IMT interview 2027: format, scoring, questions and how to prepare

• The latest detailed IMT interview format published by IMT Recruitment is for 2026 and consists of two 11-minute stations, with two scoring interviewers in each station.
• IMT Recruitment has stated that the 2027 recruitment process is expected to be largely unchanged.
• Station 1 assesses application and achievements, suitability for IMT, ethics/professionalism/governance and communication.
• Station 2 assesses a clinical scenario, one-minute patient handover and communication.
• Your application self-assessment is used during shortlisting but does not directly contribute to your overall score used for offers after interview.
• Each assessed area receives two independent scores from 1–5.
• Under the published 2026 scoring framework, the maximum raw interview score is 70, which is subsequently weighted to a maximum of 96.
• For most domains, 3/5 represents satisfactory performance at the level expected during F2, whereas 5/5 represents excellent performance at IMT level or above.
• A safe answer is essential, but safety alone does not necessarily demonstrate the depth of reasoning, initiative or insight required for the highest marks.
• Clinical preparation matters. ABCDE is a useful starting framework, but strong candidates also demonstrate diagnosis, prioritisation, purposeful investigation, specific management, reassessment and appropriate escalation.
• Communication is heavily weighted and should be practised as deliberately as the clinical and portfolio components of the interview.

Important 2027 update: This guide is written for candidates preparing for 2027 IMT recruitment. At the time of writing, IMT Recruitment has not yet published the full 2027 interview guidance. Its detailed interview pages still relate to 2026, although the recruitment team has stated that the 2027 process will be largely unchanged. We have therefore used the published 2026 interview structure and scoring framework where 2027-specific details have not yet been confirmed. This guide will be updated once the full 2027 guidance is released.

The IMT interview is the main selection assessment for candidates who progress through the earlier stages of national recruitment.

Under the published 2026 format, interviews are held online. Candidates complete two stations, each lasting 11 minutes, with a different pair of scoring interviewers in each station. IMT Recruitment has indicated that the overall 2027 recruitment process will remain largely unchanged, although the full 2027 interview guidance is still awaited. The interview is the same whether you wish to be considered for IMT, ACCS-IM or both.

The two stations assess different but complementary aspects of your readiness for training. Station 1 concentrates primarily on you as an applicant and future physician. Station 2 tests how you assess and manage a clinical problem and communicate the relevant information.

The interview is therefore not simply a test of how many points you accumulated on your application. Once you reach interview, you need to demonstrate the judgement, communication, achievements, professional behaviour and clinical reasoning expected of someone progressing towards Internal Medicine Training.

The published 2026 interview format consists of two 11-minute stations. Unless this changes when the detailed 2027 guidance is released, candidates should expect the same broad structure.

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Station 1: achievements, suitability for IMT, ethics and communication

Station 1 assesses:

• Application and achievements
• Suitability for IMT
• Ethics, professionalism and governance
• Communication

The first six minutes are devoted to your application, achievements and suitability for IMT. As part of this, you deliver a prepared two-minute verbal presentation about the achievements most relevant to your application for Internal Medicine Training. The interviewers can then explore your suitability for IMT and ask questions relating to your presentation, application or motivation for physician training.

The remaining part of the station includes an unseen hypothetical scenario involving ethical, professional, legal or governance issues. This is not intended to be another clinical scenario. It is designed to assess how you identify and manage professional issues and may involve principles contained within GMC Good Medical Practice.

Communication is independently scored throughout the station.

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Station 2: clinical scenario, handover and communication

Station 2 centres on an unseen clinical scenario. Under the published 2026 format, the clinical scenario is read to you on entering the station and you are permitted to make notes while it is being read. There is no separate three-minute preparation period specified in the official published guidance.

You may be asked about:

• Additional information you would obtain
• Investigations
• Differential diagnosis
• Management

Further information may be introduced as the scenario progresses. Some scenarios may also include written information or clinical material such as an ECG.

Questioning on the clinical scenario lasts for up to 10 minutes. The station then concludes with a one-minute patient handover.

Communication is again independently assessed. This means the clinical station is not purely a test of medical knowledge. The interviewers also need to understand how you think, how you prioritise and how effectively you communicate a clinical problem.

Under the published 2026 scoring framework, there are seven assessed areas. Each area is scored independently by two interviewers, with each interviewer awarding between 1 and 5 marks.

The two marks therefore produce a maximum raw score of 10 for each assessment area.

The raw scores are then weighted because the different areas do not contribute equally to your final interview score.

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IMT interview scores and weighting

Assessment	Maximum raw score	Weighting	Maximum weighted score
Application and achievements	2 × 5 = 10	×1.6	16
Suitability for IMT	2 × 5 = 10	×1.6	16
Ethics, professionalism and governance	2 × 5 = 10	×1.2	12
Station 1 communication	2 × 5 = 10	×1.6	16
Clinical scenario: investigations, diagnosis and management	2 × 5 = 10	×1.2	12
Clinical scenario: patient handover	2 × 5 = 10	×0.8	8
Station 2 communication	2 × 5 = 10	×1.6	16
Total	70		96

The weighting is worth paying attention to.

• Communication is assessed separately in both stations and contributes a combined maximum of 32 out of 96 marks – exactly one-third of the total weighted interview score.
• Application and achievements and suitability for IMT are also heavily weighted, with each contributing up to 16 marks.
• The clinical station should not therefore be thought of as simply “the clinical marks”. Your performance there contributes through clinical reasoning, handover and communication.

Under the published 2026 appointability rules, candidates must satisfy all three of the following requirements:

• No individual interviewer score of 1/5
• No more than two individual interviewer scores of 2/5
• A total raw interview score of at least 42/70

This means a very strong performance in one area cannot compensate for a serious deficiency elsewhere. You need to demonstrate an acceptable standard across the interview. Being appointable, however, is not the same as obtaining a highly ranked score. Candidates are subsequently ranked according to their interview performance for the purposes of offers.

Understanding the scoring descriptors is one of the most useful things you can do before starting interview preparation. For most assessment areas, the published scoring framework describes:

• 3/5 – satisfactory performance at the level expected during F2
• 4/5 – good performance at the level expected on completion of F2
• 5/5 – excellent performance at the level expected at IMT or above

In other words, to score exceptionally well, you want to show you are someone who already thinking at IMT level and not someone who is just one of many F2 operating at the standard level.

This distinction matters. Many candidates prepare by asking: “Is my answer safe?” A better question is: “What evidence does this answer give the interviewers about the level at which I am performing?”

Safety is non-negotiable. But many safe actions are exactly what would be expected of an F2 doctor. Moving beyond a satisfactory answer may require greater prioritisation, clinical reasoning, insight, leadership, initiative, measurable impact or evidence that learning subsequently changed your practice. There is no phrase or interview technique that automatically turns an answer into 5/5. The substance of the evidence has to be there.

The presentation question in the published 2026 interview guidance is: “Give an overview of your achievements to date which are most relevant to your application to be a trainee in internal medicine.”

You have a maximum of two minutes. The presentation is verbal. PowerPoint, visual presentations and screen sharing are not permitted.

The official guidance recommends giving headlines and brief descriptions of your achievements, using a clear structure and focusing on achievements that demonstrate skills transferable to being an internal medicine trainee.

The most important words in the question are arguably: “most relevant”. You are not being asked to recite your CV. Trying to mention every audit, teaching session, poster and course you have completed can make the presentation weaker because your most impressive evidence becomes buried among relatively minor achievements. Select your strongest evidence and explain its significance.

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How are achievements scored?

Application and achievements have their own scoring descriptors.

• A score of 3/5 represents achievements commensurate with your experience and personal circumstances, with at least some relevance to being an IM trainee.
• A score of 4/5 represents achievements above expectations, with good relevance to IMT.
• For 5/5, the descriptor refers to a high-achieving applicant whose achievements are significantly above expectations for their experience or personal circumstances and highly relevant to being an IM trainee.

This is an important distinction because presentation technique cannot turn ordinary achievements into exceptional ones. A candidate can present relatively standard Foundation-level achievements extremely well and still provide evidence more consistent with 3/5. Conversely, candidates with genuinely impressive achievements sometimes undersell themselves because they fail to explain their personal contribution, the scale of what they achieved or its impact.

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Example of an achievements presentation that might score 3/5

There is nothing wrong with this presentation. The candidate has worthwhile achievements across several relevant domains and explains their relevance to IMT. However, the achievements themselves are relatively typical for Foundation level. There is evidence of participation and contribution, but less evidence of achievement substantially beyond what might reasonably be expected for the candidate's career stage.

This could therefore be consistent with a satisfactory 3/5 performance without necessarily demonstrating the significantly above-expected achievement required for 5/5.

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Example of an achievements presentation that might score 5/5

The difference between the two presentations is not primarily vocabulary or presentation style. The second candidate has stronger underlying evidence. There is greater ownership, leadership, impact, sustainability and dissemination.

The candidate does not simply complete a QIP. They identify the problem, lead the intervention, involve multiple professional groups, complete further cycles, demonstrate sustained improvement and achieve wider adoption.

They do not simply teach. They identify a training need, develop a programme, recruit other teachers, evaluate it and establish something that continues after they leave. Their academic achievement also demonstrates a substantial personal contribution and a significant output.

That is much closer to the type of evidence described by the 5/5 achievement descriptor.

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What separates the 3/5 and 5/5 presentations?

Do not invent or embellish achievements to fit a high-scoring pattern. But equally, do not undersell what you have genuinely done.

If you say only that you “completed a QIP” when you actually designed the intervention, led the team, completed several cycles and changed departmental practice, you have omitted the information that demonstrates the true scale of your achievement.

Similarly, saying that you “teach medical students” significantly undersells an achievement if you actually designed a programme, recruited faculty, evaluated outcomes and established a programme that continued after you left.

Make your personal contribution, impact and relevance explicit.

Questions about your suitability for IMT assess your knowledge and enthusiasm for medicine and your commitment to a career as a physician.

Generic answers are unlikely to make the best use of this opportunity. For example: “I enjoy medicine because it is varied, I enjoy working in a multidisciplinary team and I like solving complex problems”. There is nothing inherently wrong with those reasons. The problem is that almost any candidate could say exactly the same thing. A stronger answer connects your motivation to your own experiences.

A useful structure for “Why IMT?” would be:

• Reason
• Personal evidence
• Relevance to IMT
• Future development

If you tell the interviewers that you enjoy diagnostic complexity, give them an experience that demonstrated this.
If you say you enjoy managing acutely unwell patients, explain what experience helped you reach that conclusion.
If you say IMT fits your career plans, demonstrate that you understand what the training involves.

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Model answer: “Why do you want to do IMT?”

This answer goes well beyond simply demonstrating enthusiasm for medicine. It provides evidence that the candidate understands what IMT is preparing them to become and has thought carefully about why that training fits their interests and career direction.

There are several features that make it stronger.

1. The motivation is specific to internal medicine

The candidate does not rely on generic statements such as enjoying variety, teamwork or problem-solving. They identify specific aspects of physician work that attract them: diagnostic uncertainty, multimorbidity, competing clinical priorities, acute deterioration and the need to continually reassess management. These are much more convincing reasons for choosing physician training because they demonstrate an understanding of the actual work.

2. They prove their motivation with clinical experience

Rather than simply claiming to enjoy complex medicine, the candidate gives an example of a patient with heart failure, infection, renal impairment and competing management priorities. The example is brief enough not to take over the answer, but it demonstrates why the candidate enjoys this type of medicine. This is much stronger than saying: “I enjoy managing complex patients”. They make a claim, provide evidence and demonstrate insight.

3. Their specialty interest is credible rather than superficial

The candidate has a developing interest in cardiology and can explain what attracts them to it. Importantly, they have also explored that interest through clinical experience, teaching and quality improvement. This gives their career direction credibility. Candidates do not need to know which higher specialty they ultimately want to pursue. However, if they do have a genuine specialty interest, discussing how they have explored it can strengthen the answer considerably.

4. Cardiology strengthens the case for IMT rather than replacing it

This is one of the strongest aspects of the answer. A weaker candidate might say: “I want to do IMT because I need it to become a cardiologist”. That makes IMT sound like an obstacle that must be completed before the candidate reaches the career they actually want. Instead, this candidate explains that their cardiology experience has made them appreciate the importance of broad internal medicine. The patient with heart failure may simultaneously have infection, renal impairment, anaemia, diabetes or frailty. The candidate therefore understands that becoming a good specialist requires the ability to manage the whole medical patient, not simply the disease belonging to their eventual specialty.

5. They understand the developmental purpose of IMT

The candidate identifies a clear progression: recognising illness and initiating safe management, independently assessing complexity, prioritising competing problems, formulating a coherent plan and knowing when to escalate. That is much more sophisticated than simply saying: “IMT will improve my clinical skills”. They understand what greater responsibility actually looks like.

6. They understand that being an IMT doctor involves more than clinical knowledge

The answer also refers to leading during the acute take, supervising junior colleagues, communicating difficult decisions and contributing to service improvement. This demonstrates a broader understanding of the role of a physician and the responsibilities towards which IMT develops trainees.

7. There is a coherent career narrative

Perhaps most importantly, the answer has a logical progression:

• Clinical experiences
• Enjoyment of complex medicine
• Developing specialty interest
• Recognition of the need for broad physician training
• IMT as the next developmental step
• Future physician

Nothing feels bolted on simply to collect interview marks. The candidate is effectively answering three questions simultaneously:

• Why medicine?
• Why IMT?
• Why is IMT the right next step for you?

That coherence is what makes the answer particularly convincing.

A 5/5-level “Why IMT?” answer should not simply contain more reasons than a 3/5 answer. It should contain better evidence and greater insight. The strongest candidates demonstrate that they have experienced enough of medicine to understand what they enjoy, have reflected on the type of physician they want to become and can explain specifically how IMT will help them make that progression.

The specialty does not have to be cardiology, and candidates do not need to have decided on a specialty at all. The important thing is that the answer is personal, evidenced and specific to physician training, rather than a collection of reasons that could equally be used in almost any specialty interview.

Experience-based questions are another area where candidates frequently stop too early. They describe an event, explain what they did and conclude:“I reflected on the incident and learned from it”. Reflection is important, but sometimes the most useful evidence comes from what happened after the reflection.

Consider a classic interview question: “Tell me about a mistake you have made.”

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Example of a mistake answer that might score 3/5

This is a reasonable and safe answer. The candidate recognises the error, protects the patient, takes responsibility, reports the incident, reflects and changes their own practice.

However, these are also broadly the actions that would be expected of a competent Foundation doctor following a prescribing error.

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Example of a mistake answer that might score 5/5

The second answer goes beyond appropriate incident management and personal reflection. The candidate identifies a wider patient-safety issue, investigates it, engages relevant stakeholders, implements an intervention and measures its effect.

This does not mean every mistake must lead to a QIP to score highly. The principle is broader: if an experience genuinely resulted in wider learning, change or impact, tell the interviewers. Do not make “I reflected” the automatic end of the story.

Leadership answers often become descriptions of being organised. A candidate might describe a busy shift where they allocated jobs between colleagues and ensured the work was completed. That may demonstrate useful skills, but stronger examples often show how you influenced other people or brought about change.

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Model leadership answer

This example demonstrates more than organisation. It shows initiative, stakeholder engagement, adaptability, implementation and reflection on the nature of leadership itself.

Questions about negative feedback are not asking you to prove that you have never had a significant weakness. They are assessing how you respond when somebody identifies an area in which you need to improve.

A strong answer should therefore demonstrate that you can accept feedback without becoming defensive, understand why it matters, act on it and show evidence that your practice subsequently changed. Choose an example that gives you enough substance to demonstrate this development.

Sometimes candidates use examples that initially sound like disguised strengths: “My supervisor told me that I work too hard” or: “I was told that I am too much of a perfectionist”. These are not automatically poor examples. The problem is that, on their own, they are not sufficiently explicit. “Working too hard” tells the interviewers very little about what the candidate actually needed to improve.

The important question is: What did “working too hard” actually look like in practice? Perhaps you were taking on too many tasks yourself rather than delegating. Perhaps you were spending disproportionate amounts of time on relatively low-priority jobs. Perhaps your desire to complete everything personally meant that you were not using the wider team effectively. Those are genuine developmental issues. Similarly, “being a perfectionist” only becomes meaningful when you explain the behaviour behind it and its consequences.

You can be as genuine as you want. What matters is that it feels authentic and that you describe the weakness or negative feedback in terms of a behaviour you can actually do something about and change for the better.

To share my own experience:

• When I used to attend interviews earlier in my career, one of the weaknesses I often discussed was my tendency to take on too many projects at the same time. I have always had lots of ideas – new projects I wanted to develop, courses I wanted to launch, books I wanted to write – and my instinct was often to get started on all of them. At times, I would find myself with four or five projects running simultaneously, which meant that I was spreading myself too thinly and, although I was working hard, each project progressed more slowly than it should have. I therefore introduced a simple rule: I would never have more than three major projects on the go at any one time, and I could only start something new once one of the existing projects had been completed. This gave me much greater focus and, importantly, meant that projects actually started getting finished. I also became better at delegating rather than feeling that I needed to do everything myself.
• Another one of my weaknesses (as you can see, I have lots!) is that I have often been tempted to do things myself when I know I can get them done more quickly that way. The problem, of course, is that while this may save time in the short term, it is not always the most effective approach in the longer term. It can leave me taking on too much personally, while also denying other people the opportunity to develop their own skills and take greater responsibility. Over time, I have become much better at recognising when I need to step back, delegate appropriately and accept that someone else may initially do something differently, or even more slowly, than I would. The investment of time at the beginning usually pays off, because it allows other people to become increasingly confident and independent, while freeing me to concentrate on the areas where my own input is most valuable.

A useful structure for your answer is:

• Feedback
• Why it mattered
• Your response
• What you changed
• Evidence of improvement
• Wider learning

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Model negative feedback answer: “You work too hard”

This is a strong answer because the candidate explains what “working too hard” actually meant in practice. The underlying problem was not their willingness to work hard, but their tendency to take on too much personally rather than delegating appropriately.

The candidate also shows that they responded constructively when the feedback was initially unclear. Rather than dismissing it or becoming defensive, they asked their supervisor to explain what they meant. This allowed them to identify the specific behaviour that needed to change and understand why it mattered.

Importantly, the answer then demonstrates what the candidate did differently. They became more deliberate about prioritising their workload, recognised which tasks genuinely required their own clinical input and made better use of the wider team. They also understood that appropriate delegation does not mean relinquishing responsibility, as they continued to maintain oversight and follow up important tasks.

There is a clear development in the candidate's thinking. Initially, they associated being conscientious with personally ensuring that everything was completed. The feedback helped them recognise that working effectively also requires prioritising, delegating appropriately and using the skills of the wider team.

The fact that their supervisor subsequently noticed an improvement provides evidence that the feedback resulted in a genuine change in behaviour rather than simply reflection. These skills become increasingly important during IMT, when trainees are expected to manage greater workloads and responsibility while working effectively within a multidisciplinary team.

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Another example: presentations that are too detailed

A different candidate might choose feedback about communication:

Again, the strength of the answer is not the nature of the original weakness. It is the candidate's response to it. They accept the feedback, seek clarification, make deliberate changes, obtain further feedback and demonstrate improvement.

You do not need to choose the most serious criticism you have ever received, nor should you try to find a weakness that secretly makes you look impressive. Choose something genuine that allows you to demonstrate development.

The interviewers should be able to identify:

• What was the problem?
• Why did it matter?
• How did you respond to being told about it?
• What specifically did you change?
• How do you know you improved?
• What have you carried forward into your subsequent practice?

The final point is particularly important. Avoid ending the answer simply with: “I reflected on the feedback”. Reflection is useful, but the stronger evidence is often what happened because you reflected. If the feedback genuinely changed the way you work and you can demonstrate that change, make sure the interviewers hear it.

The professional scenario is designed to assess how you reason through an unfamiliar problem. Trying to memorise answers to dozens of scenarios is therefore less useful than developing a consistent approach.

Common themes may include confidentiality, consent, capacity, patient safety, raising concerns, professional conduct, honesty, boundaries and conflicts between professional responsibilities.

Step 1: identify the central problem. Start by identifying what the scenario is fundamentally about. There may be several issues, but determine whether there is an immediate patient-safety or professional concern.

Step 2: establish the facts. Do not rush to judgement. Professional scenarios are often deliberately incomplete. Establish what has happened, who is involved, how reliable the information is and whether anyone is currently at risk.

Step 3: protect patients. If there is an immediate patient-safety issue, address it first. Do not delay necessary action while investigating the wider circumstances.

Step 4: communicate appropriately. Where safe and appropriate, speaking directly and privately with the person involved may clarify the situation. However, this should not delay urgent action if patients may be at risk.

Step 5: escalate proportionately. Do not simply say: “I would escalate to my senior”. Explain why escalation is required, how urgently you need it and what you need the senior clinician to do. Depending on the circumstances, escalation might involve the registrar, consultant, clinical supervisor, educational supervisor or another appropriate organisational route.

Step 6: consider documentation and wider learning. Consider whether formal documentation, incident reporting or another governance process is required. Where appropriate, also consider whether the incident reveals a wider problem that needs addressing.

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Model ethics scenario: a colleague appears impaired at work

Ethics, professionalism and governance scenarios are designed to assess how you deal with situations in which there may be competing professional responsibilities. These questions are rarely about identifying a single rule and reciting it. Interviewers want to see whether you can recognise the central issue, establish the relevant facts, protect patients, communicate sensitively and escalate concerns appropriately.

A useful approach is to consider the situation in stages. First, identify the immediate concern and whether anyone is at risk. Then establish the facts rather than making assumptions. Consider who you need to speak to, whether senior input is required and what needs to happen immediately to keep patients safe. Once the immediate problem has been addressed, you can consider wider issues such as confidentiality, documentation, reporting, support for those involved and any lessons for future practice.

The key is to show proportionate professional judgement. Escalating everything immediately without first understanding the situation can be just as unconvincing as failing to escalate a serious concern. Your answer should make clear not only what you would do, but why.

Consider the following example. Imagine that you notice a colleague smelling of alcohol shortly before they are due to review patients. Here is what a good answer would look like:

This answer demonstrates an important balance. The candidate does not assume that smelling of alcohol proves that the colleague is intoxicated, but neither do they use uncertainty as a reason to ignore a potential risk. They establish the facts sensitively, protect patients if concerns remain and escalate appropriately.

At the same time, they recognise that the colleague should be treated with dignity and may themselves need help. This demonstrates the combination of patient safety, professional responsibility, proportionality and compassion that these scenarios are designed to explore.

Clinical preparation has become increasingly important in specialty interviews, and IMT is a good example of why candidates need to go beyond generic interview frameworks.
For an acutely unwell patient, an ABCDE assessment is an appropriate starting point.
It is not a complete answer.

If most candidates recognise that an unwell patient requires ABCDE, oxygen where appropriate, IV access, blood tests and senior review, simply reproducing that list gives the interviewers limited evidence with which to differentiate you.

Your answer needs to progress from framework to clinical reasoning.

1 - Start with ABCDE – but do not stop there

Use ABCDE to identify and treat immediate threats. As information emerges, however, your answer should become increasingly specific to the patient.

• What do you think is happening?
• How sick is the patient?
• What requires treatment now?
• What diagnoses must you exclude?
• What would make you escalate?

2 - Prioritise your differential diagnosis

Avoid producing a long list of possible diagnoses simply to demonstrate knowledge.
Think instead:

• What is most likely?
• What is most dangerous?
• What must not be missed?
• What evidence supports or contradicts each possibility?

3 - Make your investigations purposeful

Avoid saying: “I would order routine bloods”. Explain what you need. More importantly, demonstrate why you need it.

• If you request a blood gas, what question are you trying to answer?
• If you request an ECG, what abnormalities are you looking for?
• If you request imaging, which diagnosis are you attempting to confirm or exclude?

This makes your clinical reasoning visible.

4 - Give specific management

“I would treat appropriately” is not a management plan. Where enough information is available, explain what treatment you would initiate, how urgently you would give it and what factors might alter your approach.

5 - Reassess

Do not treat management as a list of interventions that ends once they have been prescribed.

• How will you know whether your patient is improving?
• What will you reassess?
• What would make you change your management or escalate further?

Consider the following hypothetical case:

A 68-year-old man presents with increasing breathlessness and productive cough. His blood pressure is 88/54 mmHg, heart rate 125 bpm, respiratory rate 30 breaths per minute, oxygen saturation 89% on room air and temperature 38.7°C.

A basic answer

Most of these actions are sensible. The limitation is that the interviewers hear relatively little clinical reasoning.

A stronger answer

Why is the second answer stronger?

Both candidates recognise that the patient is unwell and initiate sensible treatment.

The second candidate also:

• identifies the severity of illness
• provides a working diagnosis
• maintains important alternative diagnoses
• explains the purpose of investigations
• gives patient-specific management
• anticipates deterioration
• explains why escalation may be necessary
• reassesses the response to treatment

That is the difference between using ABCDE as a framework and demonstrating the clinical reasoning within that framework.

In the published 2026 format, the clinical station concludes with a one-minute patient handover.

One minute is very short. The challenge is therefore not remembering everything about the patient. It is deciding what the receiving clinician actually needs to know.

SBAR provides a useful framework for the IMT handover:

• Situation: Who is the patient and what is happening now?
• Background: What essential background does the receiving clinician need?
• Assessment: What do you think is happening and how unwell is the patient?
• Recommendation: What has been done and what do you need the receiving clinician to do?

Again, the framework is only useful if you populate it with relevant information. Do not simply repeat the entire clinical scenario.

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Model one-minute handover

The recipient immediately knows:

• Who the patient is
• Why they are unwell
• What has been done
• What you are worried about
• What you need next

That is the purpose of an effective clinical handover.

Communication is not simply about sounding confident or polished. Under the published scoring framework, it is independently assessed in both stations and contributes a combined maximum of 32/96 weighted marks.

Interviewers need to be able to follow your reasoning.

Signpost your answers

Simple signposting can make complex answers much easier to follow.

For example:

• “There are three issues I would consider initially…”
• “My immediate priority is patient safety. Once that is addressed, I would consider the wider professional issues…”
• “My leading diagnosis is X, but there are two important alternatives I would want to exclude…”

This provides structure without making the answer sound artificially rehearsed.

Do not confuse length with quality

Longer does not mean better. Some candidates give so much information that their strongest points become difficult to identify. Others give answers that are so brief that the interviewers never hear their reasoning.

Your objective is to give enough information to demonstrate depth while remaining focused on the question.

You cannot predict the exact questions that will appear in your interview, and trying to memorise scripts for dozens of possible questions is unlikely to be helpful.

However, you should be prepared to discuss themes such as:

• Why do you want to do IMT?
• What achievements are you most proud of?
• Tell us about a time you demonstrated leadership.
• Tell us about a mistake you made.
• Tell us about some negative feedback you received.
• Describe a quality-improvement project.
• Tell us about your teaching experience.
• Describe a difficult communication situation.
• Tell us about a conflict within a team.
• How do you prioritise when several patients require your attention?
• What have you done that demonstrates commitment to internal medicine?

The objective is not to predict the wording of the interview. It is to understand your own experiences sufficiently well that you can select the most appropriate example for the question you are actually asked.

Mistake 1: assuming safe equals excellent.

Safety is essential. But many safe actions are expected at Foundation level. For higher marks, make your reasoning, prioritisation and insight visible.

Mistake 2: ending every answer with “I reflected”

Reflection should lead somewhere. Ask:

• What did I learn?
• What did I subsequently do differently?
• Did anything change as a result?
• Can I demonstrate that I subsequently applied the learning?

“Following reflection…” may be the beginning of the strongest part of your answer rather than its conclusion.

Mistake 3: treating DATIX as the solution

Incident reporting is important when appropriate. But submitting a DATIX does not itself make a patient-safety problem disappear. Consider what happened afterwards.

• Were contributory factors identified?
• Was anything changed?
• Were you involved in that change?
• Was its effect subsequently assessed?

Mistake 4: calling a senior without explaining why

Escalation is an essential part of safe practice. However “I would call my senior” is not enough to demonstrate clinical reasoning. Explain what concerns you, what you have already done, why you need additional expertise and how urgently you need it.

Mistake 5: listing achievements without demonstrating their significance

The interviewers do not need you to read your CV aloud. Explain what you did, what your contribution was, what happened and why it matters.

Mistake 6: memorising model answers

Model answers should teach you principles, not scripts. An interviewer can alter a question, interrupt you, challenge your reasoning or introduce new information. If you have memorised paragraphs rather than understood the underlying principles, your answer can quickly unravel.

Effective preparation should be systematic.

Step 1: Understand the interview and scoring

Know exactly what is assessed and how the different domains are weighted. Most importantly, understand the difference between satisfactory F2-level performance and evidence of performance at IMT level or above.

Step 2: Review your application

For every important achievement or experience, ask:

• What exactly did I do?
• What was my personal contribution?
• What was the outcome?
• What difficulties did I encounter?
• What did I learn?
• What happened afterwards?
• Why is this relevant to IMT?

Step 3: Build an experience bank

Identify genuine experiences covering areas such as:

• leadership
• teamwork
• conflict
• mistakes
• feedback
• quality improvement
• teaching
• communication
• prioritisation

Do not write a script for every possible question. Know your experiences well enough to adapt them.

Step 4: Prepare your achievements presentation

Select your strongest and most relevant achievements. Practise delivering the presentation within two minutes. Then practise it again. Two minutes passes quickly, and you need to know which details are essential.

Step 5: Revise acute clinical medicine

Do not assume that good interview technique will compensate for weak clinical knowledge. Revise common acute medical presentations and practise explaining your management aloud. For each scenario, work through:

• Immediate assessment
• Diagnosis
• Differential diagnoses
• Investigations
• Management
• Reassessment
• Escalation
• Disposition

Step 6: Practise professional scenarios

Review GMC Good Medical Practice and common professional themes. Then practise applying those principles to unfamiliar situations rather than simply reciting guidance.

Step 7: Practise one-minute handovers

Take clinical cases and force yourself to hand them over in 60 seconds. This quickly teaches you to distinguish essential information from unnecessary detail.

Step 8: Practise aloud under time pressure

Reading an answer and delivering it under interview conditions are very different skills. Timed mock interviews expose weaknesses in structure, communication, clinical reasoning and timing that are difficult to identify when preparing alone.

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Check your online interview setup

The published 2026 interviews are conducted online, so your technical setup is part of your preparation. Check your camera and microphone in advance, make sure your internet connection is reliable and choose a quiet, well-lit environment where you will not be interrupted.

Position your camera so that you can communicate naturally with the interviewers rather than repeatedly looking away from the screen.

It can also be useful to record yourself answering practice questions. Answers that feel clear while you are speaking can sound very different when you watch them back.

Look particularly for answers that are too long, excessive use of filler words, poor signposting or a tendency to stop before explaining the most important part of your reasoning.

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On the day of your IMT interview

Be ready well before your allocated interview time and have any required identification or documentation available.

Dress appropriately for a formal professional interview and make sure your interview environment and equipment have already been tested.

The day of the interview is not the time to discover that your microphone, camera or internet connection is unreliable.

You are not expected to perform like a medical registrar before starting IMT. However, the clinical station is a genuine assessment of your readiness to progress into physician training.

You should be comfortable assessing common acute medical presentations, recognising deterioration, constructing and prioritising differential diagnoses, choosing appropriate investigations and initiating practical management.

You should also recognise your limitations. A strong candidate does not pretend to know everything. They demonstrate what they can manage, recognise when additional expertise is required and escalate appropriately while continuing to care for the patient. There is an important difference between recognising your limitations and using escalation as a substitute for clinical reasoning.

There is no single template that guarantees 5/5. For most assessment areas, the published scoring framework describes 5/5 as excellent performance at IMT level or above. In practical terms, stronger answers tend to make the candidate's thinking visible.

• Do not merely identify the correct action. Explain why.
• Do not merely say you reflected. Explain what changed.
• Do not merely say you led. Demonstrate how you influenced people or outcomes.
• Do not merely list investigations. Explain what clinical questions they answer.
• Do not merely call a senior. Explain what concerns you and why escalation is necessary.
• Do not merely list achievements. Demonstrate your contribution, their impact and their relevance to IMT.

The objective is not to make every answer sound extraordinary. It is to give the interviewers enough evidence to recognise the level at which you are actually performing.