All medical students who wish to proceed to the UK Foundation programme must sit the Situational Judgement Test (SJT). This is an important exam in a junior doctor’s career, and it is not an easy one to prepare for. Here are some useful tips to help you ace your SJT!
1 - Understand what the situational judgement test (SJT) is, and what it is for
The situational judgement test is an important assessment that comprises 50% of the score for applications to the UK Foundation Programme (the other 50% comes from the educational performance measure (EPM) which is based on your performance at medical school).
This assessment can make a great difference to your overall score and therefore should not be overlooked when preparing to apply for the UK Foundation programme.
It examines medical students’ non-academic competencies which have been shown to greatly impact their performance in training and later in clinical practice. It is used to assess the behavioural response of an individual to various scenarios that could occur in school, training, or in clinical practice.
The assessment focuses on examining communication skills, ability to cope with pressure, ability to interact well with patients and prioritise patient safety, team working, and other similar pre-professional competencies.
2 - Know with the format of the situational judgement test
The SJT consists of 70 questions, and applicants are given 2 hours and 20 minutes to answer them. The questions can have a variety of formats, but generally they are either ranking questions, or selection questions.
The questions will introduce different work-related scenarios, and you are asked to indicate how you would react in each situation or whether you agree or disagree with how it was handled.
In ranking questions, applicants will be asked to rank 5 answer options from most to least appropriate, 1 being the best and 5 the worst. In Selection questions, you will be presented with 8 options, out of which you should select 3 that would be the best response to the given scenario.
The scenarios can describe evolving dilemmas, ie, up to 3 scenarios linked by a common context, each presenting new information and requiring an independent response. The questions can also describe speech dilemmas, which require the applicant to decide how they would respond in a conversation in different situations. Some questions will also feature media content, such as videos.
3 - Be familiar with Good Medical Practice by the GMC
The focus of the SJT is examining whether the applicants can make clinical and practical decisions in accordance with Good Medical Practice.
This is a document devised by the GMC that details the behaviours expected from a medical practitioner in the UK in sensitive areas such as confidentiality, raising concerns about your colleagues, maintaining boundaries with patients, use of social media, and several others.
Good Medical Practice is considered the standard which applicants must aim to meet when sitting the SJT, and this is what examiners will look for. Therefore, it is key to be familiar with its contents, and to keep this in mind when sitting the exam.
4 - Study the areas that are being tested
There are 5 broad domains being tested within the SJT. These domains encompass the attributes deemed by the governing bodies, mainly the GMC, to be important to be a good Foundation doctor. The domains and some examples of the attributes are as follows:
Patient focus - putting the patient at the centre of care, showing empathy and respect towards the patient, ensuring patient safety
Coping with pressure - good judgement in difficult situations, remaining calm and in control, knowing when to seek help
Effective communication skills - clear and understandable language (avoiding jargon), appropriate written communication, adapting communication patterns to different patients
Commitment to professionalism - taking responsibility, honesty, commitment to ethical practice, raising concerns when appropriate, respecting confidentiality
Team working - showing respect to colleagues, ability to take to directions, ability to delegate, sharing knowledge with others
Applicants should focus on learning these domains and attributes both in theory and in practice, and when in the exam, it is often useful to try to first determine which of these is being tested, and then approach it appropriately.
5 - Make the most of placements
Medical students will likely encounter many of the scenarios presented in the SJT during their time on wards. It is important that students take note of these scenarios and how they were handled and evaluate it accordingly.
You should also observe how the senior doctors communicate with patients and their relatives, as well as with their colleagues. If you are unclear about what to do in certain situations or about any areas of the Good Medical Practice, do not be afraid to ask one of your seniors.
They will often have encountered such situations before and may be able to offer valuable advice.
6 - Start preparing early
Although SJT doesn’t examine factual knowledge, you can still prepare for it. Understanding different scenarios and dilemmas and how the GMC guidelines relate to them is important for the exam.
To understand the questions and how the examiner expects them to be answered, you should do as many practice questions as possible. There are plenty of practice/past papers available on the UK Foundation Programme (UKFP) website for applicants to work through before their own exam.
The UKFP also shares the general marking scheme for the exam, and students should try and incorporate this into their timed practice papers as the same marking scheme is used to mark the real exam.
To know the core content, students should study the GMC guidelines detailing the aforementioned domains and attributes that determine a good Foundation doctor.
7 - Practise your timings and take your time!
One of the most common mistakes applicants make is rushing through the exam paper. The questions are complex and often require more than one read for students to fully understand them and be able to adequately answer.
It is therefore important to practise your timing. The exam is divided into two sections. Section one contains usually around 33 scenarios, some of which are multiple choice, some rating type scenarios, each with multiple questions to answer. Section two usually contains 32 rating scenarios, each with multiple questions to respond to.
Most of the marks (2/3) come from the first part of the exam, and the remainder comes from section two. It is advised that students spend approximately 1 hour and 30 mins on section one and the remaining 40 minutes in section two, and they should generally aim to spend about 90 seconds on each question to have some time at the end of the exam to consolidate the paper, or to be able to take breaks throughout the exam.
8 - Develop strategies in your approach to questions
When practising for the exam, students will often develop their own strategies that help them answer the different types of questions.
An example of this is, in rating questions, to think of your preferred option, and consider: “if I could not do this, I would…” for each following option until you have ranked them all. In selection questions, where you need to select 3 best possible options in a given scenario, students find it useful to try and add the word ‘and’ between the 3 answers to determine whether they are appropriate not only individually but also all together.
9 - Avoid making assumptions
Some questions will contain limited information, and students might be tempted to make assumptions to facilitate their decisions.
This can be counter-productive, as incorrect assumptions may lead you to choosing an inappropriate response. It is therefore best to use only the information you are provided with in the questions.
10 - Double check your responses
Make sure that you have clearly and correctly marked your answers, as the exam is machine marked and it is easy and very regrettable to lose marks due to transcription errors.
11 - Remember to take breaks!
In an exam where you are asked to make difficult decisions for 2 hours and 20 minutes, getting fatigued and losing focus is almost expected. Ensure that you are taking small breaks of 20-30 seconds if you feel fatigued between questions. Take some time to regroup before getting back into it.
12 - Some general information about the SJT 2021/2022
In 2021/2022, the SJT exam dates are set for 6th-18th of December 2021 and 17th-22nd January 2022. There is no advantage or disadvantage to sit the exam in either December or January.
You will need to book the test in a window from either 29th of September (for applicants with approved Reasonable Adjustments), or from 4th of October until 7th of October, when the booking system closes. The booking system is on the Pearson VUE website.
If you need to change the date or time of your test, you are allowed to cancel your original date and re-book it on the Pearson-VUE website. Re-booking must be done within 48 hours of cancellation.
You can choose to do the SJT remotely at home, or at a local test centre.
When taking the test, you will be required to present with a valid government-issued ID that includes your name, recent photo, and signature. If you do the test in a test centre, you are not allowed to take any personal items into the testing room.
The SJT results are available on the NHS employment platform, called Oriel, once the first round of Foundation programme allocations is released.
The main resources available to applicants about the SJT will be found on the UKFP website. Additional resources can be found on websites such as Messly.com, or Geekymedics.
Messly. Messly’s top tips for the SJT 2021/2022. Available from: https://www.messly.com/blog/messly-top-tips-for-the-sjt (accessed Oct 2021)
UK Foundation Programme (UKFP). Situational judgement test FAQs. Available from: https://foundationprogramme.nhs.uk/faqs/situational-judgement-test-sjt-faqs/ (accessed Oct 2021)
Geeky Medics. Top tips for the situational judgement test (SJT). Available from: https://geekymedics.com/top-tips-for-the-situational-judgement-test-sjt/ (accessed Oct 2021)
UKFP. Situational judgement test (SJT). Available from: https://foundationprogramme.nhs.uk/situational-judgement-test-sjt/ (accessed Oct 2021)
Pearson VUE. UK foundation programme (UKFP). Available from: https://home.pearsonvue.com/Clients/UK-Medical-Foundation-Programme-(UKFP).aspx (accessed Oct 2021)
The Medical Defence Union (MDU). Mechanics of the SJT. Available from: https://www.themdu.com/for-students/sjt-preparation/mechanics-of-the-sjt (accessed Oct 2021)
Medics Academy blog. The SJT part 1: a short introduction. Available from: https://blog.medics.academy/sjt-intro/ (accessed Oct 2021)