The CT1 anaesthetics and ACCS interview is one of the most transparent in UK recruitment. The format, the timings, the scoring domains and even the fact that the clinical scenario is given to you in advance are all published by the recruitment office. That means the questions are predictable, and this guide walks through the ones that come up in nearly every interview and what the assessors are scoring in each.
The format
Two online stations on the Qpercom platform, fifteen minutes each, with two assessors in each station scoring independently and then giving a global rating. The whole thing, including identity checks, takes about fifty minutes. The total is scored out of 100 and a score of 60 is required to be appointable. A veto can be applied for an answer that is unsafe or unprofessional, which overrides the numbers.
The two stations test different things and are prepared differently.
The clinical judgement station
You are given the scenario before the station starts, with five minutes to read it and make notes, which you can bring in. The scenario is an acutely unwell patient, pitched at FY2 level. No anaesthetic knowledge is expected or scored. The three domains assessed are clinical judgement and decision making, reflective practice, and working under pressure.
The scenarios that recur year after year:
- You are the SHO on call and are fast bleeped because a patient has vomited a large volume of fresh blood. Then the blood pressure falls and he becomes drowsy.
- A patient in recovery after a hip replacement is drowsy with a respiratory rate of six and small pupils.
- A patient two days after a laparotomy is tachycardic, hypotensive and oliguric.
- A patient in the emergency department with severe asthma is tiring.
- An anaphylaxis call goes out on the ward and you arrive first.
- A nurse tells you a patient has received ten times the intended dose of an opioid.
- A patient with a head injury is combative and will not keep oxygen on.
- A patient refuses a blood transfusion before an operation that may need one.
The assessors ask you to describe your approach, then probe: what if the pressure is 80, who do you call and what do you tell them, what would you do differently next time. The questions about reflection and pressure are explicit, so prepare them: what would you reflect on afterwards, how would you keep yourself effective while the registrar is in theatre.
The general interview station
Four areas are published: your training to date, your commitment to the specialty, your experience of working in and leading teams, and your knowledge of the NHS as it affects anaesthetics and ACCS. The scored domains are professional behaviour and communication, teamwork, and commitment to specialty. The questions that recur:
- When did you first realise you wanted to do anaesthetics, and what have you done since to test that?
- What have you done to demonstrate commitment to anaesthetics or ACCS?
- Talk us through your training to date and what has prepared you for this post.
- Tell us about a time you worked well in a team, and a time you led one.
- What do you know about the anaesthetic training programme, the stages and the FRCA exams?
- Which parts of anaesthetics do you think you will find hardest?
- What challenges does the NHS face at the moment, and how do they affect anaesthetics and theatres?
- What would you do if you were not appointed this year?
Commitment is scored on evidence: a taster week, time in theatre or intensive care, a course, an audit on pain or perioperative care, a conference, membership of a trainee group. Say what each taught you. For the NHS question, link the pressures to the specialty: the workforce census and its shortfall in anaesthetists, theatre productivity and the waiting list, anaesthesia associates, perioperative medicine.
What the assessors are listening for
In the clinical station, a safe and systematic approach with early escalation, a clear handover using SBAR, honesty about the limits of an FY2, and genuine reflection. In the general station, evidence of commitment rather than enthusiasm, examples where your own role is clear, and an understanding of the specialty's place in the NHS.
A three week plan
Week one: the ten clinical scenarios, each talked through aloud as the SHO, with the escalation and the reflection prepared. Week two: the general station answers, one minute each with a specific in every one, and the NHS pressures linked to anaesthetics. Week three: timed practice of both stations with someone who probes, including practising the five minutes of reading time, because using it well is a skill in itself.
ACCS candidates prepare the same interview; the commitment questions ask about the ACCS route and the parent specialty, so have an answer for why both.