Succeeding at consultant interview: how to stand out from the crowd for the right reasonsBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e782 (Published 15 February 2012) Cite this as: BMJ 2012;344:e782
- Robert Ghosh, consultant physician, Homerton University Hospital NHS Foundation Trust, London, UK,
- Matt Green, medical publisher director, BPP University College, London
Robert Ghosh, consultant physician at the Homerton University Hospital NHS Foundation Trust, together with Matt Green, from BPP University College’s School of Health, explore the factors that you need to consider when preparing for and undergoing a consultant interview
For senior trainees the post of consultant remains the pinnacle of achievement and carries a sense of grandeur together with an element of fear of the unknown. It is paramount that every potential interviewee gives the interview due respect. Preparation should be meticulous.
Employers hold the role of consultant in the highest regard and will look at new recruits as leaders and valuable commodities, helping the institution to deliver first class healthcare. They will need to see evidence of credibility and team working, rather than misplaced negativity or resistance. Selection criteria will be more stringent than ever; no longer will simple clinical credibility and tacit acknowledgment from former consultant bosses dictate success.
Preparation and application
Clinical skills should be beyond reproach; a basic awareness of management and political topics, including ethical issues, is essential; and leadership skills should be developed. Above all, you must “feel ready.”
Ensure that your application is specifically tailored to the position you are applying for. The advertisement and person specification for a consultant position are very detailed and include a list of essential criteria required of the successful applicant. Make sure that your application clearly refers to these criteria. For example, if a desirable criterion is experience of a particular technique, then make sure that this is clearly mentioned in your CV to boost your chances of being shortlisted.
Consider the appropriateness of your future employer beforehand. You should not compromise at this stage, as lack of job satisfaction in years to come will make you unhappy. Consider an informal visit if this is acceptable to the trust.
Formal visit after shortlisting
The aim here is not to canvass opinion but rather to display genuine interest and also to glean from relevant personnel the issues that are important to the trust. Therefore you should not restrict your visit to those who will be sitting on the panel. Confirm the reasons for your application, and try to investigate the following:
From the lead clinician: the department’s clinical interests
Clinical director: success and room for improvement in standards and targets
Medical director: perennial managerial problems with regard to the department and the trust
Chief executive: future direction and sensitive topics for the trust
Department: engage with all relevant personnel
Directorate general manager: a non-medical perception of the department or directorate, with similar viewpoint to the clinical director
Departmental matron: issues for nurses
Key executive directors: strategic and topical issues.
You may be able to give these key people the impression that you are a problem solver and subsequently bring these issues into the interview.
Interview practice and dress code
Repeated interview practice cannot be recommended highly enough. You should prepare thoroughly; and mock interviews should be taken seriously by both the mock interviewer and mock interviewee. Dress on the day to look formal, smart, and professional, but clothes should be comfortable. Tribalism should be avoided (such as club ties, which may evoke a negative response), and do not use overpowering scents.
Advisory appointment committee (interview panel)
Remember that the technical role of the advisory appointment committee is to recommend suitable candidates to the trust’s executive board. In practice, however, the trust will delegate full power to the committee to identify and appoint a candidate. The advisory appointment committee is large (probably the largest interview panel you will have encountered), and each member has a specific role:
Chairman: provides introductions and chairs the panel
Chief executive officer: often asks about vision, strategy, and leadership
Medical director: often asks about revalidation, appraisal, probity, and data protection
Clinical director: often asks about quality indicators, including financial indicators
External college representative: provides quality assurance for previous training and competencies
Lead clinician: acts as a gatekeeper for the department; often asks about clinical skills and vision for the department
University representative (if relevant): to assess your experience of teaching and research
Layperson: may occasionally ask patient centred questions
Human resources: rarely asks any questions.
Presentation and other pre-interview tasks
Presentations are increasingly common, entail varying formats, and will invariably concentrate on an aspect of standards pertaining to your specialty. A half day may be set aside for a presentation, or it may be incorporated into the interview. The topic may be preset, together with an agreed audiovisual format; or the topic and audiovisual format may be determined on the day. The second scenario requires rapid identification of the reason for topic selection and delivery method.
Psychometric testing in mock scenario stations is increasingly common. This is designed to highlight behaviour and personality traits that are conducive to team working and also often deals with leadership skills; assertiveness and submissiveness; tendency to frustration; and anxiety and articulation. Never second guess in psychometric testing: always be yourself.
Performing on the day: your body language, general behaviour, and influencing skills
Confidence will influence how you behave on the day, and this in turn will play a large part in the outcome. Influential traits include flexibility, optimism, and demonstration of an analytical approach.
You should assess and practise:
Body language—particularly achieving eye contact and smiling
Seating posture—particularly hand posture
Speech—particularly volume and depth of voice, speed of delivery, and length of answers (neither too long nor too short).
Above all, you should always be spontaneous rather than robotic.
Some general strategies
Always determine why a question has been asked, and remember that the interview is not the forum to express controversial views. Questions of fact require a brief demonstration of working knowledge—it is common for them to be relevant to topical issues or your specialty. Questions on opinions require identification of pros and cons, followed by a pragmatic and wise conclusion. In “approach” and “scenario” questions, identify the issue or problem and be aware of the processes entailed. Most paths lead to patient safety.
You should assume that virtually all questions are linked to standards. In response to questions on quality or performance in particular (such as those relating to Care Quality Commission standards, Payment by Results, and Commissioning for Quality and Innovation (CQuINS)), try to highlight the relevance of your answer to your specialty and to the interviewing trust.
Often there are different ways of asking the same question. It is may be worthwhile grouping mock or practice questions that you think should generate a similar response.
Questions investigating self reflection aim to measure your self awareness, standards, intellectual honesty, maturity, and dependability. These may include questions about the post, the specialty, stress, and your leadership qualities.
Knowing the political landscape
It is important that any important decisions you make as a consultant are bolstered by a sound working knowledge of political structures, and therefore the following may be referred to with relevance to your specialty:
Department of Health
Primary care trusts and commissioning groups
Governors and their roles
Trust boards and delegation of responsibilities to divisions, directorates, and your department.
Important events in modern healthcare history
Many recent events have shaped changes in process that may be relevant to the way departments work:
1983—Griffiths report: the introduction of general management
1989—Working for patients: “the internal market”
2000—The NHS Plan: A Plan for Investment, a Plan for Reform—key financial features, new contracts, and patient information and empowerment (including NHS Direct and patient advice and liaison services), performance targets (including the monitoring bodies the Commission for Health Improvement, Healthcare Commission, and Care Quality Commission)
Other reports: Tooke, Darzi, Kennedy, Francis
2010—The white paper Equity and Excellence: Liberating the NHS
Reasonably detailed knowledge of some key “governance” or “quality” items is essential for day to day survival as a consultant:
Concept of governance or quality itself
Patient experience and complaints
Patient safety: adverse healthcare events and risk, mortality and morbidity, infection control
Clinical effectiveness, including creation of policies, clinical audit, the role of the National Institute for Health and Clinical Excellence, specific clinical models such as Hospital at Night
Capacity and other legal and ethical issues
Finance, including Payment by Results; awareness of the trust’s basic financial duties; division and directorate; and your department
Appraisal, revalidation, performance management (including job planning), disciplinary processes
Medical education, including Modernising Medical Careers, role of clinical and educational supervision, risks of negative deanery feedback, continuing medical education for consultants
Staff welfare, including the European Working Time Directive, diary cards
Research and research governance.
Be aware of the key people and trust committees who deal with these topics.
Leadership and management
In our target driven and egalitarian times it has become apparent that genuine leadership, authority, and motivational skills are required rather than mere assumption of power. It is also apparent that our profession has not until now required a curriculum for leadership. This has in part been provided by the Medical Leadership Competency Framework1 (and the NHS Leadership Framework).
End of the interview
At the end of the interview, when you are asked, “Have you any questions?” you must choose your words carefully. It is quite acceptable to use this moment to correct errors or misunderstandings that may have occurred during the interview. It is equally acceptable to say, “I have no questions whatsoever.” It is not prudent to discuss financial or leave matters, as there will be appropriate opportunities at another time. Try to leave a lasting impression that is professional and courteous, and do not let nervousness take control of your exit. Top tip: use the exit door when leaving, not the broom cupboard. Good luck!
Competing interests: RG is the author of Succeeding in Your Consultant Medical Interview, published by BPP Learning Media, and delivers courses on preparation for consultant interviews. MG is medical publishing director of BPP Learning Media ().