“There is so much to read. I just don’t know where to start”. Sounds familiar?
Candidates applying for consultant posts are very good at scaring themselves about NHS issues during their preparation for the big day. Across the range of thousands of candidates that we coach every year for their consultant interview, it is common to hear comments of the type: “I heard they can ask you anything about NHS issues” or “I don’t understand anything to all this management stuff”.
In reality, although it is of course important to understand what is going on in the NHS, the emphasis is not so much on knowing a lot of facts, but on understanding at a more global level how this will affect your speciality in the forthcoming years and therefore your role as a consultant in the unit which you are aiming to join. Doctors have always been trained to learn information which is then tested at exams. At the interview, it is your awareness and analytical power which is being tested rather than your ability to regurgitate information.
As such, it is unlikely that you will be asked very factual consultant interview questions such as “What are the 8 ways in which the clock can stop for the 18-week target calculation?”; and you will only be asked questions of the type “Tell me what you know about Darzi.” in the 4 to 6 weeks or so following the publication of a report. Instead, you are far more likely to be tested on the broader implications of those reports, which, by itself, does not require any detailed knowledge of those issues. For example, currently, consultant interview questions associated with the Darzi report are more likely to be of the type:
- “How can we improve quality of care in a cost-cutting environment?”, a question which refers both to the emphasis on quality in the Darzi report and to the forthcoming cuts in NHS budgets, but requires no specific knowlegde of the Darzi report. Instead, it requires a good knowledge of the areas of inefficiencies in your speciality in general and in the department that you are aiming to join.
- “How would you measure quality of care in your specialty?”, a question which relates directly to the Darzi report, Patient-Reported Outcomes Measures (PROMs) and patient experience, thus linking to the auditing of key performance indicators and patient feedback, neither of which are fully developed in the Darzi report.
- “How can we improve the quality of training in the current environment?”, a question which relates not only to the diminishing hours of training imposed by the EWTD, but also to the fact that spending time on training juniors is not always compatible with a drive towards efficiency and cost-cutting. No report will give you the answer to this question.
Consequently, although it is of course important to read and understand the key reports published by various organisations, you should not fall into the trap of trying to learn their content with a view to regurgitate it. Instead, you should make note of the key issues and try to understand their practical implications.
One of the greatest difficulties in reading about NHS issues is that it seems like there is an endless supply of documents. So don’t make the mistake that many candidates at consultant interviews make, which is to start right back to 1948. No one really cares about the old issues, and even the Tooke report which dates back to 2008 is no longer talked about. Look at the key documents published in the last 18 months or so, both at a global governmental level (e.g. Darzi) and at speciality level (e.g. recent NICE guidelines, Royal College strategy documents, etc). You may start with one and find that it refers to 2 or 3 others, which in turn refer to 2 or 3 others. It is important that you follow the trail so that you can appreciate how they all interlink. This should take about 4 or 5 hours of your time. If you feel that you are spending excessively longer then you are probably spending too much time on the detail.
Then, once you have a rough idea of what it going on, think of the implications. Try to do this by yourself to start with because at the interview there will be no one to help you, so it is important that you forge your own opinions and ideas about the implications of what you read.
Some of those implications may be common sense (for example, if you are place an emphasis on productivity and cost saving then training may be affected) but others may be less obvious to you simply because you are not involved in the day-to-day management of their unit. For that reason, as a second step. it is useful to discuss issues with your educational supervisors as well as clinicians in their team how this influences their speciality and their department in practice. If you are applying for a job as an external candidate, it is also extremely useful to raise those issues at pre-interview visits so that you can get the local point of view on all important matters (knowing you may well be quizzed on those at your consultant interview).
All those impostant NHS topics are also obviously discussed on our consultant interview courses.
Tags: consultant interview, consultant interview courses, consultant interview questions, Consultant interviews, ISC Medical, NHS issues