Pain and palliative medicine: Specialty Training Interview Questions Australia

The pain and palliative medicine questions that sit on top of the specialty training core: clinical scenarios, the system and governance questions specific to the specialty, and presentation titles.

Updated 24 October 2026

The structures these questions are marked on

ETHICS Establish the facts and capacity, Think through the four pillars and name the tension, Hear the other side fairly, Identify two or three options, Choose a patient centred action with the next step, Safeguard and document. Full guide →
SAFER See the patient, Assess systematically with ABCDE, Fix what you can and decide, Escalate with a clear request in SBAR or ISBAR, Review: the patient told, the handover, the documentation and what you would do if the first plan failed. Full guide →
The What it is in a sentence, Why it matters with a fact, What it means for this organisation and specialty, What I would do at my level and how I would measure it. Full guide →

Motivation

Evidence of commitment over enthusiasm: rotations, courses, audits, exams sat. Know the programme's stages, exams and rural requirements. Say what you would bring to a rural site, not just that you are willing to go.

Asked in most interviewsUsually asked by the head of department
Why pain medicine, or why palliative medicine, and what experiences brought you here?
The experiences in terms of patients: the one whose pain you could not fix and what you learned, the death you were present for and what it taught you. Then what you have done to test the choice. Avoid abstractions about suffering.
Asked in most interviewsUsually asked by the staff specialist colleague
What do you understand the biopsychosocial model to mean in practice, and how have you used it?
A patient in whom the biology, the psychology and the circumstances all mattered, and what you did about each: the medication, the psychology referral, the work or housing or family issue addressed. Say what changed when all three were treated.
Asked in most interviewsUsually asked by the head of department
What do you know about the training programme, its requirements and its assessments?
The structure, the requirements including the primary fellowship for pain medicine, the assessments and the supervised practice. Two accurate sentences, then what will be hardest.
Often askedUsually asked by the staff specialist colleague
This work carries emotional load and slow progress. How will you sustain yourself, and how will you know when you need support?
A strategy and an escalation: supervision, peer support, the debrief after a hard death, life outside the unit, knowing your warning signs, and who you would tell. Say that burnout in this work is quiet and that you would watch for it.
Often askedUsually asked by the head of department
Tell us about your experience working in a multidisciplinary team with psychologists, physiotherapists and nurses.
A real example: the team, your role, what the psychologist or physiotherapist or nurse saw that you did not, how the plan changed, and the outcome for the patient. Say what you learned about leading without being in charge.

Communication

One real conversation, stepped through, with the outcome. For the family refusing analgesia or treatment, explore the belief, involve an interpreter or cultural liaison, explain without pressure, and find the acceptable option. Practise ISBAR until it is automatic.

Asked in most interviewsUsually asked by the staff specialist colleagueSPIKES
A patient with chronic back pain is angry that you will not increase their opioids. Talk us through that consultation.
Acknowledge the pain and the anger first and mean it. Find out what the pain is doing to their life. Explain the evidence plainly: more opioid does not mean less pain and brings harm. Offer what can help: the multidisciplinary plan, the alternatives, the focus on function. Hold the line with respect, book the follow up, and keep the relationship.
Asked in most interviewsUsually asked by the head of departmentSPIKES
A family want their dying mother to have fluids and antibiotics that will not help. Have that conversation.
The goals of care, what the treatments would and would not do, the patient's wishes if known, the comfort that will be given, and the family's fear of abandonment addressed directly. The consultant involved. Say what you would do if they refused to accept it.
Often askedUsually asked by the staff specialist colleagueSPIKES
A patient asks you directly how long they have to live. What do you say?
Find out why they are asking and what they want to know. Honesty with ranges, not false precision, the uncertainty acknowledged, and what you are watching for. Link it to what they need to know for. Stay with the reaction and offer to talk again.
Often askedUsually asked by the head of departmentSPIKES
A patient asks about voluntary assisted dying. How do you respond, and what are your obligations in this state?
Respond with respect and curiosity: find out what lies behind the question and whether palliative care can address it. Give information as your state's law allows. Know your obligations including those of the conscientious objector. Involve the team and the consultant, document, and continue palliative care whatever the decision.

Ethics and professionalism

For the supervisor, stay professional, use the supervisor of training and the college channels, and keep patients safe. Define cultural safety as the patient's experience and give your own actions. Know mandatory notification and open disclosure.

Asked in most interviewsUsually asked by the head of departmentETHICS
A patient with cancer pain in a nursing home is receiving inadequate analgesia because staff fear opioids. What do you do?
Assess the pain, prescribe what the patient needs with the appropriate route and the breakthrough doses, educate the staff about the evidence and the safety of appropriate opioid use in cancer pain, involve the palliative care team, and review. Say that fear of opioids causes suffering as surely as overuse.
Often askedUsually asked by the staff specialist colleagueETHICS
A patient asks you to document a pain condition to support a compensation claim you do not think is justified. What do you do?
Document what you find, accurately and fully including the uncertainty, and nothing you do not find. Explain that your report is your honest assessment and may or may not help the claim. Keep the relationship.
Often askedUsually asked by the independent chair or consumer representativeETHICS
How do you provide culturally safe end of life care to an Aboriginal patient and their family?
The wish to die on country, the family's role in decisions, the Aboriginal liaison officer and the community health service, the practices around death and the body, and the humility to ask rather than assume. One example if you have one.

Clinical scenario

Systematic assessment, treat what you can, escalate early and clearly even when the consultant is distant, use retrieval and telehealth where they apply, and say what you would do afterwards. A safe answer that asks for help beats a clever one that does not.

Asked in most interviewsUsually asked by the head of departmentSAFER
A patient with metastatic cancer has uncontrolled pain despite escalating opioids and is now drowsy and confused. What do you do?
Opioid toxicity or an accumulating metabolite, a new cause of pain, or a complication: assess the whole patient, the renal function, the drug history. Reduce or rotate the opioid, treat the delirium's cause, add the adjuvants, involve the team, and talk to the family about what is happening. Say what you would not do: simply escalate further.
Asked in most interviewsUsually asked by the staff specialist colleagueSAFER
A 45 year old presents with three years of back pain, is on high dose opioids, is not working and is depressed. How do you assess and plan care?
Assess the whole person: the pain, the function, the mood, the opioid dependence, the work and the compensation context. The plan: the multidisciplinary programme, the slow negotiated opioid taper with support, the adjuvants, the psychology, the return to activity. Say how you would keep the patient engaged when the plan is not more opioid.
Often askedUsually asked by the head of departmentSAFER
A patient at the end of life becomes acutely agitated. What do you do?
Terminal agitation: the reversible causes sought and treated where appropriate (pain, retention, constipation, hypoxia, a drug), the family reassured and supported, and the medications in the terminal agitation protocol titrated to comfort. Say what you would tell the family and that you would review often.
Often askedUsually asked by the staff specialist colleagueSAFER
A patient develops opioid induced hyperalgesia. How do you recognise and manage it?
Recognise it: pain that worsens as the opioid rises, more diffuse, with allodynia. Confirm the pattern, reduce the opioid rather than increase it, rotate if needed, add the adjuvants, and explain to the patient why less may mean better. Say that it is often missed and treated with more.
Often askedUsually asked by the head of departmentSAFER
A patient on a ketamine infusion becomes hallucinated and distressed. What do you do?
Stop or reduce the infusion, make the environment safe and calm, a benzodiazepine if needed, reassurance, and the review of the dose and the indication. Say what you would tell the patient and that the hallucinations will pass.

System knowledge

Know the programme's requirements in detail. Name three current pressures and link each to your specialty. Be able to explain clinical governance and the standards most relevant to your work in a sentence each.

Often askedUsually asked by the head of departmentSYSTEM
What are the main gaps in pain or palliative care services in Australia, including in rural areas?
Rural access, the community palliative care workforce, the gap for Aboriginal patients, the waiting lists for pain services, and the cost of multidisciplinary care. Say what a trainee can do about one.
Often askedUsually asked by the staff specialist colleagueSYSTEM
How do community palliative care, hospital teams and hospices fit together in this state?
The names and how they work in your state: the community teams, the hospital consult services, the inpatient units and hospices, the specialist palliative care advice lines, and where the gaps are. Say what you have seen work.

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