Psychometric testing for NHS consultant interviews: a complete guide

• Psychometric testing is not a standard requirement for every NHS consultant appointment, but some NHS organisations use it as an additional part of the selection process.
• Psychometric testing does not necessarily mean a personality test. Assessments can measure personality and behavioural tendencies, motivation and values, reasoning ability or judgement.
• There is no single NHS consultant psychometric test. The assessment and provider used will depend on the recruiting organisation.
• Personality questionnaires generally identify behavioural tendencies and preferences rather than producing a simple pass or fail result.
• There is no universally ideal consultant personality. Trying to work out the “right” answers and manufacture the profile you think an NHS Trust wants is therefore unlikely to be helpful.
• Psychometric findings may be used to identify areas for further exploration at interview rather than make the appointment decision by themselves.
• A documented example from University College London Hospitals NHS Foundation Trust described an enhanced consultant appointment process involving three online psychometric assessments before the main AAC interview.
• You cannot revise your personality in the same way that you revise clinical knowledge, but you can prepare properly for the assessment process. If you are taking an aptitude or reasoning test, familiarisation and appropriate practice may be useful.
• If psychometric feedback identifies a possible weakness, do not immediately reject it or feel obliged to accept everything it says. Strong candidates demonstrate self-awareness, context and evidence of how they manage their own tendencies.
• Reasonable adjustments can apply to recruitment assessments. If you need one, raise it with the recruiting organisation as early as possible.

The first thing I need to make clear is that psychometric testing is NOT the same as personality testing. Most people use these two terms interchangeably but they are not quite the same thing.

The term ‘psychometric test’ is a broad term for structured methods used to measure psychological characteristics such as abilities, personality traits, behavioural preferences or aspects of judgement.

A personality questionnaire is just one form of psychometric assessment. Other psychometric tests can assess areas such as verbal reasoning, numerical reasoning, problem-solving ability, professional judgement, motivation or workplace preferences.

Psychometric testing is one of several methods employers can use alongside interviews and other selection techniques. Importantly, the assessment should be relevant to the job and supported by appropriate evidence regarding its validity and reliability. So, if an NHS Trust tells you that you will undergo psychometric testing before your consultant interview, do not immediately assume that you are about to complete a personality questionnaire.

Yes, although it is important not to overstate how common it is. There are no reliable national figures showing what proportion of NHS Trusts use psychometric testing when appointing consultants, and psychometric assessment is not a standard requirement of every NHS consultant interview or Advisory Appointments Committee (AAC). Many consultant appointments take place without any psychometric assessment at all. However, there are well-documented examples of NHS organisations incorporating psychometrics into their consultant selection processes, sometimes alongside stakeholder panels, presentations or other assessment exercises.

One particularly useful example comes from University College London Hospitals NHS Foundation Trust (UCLH). A published Employment Tribunal judgment describing its recruitment arrangements recorded the introduction of an enhanced “AAC plus” process for substantive consultant appointments. Shortlisted candidates completed around two hours of online psychometric testing involving three different assessment tools, as well as a stakeholder panel, before the main AAC interview. Importantly, the psychometric results were not simply treated as a separate pass-or-fail test. They could be used to inform and adapt the questions asked at the subsequent interview, allowing the panel to explore aspects of the candidate's suitability in greater depth.

There are other examples. Northumbria Healthcare NHS Foundation Trust has advertised substantive consultant posts using an assessment-centre approach in which shortlisted candidates undertake behavioural and thinking-style psychometric tests, with the results subsequently validated during the recruitment interview. This has formed part of a wider assessment process that can also include competency and clinical assessment.

The important point is therefore not to assume either that psychometric testing is routine or that its use is particularly unusual. The selection process varies between NHS organisations and sometimes between appointments within the same organisation. If psychometric assessment forms part of your consultant recruitment process, you should normally be given information about it in advance. Find out what type of assessment you will be completing and, if possible, how the results will be used. As the examples above illustrate, the purpose may be less about obtaining a single “psychometric score” and more about giving the appointment panel additional information to explore alongside your experience, behaviour and performance at interview.

A substantive consultant appointment is a significant recruitment decision. The organisation is not simply asking whether you possess sufficient clinical knowledge to do the job. By the time you reach interview, your qualifications, specialist training and professional experience should already provide substantial evidence that you satisfy the essential requirements of the post. The appointment panel is considering something broader : what you are likely to be like as a consultant within their organisation

Consultants make decisions under uncertainty. They work with competing priorities, they influence other people, they supervise colleagues, they deal with conflict, they participate in clinical governance and they also work across professional and organisational boundaries. They also have considerable autonomy and may remain within the same consultant team for many years.

Let’s face it. The interview process can be a bit random. How do you assess that someone is a team player? If you just ask them ‘What makes you a good team player’, they’ll probably serenade you with all the right words. If you ask them to give an example where they showed good team-playing abilities, they’ll always find the perfect example for you but will keep quiet about all the other times when they made everyone’s life miserable.

A Trust may therefore use psychometric assessment to provide another source of information about how somebody tends to approach work and relationships. The assessment should not replace evidence of what you have actually done. A questionnaire can never demonstrate that you successfully led a difficult service redesign, handled a serious patient-safety incident or supported a struggling trainee. But it might identify something that the panel wishes to explore.

For example, an assessment suggesting a strong preference for working independently could generate questions about collaboration, whilst a strong preference for consensus might prompt exploration of what you do when an unpopular decision genuinely has to be made, fearing you might be too much of a people pleaser. Someone whose assessment highlights a very cautious decision-making style could prompt the panel to wonder whether they can handle situations requiring timely action despite uncertainty. The test provides a possible line of enquiry whilst your experience provides the evidence.

There is no standard NHS consultant psychometric assessment, so exactly what you encounter will depend on the Trust and the provider it has chosen. You might complete one questionnaire or several different assessments, and they may be completed online at home or form part of a wider assessment day.

The important thing is that these tests are not all doing the same job. Some are interested in how you typically behave, others in what motivates you, and others assess your reasoning or judgement. That distinction also affects how you should prepare for them.

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Personality and behavioural questionnaires

This is probably what most doctors imagine when they hear the words “psychometric testing”.

You will usually be presented with a series of statements about how you tend to behave or interact with other people. Depending on the test, you might indicate how strongly you agree with each statement, how accurately it describes you, or choose which of several statements is most or least like you. The actual wording will vary, but you might encounter statements along the lines of:

• “I am comfortable taking the lead when a group is uncertain what to do.”
• “I prefer to consider all the available information before reaching a decision.”
• “I find it easy to challenge other people's views.”

The test is not usually interested in any one answer in isolation. It looks at patterns across a much larger number of responses to build up a picture of how you generally prefer to work.

Depending on the particular assessment, this might include your levels of assertiveness, independence, sociability or conscientiousness, your approach to change and risk, how you make decisions, how you relate to other people and how you tend to respond under pressure.

The resulting report may therefore say much more than simply that you are an “introvert” or an “extrovert”. It might suggest, for example, that you tend to take ownership quickly, prefer working autonomously, seek consensus before making decisions or have a particularly strong attention to detail.

That is potentially much more useful to an appointment panel because each of those findings gives them something specific to explore.

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Values and motivation questionnaires

Some assessments look less at how you behave and more at what drives you. You might therefore be asked questions designed to establish the importance you attach to things such as achievement, recognition, autonomy, influence, security, collaboration or intellectual challenge.

This may seem less obviously relevant to a consultant appointment, but think about two very different jobs. One might be an academic consultant post with significant research opportunities, specialist work and protected academic time. Another might predominantly involve high-volume clinical service delivery and operational improvement.

A doctor strongly motivated by academic discovery and developing specialist expertise might thrive in the first role and become frustrated in the second. Another candidate may gain far more satisfaction from improving practical services, developing teams and solving operational problems.

Neither motivation is intrinsically better. The question is whether there is a sensible match between what motivates the candidate and what the job can realistically offer.

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Behaviour under pressure and potential derailers

Some occupational assessments also look at tendencies that may become more prominent when somebody is stressed, tired or under pressure. You may hear these described as potential derailers. The word sounds rather alarming, but the concept is actually quite straightforward. A derailer is not necessarily a bad characteristic. It can simply be what happens when an otherwise useful characteristic becomes excessive.

• Confidence is useful in a consultant. Too much confidence can become overconfidence.
• Independence is useful. Taken too far, it can become reluctance to consult other people.
• Attention to detail is important. At an extreme, it can become perfectionism or difficulty prioritising.
• Caution can protect patients. Excessive caution can make decision-making unnecessarily slow.
• Assertiveness can help you challenge unsafe practice. Excessive assertiveness can mean that other people stop feeling heard.

One established assessment that specifically examines this area is the Hogan Development Survey. NHS Resolution has used this alongside the Revised NEO Personality Inventory in its behavioural assessment work with doctors. This does not mean that Hogan is the standard test used for NHS consultant appointments. There is no standard test! But it illustrates the sort of characteristics occupational psychometrics can explore.

The interesting question for an appointment panel is therefore not simply whether you have a particular characteristic. It is what happens when that characteristic is pushed too far, particularly when you are under pressure, and whether you have enough self-awareness to recognise and manage it.

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Aptitude and reasoning tests

These are quite different from personality questionnaires because there usually are right and wrong answers.

An aptitude assessment might examine verbal, numerical or abstract reasoning. You could be asked to interpret written information, analyse numerical data, identify patterns or solve problems within a limited amount of time.

For example, a verbal reasoning test might give you a short passage followed by several statements and ask you to decide whether each conclusion is supported by the information provided. A numerical reasoning test might present information in a table or graph and ask you to calculate or interpret a result. An abstract reasoning test may give you a sequence of shapes or patterns and ask you to identify what comes next.

This distinction is important when we come to preparation. There is little value in practising how to have a different personality. There can, however, be considerable value in familiarising yourself with the format of an aptitude test before you take it.

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Situational judgement assessments

A situational judgement assessment presents you with a realistic workplace problem and asks you to evaluate possible responses. You might have to select the action you consider most appropriate, rank several possible responses or rate how effective each would be.

This type of assessment may already be familiar to you from medical recruitment. Situational judgement testing is used in recruitment to some postgraduate training programmes. For example, the Multi-Specialty Recruitment Assessment (MSRA), used for entry to a number of medical specialties, includes a Professional Dilemmas paper which is a Situational Judgement Test. Public Health specialty recruitment also uses a dedicated SJT as part of its assessment centre.

The principle is similar: you are presented with a professional situation and asked to judge the relative appropriateness of different responses. In the MSRA Professional Dilemmas paper, for example, the emphasis is on professional attributes such as integrity, coping with pressure, empathy and sensitivity rather than testing specialist clinical knowledge.

In a consultant recruitment context, the scenarios could potentially explore issues such as conflict between colleagues, competing priorities, concerns about somebody's performance, leadership or difficult organisational decisions. The assessment is interested in the judgement you apply to the situation rather than simply asking what sort of person you think you are.

This is particularly relevant at consultant level because many of the difficult decisions consultants face do not have one neat textbook answer. You may need to balance patient safety, professional relationships, limited resources, organisational processes and the need to act promptly.

However, do not assume that you will encounter a situational judgement test simply because your Trust mentions psychometrics. Although SJTs are well established in some medical training recruitment processes, they are only one possible form of psychometric assessment and are not a standard component of NHS consultant recruitment.

If you complete a personality or behavioural assessment, you are unlikely simply to receive a mark of 72% and be told whether you passed. The output is more likely to be a profile describing your relative tendencies across a number of areas. The terminology will depend entirely on the particular assessment, but it might suggest that you tend to:

• make decisions independently;
• take charge when situations are unclear;
• seek consensus before making important decisions;
• challenge other people's views readily;
• prefer structure and established processes;
• enjoy change and trying new approaches;
• place considerable emphasis on detail and accuracy;
• become more cautious under pressure;
• prefer maintaining personal oversight of important work.

None of those statements is automatically good or bad.

Suppose your report suggests that you are comfortable making decisions independently. That could describe a confident consultant who is prepared to take responsibility rather than constantly looking to somebody else for reassurance. But an appointment panel might reasonably want to know whether you always involve colleagues sufficiently.

Similarly, strong attention to detail could indicate somebody conscientious and clinically thorough. The potential downside is whether you struggle to prioritise, delegate or recognise when something is good enough rather than perfect.

Even a characteristic that sounds unequivocally positive can have another side. Somebody who strongly values consensus may be an excellent listener who brings teams together. The panel might nevertheless want to establish whether that person can challenge a colleague or make an unpopular decision when necessary.

So rather than reading a psychometric report as a list of strengths and weaknesses, it is more useful to think of it as a description of behavioural tendencies whose effect depends on the situation and how well you manage them.

This is probably the most important thing to remember when completing a personality questionnaire. It is tempting to try to work out what the Trust wants and answer accordingly.

You might think that consultants need to be leaders, so you should choose the most assertive answers. Then you remember that consultants need to be team players, so perhaps you should choose the collaborative answers instead. Consultants need resilience too, so maybe you should imply that nothing ever bothers you.

Before long, you are no longer answering questions about yourself. You are trying to construct an imaginary perfect consultant.

The problem is that there isn't one. And more importantly you might gamble on a profile that is not the profile they are currently looking for or a profile that does not fit this particular team.

• A department already containing several forceful, highly innovative consultants might particularly value somebody who brings stability, listens carefully and builds consensus.
• Another service facing substantial transformation might need somebody prepared to challenge established ways of working and push change forward.
• An academic department may value intellectual curiosity and research motivation particularly highly, while a busy service-facing post may place greater emphasis on reliability, practical problem-solving and operational improvement.

Even within the same consultant, different characteristics will be useful at different times. You may need to be collaborative during service redesign, decisive during a clinical emergency, challenging during a governance meeting and supportive when supervising a struggling trainee.

Your objective is therefore not to demonstrate that you possess every desirable characteristic in equal measure. It is to understand your own working style and show that you can adapt it appropriately to the situation.

You can certainly try, but it is unlikely to be a sensible strategy. Occupational personality questionnaires are generally more sophisticated than a series of obvious questions where one answer represents the perfect consultant and another represents somebody nobody would employ. Some instruments also look at patterns within your answers, including consistency and unusually favourable self-presentation. That does not make them lie detectors and we should not pretend that they can somehow uncover your “true personality” with perfect accuracy.

There is a much more practical problem with trying to manufacture an impressive profile, which is that you may subsequently have to discuss it! Imagine that you deliberately create the impression that you are exceptionally assertive, and comfortable confronting people because that sounds suitably consultant-like. The panel might then ask:

• “Tell us about a time when you challenged a senior colleague.”
• “Describe a significant conflict you have managed.”
• “Tell us about a situation where somebody challenged your view and you changed your mind.”

If the evidence from your career does not fit the personality you tried to construct, you have made your interview harder rather than easier. The better advice is simply to answer naturally, thinking about how you genuinely tend to behave at work, rather than trying to predict which answer will impress the Trust.

Exactly how the results are used will depend on the organisation and the assessment process. They might contribute to an assessor's report, be discussed with you during a separate feedback interview or be made available to the consultant appointment panel.

One particularly interesting possibility is that the results can influence the questions you are subsequently asked.

The documented UCLH “AAC plus” process provides a useful real example. The psychometric assessments were not simply an additional hurdle that produced a score. The results allowed the main panel to adapt its questioning in order to explore individual candidates' suitability further. Think of it as generating a hypothesis.

• The psychometric assessment suggests that the candidate appears particularly independent. The interview can then explore how they respond when somebody disagrees with them?
• The assessment suggests that the candidate appears very cautious. The panel can explore whether they can still make a timely decision when the evidence is incomplete
• The assessment suggests that the candidate strongly prefers harmony and consensus. The interview can test whether they challenge poor performance when necessary.

The psychometric profile has not answered those questions. It has simply given the panel a reason to ask them.

Psychometric testing can provide useful additional information during recruitment, but simply using a psychometric test does not automatically make a selection process more scientific or more reliable.

The quality of the information depends on the test being appropriate for the purpose, having evidence of validity and reliability, being administered and interpreted properly and, crucially, the conclusions drawn from it being reasonable. Professional guidance from the CIPD makes exactly these sorts of distinctions. It recommends considering whether a test is actually relevant to the job, whether appropriate norm groups are being used, who is qualified to administer and interpret it, how the results will contribute to selection and whether there are potential equality issues.

There are several ways things can go wrong.

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Using a test for something it was never designed to measure

A test can be a perfectly respectable psychometric instrument without necessarily being suitable for every recruitment decision.

For example, evidence that a questionnaire reliably measures certain personality characteristics does not automatically mean that it has been shown to predict who will make the best NHS consultant.

Those are two different claims. Recruiters therefore need to understand not merely whether a test is “validated”, but what it has actually been validated to measure and whether that information is relevant to the particular job.

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Using the wrong comparison group

Some psychometric results are interpreted by comparing your responses with a reference population, usually known as a norm group. That raises an obvious question: compared with whom?

Being described as unusually assertive, cautious or independent only makes sense in relation to the population against which you are being compared. CIPD guidance specifically highlights the importance of appropriate benchmark or norm groups when psychometric scores are interpreted.

This is one reason candidates should be cautious about treating percentiles and graphs in psychometric reports as absolute measurements of their personality.

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Turning a tendency into a label

Perhaps one of the easiest mistakes is to turn a relative tendency into a definitive description of somebody. Suppose your assessment suggests that you are more comfortable than the comparison group with working independently.

That can subtly become: “He's very independent.”

And then: “He's probably not much of a team player.”

But those are three different propositions.

The first is a psychometric finding. The second is an interpretation of that finding. The third is effectively a prediction about how you will behave as a consultant.

That final conclusion needs evidence. A much better use of the result would be to ask about multidisciplinary working, seeking advice, responding to disagreement and occasions when you changed your view after listening to colleagues. The psychometric result has then generated a sensible area for exploration rather than becoming a verdict.

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Giving the report more authority than it deserves

There is something rather persuasive about a professionally produced psychometric report. Give somebody a graph, a percentile and a 15-page report containing phrases such as “behavioural tendency” and “potential derailer” and the findings can begin to feel considerably more objective than somebody's opinion at interview.

But precision of presentation is not the same thing as certainty.

The report remains an interpretation of somebody's responses to a particular assessment, based on a particular psychological model and, in many cases, comparison with a particular reference population.

This is why psychometric results should form part of the evidence rather than automatically overriding everything else. CIPD guidance specifically cautions that psychometric test results should not be the sole basis for a selection decision.

If ten years of somebody's career demonstrate successful multidisciplinary working but one questionnaire suggests unusually high independence, the sensible response is not automatically to believe the questionnaire and disregard the ten years of evidence.

The discrepancy itself is something worth exploring.

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Confirmation bias: allowing the result to influence how everything else is interpreted

There is another, subtler danger: confirmation bias. Imagine that an interviewer has already read a report describing you as unusually dominant. You then give a confident and decisive answer at interview. The interviewer may interpret that as further evidence of dominance. Another candidate gives an equally confident answer but has no such description in their psychometric report. Their behaviour may simply be interpreted as good leadership.

Similarly, if somebody has been described as highly cautious, taking a few seconds to consider an interview question could suddenly look like further evidence of indecisiveness.

This does not mean panels should be prevented from seeing psychometric results. Indeed, some recruitment processes deliberately use the results to guide subsequent questioning. But interviewers need to recognise that prior information can influence how subsequent behaviour is interpreted.

Structured questions, agreed assessment criteria and evidence-based scoring become particularly important for that reason. CIPD recommends structured interviewing precisely because consistency and objective criteria help reduce the influence of bias.

Treating the test result as the answer rather than something to investigate

This is perhaps the simplest principle of all. If an assessment suggests that a candidate is highly cautious, the conclusion should not automatically be: “This person won't make decisions quickly enough to be a consultant.”

The appropriate response is to investigate it: “Your profile suggests that you have a cautious decision-making style. Tell us about a situation where you had to make an important decision quickly despite incomplete information.”

Now the candidate has an opportunity to provide actual behavioural evidence.

Interestingly, the Northumbria consultant recruitment example we discussed earlier describes behavioural and thinking-style psychometric assessments whose results are subsequently validated as part of the recruitment interview. That is an important concept: the assessment identifies something worth exploring; the interview helps establish whether it is borne out by the candidate's actual experience.

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Using psychometrics without sufficient expertise

Psychometric testing is also a specialist area. CIPD guidance states that administering tests and analysing their results requires appropriate training and certification. It also recommends that employers establish who will choose the test, who will assess its value, how results will be used, how feedback will be provided and who will have access to the information.

This matters because the potential for misuse may not lie in the test itself. It can arise from somebody interpreting a complex report without properly understanding what its scales, scores and limitations mean.

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Using automated scores without meaningful human judgement

This is becoming increasingly relevant as recruitment becomes more digital. An online aptitude or psychometric system could potentially score candidates automatically. There is an important difference, however, between a computer generating a score that contributes to a recruitment decision and a computer effectively making the recruitment decision itself.

The Information Commissioner's Office specifically gives a recruitment aptitude test using pre-programmed algorithms and criteria as an example of automated decision-making. UK data-protection rules place additional safeguards around solely automated decisions that have legal or similarly significant effects, including certain recruitment decisions.

This is a developing area, particularly as recruitment technology becomes more sophisticated, but the underlying principle is sensible: a computer-generated psychometric score should not acquire unquestioned authority simply because it has been generated automatically.

Ignoring fairness, accessibility or reasonable adjustments

Finally, the assessment itself needs to be fair. CIPD guidance recommends considering whether a test might disadvantage particular groups and whether it needs to be adapted. Candidates should receive advance information about the test, its duration and requirements and have an opportunity to request appropriate adjustments.

This matters particularly with timed assessments. If the purpose is to measure a particular ability, an unnecessary barrier created by the way the assessment is delivered may end up measuring something else entirely.

So, if you encounter psychometric testing during a consultant appointment, do not assume that every conclusion in the report must be correct simply because it came from a formal assessment.

Equally, there is no reason to regard psychometric testing with suspicion simply because it has limitations. Used appropriately, it can provide another useful source of information.

The important questions are: Why is this particular test being used? What does it actually measure? Is it appropriate for this role? Who is interpreting it? What comparison group is being used? And how will the findings be tested against the other evidence about the candidate?

Psychometrics can inform judgement. They should not replace it.

This raises an obvious question. NHS interviews are generally expected to be fair and structured, so how can a panel use your psychometric results to ask you questions that another candidate may not receive?

The distinction is between the core interview questions and the follow-up questions used to explore an individual candidate's answers or other assessment evidence.

Good recruitment practice is for candidates applying for the same post to be assessed against the same criteria and, in a structured interview, to be asked the same core questions. This makes it possible to compare candidates fairly and reduces the risk that one candidate receives a substantially easier or more favourable interview than another.

However it does not mean that every word spoken during each interview has to be identical. Panels routinely ask follow-up questions. If one candidate gives an unclear answer, they may be asked to explain it. If somebody mentions a significant leadership role, the panel might ask exactly what they personally contributed. Another candidate may be challenged about something on their CV or asked to clarify an aspect of their experience. Those follow-up questions will inevitably differ between candidates.

Psychometric testing can work in much the same way. For example, all candidates might receive the same core question about leadership. However, if your psychometric profile suggests that you have a particularly strong preference for taking control, the panel might follow your answer with: “How do you make sure other people have sufficient ownership when you are leading a project?”. Another candidate whose profile suggests a strong preference for consensus might instead be asked: “Tell us about a situation where you had to make a decision despite significant disagreement within the team”. The questions are different, but they are exploring the same underlying area: how effectively the candidate is likely to lead as a consultant.

This is not merely theoretical. In the documented UCLH “AAC plus” consultant recruitment process, psychometric testing specifically allowed the main appointment panel to adapt its questioning to explore individual candidates' suitability further. There is nevertheless an important safeguard. Psychometric results should not become an excuse for an unstructured conversation in which different candidates are effectively assessed against different standards.

The underlying job requirements and assessment criteria still need to be applied consistently. The psychometric profile provides an additional line of enquiry; it should not create a completely different test for each candidate.

So, if your own interview contains a question that feels unusually specific to you, do not assume that everybody else must have been asked exactly the same thing. You may be hearing a follow-up prompted by your psychometric profile, application, previous answer or another part of the assessment process.

If you receive your results before the main consultant interview, this is where they become particularly useful for your preparation. Do not try to prepare a defence against every sentence in the report. Instead, look at the strongest themes and ask yourself: if I were appointing a consultant, what would I want to check about this?

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If you appear highly independent

Independence can be a considerable strength. Consultants need autonomy and must be capable of taking responsibility for decisions without constantly seeking reassurance.

The potential concern is whether independence becomes isolation or reluctance to involve others. You might therefore be asked:

• “Tell us about a situation where you needed to seek help or advice from colleagues.”
• “How do you respond when another consultant disagrees with your proposed approach?”
• “Give us an example of a situation where involving other people changed your initial view.”

A strong answer demonstrates independent judgement without confusing independence with having to do everything yourself.

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If you appear very assertive

Assertiveness is also valuable. Consultants need to challenge unsafe practice, manage difficult situations and occasionally maintain a position despite opposition. The potential downside is dominance. The panel might therefore ask:

• “Tell us about a significant disagreement with a colleague.”
• “How do you make sure quieter members of a team are heard?”
• “Describe a situation where somebody challenged your opinion and you changed your mind.”

The panel may not be trying to establish whether you are assertive. The psychometric assessment has already suggested that. It may be trying to establish whether you know when to stop asserting and start listening.

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If you strongly prefer consensus

This may indicate somebody who listens well, builds relationships and brings people together. Those are extremely useful consultant qualities. But consultants cannot always wait until everybody agrees. You could therefore be asked:

• “Tell us about an unpopular decision you have had to make.”
• “Describe a situation where you had to challenge a colleague's behaviour.”
• “What would you do if a senior colleague repeatedly failed to follow an agreed patient-safety procedure?”

The issue is whether collaboration ever becomes avoidance of necessary conflict.

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If you appear highly cautious

In medicine, caution is hardly an undesirable characteristic. It may reflect thoughtful decision-making and careful assessment of risk. But consultants frequently have to act with incomplete information. You might therefore be asked:

• “Tell us about a time when you had to make an important decision without having all the information you wanted.”
• “How do you balance thoroughness with the need to make timely decisions?”
• “Give us an example of managing risk under uncertainty.”

A strong answer shows that you understand risk without becoming paralysed by it.

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If you appear extremely detail-focused

Attention to detail is obviously important in clinical practice. The potential issue arises when there is simply too much work for you to examine everything personally. You might be asked:

• “How do you prioritise when several important demands arrive simultaneously?”
• “Tell us about something significant that you delegated to somebody else.”
• “How do you decide when something is sufficiently complete rather than continuing to refine it?”

At consultant level, thoroughness has to coexist with prioritisation and delegation.

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If you have a strong preference for control

This may reflect ownership, high standards and a willingness to take responsibility. But senior doctors cannot personally control everything.

You might therefore be asked:

• “How do you delegate safely?”
• “Tell us about developing somebody else to take responsibility for an area you previously managed yourself.”
• “How do you respond when somebody approaches a task differently from the way you would?”

A consultant who cannot relinquish control eventually becomes a bottleneck. A strong candidate can maintain appropriate oversight without micromanaging.

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If you are highly change-oriented

This could be an obvious strength for a department looking for service development. But having lots of ideas is not the same as successfully delivering change. You might therefore be asked:

• “Tell us about a service improvement you actually implemented.”
• “Describe a situation where colleagues resisted a change you were proposing.”
• “How did you know whether the change had worked?”

The panel may be checking whether your enthusiasm for innovation is matched by stakeholder engagement, implementation and measurement.

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If you tend to avoid conflict

Plenty of perfectly effective doctors dislike conflict. The important issue is whether disliking it prevents you from dealing with it. You might therefore be asked:

• “Tell us about a difficult conversation with a colleague.”
• “How would you deal with persistent poor performance in somebody you supervise?”
• “Describe a situation where you challenged behaviour despite knowing that the conversation would be uncomfortable.”

You do not need to pretend that you enjoy confrontation. You need to demonstrate that you will not avoid it when patient safety, professional standards or the functioning of the team requires you to act.

This can feel quite different from a normal interview question because it sounds more personal. Imagine that an interviewer says: “Your profile suggests that you can be quite directive and tend to take control quickly. Do you recognise that?”

There are two tempting responses.

• Immediate rejection: “No. That's completely wrong. I'm actually very collaborative.”
• Unquestioning acceptance: “Yes, I'm obviously too controlling.”

Neither tells the panel very much about your self-awareness. A better answer might acknowledge that you do tend to take ownership quickly when a situation is unclear or urgent. You could explain that this can be useful when rapid decisions are required, but that you have also learnt that the same instinct can be less helpful during longer-term service change, where people need to feel involved and have ownership. You can then explain how you manage that tendency and give an example of doing so successfully. A useful way of remembering the approach is:

• Recognise it
• Put it into context
• Explain the potential downside
• Show how you manage it
• Give evidence

You do not have to agree with every word of a psychometric report. But if there is some truth in the finding, being able to discuss it openly and intelligently demonstrates considerably more maturity than trying to prove the test wrong.

You are allowed to disagree. Psychometric assessment is measurement, not revelation. A questionnaire does not suddenly have access to some hidden version of you that you have somehow failed to notice during the rest of your life. Sometimes a description simply may not feel accurate. The language used in occupational reports can also sound stronger than the everyday behaviour it is trying to describe.

Before dismissing it, however, think about whether the finding applies in particular circumstances. Would colleagues recognise it? Does it become more apparent when you are tired, frustrated or overloaded? Could the terminology mean something slightly different from what you initially assumed?

You may still conclude that it does not describe you particularly well. If it is raised at interview, explain that calmly and use evidence.

For example:

You are now discussing your actual behaviour rather than arguing about the result of a questionnaire.

This is one of the most useful things psychometric preparation can make you consider.Most of us behave slightly differently when everything is going well compared with when we are tired, overloaded, frustrated or under significant pressure:

• A very organised person may become excessively controlling.
• A naturally cautious person may become indecisive.
• A decisive person may become too quick to act.
• Someone who values harmony may avoid a confrontation that needs to happen.
• Someone highly independent may stop asking for help.
• A detail-focused person may lose sight of the bigger picture.

The appointment panel is not particularly worried about whether you can be pleasant and collaborative on a well-staffed Tuesday morning when everything is going according to plan. It is rather more interested in what happens when the rota has collapsed, waiting times are escalating, a colleague strongly disagrees with you, a complaint has arrived and somebody has just raised a patient-safety concern.

You do not need to claim that pressure has no effect on you. That is unlikely to sound credible. What matters is demonstrating that you understand how pressure affects you and what you do to compensate for it.

People often say that you cannot prepare for psychometric testing. That is only partly true. You cannot sensibly revise your personality, and trying to manufacture the profile you think the Trust wants is unlikely to help. But you can prepare for the format, the conditions, the likely demands of the assessment and the possibility that your results will later be explored at interview.

The first step is to find out exactly what you have been asked to complete. If the Trust gives you the name of the assessment or provider, look at the official candidate guidance. Different psychometric tests work in very different ways, and preparation should match the assessment.

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If it is a personality or behavioural questionnaire

You do not need to practise giving “better” answers, but there are still things worth doing.

First, understand how the questionnaire works. Some tests ask whether you agree or disagree with statements. Others use forced-choice questions where you have to choose which description is most or least like you. Familiarity with the format means you are less likely to overthink the mechanics once you start.

Second, think about the context in which you should answer. These assessments are usually interested in your typical work behaviour, not how you behave on holiday, at home or in every possible situation. If a statement asks whether you tend to take charge, for example, think about how you generally behave professionally rather than trying to average every part of your personality.

Third, avoid answering according to the person you think a consultant should be. If you repeatedly choose the most assertive, resilient, sociable or dominant-looking response because it sounds impressive, you may create a profile that bears little resemblance to your actual behaviour and which you then struggle to support at interview.

Finally, do not rush. Personality questionnaires are not usually improved by answering every question instantly. Read each statement properly, answer naturally and move on rather than repeatedly revisiting your answers in search of the “perfect” response.

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If it is an aptitude or reasoning test

This is where preparation can be much more active. Use official practice questions if the provider offers them. Familiarise yourself with the style of verbal, numerical or abstract reasoning questions you are likely to encounter. Practise working within the time limit. A large part of the challenge in reasoning tests is often not the underlying difficulty of the questions but maintaining accuracy when time is restricted.

• For numerical reasoning, refresh basic calculations you may not use routinely, such as percentages, ratios, proportions and interpreting tables or graphs.
• For verbal reasoning, practise answering from the information given rather than relying on assumptions or outside knowledge.
• For abstract reasoning, get used to looking for changes in shape, number, position, rotation or sequence.

The aim is not to memorise answers. It is to make the format familiar enough that you can concentrate on the reasoning itself.

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If it is a situational judgement assessment

Preparation is different again. Start by reading the instructions very carefully because different tests ask different things. You may be asked to choose the best response, rank several options from most to least appropriate, or rate each option independently.

Then think about the principles that usually matter in professional judgement: patient safety, escalation where necessary, proportionality, communication, professionalism, teamwork, confidentiality and dealing with problems at the right level.

Do not approach every scenario as though the most dramatic action must be correct. Equally, do not assume that avoiding escalation is always the more reasonable response. Good judgement often means recognising the seriousness of the situation, acting proportionately and involving the right person at the right time.

If official practice material is available, use it. The MSRA and some other medical recruitment processes provide candidates with examples of professional dilemma-style questions, and these can help you become familiar with the logic of this type of assessment even though a consultant recruitment test may be different.

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Prepare the conditions as well as the content

If the assessment is online, make the practical setup as boring as possible. Use a reliable computer and internet connection. Complete the test somewhere quiet. Make sure you will not be interrupted. Allow enough time so that you are not trying to squeeze the assessment between clinics, meetings or family commitments.

If the test is timed, know whether you can pause it before you start.

If you use reading glasses, assistive technology or anything else you routinely rely on, have it ready.

These details sound trivial, but there is little point in carefully preparing for an assessment and then losing concentration because somebody rings the doorbell halfway through.

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Prepare for what may happen after the test

If the assessment includes a personality or behavioural profile, the most useful preparation may actually come after you receive the results. Read the report carefully and identify the strongest themes.

Ask yourself:

• Which parts sound accurate?
• Which parts surprise me?
• Where might this characteristic help me as a consultant?
• Where could it become less helpful?
• What do I do to manage it?
• What examples from my work demonstrate that?

Suppose the report suggests that you are highly independent. Prepare an example showing when independent decision-making was valuable, but also one showing that you can seek advice and change your position when appropriate.

If it suggests that you avoid conflict, think about a difficult conversation you have nevertheless handled properly. If it describes you as highly detail-focused, prepare evidence of prioritisation and delegation.

This matters because, in some consultant recruitment processes, psychometric findings may be used to inform subsequent interview questions. So the best preparation is not trying to produce a perfect profile. It is making sure that, whatever profile emerges, you can discuss it with insight, evidence and maturity.

Depending on what your profile identifies, the following are some of the areas you might want to prepare examples for:

If your profile raises…	Prepare examples involving…
Independence	collaboration, MDT working and seeking advice
Assertiveness	conflict, listening and challenge
Consensus-seeking	difficult decisions and challenging poor behaviour
Caution	uncertainty, risk and timely decision-making
Attention to detail	prioritisation and delegation
Preference for control	developing others and relinquishing responsibility
Change orientation	implementation, resistance and measurement
Conflict avoidance	difficult conversations
Sensitivity to criticism	complaints, feedback and reflection
Preference for structure	ambiguity, flexibility and change
High confidence	recognising limitations and changing your mind

For each example, know what happened, what your role was, what you actually did, what was difficult, what happened as a result and what you learnt. The objective is not to memorise an impressive answer to every possible personality characteristic. You simply want to be able to respond intelligently if somebody says: “Your profile suggests X. Tell me how that affects you at work.”

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What if you need a reasonable adjustment?

If a disability or health condition may affect your ability to complete the assessment under the standard arrangements, raise this with the recruiting organisation as early as possible.

Reasonable adjustments can apply to recruitment assessments. Depending on the individual and the type of test, this might involve additional time, assistive technology, accessible presentation of material or another appropriate modification.

There is no single standard adjustment because the appropriate solution depends on both the candidate and the assessment being used.

There is no single standard adjustment because the appropriate solution depends on both the candidate and the assessment being used.

Do not assume that requesting an adjustment will make you appear to be a weaker candidate. If you need one, ask.

It depends on what sort of test you are taking.

An aptitude or reasoning test normally generates a performance score because there are correct and incorrect answers. An employer may potentially compare that score with a benchmark or use it alongside other selection information.

A personality questionnaire is different. There is not necessarily one correct consultant personality against which everybody is being marked.

That does not mean the results are irrelevant to selection. An organisation may decide that certain characteristics are particularly important for a role or may have concerns about aspects of a candidate's profile. More commonly, however, the findings can provide information that is explored alongside other evidence.

This is why it is safer not to tell candidates that personality testing is something they either categorically “pass” or “cannot fail”. How the assessment contributes to the appointment decision depends on the test and the selection process designed by the organisation.

Possibly, although arrangements vary.

Some processes include a formal feedback discussion with an occupational psychologist or another trained assessor. Others may provide candidates with a written report or summary, while in some cases the information may primarily be produced for the selection process.

If the arrangements have not been explained, it is perfectly reasonable to ask the recruitment team: “Will I receive feedback on the assessment, and how will the results be used during the appointment process?”

You can also ask whether the results will be available to the main consultant interview panel. You are not asking them to reveal what profile they are looking for. You are simply trying to understand the recruitment process in which you are participating.

This distinction is worth making because some of the terminology used in psychometric reports can sound surprisingly strong.

An occupational personality questionnaire is not diagnosing mental illness or personality disorder. If an assessment describes somebody as cautious, sceptical, independent, reserved, perfectionistic or highly competitive, those words need to be understood within the framework of that particular occupational assessment.

The same applies to terms such as derailer. A behavioural derailer refers to a tendency that may become less helpful under particular circumstances. It is not a psychiatric diagnosis.

A psychometric profile should therefore be interpreted as one source of information about workplace tendencies and behaviour, not as a clinical assessment of your mental health or personality.

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Keep psychometric testing in perspective

If you are told that your consultant appointment includes psychometric testing, it is easy to become disproportionately worried about it simply because it is unfamiliar. Keep it in perspective. The Trust is still appointing a consultant. It needs evidence that you have the clinical credibility, judgement, leadership ability, communication skills and professional maturity to function as a senior colleague. It will want to understand how you approach governance, service development, teaching, teamwork, conflict and change.

A psychometric assessment adds another perspective to that information. It does not replace your professional record or the evidence you provide at interview.

If your profile describes you as collaborative, be ready to show where you have successfully brought different groups together. If it suggests that you enjoy leading change, show what you have actually changed. If it describes you as resilient, be prepared to discuss a genuine setback rather than simply saying that you cope well with pressure.

And if it identifies something less flattering, do not panic. Demonstrating that you recognise your own tendencies and have learnt how to manage them can tell an appointment panel far more about your readiness to become a consultant than presenting yourself as somebody without weaknesses.