The Situational Judgement Test (SJT) for final year medical students plays an important part in your ranking for the applications for the Foundation Programme (UKFP). Whether you have a great Educational Performance Measure (EPM) score or not, the SJT will influence which placement you get.
In this article, Dr Mahibur Rahman discusses some key tips to help you improve your score so you can get the placement that you want.
The Situational Judgement Test (SJT) is sat by all final year medical students in the UK. In this article Sarah Brown explains her tips for effective preparation and how she managed to get a place in a very competitive area.
It contributes towards 50% of your Foundation Programme score; the other 50% is comprised of your Education Performance Measure (EPM), which is based on your performance in medical school, and any additional points from a previous degree (up to 5 points) or publications (up to 2 points). As you may be aware, the difference in EPM scores between the highest and lowest ranking students is only 9 (i.e. the student in the lowest decile will receive 34 points, whilst the student in the highest decile will receive 43). However, the scores available from the SJT range from 0-50. Why does all of this matter? Understanding the system is important as it allows you to allocate your time wisely in the final year. It is very easy to become overwhelmed by the vast amount of information there is to learn for your final MB, and some students end up leaving the SJT to the last minute. However, as the SJT is so heavily weighted, it will play a huge part in determining which deanery (Unit of Application) you get. Some deaneries are more competitive than others and you may find yourself thinking that you don’t need to do particularly well in the SJT to get into the deanery that you want, however, the ranking doesn’t stop there. Once you are allocated your deanery, you then rank the jobs within it, and this too is based on points. Therefore, if you want to get into your first-choice deanery and get your first-choice job, doing well in the SJT is crucial, regardless of how competitive your desired deanery is.
On a personal note, having studied in Manchester for 3 years, and Northern Ireland for 5 years, I was eager to move back home to London for my foundation years. With the average foundation programme score required to get into North West London being between 84-86, doing well in the SJT was an absolute priority for me.
Resources I would recommend for the SJT
Whilst many medical schools, and even the SJT foundation programme itself suggest that you can’t revise for this exam, there is a lot that you can do to prepare for it. My own medical school provided little teaching on the SJT, and advised us just to use the mock exam on the SJT foundation programme website. Whilst this may have worked for some people, I didn’t feel comfortable taking this risk, as I was used to using books and multiple online resources for my medical school exams. However, a lot of people had warned me against using books and courses as they aren’t written by the UKFPO and could be misleading or inaccurate. Ultimately, I decided to try a variety of different materials to help me prepare for the SJT, so that regardless of my score I would know that I had tried my best. Here are the resources that I used and would recommend:
I chose to attend the Emedica SJT course having read one of the posts on their blog that was written by a medical student who had previously scored badly in the SJT and subsequently went on the course before resitting the exam and scoring well. Their website is also full of complementary and appreciative reviews from medical students who have attained very good SJT scores. This was enough to convince me to go, and I’m so pleased that I did.
The course is run by Dr. Mahibur Rahman who has been involved with the SJT exam not only for medical students, but also for entry onto the GP training programme. He is extremely knowledgeable about the exam and his passion for medical education is very evident in the way he delivers the course. It is incredibly informative, helping you to understand how the SJT works, the different question types, and how to tackle each of these, which is fundamental to doing well in the exam. The course ended with a mock exam, complete with full explanations, and marks that are extrapolated to give you an idea of what your score would be.
Although this is a one day course we also received free access to the Emedica SJT questions, which allowed me to put into practice what I had learnt during the course. The advice and support continued via email in the lead up to the exam, for example, reminding us of the importance of exam technique. This course boosted my confidence more than any other resource that I had used, and I walked into the exam feeling assured that I had done all I could do to prepare for this exam.
I had an online subscription with Passmedicine for my finals revision, which also included a section on the SJT. This was a valuable resource with over 200 questions, allowing you to practice the high yield topics that come up time and time again. It also provides you with good feedback as to why your chosen answer was correct/incorrect.
SJT Foundation programme website
This site allows you to print off a mock exam and practice answering the questions to time on the answer sheet (which isn’t as straight forward as it sounds). The benefit of doing this is that on the day of the exam, you are comfortable with the layout of the paper, and by the time you have done the mock exam a couple of times, you get a feel for how important it is to stick to time in order to complete the exam.
GMC ethics guidance
The GMC website has a section on their publications that is helpful for any deficits in your knowledge, for example, the intricacies of consent and confidentiality. However, some of their guidelines are lengthy and I wouldn’t recommend reading through every guideline from start to finish as this would be very time consuming.
Preparing for the SJT
The key here is starting early. I would recommend attending the Emedica course well in advance of your SJT exam date, as this gives you time to refine your technique and get plenty of practice in. I would suggest accessing the material available on the SJT foundation website, especially the mock exam (which you should practice under exam conditions if possible). Do as many MCQs as you can in the run up to the exam, as this helps you get into the right mind-set. Spend time on the wards: you can envisage nearly all of the scenarios in the exam happening in F1, or you may have had direct experience of them already. Remember that the only resource that is truly accurate is the UKFPO, so if you come across questions from other sources that you don’t quite agree with, use these as discussion points with friends.
The day of the exam
It is really important to be well rested for this exam, as it is long and mentally taxing. Make sure you get a good night’s sleep the night before and eat well on the day. Have a practical plan in mind for how to tackle the exam: for me, this was to keep to time and to transfer my answers directly to the answer sheet (there is no time to go back). Read into the details of each question e.g. if they tell you that the patient lacks capacity, this is for a reason! Try not to dwell on difficult questions, as this will only take time away from other questions that you might be able to get full marks on. Finally, trust in the preparation you have put in.
Sarah Brown, Final year medical student, Queen’s University Belfast
Sarah Brown had an SJT score of 47.52, and was allocated a place in her 1st choice foundation programme, North West London. Dr. Brown is due to start here FY1 post in August 2017.
The Foundation SJT is an important part of the application process for entering the Foundation Programme (FPAS). In this article, Niamh Rogers explains how she managed to score amongst the top 2% of over 8,000 candidates that took the SJT for Foundation Programme entry in her year. She scored 45.42 and got a place in her 1st choice Foundation Programme, Northern Ireland.
The Foundation SJT
The Situational Judgement Test (SJT) is an exam that is now faced by all final year medical students hoping to gain a Foundation Programme training place in the United Kingdom. As the exam itself has only recently been brought in as a method of selecting candidates to training posts, a lot of speculation and anxiety surrounds the test. The fact that the SJT accounts for 50% of all marks available means that for most students this exam is the single most determining factor in allocation of foundation schools and house officer jobs. I was lucky enough to achieve a high score, placing me in my first choice deanery with my choice of jobs. Here is my experience of preparing for the situational judgement test and hints and tips for performing well on the day.
I booked one SJT preparation course, Emedica, to tackle the SJT. I choose Emedica because although the SJT is new for medical students, it has been used for doctors in GP training since 2007, and Emedica has been running courses for it since it began. As my SJT assessment date was in December I made sure to book the earliest course in October to give myself sufficient time to practice.
The course itself was excellent and gave me both the confidence and knowledge to know how to prepare for the exam. Emedica explained the different types of question styles, how to go about structuring your time (in what was an extremely time pressured exam) and to rank each option for the question at face value.
The mock test at the end of the day was a good insight into the process of the exam and the mark obtained was translated into points like in the real SJT.
Preparing for the Exam
The SJT isn’t an exam you can cram for! Speaking from the biggest crammer of every exam going, I soon realised that the SJT was more a “way of thinking ” than something you could learn with intense days of revision before the test. As I was revising for medical finals and doing A&E placements I knew that I would have to schedule some time to practice questions. I found that by doing around 30/45 minutes of questions 3/4 evenings a week, after I had finished revision for the evening, very manageable.
This is where going to the Emedica SJT course came into its own. There are vast numbers of SJT books with hugely varying quality between them. The Emedica course provided you with a question bank that was split into smaller sections- perfect for completing small stints of practice. The questions accurately reflected the content, length and difficulty of questions in the exam.
Initially I didn’t practice timed- I wanted to thoroughly understand why each option was in the order stated. I felt that by understanding why exactly the options ranked in a certain order , it would give me a better insight into what the exam was testing. With about two weeks to go I started timing myself and always tried to use blank answer sheets so that it would become second nature on the day.
I printed out the sample paper online along with a blank mark sheet, and over the course of my revision I did this exam x3 times. I felt that repeating questions helpful as often I was getting the same questions wrong .
In order to focus for the exam I had an early night’s sleep, went for a run that morning and made sure to have a good breakfast before the exam. The exam is long and timing is a big factor. I made a mental note of what question I should be on at 30 min intervals and wrote this down on the front of the exam paper when I sat down. Make sure you use the bathroom before you start as the exam is 2 hours 20 minutes long!
I highlighted key words in each question (each word is used specifically as the exam is developed by subject experts and psychologists) . I numbered my order on the exam paper and once happy with my answer, transferred it to the answer sheet. I found using a ruler helped focus my eye and made sure I wrote my answer in the correct box. I went through the paper systematically. I circled some questions that I felt I could spend more time on and returned to them at the end.
In summary, the SJT is a high stakes exam that can be prepared for. Practice little and often can boost your score and give you confidence on the day of the exam. Being extremely familiar with the format of the paper and the answer sheet and preparing mentally to focus for an intense 140 minutes are key factors to succeeding in the SJT.
Best of luck!
Final Year Medical Student Norwich Medical School
Niamh scored 45.42 (within the top 2% in the country) and got a place in her 1st choice Foundation Programme, Northern Ireland.
The Foundation SJT exam plays a large part in determining which Foundation rotation you get placed in. In this post, a final year medical student from Glasgow shares his thoughts on the Emedica SJT preparation course.
So recently I sat the situational judgement test (SJT), a test that every final year medical student who wants to work in the UK has to sit. The score in this test is given 50% of the total score used to rank medical graduates in the process through which they’re allocated to foundation schools across the country. Everything else one has done in medical school and before including grades, extra degrees, publications, prizes, merits and distinctions all account for the other 50% (aka EPM score). In fact the lowest EPM score one can get is 34 out of 50 while with the SJT one can get anywhere between 0 and 50 which makes the SJT all the more important. In other words this 140-minute test pretty much determines where in the country I’ll work for the first two years as a doctor, and which hospitals and rotations I get. This could potentially have a knock-on effect on where I’ll end up in the long-term and which specialty I will get into.
Needless to say I was getting anxious in the run up to the exam. This year was only the 3rd year this test has been used so the available information about it was still relatively scarce, with only 1 official practice paper released by the UK foundation programme office (UKFPO). There are several preparation books and online question banks but they were getting varying reviews and most of their questions were not similar in difficulty level to the official ones.
There were also at least 2 revision courses that I was aware of that were being advertised. One of them was in its first year, and the other one, by Emedica, had been going on for three years. A quick search on Google revealed that Emedica has also been running GP SJTs for several years. The search also led me to a blog by a King’s College med student in which she reviewed the course. Her favourable review and the fact that she got 45.6 in her test encouraged me to book this course.
A big myth which has been repeatedly regurgitated at us is that the SJT is not an exam one can prepare for. Having taken the test, I can now say that this couldn’t be further from the truth. While it’s true that the SJT doesn’t assess medical knowledge and that answering questions comes down to good judgement, one still needs to have a good knowledge of the ethico-legal framework that doctors are expected to operate within. One also needs to be aware of the natural hierarchy of the medical team, the role of other healthcare professionals, and the dynamics of interaction between all these people.
This became very clear when I attended the Emedica SJT course. I quickly realized that there is a lot more to the exam than just “using common sense” and taking the questions at face value. When I left the course I felt that while I was still not 100% confident of my preparation for the exam, I felt that there were less unknown unknowns, and that at least I had learnt a structured approach to answer the questions. The course lasted from 10 till 5.30 and apart from a small lunch break and 2 tiny tea breaks, it was a full day. It started with an introductory talk about the SJT, its significance, and how the score is calculated. I found this part was very interesting as it contained a lot of insider info not available anywhere else. The second part was a run-through of the ethical and legal issues one needs to be aware of as well as outlining the resources one can use to prepare. The third part, which I found the most useful, was about how to approach the questions. This part opened my eyes to things I was not aware of such as the big difference in the approaches required for the two types of questions (ranking and choose the best 3 out of 8). After the course I was a lot more comfortable with answering practice questions, and found myself able to answer question quicker and in a more confident manner while still sensibly considering all the choices and their potential risk/benefit/urgency. The last part of the course touched on general exam strategy and time management issues which was also very helpful. The course was well attended and the people I chatted with afterwards all gave good reviews. And although none of them said they were completely worry-free after the course, most said that it helped them adopt a structured approach to the different types of question and gave them good tips when it came to general exam strategy.
A few days after the course I was pleasantly surprised by an email from Emedica giving me extra revision material, in the form of practice questions as well GMC and other official material covering the important ethical and legal topics. They also offered to answer any questions I had in the last week before the test. Their practice questions were similar in length and difficulty level to the official practice questions, but I still didn’t take them as dogma, which is what I did with the official UKFPO answers to the practice questions.
The test went well overall. At the moment, I cannot predict my score since for most questions there were no clear right and wrong answers. And compared to the practice paper I would say there were more questions which weren’t very clear in terms of the most appropriate answers. Nevertheless I’m overall happy with how it went. I managed to finish all the questions about 6 minutes before the end of the exam which gave me enough time to go over the answer sheet again to make sure that I didn’t forget to fill in my answer for any questions. This was also reassuring for me as it meant I was able to consider all the questions without having to guess or rush though any of them, meaning I gave each and every single one of them a fair shot. My understanding is that most people who have done poorly in the SJT in previous years were those who didn’t finish all the questions in time or who made major mistake such as not transcribing the answers to the answer sheet in time. Hopefully this will mean that I won’t get a score less than 2 standard deviations from the average (i.e not less than mid-30s) which would guarantee me at least my second choice foundation school. And if all goes well and I haven’t messed up my rankings for a big chunk of the questions, I should be looking at a 40+ which would – based on previous yearly figures – be enough to get me into my first choice foundation school. Update – this student actually scored 41.5 SJT points, and accepted an academic rotation – however this score would have got him a spot in his 1st choice rotation!
The Emedica Foundation SJT preparation course has been running since the first year the SJT was used for Foundation programme entry / FPAS. It has been updated to take account of the new format questions added for 2015 entry onwards.
Unfortunately for me I’m retaking the year due to OSCE difficulties, which includes everything that comes with it- including all logbook signups and, of course, the FPAS application system. So whilst digging out my SJT notes from last year, I realised that having gone through the whole experience (including it’s ups and downs!) I had some experience and advice that may prove useful to share.
As you probably know by now, it’s a bit of an odd exam, focusing not on knowledge but on appropriate reactions to scenarios, such as your senior Doctor being drunk (there were at least three questions on that last year, bizarrely) or handling a complaint from a patient. You answer each question by ranking five possible scenarios, from most to least appropriate. The tricky part comes when you realise you can’t justify your answers, or gain extra information, and have to go exactly with what’s in front of you!
So what’s the best way to learn for this new test?
It’s very tempting to try and learn the “correct” answers to a variety of questions, such as from working through the variety of SJT practice question books available. Personally, I didn’t rate any of these, as I found they each had their own biases. The Oxford Handbook version was clearly written by older Consultants with the idea of “don’t bother your seniors”- NOT the SJT ethos! Another book I found had questions on clinical scenarios- the test actually requires very little medical knowledge. We even found such bizarre options in question banks as “try to stab the patient with your pen”- unfortunately nothing in the exam was so clear-cut wrong or right!
I daresay the books/question banks will have improved this year (look out for anything on its second edition, I see on Amazon that the Oxford Handbook one is), but if you use them, use them with an open mind. Be willing to rethink answers that don’t seem right, and discuss with your peers. Remember that a slight change in the options could completely affect your answer in the exam.
(Also: order the books as soon as possible- they sell out fast, and last year one didn’t arrive for me until the week before the exam!)
My main strategy for revision was to try and get into the right “mind-set” of the test. The test isn’t about knowledge- it’s about thinking like a Doctor, and so I did my best to learn what the test was looking for, and familiarise myself with the principles I should be applying/would be tested on. To start with, you can do background reading about how the test was developed and what it is looking for. I went to www.isfp.org.uk for this, and specifically read through the SJT monograph which is a really good explanation of what the test is looking to measure, and how.
The UK Foundation Programme Website also provides a person specification for the SJT on their documents page.
Finally, I would definitely recommend going on a revision course. While my University tried to advise us on this exam, they aren’t familiar with it- but GP trainees are, having been doing SJT’s for years now. Emedica ran an intensive day course where they provided key background information, including the ethical principles, GMC guidance and day-to-day problems you may face as a junior doctor (and so on the test). They provided and confidently went through example questions; explaining the correct answers in a really sensible way that made sense. This was supplemented by a set of practice questions to go through online afterwards; which I found very useful, as I knew I could trust the examples!
The course also included a timed practice test that forced you to answer each question in a set amount of time- this is really important thing as the timing is close and indeed I know of some people whose mark dropped simply due to running out of time.
The Emedica Foundation SJT preparation course has been running since the first year the SJT was used for Foundation programme entry / FPAS. It has been updated to take account of the new format questions added for 2015 entry onwards.
Foundation Programme Situational Judgement Test Preparation Course Launched
Emedica have launched an intensive half day course aimed at final year medical students from all UK medical schools. This course will help students gain a thorough understanding of the Foundation Programme entry Situational Judgement Test.
All final year medical students will sit the SJT exam as part of their Foundation Programme application for 2013 entry. The exam will be held on the 7th December 2012 and the 7th January 2013.
The course covers key theory as well as all important tips and techniques to help you boost your SJT score. We hope this will maximise your chances of getting your first choice Foundation Programme / Foundation School.
This course is aimed at final year medical students at any university applying for entry in the UK Foundation Programme 2013 – you will be sitting the SJT exam in December 2012 or January 2013.
The course covers:
Situational Judgment Tests in Foundation Programme Entry – Background, development, piloting for Foundation programme entry. How your SJT score is calculated / used. Why the SJT score is more important than your EPM in ranking.
Key Theory and Techniques for SJT exams – Key attributes and domains tested in the Foundation SJT exam. Medical ethics, confidentiality, capacity, consent,GMC Good Medical Practice. Differences in how to approach ranking SJT questions vs. selection SJT questions. Understanding how the SJT exam is marked. Key tips and techniques to boost your scores.
SJT Mini Mock Exam – 24 question mock SJT paper with the same timings per question as the real exam. This includes 16 ranking questions and 8 selection questions. Detailed answers and explanations with discussion of WHY the best responses are correct, mapped to the Foundation Programme SJT attributes / person specification.
Questions and Answers – Dedicated question and answer session on SJT questions and Foundation programme entry. 1 to 1 clinic at the end of the day if you wish to discuss anything privately.
The course will be taught by Dr Mahibur Rahman – the author of the first article on Situational Judgement Tests in medical recruitment –Tackling Situational Judgement Tests – BMJ Careers 2007. Dr Rahman is a Portfolio GP and a consultant in medical education – he is an expert in medical careers, and has taught over 15,000 delegates since 2005.
13.15 Welcome and Introduction
13.20 Situational Judgement Tests in Foundation Programme Entry: Overview
13.35 Tackling SJT exams: Key theory, tips and techniques
14.30 Situational Judgement Test Mini Mock Exam
15.30 Break for Refreshments
15.50 SJT Mock: Answers, explanations and feedback
17.30 Questions and Answers
17.45 Summary and Close
The course costs £95 – but you can save £20 by taking advantage of the early bird discount – just book by the 30th September 2012. You can save a further £20 each if you book with a friend – so it pays to be social!