The academic station generally begins with a personal question and is your opportunity to demonstrate why you are applying for a specialised foundation programme. Whether that be medical education, leadership, or research programmes, you are likely to be presented with a generic and standardised interview station – it is up to you to draw on your own experiences, tailor your answers and ultimately demonstrate why you are an outstanding candidate.
Below are some common questions for the personal component of the academic section are
- Why do you want to do the SFP/your chosen SFP?
- Why do you think you will make a good SFP doctor?
- What are the key challenges associated with being an SFP doctor?
- What do you see yourself in 5/10 years time?
- Tell me about yourself.
- Should all doctors participate in research, and why?
These answers should be prepared ahead of time, without sounding scripted. You will likely have 1-2 questions, the answers for which should not last >2 minutes to allow time for appraisal and interpretation of the abstract. The perfect answer will flow whilst covering academic, clinical, social, and personal components. The perfect applicant will demonstrate that they have really considered why they want the SFP jobs that they have applied for, that they are motivated to meet the challenges associated with the job, and that they will be able to excel within the job. This is extremely challenging within the limited time available, hence the need to prepare in advance. One useful resource for this section of the interview process is ‘Medical Interviews: A Comprehensive Guide to CT, ST & Registrar Interview Skills’. Other resources are of course, available.
After personal questions are completed, you will then have an opportunity to summarise the abstract you are given. Do not waste time critiquing at this stage, your answer should consist of a couple of sentences summarising the paper and taking no longer than 15-30 seconds e.g. “This is a large, 12-month UK-based multicentre double-blinded randomised controlled trial comparing the efficacy of drug x vs. drug y amongst a group of middle-aged, female patients with stage IV invasive ductal carcinoma of the breast. The primary findings were that there were no statistically or clinically significant differences in patient outcomes by treatment group, with a trend towards increased frequency of severe side effects in the drug x group. There are several strengths and limitations of this study with implications on its external validity which I will go through in turn during my critique of the paper.”
Again, this is no time to re-invent the wheel, almost all participants will critique the abstract using the PICO format (participants, intervention, comparison, outcomes). This is an effective and efficient way to structure your critique, whilst ensuring that you cover the key components of the paper. Obviously, it will need to be adapted dependent on the type of abstract you are given. For example, prospective observational studies will not have an intervention, but will have a data collection period the methods of which you can critically appraise.
It is beyond the scope of this article to talk you through a comprehensive approach to critical appraisal within PICO, instead we will provide links to several resources which you can use below. Here are some excellent resources that we used to supplement our studies during medical school and beyond:
- CASP checklist
- Y4 Critical Appraisal of RCTs – a useful presentation going through different type of biases
- The Doctors Guide to Critical Appraisal. 5th Edition. Gosall and Gossal.
- How to Read a Paper: The Basics of Evidence-Based Medicine and Healthcare. 6th Edition. Greenhalgh.
- Crash Course Evidence-Based Medicine: Reading and Writing Medical Papers. 1st Edition. Kaura.
- BMJ Endgames
Be prepared to justify your appraisal within this section. It is not unlikely that your interviewers will either ask you to clarify or expand upon your argument, they may even not agree, if you are clear in your reasoning then do not be afraid to politely disagree with the examiners. If you think the study lacks external validity, then explain what drew you to this conclusion and perhaps explain how the trial could have been adapted in order to improve this component. You are being examined on how you can communicate your appraisal, and form an argument, so it is vital to be clear and adapt your approach if it is not working effectively. Rewording an argument in response to an interviewer seeking clarification is a skill, not a flaw.
A common question within the academic section is “would this research change your practice?”. The answer is almost always no. This is an opportunity for you to demonstrate your understanding of the hierarchy of evidence, and how research informs clinical practice. Almost without exception, your practice should be guided by national clinical guidelines (e.g. NICE), the evidence base for which should be guided by meta-analysis, systematic reviews, and large randomised controlled trials of high quality. If you feel that with further investigation the findings outlined may be used to guide future clinical guidelines and practice then state so and justify your answer, but no single trial should guide real-world practice. If however, you have observed single trials influencing practice, for example over the last couple of years when reacting to COVID-19 data, then feel free to discuss this critically appraising as you go… another opportunity to demonstrate your awareness of changing practice within research as well as clinical settings.
There will also be an opportunity to also demonstrate your understanding of the ethical underpinning of research. If there isn’t one, make one. Usually this will be when critiquing the methods section of the abstract. Many candidates directly reference the Helsinki Declaration, we are not convinced that this is essential so long as you demonstrate that you consider the ethical implications of research trials e.g. if this study was performed in a patient population of end-stage lung cancer patients, what implications does this have on informed consent and coercion? If this study was performed on a group of patients unable to provide informed consent, what criteria must be met in order for it to be considered ethically sound?
Sometimes, the examiners may ask you to interpret the numbers. Be familiar with these terminologies and what they mean and how it applies to the data you have been presented
- P value
- Odds ratio, risk ratios
- Number needed to treat/harm
- Confidence interval
- Type 1 and Type 2 error
- Absolute/relative risk reduction
- Parametric and non-parametric
It is not necessary to have a deep understanding of medical statistics, but it is essential to understand why certain types of tests may have been used and what this means to you when interpreting the data. For example, if multiple T-tests were performed what does this mean for the likelihood of a type 1 error? If a small number of participants were recruited for the trial, and results were approaching significance, what does this mean to you when interpreting the data?
There really is no replacement for repetitive practice with a range of individuals for this section (and the clinical as well in truth). We used a combination of revision of our medical research lectures, additional targeted lectures and reading on critical appraisal, and discussions/feedback from supervisors and colleagues with a background in medical research.
- Only practising interpretation of randomised controlled trials
- Getting bogged down in the minutiae of the statistical analysis without considering the real-world implications of the study – what does this mean for your patients? You remain a clinician first
- Focusing purely on the methodological quality of the study without considering ethical and clinical implications
- Only interacting with research in the preparation for interview – Try to make reading through research a habit, this will not only help in preparation but if you are considering academic life remember that you will be spending a significant amount of time reading research and a large part of the battle is speaking the language of researchers.
Written by Dr Jack Barton, Dr Daniel Richardson, Dr Jack Teh, Dr Abigail Whittaker, and Dr Rachel Millar.
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