11 tips to help you boost your Foundation SJT exam scores

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.

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How I got my 1st choice Foundation rotation – SJT preparation tips from a high scorer

The Foundation SJT is an important part in your overall FPAS ranking, and getting a good score will improve your chances of getting your 1st choice rotation. In this article, Dr Sarah Levy discusses how she managed to score 49.16 in the SJT (this is in the top 1% in the country) and her tips on how to do well in the SJT.

How I prepared for the Foundation SJT

I sat the SJT on the 1st December 2017 and probably first starting thinking about it at the end of October when I attended an information session run by my medical school where they discussed the format of the exam and gave advice on how best to prepare. I was fortunate to attend three further preparatory session delivered by my medical school, which involved running through various questions and discussing possible strategies for how to go about selecting answers. However, the main take-home message that I personally got from these sessions was that it is tricky to know how best to prepare for the SJT aside from practicing the official questions available online.

Test Quiz

I am inclined to agree that perhaps the most important thing I did to prepare was to do the official questions available online. I did these under exam conditions, including printing out the answer sheet example. This was useful to familiarise myself with the timings of the exam, and also with how to fill in the answer sheet (it is surprisingly easy to lose concentration momentarily and accidentally fill in the answers in the wrong order!)  I also bought one book with practice questions and borrowed another book, and spent perhaps around 8 hours in total working through questions from these books. I found that whilst some of the questions and explanations were useful, they were not hugely similar to the questions asked in the actual exam with some being far too easy and others being very difficult with unclear explanations which left me still believing my original answers to be correct. I also attended an Emedica SJT course (discussed in detail below), which proved very useful in my preparations.

Another resource that I found helpful to use in my preparations was the GMC’s “Good medical practice” document and the Ethical Guidance section of their website. The “GMP in action: GMC guidance brought to life” scenarios provided a huge array of different dilemmas that can come up in clinical practice (and in the SJT) along with explanations of how best to deal with them.

Retrospectively, having sat the SJT and achieved a score that I was very pleased with, I think that much of the “preparation” that I did was actually done subconsciously when spending time on the wards.

Female doctor explaining diagnosis to her female patient

Many of the questions I encountered in the SJT had similarities to the sort of situations that medical students witness when on clinical attachments. Whilst clearly these situations are not always dealt with in the correct way suggested by the SJT answers, I found it useful to have previously thought about such situations and how I might act if/when they were to occur in my own life. I also found it helpful during the test to think about doctors who I had found to be particularly competent and contemplate about how they might act in each given situation.

Emedica SJT course

I did the Emedica SJT course a couple of weeks before I sat the SJT, and found it to be a very beneficial experience. I was fortunate to be able to do the course a mere 20 minutes from my house but met others there who had travelled literally half way up the country to attend and also agreed it was worthwhile! Dr Rahman gave helpful hints and tips on how to tackle the SJT as well as reviewing core knowledge relating to ethics, confidentiality, consent etc.

We also went through numerous questions together and were given clear and concise explanations which I was able to learn from and later recall when answering similar questions. It was also useful to go through a mock SJT exam which again gave an idea of the timings required. The course was efficient and all the staff I encountered were friendly and welcoming. It also put my mind at ease and meant I was more confident on the test day itself. The most useful things I took away from the Emedica SJT preparation course were an improved awareness of the importance of good time management, a better familiarity with the different question types (including the newer ones) and how best to tackle them, and a sense of the importance of remaining calm on the day.

My tips for exam day

In terms of preparing for the day itself, I would recommend having a relaxed evening the night before to try and clear your head. This is probably good advice before any exam (although sometimes hard to take!) but I think it is especially relevant for the SJT which is not an exam that can be approached with fact-cramming in the hours beforehand. Personally I relaxed by phoning friends and family for a chat and reading a book before having an early night.

On the actual day, I made sure to have a decent breakfast and some coffee (but not too much!)  I found the exam itself to be tight for time, so it is important to read the questions quickly and ensure that you don’t run out of time at the end. For me, the latter “select 3” questions were quicker to complete than the initial “rank the 5 options in order of best to worst” questions. This may be worth bearing in mind when working out how best to manage your time during the exam.


In summary, from my own experiences of sitting the SJT, I would recommend specifically practicing and reviewing all the official questions available and thoroughly familiarising yourself with the format and time constraints of the test itself. I found the Emedica SJT course to be helpful and concise, and an important part of my SJT preparations.

Dr Sarah Levy scored 49.16 in her Foundation SJT and is now in her FY1 year in her 1st choice programme in the North Central and East London Foundation Programme!

The Specialty Recruitment Assessment (SRA) – what to expect and how to prepare

The Specialty Recruitment Assessment (SRA) plays in important part in the shortlisting and assessment process for 8 different specialties: GP, Radiology, Ophthalmology, Obstetrics and Gynaecology, Psychiatry, Neurosurgery, Child and Adolescent Mental Health Services (CAMHS) and Community Sexual and Reproductive Healthcare (CSRH). It is also known as the Multi Specialty Recruitment Assessment (MSRA).

It will be done entirely on computer, and consists of two parts lasting a total of 3 hours 5 minutes – a clinical problem solving section and a professional dilemma section. Each specialty uses the results of the SRA in a slightly different way in the recruitment process for ST1 / CT1 posts – in most cases, the score is used both to shortlist for interview / selection centre, but also carries over and makes up a part of your overall ranking (the rest coming from interview / selection centre). For applicants to GP or Psychiatry, an exceptional score (~top 10%) can lead to a direct offer without needing to attend the next stage.

Clinical Problem Solving


This is a 75 minute assessment with 97 questions testing your clinical knowledge and ability to apply it in practice.  This paper is set at the level of knowledge expected for a Foundation Year 1 doctor at the END of their first year.  The paper is very broad, covering almost all the medical and surgical specialties.  There are a variety of question types, including:

  • Extended matching questions (EMQ)
  • Single best answer (SBA)
  • Multiple best answer (MBA) – there are up to 3 correct answers
  • Picture questions – this could include skin lesions, fundoscopy, blood reports, ECGs etc.
  • Algorithm questions – you may have to drag boxes into the right part of the algorithm or select the correct answer from a list. Algorithms could include BLS / ALS / important guidelines etc.

Question may relate to diagnosis, investigation or management of both common and important diseases as well as rare but serious presentations.

There are some example of the 2 most common question types (EMQ and SBA) below:

EMQ – Investigations for back pain

1. A 25 year old man is involved in a road traffic accident. He was on a bike and hit from the side. He did not want to attend the hospital, and was taken home by his friends. He now complains of severe pain in his lower back and cannot pass water. He has tingling in his legs below the knee. Select the most suitable investigation from the list.

A X-ray of the lumbar spine E Routine MRI scan lumbar spine
B X-Ray of sacro-iliac joints F Urgent MRI scan lumbar spine
C Routine CT scan lumbar spine G DEXA scan
D Urgent CT scan lumbar spine H No investigations needed

2. A 68 year-old woman with known osteoporosis. She has had a fractured neck of femur in the past after a fall in her garden. She now complains of pain in her lower back, but does not have much muscular tenderness. She has no bowel or bladder symptoms. She has no neurological symptoms. Select the most suitable investigation from the list.

A X-ray of the lumbar spine E Routine MRI scan lumbar spine
B X-Ray of sacro-iliac joints F Urgent MRI scan lumbar spine
C Routine CT scan lumbar spine G DEXA scan
D Urgent CT scan lumbar spine H No investigations needed

3. A 40 year old labourer attends complaining of severe low back pain after finishing his shift. He does not have any bowel or bladder problems, and on examination has a straight leg raise of 90 degrees in both legs. He has no other significant medical history. Select the most suitable investigation from the list.

A X-ray of the lumbar spine E Routine MRI scan lumbar spine
B X-Ray of sacro-iliac joints F Urgent MRI scan lumbar spine
C Routine CT scan lumbar spine G DEXA scan
D Urgent CT scan lumbar spine H No investigations needed

SBA – Allergic reactions

4. A 35 year old man has a severe allergic reaction while in hospital. He has no history of past allergic reactions. Which ONE of the following is most likely to cause a reaction WITHOUT prior exposure or sensitization? Select ONE answer only.

A. Peanuts

B. Hymenoptera stings

C. IV Penicillin

D. IV Contrast media

E. Latex

Answers and explanations are available at http://www.emedica.co.uk/sra-answers.html

Click the image below for details on how to access over 2000 realistic exam level questions to help you prepare for both papers in the SRA.

Professional Dilemma paper

Businessman looking at arrows pointed in different directions

This is a 110 minute assessment with 58 situational judgement test questions (SJT). Questions test judgement and decision making in a workplace context. It also assesses knowledge of important ethical and medicolegal guidance from the GMC. Questions assess 3 domains – empathy and sensitivity, coping with pressure, and professional integrity.

There are two types of SJT questions in equal proportion. The questions in section 1 ask you to rank 4 or 5 actions from best to worst in the context of a workplace scenario. The questions in section 2 ask you to select 3 actions that taken together make the best response to the situation. There are up to 8 options to select from in this type of question.

Sample ranking question:

You have just started a job as a medical F2 in a new hospital. Your partner has a chest infection, and is not yet registered with a GP and has asked you to prescribe antibiotics.

Rank the following options 1-5, 1 being the most effective / best option, 5 being the least effective / worst option:

A. Prescribe the medication as a private prescription, and arrange for your partner to register with a GP the following week.

B. Tell your partner to register with a GP locally.

C. Prescribe the medication on a hospital take home prescription with your partner’s details on it.

D. Prescribe the medication on a hospital take home prescription with one of your patient’s details on it.  Collect the medication from the hospital pharmacy.

E. Pressure one of your FY1 colleagues to write a prescription on a hospital take home script without seeing your partner.

Sample selection question:

You are an F2 in Orthopaedics. An 80 year old lady has a fracture of her right neck of femur. You have been asked to consent her prior to surgery but on talking to her she seems confused. Her daughter tells you she has dementia and this is confirmed in the notes.  She is first on the morning list.  Select the THREE most appropriate actions to manage this situation:

A. Ask her daughter to sign the consent form and state that she is the daughter.

B. Inform your consultant she has dementia and ask him to complete the consent form.

C. Encourage the patient to sign the form as the procedure is in her best interests.

D. Exclude any acute causes that could be worsening her confusion.

E. Discharge the patient as she will be unable to have surgery without consent.

F. Cancel the patient’s operation.

G. Ring the theatre to rearrange the list so this lady is lower down on the list.

H. Complete the consent form on the patient’s behalf as it is in her best interests.

Answers and explanations are available at http://www.emedica.co.uk/sra-answers.html

Preparing for the SRA

It is important to allow enough time to prepare for both papers – some specialties use the scores as part of a ranking process to determine eligibility for interview / selection rather than as a pass / fail criterion. In most cases the SRA score carries over to the next stage and is added to the interview score to determine overall rank so it is important to do as well as possible. Try to combine reading to cover the key clinical theory (Oxford Handbook of Clinical Medicine and Oxford Handbook of Clinical Specialties) and understand key GMC ethical guidance with practising sample SRA questions to develop exam technique and get a feel for the different types of questions. As you get nearer the time of the exam, you will benefit from doing a timed mock exam to get used to the pressure of the exam.

I hope this article has given you a clearer understanding of what to expect in this important assessment. I wish you every success with your revision and in getting a place on your chosen rotation.

Dr Mahibur Rahman is medical director of Emedica, and has helped thousands of doctors prepare for this type of assessment since 2007. He teaches on the popular Specialty Recruitment Assessment Crammer course which covers both papers. You can get a £20 discount on the course which carries 6.5 CPD credits by using the code srapass at http://courses.emedica.co.uk/acatalog/GP_ST_Entry_Stage_2_Exam_Crammer_.html 

Preparing for the Foundation SJT – how I got my 1st choice Foundation programme

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:

Emedica – Foundation programme SJT preparation course

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

Taking a Test

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.

Good luck! 

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.

Foundation SJT Course

Foundation SJT tips from a high scorer – how I got my 1st choice Foundation programme

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.

Foundation SJT

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.

Emedica Foundation SJT Course

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 .

Two other SJT books I found useful were Situational Judgement Test for the Foundation Years Programme by Dr Omar Taha and Dr Mizanul Hoque and Get Ahead ! The Situational Judgement Test. These were handy to have in your bag whilst travelling or having a spare few minutes when you could look at question or two.

Exam Day

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!

Niamh Rogers

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.

Foundation SJT Course

Foundation SJT course review – preparing for the FPAS SJT exam

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.100281534

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.

Foundation SJT tips from a resitter, Part 2

Foundation SJT tips from a resitter, Part 2100281534

With FPAS applications open now, the day is getting closer- the SJT, which will rank you with the rest of the UK medical students for jobs. It seems daunting, but remember that to get this far you are a sensible, intelligent person- it’s simply a matter of showing this as best you can, with my help!

As the exam comes up, I can’t stress enough that it is different- not about knowledge but about applying the right principles to make sensible decisions. It’s really not about cramming practice questions- after finding many of the books problematic I did very few. It’s about knowing the key guidance. It’s about showing that you know the GMC Duties of a Doctor and can apply them in scenarios of day-to-day hospital life.

You will need to reduce these massive documents to frameworks that are easily memorable for you. Have an idea of the kind of situations you will need to seek help in- when will you talk to an F1 colleague? When will you escalate a problem, and to who? We found it useful to have a framework “hierarchy” of who you would go to next with an unsolved problem.

It’s also worth reading over things such as DVLA guidance and ethical guidance on issues such as confidentiality and consent, so you are prepared for any of those issues that may come up.

Last year as part of my preparation for the SJT I took a course with Emedica– part of what was so helpful about it was their clear summaries of ethical principles, conscientious objections, confidentiality and other guidance that can almost be applied as “rules” to certain questions.

Remember that the test reflects “real-life” behaviour: Are you remembering to take care of yourself in your decisions, as well as projecting the image of the perfect caring Doctor?

On the flip-side, remember that the exam tests what you should do ideally: so even if you’d be too scared to phone your Registrar in real life, so you can put the ideal option.

FPAS provides a practice paper, which is the only “official” one so you might want to consider when you use it- early on to get an idea of real questions, or closer to the exam as a “mock”.

Consider how you’ll answer the questions. With 70 questions in 140 minutes, you have just 2 minutes in which to read a question, weigh up the scenario, and mark your answer down. Usually with MCQ’s I like to go through the question paper at least twice- you won’t have time here. Also if you’re one of those people who likes to write down your answers and transfer them at the end, consider if you want to risk running out of time for that! Bring several sharp HB pencils (so you don’t waste time sharpening, or worse, waiting for an invigilator to sidle along to you to bring you a new pencil), and please, a decent rubber, so we can avoid the marksheet fiasco of 2012!

I wouldn’t recommend cramming for this exam at all. You can’t learn answers as a slight variation in a question would change it completely. (None of the past paper questions came up last year, either!) Even if it’s not your usual pre-exam style, I’d recommend a good night’s sleep and a good breakfast before the exam, so you’re awake and ready to reason out situations, and apply some well-needed common sense!

This article was written by a final year medical student at Kings College London medical school. She has since passed finals, got a great SJT score again, and is now a foundation doctor at her 1st choice Foundation rotation in London.
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.

Situational Judgement Test Questions in Medical Recruitment – Preparing for SJT Exams

Situational Judgement Tests in Medical RecruitmentSituational Judgement Test Questions

Dr Mahibur Rahman

Over the past few years, SJT questions have become more popular as part of medical recruitment processes.  The first medical specialty to introduce SJT questions was the GP Recruitment process – the professional dilemma paper makes up 50% of the marks from the GP Stage 2 assessment, and the use of situational judgement test questions has shown to have good correlation with performance in GP training. The National Recruitment process for GP ST Entry in the UK has been using SJT questions since 2006 (piloted), with the SJT exam scores actually contributing since 2007.

They have become increasingly popular in other parts of medicine.  SJT questions were trialled as part of the CMT recruitment process in 2009, for recruitment to Public Health Specialty Training for the past 2 years, and are now part of the recruitment process for the Australian GP Training (AGPT) programme via the GPET Stage 2 assessment.  In the future, they will also be used as part of Foundation Programme 2013 entry in the UK after a successful pilot in 2011 showed good correlation to other methods of assessment, and increased reliability compared to “white space” questions. They are also being considered for some surgical specialties.

There are two main types of SJT question used: ranking, and selection.

Ranking SJT questions

In this type of SJT question, the candidate is given a scenario that they might encounter in the job they are applying for, with a work based scenario.  This can involve an ethical dilemma, a difficult decision, issues with other team members, or issues relating to patients. Questions are written to test specific competencies essential for that job.  The candidate will be offered a set of possible responses (usually 5), and must rank the options from 1 to 5, with 1 being the best (or most effective) option, and 5 being the worst (or least effective) option. This type of question is usually marked using a keyed response mark scheme – the total marks awarded for an answer depends on how close the answer is to the “best response” or “model” answer, as determined by a panel of experts. This means that a sensible answer that is not perfect will still receive a high score.

Selection SJT questions

In this type of SJT question, the candidate is given a scenario with many more options to choose from – up to 10 options in some cases.  From these, they have to select 2 or 3 options (depending on the question) that TOGETHER make the best overall response to the scenario.  These do not need to be ranked – so a candidate might pick options A, D, and G, but would not need to rank these 1st, 2nd and 3rd.  Marking for this question type depends on the specific exam. In some cases, these questions are also marked using a keyed response scheme, in others, there is one “correct” answer, with a set number of marks for each of the correct responses selected.

Most of the current examinations using situational judgement test questions tend to have more ranking SJT questions compared to selection SJT questions.

Preparing for Situational Judgement Test questions

This type of question is designed to test judgement and decision making ability, and to explore whether a candidate meets specific job related competencies.  They do NOT test knowledge in the way a clinical exam does.  So how can you improve your performance in an SJT exam? Here are a few simple tips:

Learn the competencies

Each SJT question is written to map to one or more specific competencies. If you understand which competencies are being assessed as a whole, it becomes easier to spot which ones are being tested in any given question.  This can make it easier to rank items that demonstrate the competencies higher.  The specific competencies vary depending on the specific exam – so make sure you have read the person specification for the job you are applying for.  As an example, some of the competencies being tested in the GP Stage 2 exam include team working, empathy and sensitivity, communication skills, coping with pressure, and professional integrity.

Understand the difference between the two question types

Ranking questions are asking you to compare each option with the others – they are NOT asking you for “good” or “bad” options alone.  Sometimes all 5 options may be poor, or  they may all be beneficial, you are looking for which one is comparatively better or worse than the other options.  Selection questions are NOT asking you to rank anything, just the best 3 options taken together.  This allows you to eliminate some options as they cannot work together. Once you have worked out the 3 best options that work together, you do not need to waste any time deciding which of these 3 options is better or worse than the others in your final answer.

Practice, practice, and practice to time

Because of the way situational judgement test questions are marked, you can often get a high score simply by attempting every question – so getting used to the pace of the real exam is really helpful.  If you answer 50 questions imperfectly, you will usually get a higher score than someone that answers 40 questions perfectly.  Some candidates struggle to finish in time, especially when they spend too long on a specific question trying to get the “perfect” answer.  Get used to the timing, and then try to be strict with your time management – have a sensible go at every question to maximise your score. This type of question is often new to many students and doctors – you have all sat numerous clinical exams with single best answer and extended matching questions, but SJT questions are still relatively new.  The more you practice, the more you get used to understanding, evaluating and answering sensibly in a limited amount of time.


Situational judgement tests are increasingly common in medical recruitment – from medical school entry (UKCAT), to recruitment to postgraduate training. They have been shown to be a valid and effective way to select candidates, especially when used as part of a holistic recruitment process that also takes into account knowledge and the right experience for the job. Understanding how the questions are written and marked, and practicing to improve your examination technique can help you improve your performance on the day.

Further reading:

Tackling Situational Judgement Tests – BMJ Careers – inlcudes samples of both types of SJT question

Emedica were the first company to include situational judgement test questions as part of their GP Stage 2 online revision service.  We recently launched the first dedicated situational judgement test preparation package with 115 high quality SJT questions.  This includes both types of SJT question, with detailed explanations and answers, and includes a timed 25 question mini mock SJT exam.