Why Interviewers Use Situational Judgement Questions

Situational judgement questions (SJQs) are increasingly common in medical school interviews. They are designed to assess your professionalism, ethical reasoning, decision-making, and empathy. Unlike factual questions, SJQs do not test your medical knowledge; instead, they evaluate how you would respond to complex, real-world scenarios as a future doctor.

Medical schools use these questions because doctors frequently face situations where there is no single “right” answer, and the best approach depends on prioritising patient safety, ethical principles, and effective communication. SJQs provide insight into your judgement, reasoning, and ability to act professionally under pressure.

Key Principle: Safety First

The priority must always be the safety of your patient, other staff, and yourself. Never take a risk in an interview scenario, even if in real life you might consider a low-probability gamble (e.g., a 1–5% chance). Interviewers are assessing your judgement and professionalism, so always err on the side of caution. Demonstrating a commitment to safety shows maturity and awareness of the responsibilities of a doctor.

Types of Situational Judgement Questions

SJQs can appear in different formats:

1. Written Scenarios – You read a scenario and are asked how you would respond or rank potential actions.

   • Example: “You notice a colleague consistently arriving late to clinic. What would you do?”

2. Verbal/Interview Scenarios – Presented as a live discussion during the interview.

   • Example: “A patient refuses treatment that could be life-saving. How would you handle this?”

3. Ethical Dilemmas – Questions that test moral reasoning and professional principles.

   • Example: “You witness a senior doctor behaving unprofessionally towards a patient. What would you do?”

Medical Example: Safety-Critical Scenario

Scenario:
You are assisting in surgery when you notice that your senior surgical colleague has turned up to work smelling of alcohol and visibly shaking. You are responsible for supporting them during the procedure.

Key Priorities:

1. Patient safety – proceeding with surgery under these circumstances is unsafe.

2. Staff safety – protect yourself and other team members.

3. Professional and ethical responsibility – escalate the situation appropriately.

Crucial Point on Escalation:
Irrespective of whether your colleague listens to you and stops, you must always escalate. This is for two reasons:

• Patient safety – even if your colleague seems to comply, the risk remains that unsafe behaviour could recur in this or future situations. Escalation ensures the issue is formally addressed.

• Supporting your colleague – escalating allows them to access help they might not be willing or able to seek themselves at that moment. Proper escalation can prevent harm and provide a pathway for professional support and intervention.

How to Approach Situational Judgement Questions

1. Identify the Key Issues

Recognise the primary concerns in any scenario:

• Risk to patient safety

• Risk to staff or yourself

• Professional duty to escalate or act appropriately

• Emotional or ethical implications for all parties involved

Always prioritise safety first. Even if a scenario seems low risk, err on the side of caution in an interview.

2. Consider Your Priorities

Your response should balance:

• Patient, staff, and personal safety – absolute priority

• Professionalism – integrity, accountability, escalation where appropriate

• Communication and empathy – understanding others’ perspectives

• Teamwork – knowing when and how to involve others appropriately

3. Structure Your Response

A clear structure is essential in verbal SJQs:

Step 1: Acknowledge the scenario and main concern

• “This situation presents a serious patient safety risk, and my primary concern is ensuring the patient is safe.”

Step 2: Immediate actions

• Take steps to protect the patient and staff.

• Intervene directly if safe to do so.

• Escalate appropriately to senior staff, supervisors, or hospital protocols.

Step 3: Reflection and empathy

• Acknowledge the difficulty for the colleague while maintaining professionalism:

• “I recognise this is a sensitive situation, and I would handle it respectfully, but patient safety must remain the priority.”

Step 4: Offer follow-up

• Ensure the patient is cared for.

• Provide information or support for the colleague as appropriate.

Common Pitfalls

1. Ignoring safety – never compromise patient, staff, or personal safety.

2. Delaying escalation – always escalate serious concerns; it may save lives and provide help to colleagues.

3. Focusing on the colleague rather than patient welfare – patient safety comes first.

4. Jumping to conclusions – consider all stakeholders and consequences.

5. Overcomplicating responses – clarity, structure, and prioritising safety matter most.

Practice Example

Scenario:
A junior doctor is drowsy and confused while preparing medications on the ward.

Structured Response:

1. Identify the immediate risk to patient safety.

2. Intervene to prevent errors, without confrontation.

3. Escalate to a senior nurse or supervisor.

4. Reflect on the colleague’s wellbeing and provide support after ensuring patient safety.

Notice that safety is always the first step, followed by professional escalation and empathetic handling.

Key Takeaways

• Safety first – patient, staff, and personal safety are always the top priority.

• Always escalate serious concerns, both to protect patients and to help colleagues access support.

• Structured approach – acknowledge → assess → act → escalate → reflect.

• Empathy and professionalism – balance compassion with firm, appropriate action.

• Clarity over perfection – clear, logical responses are valued more than a “perfect” answer.

Final Advice

Situational judgement questions test your ability to think like a doctor before you have medical knowledge. Practicing both medical and everyday scenarios, reflecting on ethical principles, and using a structured approach will help you respond confidently. Never take a risk on safety in an interview scenario, and always escalate serious concerns, even if your colleague seems to respond. Demonstrating safe, thoughtful, and empathetic decision-making is exactly what interviewers are looking for.