The IMT interview has a published shape and a public mark scheme, which means the questions are more predictable than candidates expect. There are two stations with the same two assessors, about 25 minutes in total, and seven scored areas: application and achievements, suitability, ethics and governance, clinical assessment and management, handover, and communication in each station. This guide walks through the questions that appear in nearly every interview and what the assessors are listening for.
Station 1: the two minute presentation and suitability
The first station opens with a prepared presentation of about two minutes on why you are suited to internal medicine. Panels then ask follow up questions drawn from it and from your application. The questions that recur:
- Why internal medicine, and why now?
- What have you done to show your commitment to a career in medicine, and what is your strongest achievement?
- What makes you suited to being a medical registrar, and what will you find hardest?
- Which medical specialty are you aiming for, and why?
- Tell us about an audit, quality improvement project or teaching activity in your portfolio and what it changed.
The scoring here rewards evidence. "I enjoy the variety" scores nothing; a taster week, an audit on the acute take, a course you paid for yourself, and an honest sentence about what you will find hard all score. Treat the presentation as an argument for your suitability with three supporting points, not a chronology, and rehearse it against a timer until it lands at one minute fifty.
Station 1: the ethics and governance scenario
The second half of station 1 is a scenario given without reading time, often linked loosely to the clinical scenario in station 2. The common ones:
- A patient with capacity refuses treatment for a life threatening condition.
- You discover a colleague prescribed the wrong dose of insulin and the patient became hypoglycaemic.
- A relative asks you not to tell the patient their cancer diagnosis.
- Your registrar asks you to discharge a patient you do not think is ready.
- What is the duty of candour, and when have you applied it?
Assessors score a safe, structured approach: patient safety first, then gather information, then escalate through the right route, then support the people involved. Name the obligations that apply, including candour and capacity law, and say what you would do rather than what should happen. The follow up is usually "and what if they still refused?" so have a second step ready.
Station 2: the clinical scenario and the handover
Station 2 gives a clinical scenario with investigations, and asks for assessment, diagnosis and management, then a handover to the medical registrar. The scenarios recur year to year: sepsis, diabetic ketoacidosis, hyperkalaemia, stroke, acute coronary syndrome, COPD exacerbation, acute kidney injury, the acutely confused patient, and the sick patient with a DNACPR question attached.
Answer as a medical registrar on the post take ward round would: ABCDE, the immediate treatment, the investigations you want and why, the diagnosis and its differentials, the management plan, and the escalation. Then the handover, which is scored separately. Use SBAR and say plainly what you want the registrar to do. Candidates lose marks here by giving a good clinical answer and a vague handover.
How to prepare in three weeks
Week one: write your presentation and the examples for the suitability questions, in your own words, and say them aloud. Week two: work through the ten recurring clinical scenarios until the structure is automatic, and practise the handover for each. Week three: ethical scenarios with a partner or an AI panel that probes, because the second step of an ethical answer is where candidates separate.
The IMT interview is competitive, with nearly nine thousand applicants for under two thousand posts in 2025, but it is also one of the most preparable interviews in medicine. The questions above are the ones to have ready before anything else.