The Interview Process

The Interview Process

By Dr Andy Ratcliffe – FICM Trainee Representative

As I approached West Bromwich Albion football ground memories of my previous visit came flooding back; my mouth became slightly drier, palms slightly sweatier and my heart rate definitely skipped a few beats - no I wasn’t there to stand on the terraces and support “The Baggies”, nor this time was my freshly organised portfolio tucked under my arm, but I had been invited by the Faculty to observe this year’s interview process.

After convincing the welcome party at the main door that I really wasn’t a candidate and that I really was here to observe, I was shown to the interviewer’s holding pen. Yes, just like the candidates, interviewers are led into an equally large waiting area, filled with caffeinated Consultants, bustling representatives from West Midland’s Deanery and an air of anticipation for the day’s events.

The degree of organisation and preparation that had gone into the day was nothing less than military in its precision and execution from the outset.  As trainees, we spend hours printing, laminating, organising and filing our portfolios, ready to jump straight to our latest QIP or poster presentation; we peruse the FICM website hoping to demystify the training programme; we ask colleagues to quiz us on previous interview questions to stand us in the best stead to shine on the day of the interview. Yet we perhaps forget, or like me, overlook, the amount of time and effort that the interviewers also surrender to ensure that they extract the best from each candidate as they tentatively take their seats in the executive boxes.

Whilst the first set of candidates were busily reflecting on their time as SHOs, we were shown videos of mock interview stations and asked to mark various candidates’ performances. This was part of the quality assurance exercise (a process that continues throughout the day) to ensure the interviewers were all assessing candidates to the same standard - which, reassuringly the vast majority were. The old adage of “hawks and doves” really didn’t appear to exist, neither during this rather informal discussion nor indeed during any of the real interviews that I subsequently witnessed.

I was fortunate to observe all stations in the process - portfolio, presentation, clinical, task prioritisation, and read through some of the reflections. The marking process and score collection, like all other aspects of the day, is a seamless and highly scrutinised process with opportunity throughout to quality assure. Marks from each interviewer are entered in silence into the electronic system before any form of discussion takes place. These marks are sent in real time to the master spread sheet back in the main control hub. 

The candidates came from a range of clinical backgrounds and with varying degrees of experience. I have been asked on several occasions how, for example, an ST4 Anaesthetic registrar can be compared to a CT2 medical SHO at interview. The simple answer to this is, they’re not. The level expected in the clinical stations and elsewhere is that of a senior SHO. A logical, considered and above all, safe approach to patient care is key, not necessarily the detailed pathophysiology of serum rhubarb. Similarly, granted the ST4 may have had more time to produce an international poster presentation for the European Society of Who-Really-Cares, but the overall scores from the portfolio station are so similar that in reality an extra point scored here can easily be picked up elsewhere, and the discrimination factor is minimal. So, don’t panic! A word of advice though, make sure you have dividers in your folder, there is nothing more embarrassing for all parties than to watch the candidate shuffle through paper, desperately looking for the MSF with “excellent” remarks!

Reflection is a word that fills some of us with dread, but a word that, like the “difficult cannula” request, will follow us throughout our careers. Just as the person specification/matrix is examined several times in multiple different stations throughout the day, so is your ability to reflect and learn from your previous experiences. I would suggest not overlooking this in your preparation for the big day. I cannot over emphasise this enough. I would encourage you to look though the AoMRC guidance on reflection. This provides a very good foundation on which to build your reflections and thought processes. The story is not important; it’s what you learned from it and how you will act/behave/do differently next time that the interviewers are interested in.

I would be the first to admit that my handwriting leaves much to be desired. Judging from the state of some of the presentations I witnessed, I am not alone in this affliction. Regardless of the topic, try to present it in a concise manner, neat handwriting, and in more than one colour. The style of the presentation is taken into account, so I would advise taking a few seconds to think about this before your respective spiders start walking across the pages. Those that performed better were not necessarily the ones with the most written on paper - but they were neat and had reflected on the task in hand!

It may sound obvious, but another recurring theme throughout the day appeared to be the inability of some candidates to read the question fully. This was not more evident than in the task prioritisation station. Like most scenarios in Critical Care, there is no right or wrong answer. We were presented with comprehensive arguments for most combinations of answers. Yet several candidates failed to use all the resources presented to them. Training in Intensive Care Medicine is renowned for its supportive and collective approach to patient management. Consultants are contactable and amenable to offer help and advice 24/7, as they are in the scenarios you will face in the more fictitious environments at interview. Make sure you make use of all the resources presented to you; attempting to brave it alone and fight fires without support, will result in just as much difficulty in the interview as it will in real life. 

I was pleasantly surprised at how rigorous the process that quality assures the day is. Everything from the phrasing of the questions to the layout of the room is scrutinised by multiple people on multiple occasions. This ensures standards are maintained and comparable from year to year and from day to day. Discrepancies in the marking system are flagged almost in real time as the results come in. This allows prompt analysis of the performance of both the candidate and interviewer, again to maintain fairness across the board. As I alluded to earlier, the matrix is examined in several places throughout the day, so if you “fluff” a question in one station, you can redeem yourself elsewhere. 

Throughout the day candidates were martialled around the labyrinth of corridors and rooms by representatives from the West Midlands Deanery.  Like a well-oiled machine they turned a logistically challenging process into an exercise of precision that the military would be proud of; for which they should be highly commended

Given the degree to which I have harped on about reflection, it would be slightly hypocritical not to end on a note on what I have taken away from this process. The view from the other side of the table is an interesting one, filled with similar amounts of angst; whether it be to phrase the questions appropriately, ensure fairness and equality across the board and, ultimately, to ensure we are recruiting the best candidates to become our colleagues of the future. Without doubt those applying are already highly talented individuals with much to offer the specialty. We are not looking for the finished article, that’s what the training programme is there for, but to select those who have the potential to train and become the next generation of Consultant Intensivists. Perhaps my next visit to West Brom will be to ask the questions rather than simply observe. Either way, it’s clear that the future is bright for our new cohort of trainees. I look forward to working alongside some of you in the future and wish you all the very best for your future careers in this great specialty. 

My thanks to Drs Daniele Bryden, Jonathan Goodall and Mark Carpenter for inviting me and allowing me to observe the day’s events.

Top ten take homes:

  1. Organise your portfolio
  2. Prepare to reflect
  3. Improve your handwriting
  4. Read the question
  5. Use all the resources available
  6. Dress appropriately 
  7. Don’t argue with the interviewer (!)
  8. Practice, practice, practice
  9. Reflect a bit more
  10. Smile