The ST1 paediatrics interview is two online stations of about 45 minutes in total, covering four scored domains of up to ten minutes each: clinical reasoning, communication, professionalism and commitment. The communication domain is a scenario with a parent played by an assessor, which is the part candidates most often underprepare. This guide covers the questions and scenarios that come up in nearly every interview.
Commitment to paediatrics
- Why paediatrics, and what have you done to show you are committed to it?
- What makes you suited to working with children and families, and what will you find hardest?
- What do you know about the RCPCH Progress curriculum, the MRCPCH exams and the length of training?
- Tell us about an audit, QI project or teaching activity relevant to child health.
- Paediatrics has pressures on rotas and out of hours work. How will you sustain a career in it?
Commitment is scored on evidence: a paediatric rotation and what it taught you, a taster in neonates or community paediatrics, a child health audit, a course, a conference, a role with children outside medicine. Name what you will find hard honestly: the out of hours load, the sick child who deteriorates fast, safeguarding, the length of training. Know the curriculum's structure and the exam timings in two sentences.
The clinical scenarios
Pitched at an ST1 who will be the first doctor to see a sick child, with escalation scored explicitly. The scenarios that recur:
- The six week old with a fever of 38.5 who is feeding poorly, then becomes mottled and lethargic.
- The four year old with a fever, a non blanching rash and a capillary refill of four seconds.
- The two year old who has been fitting for ten minutes on arrival.
- The twelve year old with type 1 diabetes, vomiting, with a glucose of 30.
- The eight month old who is wheezy, feeding poorly, with a respiratory rate of 70.
- The three day old who is jaundiced and sleepy.
- The five year old with a limp and a low grade fever.
- The child who develops anaphylaxis on the ward.
- The newborn who is not breathing at delivery.
Answer with a structured assessment, the immediate treatment with the paediatric specifics (weight based doses, the fluid calculation, the cerebral oedema risk in DKA, the benzodiazepine pathway for the fitting child), the escalation to the registrar and the consultant, and the conversation with the parents. Say what you would do if the first step did not work.
The communication scenario
An assessor plays the parent and stays in role. The scenarios that recur:
- Telling a parent their baby has a heart murmur and needs an echo.
- The mother angry that her child has waited four hours in the emergency department.
- The father who refuses to let you examine his child and wants to leave.
- Explaining why a child with bronchiolitis does not need antibiotics.
- Beginning the conversation that a blood test suggests leukaemia.
- The teenager who asks you not to tell her parents she is pregnant.
Listen first, acknowledge the feeling before the facts, use plain words, give information in small pieces, check understanding, and agree the next step and a named contact. Adapt: the angry parent needs acknowledgement and a plan; the frightened parent needs calm and information slowly; the parent refusing examination needs to be understood before being persuaded.
The professionalism scenarios
- A two year old has bruises of different ages and the parents' account does not fit.
- Parents refuse a blood transfusion for their child on religious grounds.
- A fifteen year old wants contraception and does not want her parents told.
- A colleague appears unwell and is covering the neonatal unit tonight.
These test safeguarding, consent and Gillick competence, and a safe response to a colleague. The child's welfare is paramount; you gather information without accusing, involve the senior and the safeguarding team early, document carefully, and know the legal routes. Say what you would say to the parents, because that is usually the follow up.
What the assessors score
In clinical reasoning, a structured and safe approach with early escalation and paediatric specifics. In communication, listening, adaptation and plain language. In professionalism, child safety and knowledge of the frameworks. In commitment, evidence and insight.
Preparing
The nine clinical scenarios talked through aloud with the paediatric specifics and the escalation. The six parent conversations practised with someone who stays in role and pushes back. One minute answers to the commitment questions with a specific in each. Then full timed runs, because the assessors will probe and the parent will not make it easy.