneumonia, Pulmonary Edema, Pneumothorax, Pleural Effusion)
• ABG interpretation
• Stroke
• Addissonian Crisis
• AF
• SVT
• Fall
• Respiratory Failure
• Stroke

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Part 3: Ethical, Professionalism and Governance

এই অংশে এসে আপনাকে এক/একাধিক প্রশ্ন করা হবে যেগুলো Ethical/Professionalism/Governance কিংবা একাধিক কনসেপ্ট ওয়ালা হয়।এই পার্ট এর সময় ৫ মিনিট। কিন্তু এখানে আপনাকে প্রশ্ন পড়ার জন্যে কিংবে উত্তর সাজানোর জন্যে আলাদা করে কোন সময় দেয়া হবেনা।

এই প্রশ্নগুলো তিন ধরনের হতে পারে আমার দেখা অনুযায়ীঃ

• Purely Ethical Question
• Governance related Questions
• STAR questions

Purely Ethical questions:
এই প্রশ্নটা purely ethical: হতে পারে patient related, হতে পারে colleague related. যেমনঃ
Example 1: You have a patient in the hospital who has been diagnosed with pneumonia and is refusing treatment. On the other hand, his family members have an impression that the doctors have decided not to treat him. How would you plan to manage this scenario?

Example 2: You are in a morning shift and one of your colleagues appear to be drunk. How would you deal with this situation?

এধরণের প্রশ্নগুলো ISPIED Protocol এ উত্তর দেওয়ার চেষ্টা করা উচিত। (ISPIED- Issues raised, Seek information, Patient safety, Initial measures, Escalate, Document & Reflect)

সেই সাতে চেষ্টা করা উচিত medical ethics এর চারটা প্রিন্সিপাল
(Autonomy, Beneficence, Non-maleficence, Justice)
এবং Good Medical Practice কে এই প্রশ্নের উত্তরের সাথে জোড়া দেওয়া, যদি সম্ভব হয়।

https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/good-medical-practice

Clinical Governance Related Questions:
এখানে আপনাকে কিছু knowledge based question করা হতে পারে. এই ধরনের প্রশ্ন খুব কমন না, কিন্তু করে মাঝে মাঝে।

• What do you mean by audit? What are the steps of audit?
• What do you mean by research?
• What is the difference between audit and research?
• What is QIP?
• What do you mean by Clinical Governance?
• What are the pillars of Clinical Governance?
• What do you mean by portfolio?
• What do you mean my apprisal?
• What do you mean by revalidation?
• What do you mean by Evidence Based Medicine?

STAR Questions:
এছাড়া আপনাকে আরও কিছু প্রশ্ন করতে পারে যেগুলো আপনার ক্লিনিক্যাল এক্সপেরিয়েন্স থেকে কিছু উদাহরণ দিয়ে উত্তর দিতে হবে।
যেমনঃ

Tell us about:

• a Mistake that you have done
• ⁠your Strength
• ⁠your Weakness
• ⁠a Conflict that you have had with one of your colleagues
• ⁠Difficult situation that you have faced
• ⁠a situation where you showed Leadership
• ⁠a situation where your Communication skills helped to make a difference
• ⁠a situation where you showed Teamwork
• ⁠a situation where you face Difficulty communicating with a colleague
• a situation where you showed integrity

এই প্রশ্নগুgলোর উত্তরে সবসময় একটা উদাহরণ দেওয়া উচিত এবং STAR Approach ব্যবহার করে উত্তর দেওয়া উচিত- (Situation, Task, Action, Reflection)

Suggested Study Materials:

• Medibuddy
• CT-ST Interviews
• Optimise Interviews

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My Preparation

Study Material:

CT-ST interview বইটা ছিল আগে থেকে, এর পাশাপাশি Medibuddy এবং Optimize interviews এর কোর্সে subscribe করেছিলাম।Medibuddy ৭০% এর মত পড়েছিলাম এবং CT-ST Interview বই থেকে chapter 10,11,12 পড়েছি। Optimize থেকে তেমন কিছুই পড়তে পারিনি সময় ছিলনা তাই।

Preparation:

আমার ইন্টারভিউ প্রস্তুতি শুরু হয় Optimize এর mock দিয়ে। ওদের মক টেস্ট দেই আমি কোনরকম প্রস্তুতি ছাড়া। এবং এরপর আস্তে আস্তে প্রস্তুতি শুরু করি।
Application and Suitability for IMT পার্টের সবগুলো কমন প্রশ্নের উত্তর আমি লিখে ফেলেছিলাম এবং কারপর প্র্যাকটিস করেছি নিজে নিজে ঘড়ি ধরে।

Clinical Part এর জন্যে আমি Medibuddy, Oxford Handbook of Clinical Medicine পড়েছি। সেই সাথে Optimize Interviews এর একটা/দুইটা ভিডিও দেখেছি। ওদের ভিডিওগুলো দেখে শেষ করতে পারলে বেশ ভালো হতো বলে আমার ধারণা। কিছু কিছু টপিকের জন্যে NICE Guideline এ দেখেছি।

Ethical, Professionalism and Governance related question এর জন্যে আমি Medibuddy এবং CT-ST Interviews বইটা পড়েছি (Chapter 10,11,12)

IMT Interview এর আগে আমি ৭ দিন annual leave নিয়েছিলাম, তার মধ্যে ৫ দিন ইন্টারভিউর জন্যে প্রস্তুতি নিয়েছি।
এই ৫ দিন আমি পড়েছি এবং এর ফাঁকে ফাঁকে দুইজন কনসালট্যান্ট, দুইজন Internal Medicine Trainee এর কাছে মক দিয়েছি এবং একজন candidate এর সাথে প্র্যাকটিস করেছি।

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The ranking for the “Internal Medicine Training” interview was published yesterday. Thankfully, my score was 79.2 out of 80 and Rank was 171 out of 3346 candidates.

In this post, I will make an attempt to write how you make a solid preparation for an IMT interview and in the final part, I will add what I did for my own preparation.

My score in different stations of the Interview (all out of 10)

First of all, you need to learn all the details of the interview. You can go through the following  links.

1. https://youtu.be/LwDr40nuiDU?si=ZiWpM4xZKEvuu5WU
2. https://www.imtrecruitment.org.uk/recruitment-process/interview/interview-structure-and-content
3. https://medcourse.co.uk/speciality-guide/imt-interview-guide/

There are three main parts of the interview.

1. Application and Suitability for IMT
2. Clinical Scenario and Patient Handover
3. Ethical, Professional and Governance Question

You’ll be asked one or more questions from every part. The entire interview may take approximately 25 minutes to complete.

Part 1: Application and suitability for IMT

This part is again divided into two portions, with a duration of 6 minutes. 

1. 2 minute presentation
2. Questions related to your application/CV/Portfolio and suitability to be a trainee in medicine

1. 2 minute presentation

In the first part, you have to give a 2 minute oral presentation on this topic:

“Give an overview of your achievements to date which are most relevant to your application to be a trainee in internal medicine”

Your interview will begin with this question and you will have 2 minutes to respond. Once the two minutes are up, you will not get a further chance to speak up. There’s no need to show any powerpoint or slide in this section. But you can keep a note if you want.

2. Questions related to your application/CV/Portfolio and suitability to be a trainee in medicine

In the second part, they will evaluate whether you’re suitable for joining the IMT or not. For this, you’ll be asked a few questions from your CV or portfolio, as well as outside those materials. Hence, prepare the following questions for this part:

• Why do you want to get into IMT?
• What have you done so far to get into IMT/that shows your commitment to get into IMT?How have you prepared yourself for IMT?
• What do you know about the IMT curriculum?
• Tell us about your research experience
• Tell us about your quality improvement project
• Tell us about your publication
• Tell us about your teaching experience
• Why do you think teaching is important for an IMT?
• Why do you think research is important for an IMT?
• Why do you think quality improvement is important for an IMT?

Suggested Preparatory Materials for Part 1:

• Medibuddy
• Optimize Interviews

Part 2: Clinical Questions and Patient Handover

Once the first part is done, you’ll be given 3 minutes to read the clinical questions and to plan your answers. Then they will ask you some questions from the clinical scenarios and you have to answer those. It may take 8 minutes in this section. The questions may include:

• How will you assess and manage this scenario
• what next steps you would take, e.g. further investigations
• your differential diagnosis
• any potential treatments possible
• any further information you would gather
• how you would go about communicating with any people (eg. patients, family members, colleagues) involved in the scenario.

After the alloted time is finished, you’ll be given further 1 minute to give handover.
Can you hand this patient over to your colleague?

Suggested Preparatory Materials for Part 2:

• Oxford Handbook of Clinical Medicine
• Medibuddy
• Optimize interviews
• NICE Guideline

You should be able to do the initial assessment, management and produce a list of necessary investigations and differential diagnosis of a patient coming with the following presentations:

Acute setting:

• Patient presenting with Shortness of Breath
• Patient presenting with Chest Pain
• Patient presenting with hematemesis/Malena
• Patient presenting with Headache
• Patient presenting with seizures
• Patient presenting with Confusion/Altered mental status
• Patient presenting with palpitation
• Patient presenting with low GCS
• Patient presenting with fever
• Patient presenting with fever, night sweats, weight loss
• Patient presenting with lew pain and/or swelling
• Patient presenting after a fall
• Patient presenting with diarrhea +/- vomiting
• Patient presenting with poisoning
• Patient presenting with palpitations

OP setting:

• Deranged LFTs
• Asthma Patient presenting for annual review
• High Blood pressure in clinic

Diseases:

• Pneumonia CURB 65 Score
• Sepsis
• Acute Severe Asthma
• Acute exacerbation of COPD
• Tension Pneumothorax
• Pulmonary Embolism
• Acute Coronary Syndrome
• Paracetamol Poisoning
• Hypoglycemia
• Diabetic Ketoacidosis/HHS
• Acute Upper GI Bleeding
• Hyperkalemia
• Hyponatremia
• Anaphylaxis
• Cardiac Arrest (ALS Protocol)
• Tachycardia
• Bradycardia
• ECG interpretation (ST elevation, TWI, Hyperkalemia, SVT, Atrial Fibrillation, Heart Block)
• X-Ray interpretation (Pneumonia, Pulmonary Edema, Pneumothorax, Pleural Effusion)
• ABG interpretation
• Stroke
• Addisonian Crisis
• AF
• SVT
• Fall
• Respiratory Failure
• Stroke

Part 3: Ethical, Professionalism and Governance

This part will include questions from one or more conceptions on Ethics, Professionalism & Governance. The time duration is 5 minutes. Remember, now you won’t get extra time to read or prepare your answers.

As far as I’ve seen, questions in this part can be of three types: 

• Purely Ethical Question
• Governance related Questions
• STAR questions

Purely Ethical questions:

This will be a solely ethical question, it may be patient related or colleague related. For instance,

Example 1: 

You have a patient in the hospital who has been diagnosed with pneumonia and is refusing treatment. On the other hand, his family members have an impression that the doctors have decided not to treat him. How would you plan to manage this scenario?

Example 2: 

You are on a morning shift and one of your colleagues appears to be drunk. How would you deal with this situation?

Try to answer these questions following the ISPIED protocol. (ISPIED- Issues raised, Seek information, Patient safety, Initial measures, Escalate, Document & Reflect). If possible,  you should  try to link the four principles of medical ethics (Autonomy, Beneficence, Non-maleficence, Justice) and Good Medical Practice with your answers.

https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/good-medical-practice

Clinical Governance Related Questions:

Questions in this section will be knowledge based.  Although not so common, questions like these might be asked sometimes.

• What do you mean by audit? What are the steps of an audit?
• What do you mean by research?
• What is the difference between audit and research?
• What is QIP?
• What do you mean by Clinical Governance?
• What are the pillars of Clinical Governance?
• What do you mean by portfolio?
• What do you mean by my appraisal?
• What do you mean by revalidation?
• What do you mean by Evidence Based Medicine?

STAR Questions:

Apart from all, you might be asked some questions which you have to answer from your clinical experience with proper examples. As like:

Tell us about:

• a Mistake that you have done
• ⁠your Strength
• ⁠your Weakness
• ⁠a Conflict that you have had with one of your colleagues
• ⁠Difficult situation that you have faced
• ⁠a situation where you showed Leadership
• ⁠a situation where your Communication skills helped to make a difference
• ⁠a situation where you showed Teamwork
• ⁠a situation where you face Difficulty communicating with a colleague
• a situation where you showed integrity

You must give an example while answering these questions and try to follow the STAR Approach (Solution, Task, Action, Reflection). 

Suggested Study Materials:

• Medibuddy
• CT-ST Interviews
• Optimize Interviews

My Preparation

Study Material:

I had the CT-ST interview book beforehand, and in addition, I subscribed to the Medibuddy and the Optimize Interviews courses. I had studied about 70% of Medibuddy and read chapters 10, 11, and 12 from the CT-ST interview book. Unfortunately, I couldn’t study much from Optimize due to time constraints.

Preparation:

I started my interview preparation with the Optimize mock tests. At first, I took their mock tests without any prior preparation and then gradually began my preparation. I wrote down answers to all the common questions in “the Application and Suitability for IMT” part and practiced them by myself while making a strong effort to stay within the time limit.

For the clinical part, I read Medibuddy and Oxford Handbook of Clinical Medicine. I’ve watched one or two videos from the Optimize Interviews too. I think it would have been much better if I could finish watching the videos. For some topics, I went through the NICE guidelines.

For the questions related to Ethical, Professionalism, and Governance, I studied the Medibuddy and CT-ST Interviews books (Chapters 10, 11, and 12).

Before the IMT interview, I took 7 days of annual leave, and dedicated 5 of those days to preparing for the interview. During those days, I studied and also conducted mock interviews with two consultants and two Internal Medicine trainees, as well as practiced with another candidate.

Thank you for your patience.

Use the following cheatsheet to prepare for the interview:

Tags: IMT, Internal Medicine Training, NHS