Succeeding at consultant interview: Performing on the day
Your body language, general behaviour, and influencing skills
Confidence will influence how you behave on the day, and this in turn will play a large part in the outcome. Influential traits include flexibility, optimism, and demonstration of an analytical approach.
You should assess and practise:
- Body language—particularly achieving eye contact and smiling
- Seating posture—particularly hand posture
- Speech—particularly volume and depth of voice, speed of delivery, and length of answers (neither too long nor too short).
Above all, you should always be spontaneous rather than robotic.
Some general strategies
Always determine why a question has been asked, and remember that the interview is not the forum to express controversial views. Questions of fact require a brief demonstration of working knowledge—it is common for them to be relevant to topical issues or your specialty. Questions on opinions require identification of pros and cons, followed by a pragmatic and wise conclusion. In “approach” and “scenario” questions, identify the issue or problem and be aware of the processes entailed. Most paths lead to patient safety.
You should assume that virtually all questions are linked to standards. In response to questions on quality or performance in particular (such as those relating to Care Quality Commission standards, Payment by Results, and Commissioning for Quality and Innovation (CQuINS)), try to highlight the relevance of your answer to your specialty and to the interviewing trust.
Often there are different ways of asking the same question. It is may be worthwhile grouping mock or practice questions that you think should generate a similar response.
Questions investigating self reflection aim to measure your self awareness, standards, intellectual honesty, maturity, and dependability. These may include questions about the post, the specialty, stress, and your leadership qualities.
Knowing the political landscape
It is important that any important decisions you make as a consultant are bolstered by a sound working knowledge of political structures, and therefore the following may be referred to with relevance to your specialty:
- Department of Health
- Primary care trusts and commissioning groups
- Foundation trusts
- Governors and their roles
- Trust boards and delegation of responsibilities to divisions, directorates, and your department.
Important events in modern healthcare history
Many recent events have shaped changes in process that may be relevant to the way departments work:
- 1983—Griffiths report: the introduction of general management
- 1989—Working for patients: “the internal market”
- 2000—The NHS Plan: A Plan for Investment, a Plan for Reform—key financial features, new contracts, and patient information and empowerment (including NHS Direct and patient advice and liaison services), performance targets (including the monitoring bodies the Commission for Health Improvement, Healthcare Commission, and Care Quality Commission)
- Other reports: Tooke, Darzi, Kennedy, Francis
- 2010—The white paper Equity and Excellence: Liberating the NHS
Reasonably detailed knowledge of some key “governance” or “quality” items is essential for day to day survival as a consultant:
- Concept of governance or quality itself
- Patient experience and complaints
- Patient safety: adverse healthcare events and risk, mortality and morbidity, infection control
- Clinical effectiveness, including creation of policies, clinical audit, the role of the National Institute for Health and Clinical Excellence, specific clinical models such as Hospital at Night
- Capacity and other legal and ethical issues
- Finance, including Payment by Results; awareness of the trust’s basic financial duties; division and directorate; and your department
- Appraisal, revalidation, performance management (including job planning), disciplinary processes
- Medical education, including Modernising Medical Careers, role of clinical and educational supervision, risks of negative deanery feedback, continuing medical education for consultants
- Staff welfare, including the European Working Time Directive, diary cards
- Research and research governance.
Be aware of the key people and trust committees who deal with these topics.
Leadership and management
In our target driven and egalitarian times it has become apparent that genuine leadership, authority, and motivational skills are required rather than mere assumption of power. It is also apparent that our profession has not until now required a curriculum for leadership. This has in part been provided by the Medical Leadership Competency Framework (and the NHS Leadership Framework).
End of the interview
At the end of the interview, when you are asked, “Have you any questions?” you must choose your words carefully. It is quite acceptable to use this moment to correct errors or misunderstandings that may have occurred during the interview. It is equally acceptable to say, “I have no questions whatsoever.” It is not prudent to discuss financial or leave matters, as there will be appropriate opportunities at another time. Try to leave a lasting impression that is professional and courteous, and do not let nervousness take control of your exit. Top tip: use the exit door when leaving, not the broom cupboard. Good luck!
- Spurgeon P, Klaber B, Green M. Becoming a better medical leader. BMJ Careers 31 Jan 2012. http://careers.bmj.com/careers/advice/view-article.html?id=20006444.
Robert Ghosh consultant physician, Homerton University Hospital NHS Foundation Trust, London, UK
Matt Green medical publisher director, BPP University College, London