How to Approach Residency Scenario-Based Questions

Medical Residency Application & Interview Preparation Specialists

Here we’ll take a quick look at how to approach situational-style questions that you might encounter in a Residency interview. These kinds of questions will be familiar to you from having sat the CASPer in the past, although they may now have a more overtly clinical focus. The keys to success here are having a particular approach that works for you and is tried-and-tested, having practised this approach enough, and understanding what you’re being asked – or, in other words, what attributes you will be expected to show.

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Have a clear strategy

This is the first element to success. The following is a sensible strategy that will allow you to deal with most ‘in-person’ scenarios or situations.
– Speak to the other party in private, at a sensible time that doesn’t inconvenience them
– Use open questions and allow them to explain the situation / explain themselves / etc
– Ensure that you consider the background and context of the situation and explore this appropriately
– Ensure that you are empathetic and professional throughout
– Check-in with the other party whilst you talk and ensure both that you are understanding them, and that they are understanding you
– Progress to a solution that makes sense, and check this solution with them
– If necessary, speak to a senior figure to ensure that the actions you have taken are correct

Taking the steps above, this might mean an answer along the lines of, ‘I would speak to the nurse in private, if she wasn’t too busy at that point. I would make sure that no priority clinical tasks were being left undone due to our conversation. I would then ask her open questions to better understand the situation – this would allow her to explain why she was being rude, or if there had been a misunderstanding. Even if she became rude or aggressive to me too, I would remain calm and professional. I would explore whether she was alright in general, or if something in the background was affecting her professional life. I would then… etc.’ In other words, you should create a formula that works for you, and then follow it for all of these (very common) in-person situations.

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Focus on the core competency or attribute being assessed

In general, these kinds of questions are designed to check that you are professional, empathetic, and able to communicate with others in difficult situations. However, they might also probe your ethics, your resilience, or your commitment to the profession. Therefore, before you begin answering you should consider what the purpose of the question is. If the question were, ‘Imagine that your colleague is struggling with the demands of Residency. You are a PGY-1. How would you approach this?’ Your communication, your motivation, and your team working are being assessed. Therefore, your answer should touch on each of these areas. For example, you might say something like, ‘If my colleague was struggling, my first consideration would be their wellbeing, and the wellbeing of the patients that they were responsible for. As such, I would take the time to speak to them about the problem in private. I would ensure that they felt able to communicate with me, through allowing them to speak and being gentle and empathetic. I would ensure that my help felt welcome to them, etc.’ You would then need to focus on the core issue – their lack of motivation. You would need to understand this, focus on the background issues, and then develop a plan with them that worked. You might then want to speak to a senior resident or an attending as well.


You are a PGY-1. Your attending has come to work very hungover, and seemingly still a little inebriated. He looks dishevelled. He has a significant number of patients to see on the morning ward round. How would you deal with this situation?

You are a PGY-1 here. In your first few weeks you noticed that you were feeling a little out of your depth, and this hasn’t improved since. You’ve put off doing some important procedures and left them to others to do, as you felt worried that you wouldn’t be able to carry them out to a high enough standard. How would you continue in this situation?

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