The foundation application programme is designed to test whether you will be a safe doctor who can make decisions even in difficult situations. There are several key concepts that are commonly tested. These concepts are useful when answering SJTs as they can form a framework for your decision to sit upon. For example if option A seems to put the patient first more clearly than option B then it is a better choice. We have provided a quick reference table containing many of the principles the SJT is designed to test, as summarised from official guidance and the GMC Good Medical Practice guide, and we discuss these principles in more detail with examples here.
As a foundation doctor you are expected to:
Put the patient first, treat patients as individuals and respect their dignity
This means you put patient care at the centre of your decisions and work together with them to come to the right decision. You should show them respect and empathise with their point of view. If a patient is angry at having to wait, you should demonstrate empathy by apologising and trying to rectify the problem.
Maintain patient safety
You should do this always. If a medication required by the patient has been missed for whatever reason, then your first duty is to ensure that the medication is given, and to apologise to the patient for the mistake.
Be committed to professionalism
This means that you take responsibility for your actions, and if necessary challenge others on their behaviour. For instance, if other members of staff, even those senior to you are behaving unprofessionally around a patient, you should intervene and ask them not to do so in front of a patient.
Understand the extent and boundaries of your professional responsibilities and work within your own limitations, asking for senior help when needed
You should be aware of your role as the FY1, and appreciate that you will often need to ask for help. If there is a situation that you feel is beyond your capabilities then your first port of call is normally your registrar, however the SHO or Consultant may also be able to help you.
Maintain working relationships, and work well in a team
In a team you should be trustworthy and reliable and demonstrate commitment and enthusiasm. You should work effectively with other doctors and in a multidisciplinary team. This should be done via a collaborative approach, respecting others’ views. You should offer support and advice to your colleagues and share tasks appropriately. It is also important to show that you understand your own role within the team and ask for help when you need it.
Teamwork has various applications and can be tested with scenarios involving other FY1s, (eg not turning up on time), nurses (eg the wrong dose of a medication you prescribed is given), senior doctors (eg a bully as a registrar). In these questions you should choose an option that demonstrates good communication and diplomacy, and shows an ability to maintain working relationships.
Demonstrate good verbal and written communication
Good verbal communication can be demonstrated through actively engaging with patients and colleagues in an equal and open dialogue and through active listening. Good written communication is concise and clear. Both should be adapted according to the context.
Cope well with pressure and make decisions in stressful conditions
An FY1 should be able to work under pressure, adapt to changing circumstances and manage uncertainty. You should remain calm when faced with confrontation from colleagues or patients.
This means you remain calm and in control of a situation regardless of how stressful it is. Emphasis is placed on the ability to make decisions under pressure. For instance if you are in a cardiac arrest, a good decision would be to ensure someone is running the arrest eg the registrar whilst you take the patient’s blood.
Be honest and act with integrity
You should display honesty and integrity at all times and be aware of confidentiality and ethical issues. Never lie. In the SJT it is probably safe to assume that any option that involves a lie will be an inappropriate response.
Respect a patient's right to confidentiality.
This includes: Keeping patient lists anonymised, logging out of the computer after viewing patient records, not leaving patient notes lying around, asking the patient if they are happy discussing things with friends or family present, not using family members as translators, not discussing matters over the phone with family members unless specifically given permission by the patient. If you have to breach confidentiality, you should always discuss it with the patient and a senior beforehand
(Sources include the foundation programme website and the GMC Duties of a Doctor which you should all take time to read)
Write these down on a piece of paper early in your practice for the SJT exam. Whenever you aren't sure which option is more appropriate see if one of the above principles applies and ask yourself which option allows you to best keep to these principles.
As a foundation doctor you are expected to:
Put the patient first, treat patients as individuals and respect their dignity
This means you put patient care at the centre of your decisions and work together with them to come to the right decision. You should show them respect and empathise with their point of view. If a patient is angry at having to wait, you should demonstrate empathy by apologising and trying to rectify the problem.
Maintain patient safety
You should do this always. If a medication required by the patient has been missed for whatever reason, then your first duty is to ensure that the medication is given, and to apologise to the patient for the mistake.
Be committed to professionalism
This means that you take responsibility for your actions, and if necessary challenge others on their behaviour. For instance, if other members of staff, even those senior to you are behaving unprofessionally around a patient, you should intervene and ask them not to do so in front of a patient.
Understand the extent and boundaries of your professional responsibilities and work within your own limitations, asking for senior help when needed
You should be aware of your role as the FY1, and appreciate that you will often need to ask for help. If there is a situation that you feel is beyond your capabilities then your first port of call is normally your registrar, however the SHO or Consultant may also be able to help you.
Maintain working relationships, and work well in a team
In a team you should be trustworthy and reliable and demonstrate commitment and enthusiasm. You should work effectively with other doctors and in a multidisciplinary team. This should be done via a collaborative approach, respecting others’ views. You should offer support and advice to your colleagues and share tasks appropriately. It is also important to show that you understand your own role within the team and ask for help when you need it.
Teamwork has various applications and can be tested with scenarios involving other FY1s, (eg not turning up on time), nurses (eg the wrong dose of a medication you prescribed is given), senior doctors (eg a bully as a registrar). In these questions you should choose an option that demonstrates good communication and diplomacy, and shows an ability to maintain working relationships.
Demonstrate good verbal and written communication
Good verbal communication can be demonstrated through actively engaging with patients and colleagues in an equal and open dialogue and through active listening. Good written communication is concise and clear. Both should be adapted according to the context.
Cope well with pressure and make decisions in stressful conditions
An FY1 should be able to work under pressure, adapt to changing circumstances and manage uncertainty. You should remain calm when faced with confrontation from colleagues or patients.
This means you remain calm and in control of a situation regardless of how stressful it is. Emphasis is placed on the ability to make decisions under pressure. For instance if you are in a cardiac arrest, a good decision would be to ensure someone is running the arrest eg the registrar whilst you take the patient’s blood.
Be honest and act with integrity
You should display honesty and integrity at all times and be aware of confidentiality and ethical issues. Never lie. In the SJT it is probably safe to assume that any option that involves a lie will be an inappropriate response.
Respect a patient's right to confidentiality.
This includes: Keeping patient lists anonymised, logging out of the computer after viewing patient records, not leaving patient notes lying around, asking the patient if they are happy discussing things with friends or family present, not using family members as translators, not discussing matters over the phone with family members unless specifically given permission by the patient. If you have to breach confidentiality, you should always discuss it with the patient and a senior beforehand
(Sources include the foundation programme website and the GMC Duties of a Doctor which you should all take time to read)
Write these down on a piece of paper early in your practice for the SJT exam. Whenever you aren't sure which option is more appropriate see if one of the above principles applies and ask yourself which option allows you to best keep to these principles.