Unaccredited, or service, registrar posts are how most doctors gain the experience that gets them into accredited training, and the interview for them looks like the RMO interview because it is the same template. What changes is the level the panel expects and the questions about where you are going. This guide covers what is added and how to answer at registrar level.
The same format, a higher bar
The panel, the twenty minutes and the four to six questions are the same. The opening question, the behavioural questions and the error questions are the same. The differences are in the clinical scenario, which is pitched at a registrar who leads a team overnight, and in the questions about your path into training, which the panel asks because they want a registrar who will be worth training and who will stay the year.
The clinical scenario at registrar level
The stem may be the same post operative patient with chest pain, but the panel expects more: that you lead the response, delegate to the resident, decide on the next step, and call the consultant with a plan rather than a question. For a surgical unaccredited post, the deteriorating post operative patient with the leak on the CT and the decision about theatre. For a medical post, the septic patient not responding to fluids and the call to intensive care. For an emergency post, the undifferentiated shocked patient with the team allocated.
Say what you would decide and why, when you would call the consultant and what you would ask for, and what you would do while waiting. The panel scores decision making and escalation with a plan; the resident's answer, assess and call, is not enough here.
The path into training
Expect: why this specialty; what you have done to prepare for the training programme; where you are up to with the college's requirements and examinations; what you would do if you were unsuccessful in the next training round; and why this hospital's unaccredited post rather than another. The panel wants to hear a plan: the exam you will sit this year, the research or audit you will complete, the referees you are building, and the honest acknowledgement that unaccredited years are a route and not a destination.
Answer with specifics. "I am sitting the primary in February and completing an audit on the unit's surgical site infection rate" scores; "I hope to get into training" does not.
Supervision and teaching
Unaccredited registrars supervise residents and interns, so the panel asks: how do you support a junior who is struggling; how do you give feedback; how would you run a ward round; and what teaching have you done. STAR examples at the level of someone who has led juniors, with respect for the nurses who will tell you when a junior is in trouble.
The service questions
Unaccredited posts carry service load, and panels ask about it honestly: can you meet the on call requirements; how do you manage fatigue; what would you do if the roster became unsafe. Answer yes plainly, with a strategy for sustainability and a clear statement that you would raise an unsafe roster with the head of department.
Scope of practice
Registrars are asked to do more, and the question about a task outside your scope is more likely here. Say that you would state the limit, offer what you can safely do, find the person who can, and if the patient needed it now and no one else was available, do what is safe and escalate. Tell the consultant either way. Panels want a registrar who knows the edge of their competence.
Showing you are ready for accredited training
The unaccredited interview is also an audition for the training programme, because the same consultants often sit on the selection panel later. Show the things the college will score: structured clinical reasoning, early escalation, honesty about errors, teaching, audit, and a professional response to the difficult supervisor or the impaired colleague. Treat the interview as the first step of the selection process it leads to.
Preparing
Take the RMO question set and raise each answer a level: lead rather than attend, decide rather than defer, supervise rather than be supervised. Prepare the training plan with dates. Prepare the service questions with a strategy. Then practise with someone who probes for the decision in the clinical scenario and for the specifics in the training plan.