Clinical scenario: NHS Interview Questions for International Doctors

A deteriorating patient scenario, usually in two parts, is in nearly every interview, with escalation and the limits of your role scored explicitly.

Updated 26 October 2026

How to answer

Go to see the patient, assess with ABCDE, treat what you can, escalate early with a clear SBAR, and know what an SHO or registrar does and does not do alone. A safe answer that asks for help early scores well.

Frameworks: SAFER, with ABCDE inside Assess and SBAR for the handover at Escalate

  • 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 →
  1. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    You are called to see a patient who is deteriorating on the ward. Talk us through your approach.

    Go and see them now, ABCDE, treat what you find, review the chart and the trend, decide how unwell they are, and escalate early with SBAR. Say what you would do while waiting for the senior and when you would call again.

  2. Asked in most interviewsUsually asked by the consultant colleague in the specialtySAFER

    Describe a difficult clinical scenario you have been involved in. How did you contribute?

    One real situation, what your role was, what you did and what the outcome was. Say what you learned about your limits and about asking for help.

  3. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    When would you escalate to a senior colleague, and how would you do it?

    Early, whenever the patient is deteriorating, whenever you are unsure, and whenever the plan is beyond your competence. By phone with SBAR, stating what you want them to do, and in person if the patient is very unwell. Say that you would rather escalate once too often.

  4. Often askedUsually asked by the clinical director or clinical leadSAFER

    A nurse calls you about a patient with chest pain and a low blood pressure. What do you do, and what do you ask for?

    Go now, ABCDE, oxygen, access, ECG, bloods, fluids if appropriate, treat what you find, and call the senior early with SBAR. Ask the nurse for the observations and the chart on the way. Say what would make you call an arrest.

  5. Often askedUsually asked by the consultant colleague in the specialtySAFER

    A nurse asks you to prescribe a medication you do not know, for a patient you have not met. What do you do?

    Do not prescribe it until you know what it is and have seen the patient. Look it up, check the indication and the dose, see the patient, and ask a senior if unsure. Say how you would explain the delay to the nurse.

  6. Often askedUsually asked by the clinical director or clinical leadSAFER

    How do you prioritise when you have several unwell patients and you are the only doctor available?

    Triage by acuity using the observations, see the sickest first, delegate the simple tasks to the nurses, and escalate early for help with the rest. Say what you would ask for and when you would review the others.

  7. Often askedUsually asked by the consultant colleague in the specialtySAFER

    Describe a time your awareness of a developing situation let you avoid a problem.

    An example where you noticed a trend before it became an emergency: observations drifting, a result that did not fit, a patient who looked wrong. Say what you did and what was avoided.

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