Pesci: RMO and Registrar Interview Questions Australia

Tell us about your clinical experience and how it has prepared you for this position.

Two minutes aimed at the position: where you trained, the posts, the presentations you have managed, the procedures, and the supervision you have worked under. The panel is assessing fit for a specific role, so say what in your experience matches it and what does not.

What do you understand this position to involve, and what supervision will you have?

The scope of the role, the hours, the patients, the on call if any, and the named supervisor and how often you will see them. Say what you would do when the supervisor is not available. The panel scores whether you understand the autonomy the role carries.

What do you know about the Australian health system as it affects a doctor in this role?

Medicare and bulk billing, the referral pathways to specialists and hospitals, the PBS and prescribing rules, the state's notifiable conditions, and the local emergency and retrieval arrangements. Plain and accurate.

A patient asks you for a medical certificate for days they were not sick. What do you do?

Certify what you can verify and nothing else. Explain why, kindly, offer what you can honestly provide, and keep the relationship. Say what you would do if the patient pushed.

A patient's adult daughter phones asking for her mother's results. What do you do?

Confidentiality: the results are the patient's. Check whether the patient has consented to sharing, and if not, explain to the daughter that you need the patient's permission and offer to ask. Say what changes if the patient lacks capacity.

You are asked to do something outside your experience and your supervisor is not available. What do you do?

State the limit, do what is safe, use the advisory lines and telehealth, and refer or transfer if the patient needs it now. Tell the supervisor afterwards. The panel scores knowing the edge of your competence.

A 55 year old man presents to the practice with central chest pain for the last hour. Talk us through your assessment and management.

Recognise the emergency: call the ambulance early, aspirin, the ECG if available, oxygen only if hypoxic, analgesia, monitoring, and the transfer. The history and examination that matter, and the safety net if the pain settles and he wants to go home: he does not. Say what you would document and who you would tell.

A two year old is brought in by her mother with a fever of 39 and is miserable but drinking. What do you do?

The assessment of a febrile child: the observations, the source sought, the red flags for serious illness including the rash, the capillary refill, the breathing, the hydration. Treat what you find, give clear safety netting with the signs that mean return or an ambulance, and arrange review. Say when you would send the child to hospital.

A 40 year old woman tells you she has been feeling low for months and sometimes thinks she would be better off dead. How do you proceed?

Take it seriously and ask directly: intent, plans, means, previous attempts, protective factors, substance use. Assess the depression and the risk. Decide: a safety plan and close follow up with the mental health team involved, or urgent referral and the crisis service if the risk is high. Know the state's mental health pathway. Say what you would do if she refused help.

A result comes back on a patient seen yesterday showing a potassium of 6.8. The patient is not answering the phone. What do you do?

The result is urgent and the practice is responsible until the patient is reached: keep calling, use the emergency contact, consider whether the result is real, and if the patient cannot be reached, the police welfare check or the ambulance depending on the risk. Say what you would document and how the practice's results system should prevent this.

A 70 year old with diabetes, hypertension and chronic kidney disease comes for a routine review on eight medications. How do you approach the consultation?

What matters to the patient first, then the review: the control of each condition against targets, the medications for interactions and renal dosing, the preventive care due, the care plan and the team, and the follow up. Prioritise; not everything is done today. Say which medication you would look at first and why.

A 25 year old woman requests emergency contraception after unprotected sex two days ago. What do you do?

The options and their time limits, the assessment including the risk of existing pregnancy and the contraindications, the sexually transmitted infection screen offered, the ongoing contraception discussed, and the follow up. Non judgemental throughout. Say what you would do if she were sixteen.

A 60 year old man asks for a repeat of his sleeping tablets and his oxycodone, both prescribed by the previous doctor for years. What do you do?

Assess the indications and the dependence, check the state's prescription monitoring system, explain the risks plainly, do not simply refuse or simply continue, agree a plan toward reduction with support, and know the regulations on prescribing drugs of dependence in the state. Keep the relationship.

A patient presents with a cough for six weeks, weight loss and a smoking history. What do you do?

Cancer until proven otherwise: the examination, the chest X ray now, the bloods, the urgent referral pathway if abnormal, and the safety net if normal. Say what you would tell the patient and how soon you would see them again.

A mother brings her eight year old with a limp and a low grade fever. What do you do?

Septic arthritis and the serious causes of a limp must not be missed: the examination, the bloods, the imaging, and the same day referral to hospital if the criteria are met. Say what you would not do, which is reassure and review next week.

How does Medicare work for a general practice consultation, and what is bulk billing?

Medicare rebates for item numbers, bulk billing meaning the patient pays nothing and the practice accepts the rebate, the gap where the practice charges more, and the incentives that affect who is bulk billed. Plain and accurate.

When would you refer a patient to the emergency department rather than manage them in the practice?

Any patient who needs treatment or investigation the practice cannot provide in the time the condition allows: the chest pain, the septic child, the stroke, the suicidal patient at high risk. Say that you would send by ambulance where the patient is unstable and phone ahead.

What are your obligations around notifiable diseases and mandatory reporting?

The state's list of notifiable conditions and how to notify, mandatory reporting of child abuse under the state's law, and mandatory notification to AHPRA about practitioners. Know the names and the routes.