Entry to psychiatry training in Australia involves two separate interviews, and candidates who prepare for one are surprised by the other. The RANZCP interview decides whether the college will accept you as a trainee; the state health service interview decides whether you get a Stage 1 position. In New South Wales the health service interview is a one way recorded video. This guide covers the questions that recur in both and what each panel is listening for.
The two step process
You apply to the college and to the health service separately. The college interview is a panel of four or five, usually including a trainee, for twenty to thirty minutes, assessed alongside your CV, three referee reports and a short written statement. The published weighting from the interview covers foundations of the practice of psychiatry, interpersonal and communication skills, diverse experiences and skills, and your performance in the interview itself. The health service interview is a merit selection panel or, in New South Wales, a recorded video in which each question appears on screen and you answer to camera within a time limit.
The college interview
Why psychiatry. The panel wants the experiences that led you here, in terms of patients and moments rather than abstractions, and evidence that you understand what the work is.
What you understand the work of a psychiatrist to be, and how it differs from what you have seen as a resident. The biopsychosocial model, formulation rather than diagnosis alone, long term relationships with patients, work with families and teams, and the legal framework.
What experiences and skills, inside or outside medicine, you will bring. Diverse experience is scored. Previous careers, languages, community work, creative or sporting pursuits that shaped how you understand people, all count if you can say what they taught you.
How you look after yourself, and how you will know when you need help. Psychiatry is emotionally demanding and the panel wants a real strategy.
Self awareness questions: what are your biggest misconceptions about psychiatry, what will you find hardest, how do colleagues see you.
Clinical and ethical scenarios: a patient who hears voices telling them to harm themselves, the acutely agitated patient on the ward, a patient with depression who refuses treatment and wants to leave, a patient who discloses they have harmed someone, the first episode of psychosis.
The health service interview
The same questions as any registrar selection, with psychiatric scenarios: why this service, teamwork, conflict, errors, cultural safety, and the clinical emergencies. Risk assessment after an overdose, the agitated patient, delirium versus dementia versus depression in the elderly patient, lithium toxicity, clozapine and the sore throat, the new mother who does not feel bonded.
In the recorded format, each question gets one timed answer with no probes, so cover every part of the question yourself and close before the time ends.
What the panels are listening for
The college panel is looking for someone who thinks about people, can describe a patient as a person, has insight into themselves, and has chosen psychiatry for reasons that will last. The health service panel is looking for a registrar who is safe with the agitated patient, knows the mental health legislation, assesses risk properly, and works with the multidisciplinary team.
Answering the clinical scenarios
For risk assessment: static and dynamic risk factors, protective factors, the patient's intent and plans, collateral history, the mental state examination, and the decision about safety, with the legislation named where it applies. For the agitated patient: safety of everyone, de escalation first, the least restrictive option, medication if needed with the right choices and monitoring, and the documentation and review afterwards. For capacity and refusal: the assessment, the legal framework in your state, and the involvement of the consultant.
Preparing
Write a two minute answer to each college question with a patient or an experience in it. Prepare the clinical scenarios with structure and the legislation. Read the college's selection page and the health service's flyer for your state. If you are in New South Wales, practise the recorded format: question on screen, timer, no interruption. Then practise both interviews aloud, because the questions overlap but the panels want different things.