August 2014 ST4 Interview Questions

The National Psychiatry Recruitment Board has decided to publish questions in advance of
interviews to offer all candidates an equal chance to prepare, regardless of the date of their
interview. The questions below will be used in recruitment to ST4 psychiatry posts starting in
August 2014.

Station 1 and 2 questions will be used in all interviews. Stations 1 and 3 will be adapted to
reflect the particular specialty.

Station 1 Portfolio (15 minutes)

Using your Portfolio, explain to the panel why you should be chosen for a long term career in
[insert appropriate specialty] Psychiatry and how you meet the person specification.

The purpose of this station is to allow applicants to demonstrate what they have achieved
during core training and to use their portfolio to show how they meet the person specification
for higher training.

You are expected to present directly from your portfolio. There will be no projection facilities
and the use of electronic or paper presentations is not allowed.

Station 2 Audit and Leadership (15 minutes)

Question 1 (7.5 minutes):

Tell us your understanding of how audit influences clinical practice. Use examples to
demonstrate this.

Question 2 (7.5 minutes):

The College curriculum for training contains leadership competencies. What do you understand
by the term leadership?

Station 3 Specialty specific communication skills (15 minutes)

Child and Adolescent Psychiatry - You are a CT3 in psychiatry and have been asked to see a 15-
year-old young person who has been medically cleared following an overdose of 10
paracetamol. They have been brought to the hospital by a friend who has now left.
Please assess the reasons for the overdose and any potential risks and discuss how these risks
could be managed with your patient.

You have 15 minutes with the patient but you can finish earlier if you choose to do so. The
interviewers will assess your communication skills and your ability to form a successful doctor
patient partnership.

(Good Psychiatric Practice CR 154).

Forensic Psychiatry

You are a newly appointed ST4 in forensic psychiatry. Your consultant asked you to speak to
John Smith, who is a single 26 year old man who has been referred by his social worker. A social
worker has reported that Mr Smith has been harassing a young female neighbour who lives
alone. He has called her house on multiple occasions and left several presents on her doorstep,
despite requests he should not do this. Mr Smith has no past psychiatric history but has three
previous convictions for assault. On each of these occasions Mr Smith was intoxicated and
became involved in larger brawls. The social worker is concerned about the risk Mr Smith may
pose to his neighbour, but also feels the harassment is out of character for Mr Smith and would
like some assistance in understanding what is going on.

Please assess the potential risk of violence in this case and communicate to Mr Smith what you
are going to say to his social worker.

You have 15 minutes with the patient but you can finish earlier if you choose to do so. The
interviewers will assess your communication skills, your capability to form a successful doctor
patient partnership and your ability to explore the patients concerns and to answer any
questions they might have. (Good Psychiatric Practice CR 154).

General Adult Psychiatry

You are a CT3 in Psychiatry and have been asked to see Sam, a 30-year-old receptionist, in the
psychiatry out-patient clinic. The referral note from the GP says that Sam has been self-harming
through cutting superficially for the past 15 years. Sam was diagnosed as emotionally unstable
personality disorder by the crisis team last year but was later discharged by the community
mental health team. Sam is now presenting with suicidal ideas as Sams partner has dumped
Sam. Sam reports feeling suicidal but says I wont have anything to do with the crisis team as
they are staffed by idiots.

Please assess Sams current risk of self-harm and how this risk could be managed with your
patient.

You have 15 minutes with the patient but you can finish earlier if you choose to do so. The
interviewers will assess your communication skills and your ability to form a successful doctor
patient partnership.

(Good Psychiatric Practice CR 154).

You are a newly appointed ST4 trainee in psychiatry of intellectual disability, asked to see Alex, a
19 year old person with mild learning disability and a history of depression currently in
remission receiving treatment from your services. He/she currently lives with his/her mother
who is their main carer. Their mothers ex-partner is a registered sex offender due for release
from prison in two months time. Social services are concerned of the potential risks and safety
of Alex from him as he is likely to visit them regularly. Alex was offered supported living
accommodation but social services suspect that he/she may have been coerced into saying that
he/she wishes to continue to live with his/her mother, not understanding fully the potential
risks.

You are asked to assess Alexs current level of functioning including activities of daily living and
assess his/her capacity to decide where he/she chooses to live.

You have 15 minutes with the patient but you can finish earlier if you choose to do so. The
interviewers will assess your communication skills and your ability to form a successful doctor
patient partnership (Good Psychiatric Practice CR 154).

Medical Psychotherapy

You are seeing a patient, Sam Smith, in the outpatient department. She/he is expressing
dissatisfaction with her CPN, care coordinator, Michelle. Sam has repeatedly presented to A&E
with self-harm but is not attending care coordinator reviews. You know her care coordinator
and respect her clinically. Your consultant, Dr Green, is not available but has asked that you see
the patient.

The clinical background is that Sam is 24 years old and has presented with repeated episodes of
self-harm. There is anxiety about Sams risk.

Sam is described as having an idealised relationship with the father and an aggrieved
relationship with the mother who left home when the patient was 11. The behavioural aspects
of the relationship with the mother in adolescence included resenting and reacting aggressively
against the boundaries the mother tried to impose. The rejection of the mother was complete;
the patient has nothing to do with mother and remains very angry.

You are not expected to take a full history or carry out a risk assessment. Your two tasks are:

1. To explore the dynamics of the patients relationship with mental health professionals.
2. To persuade the patient to come to a CPA meeting next week involving consultant and
care coordinator.

The station will last 15 minutes. The role play will run for 10 minutes but you can finish earlier if
you choose to do so. The interviewers will then ask you questions about it for a further 5
minutes. They will assess your communication skills and your ability to form a successful doctor
patient partnership (Good Psychiatric Practice CR 154).
Old Age Psychiatry

You are a newly appointed ST4 trainee in old age psychiatry. Jan Thomas is the son/daughter of
a 70 year old male patient Jack who had an initial assessment for memory problems at your
consultants clinic 2 weeks ago. The son/daughter has phoned to see your consultant urgently to
discuss a number of issues and concerns regarding this assessment. Your consultant has been
called away and asks you to see the patients relative. The relative has permission from their
father to speak to medical staff.

The patients notes indicate he lives alone. A provisional diagnosis of vascular dementia has
been made, scoring 19 out of 30 on the mini mental state with dyspraxia and executive
dysfunction. Your task is to meet with the patients relative and address their concerns.

You have 15 minutes with the patient but you can finish earlier if you choose to do so. The
interviewers will assess your communication skills and your ability to form a successful doctor
patient partnership (Good Psychiatric Practice CR 154).