Emergency medicine has two entry points and they are interviewed differently. ACCS emergency medicine at CT1 is recruited alongside core anaesthetics and uses that two station format. ST3 emergency medicine is recruited separately and uses the three station physician higher specialty format. Candidates applying to both in the same year need to prepare for two different interviews, and candidates applying to one need to know which.
ACCS at CT1
Acute care common stem is a three year programme covering emergency medicine, acute medicine, anaesthetics and intensive care, leading into ST3 of the chosen parent specialty. Entry at CT1 is through the anaesthetics and ACCS recruitment, which means the interview is the one published by the anaesthetics recruitment office: two online stations of fifteen minutes with two assessors each, about fifty minutes in total.
The clinical judgement station gives you a scenario five minutes before you enter, with notes allowed, and is pitched at FY2 level. It assesses clinical judgement and decision making, reflective practice and working under pressure. No anaesthetic or emergency medicine knowledge is expected; the scenario is an acutely unwell ward patient and the assessors are scoring your approach, your escalation and your reflection.
The general interview station covers 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 the specialty. A veto applies for unsafe or unprofessional answers.
What to prepare for the CT1 interview
For the clinical station, the acute scenarios that recur: the large upper gastrointestinal bleed, the post operative patient who is breathless and tachycardic, the collapsed patient on the ward, the drowsy patient in recovery with a low respiratory rate, the tiring asthmatic, the anaphylaxis call. Practise using the five minutes of reading time well: identify the problem, the immediate steps, who you would call, and what you would reflect on afterwards, then write them down in the order you will say them.
For the general station, evidence of commitment to emergency medicine and to the ACCS route specifically: why both emergency medicine and the breadth of ACCS, what you know about the programme and its exams, teamwork and leadership examples at your level, and three current NHS pressures linked to emergency care.
ST3 emergency medicine
The ST3 interview assumes you have completed core training or equivalent and are ready to lead resus. Three stations of ten minutes: suitability and commitment, a clinical scenario at registrar level with communication scored inside it, and an ethical scenario. The clinical scenarios are the undifferentiated shocked patient, major trauma, the septic child, the tiring asthmatic, the combative head injury. The ethical scenarios are the overdose patient who wants to leave, the fifteen year old asking for contraception, the overcrowded department, and confidentiality with the police.
The difference in level
At CT1 the assessors want a safe FY2 who escalates early and reflects. At ST3 they want a registrar who decides, runs the team and holds the conversation with the family. The same scenario, a hypotensive patient with no history, is answered differently: at CT1 you assess, start treatment and call for help; at ST3 you lead the resus, allocate the team, decide on the next step and phone the consultant with a plan.
If you are applying to both
Prepare the clinical scenarios once and practise answering each at two levels. Prepare separate commitment answers: at CT1 the question is why ACCS and emergency medicine; at ST3 it is why emergency medicine as a career and how you will sustain it. Keep the formats clear in your head on the day, because the timings, the number of stations and the presence of reading time all differ.