The Savvy IMG

A guide to the WAST interview [ARCHIVED]

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WAST interview tips widening access to specialty training for international medical graduates

The WAST programme has been closed since the start of the COVID-19 pandemic. This article is for historical information only and should not be used to make any plans for the future. Please check the official websites for any updates.

Updated: April 5, 2020

WAST is a fantastic opportunity for overseas doctors to meet the requirements for application to ST1 or CT1 of UK specialty training while also gaining eligibility for Round 1 of specialty recruitment.

Success in getting this post will depend on how well you meet the WAST person specifications (job criteria), and your performance at the interview.

In this article, we take a closer look at the what the interview involves, how to prepare, why the Medical Interview book is a must-have, and how the interview impacts your application.

What is the format of the WAST interview?

The WAST interview can only be attended face-to-face in the UK. It will last around 40 minutes and consists of three stations. Each station will have 2 or more panel members who will score your performance. This score is then used to determine whether you pass the interview stage and whether you get a final job offer.

 

What are the 3 stations?

1. Psychiatry Communication Scenario Interaction with a patient (10 minutes)

The basic scenario is this: you are a Foundation Year 2 Doctor on an orthopaedic ward. Jan Smith has been admitted to hospital this morning as a day case for a knee arthroscopy to be done under general anaesthetic. You will be provided with additional information about the full scenario a week ahead of the interview. 

During this interview station you will have ten minutes with the patient but you can finish earlier if you wish. 

Likely panel members: 2 Psychiatrists, 1 simulated patient

2. Psychiatry Debrief Station (12 minutes)

For the first 5 minutes of this station, you will be asked to reflect on your interaction with the patient in the previous station.
 
Then for next seven minutes, you will be asked questions on the topic of self-harm.
 
Likely panel members: 1 Psychiatrist, 1 General Practitioner

3. Acute Clinical Scenario (12 minutes)

You will be presented with a scenario prior to starting the interview. The panel will ask questions exploring your clinical understanding and suggested management. You will need to demonstrate your systematic approach to the immediate assessment and treatment of a critically ill or injured patient. 

The panel may expect you to use a recognisable systematic approach similar to that described within ALS / ILS / PHTLS algorithms.

Likely panel members: 2 General Practitioners

How can one prepare for the interview?

Each station will require a separate approach however overall the emphasis will be on patient safety. If you have already passed PLAB 1 & 2 then you will be well prepared for the interview as you are already familiar with how these stations are conducted in the UK, and the acute clinical scenarios that can come up.

I have not personally attended the WAST interview, but having attended several interviews in the UK which have so far all led to job offers, and with Kimberly having attended specialty training interviews with a good outcome (ranked 96th percentile nationwide for Ophthalmology ST1), here is how we would prepare. This is exactly how we advised IMGs to prepare previously which led to a good outcome! So we hope it helps you!

Related: 10 ways to prepare for your first job in the NHS as an IMG

1. Psychiatry Communication Scenario Interaction with a patient

The full scenario to this station will be provided to you one week before the interview. Make sure you receive it and that you read it fully!
 
Underline the specific instructions about what you are being asked to do in the station. If you asked to explore the patient’s concerns then do not start taking a detailed history.
 
Identify the communication challenges presented in the scenario and read up on and how to address them. Common challenges include:
 
  • Discussing a sensitive issue
  • Raising a concern about a sensitive issue 
  • Managing the patient’s reaction eg. anger and denial
  • Breaking bad news about a diagnosis, outcome, cancellation of a procedure etc.
There are several UK-based articles and books on these subjects. Here are a few to get you started:
 

2. Psychiatry Debrief Station

To prepare for the first part of this station, familiarise yourself with the steps in the Gibb’s cycle of reflection. The debrief will involve going through each step and answering related questions.
 

Here are some resources:

For the section about self-harm, read up on how to assess capacity and suicide risk. Focus on how you can safely decide whether a patient is safe to be discharged, or if they must be kept in hospital as they are a danger to themselves.
 
You may find these helpful:
 

3. Acute Clinical Scenario

All the panel really want to know in this station, is that you are a safe junior doctor prepared to work in the NHS.

This means that you are able to make a competent initial evaluation and management plan for an unwell patient, you alert your seniors to patients that require senior review early on, you are aware of how the medical and nursing team works, and you are familiar with your roles and responsibilities – as well as your limitations – as an NHS junior doctor.

We personally found the book The Hands-on Guide to the Foundation Programme (Amazon link) to be extremely valuable for this.

Attending a course like ILS or ALS will familiarise yourself with the official treatment algorithms that will show the interview panel you are up-to-date with clinical standards. You can familiarise yourself with the treatment algorithms in the diagrams found on a quick Google search. Be sure to follow the UK-based ones.

 

A must-read book for interview prep

This specific book is recommended again and again by virtually all UK doctors as a high-yield reference to prepare for any medical interview. It covers all the major themes including ethical scenarios, difficult communication, team dynamics, and team conflict. I used this book during my preparation to my Standalone FY2 interview and I would say it played a huge role in helping me land a post in London. I highly recommend it to anyone attending a UK interview!

It will definitely help you prepare for WAST and any future interviews for specialty training (residency). Get yours delivered to your doorstep here on Amazon.

What happens after the interview?

Your performance in each station will be scored, and then the total score will determine whether you pass the interview stage. You will not be required to submit a portfolio so the only thing that contributes to your score is the interview, so if you get invited to interview, be sure to do your best!

Passing the interview stage means that you are “appointable” for a WAST post. Congratulations! But this is not yet a guarantee that you will get a job.

What happens next is you get added to the “talent pool”. You remain on this list for a maximum of 18 months. When the next WAST jobs are due to start, the office will review all the applicants who want to start on that date and rank them by score. Applicants will be offered jobs according to the following priorities:

  1. Rank
  2. Preferred location

Related: 10 ways to prepare for your first job in the NHS as an IMG

Let’s say there are 4 applicants on the list for February 2020 who all want to be placed in East Midlands but there are only 3 slots in that region:

  1. Dr. A has a rank of 4 but is subject to RLMT. 
  2. Dr. B is ranked 15 and is also subject to RLMT.
  3. Dr. C is ranked 20 and also subject to RLMT.
  4. Dr. D has a rank of 30 and is exempt from RLMT.

The job offers will go like this:

Dr. D will be offered a job in East Midlands first, followed by Dr. A and Dr. B.

Dr. C will not be offered a place in East Midlands as there are only 3 spots and all 3 have been taken.

Dr. C will be offered a place in the next location they’ve included on their preference list. Again, this is if there are any spots available after those who are exempt from RLMT and those who ranked higher have been placed. 

If there are no available jobs, Dr. C will not get a job for February 2020. If Dr. C only listed February 2020 as a preferred start date, then they will not get a job at all even though they passed the interview. If they listed other possible start dates, like August 2020 and February 2021 then they may get a place. If Dr. C does not get a job offer for 18 months, they will be removed from the talent pool and they will have to reapply if they are still eligible.

Frequently asked questions

No. Since the interview involves an actor simulating a patient, can only be conducted in person.

According to the official guidance, interviews are held each February and September.

Mancunian Suite
Manchester City Football Club
Etihad Stadium
Etihad Campus
Manchester
M11 3FF

Everything you need to know about applying for WAST can be found on the official WAST website. If you can’t find the answer you’re looking for, it’s best to contact the official recruitment office through email wast.recruitment@hee.nhs.uk 

WAST has numerous benefits for IMGs. You can read about them here and decide for yourself whether it’s suitable for you.

Further reading

Disclosure: There are some affiliate links in the article above. This means that at no additional cost to you, we may earn a commission if you make a booking or purchase by clicking on the link. We only recommend products and services that we use ourselves or have proven success amongst IMGs.

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Meet the Team

Hi, we’re Drs Nick & Kimberly Tan, the two IMGs behind The Savvy IMG. We write comprehensive guides, create courses, and provide one-to-one guidance to help other overseas qualified doctors on their journey to the UK.
We have scoured the official guidance to put these posts together, but we can make mistakes! If you spot anything that is incorrect, please get in touch and we’ll put it right.
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