The Situational Judgment Test, or SJT, is one of the most important exams you will sit in medical school. It comprises 50% of your application to the UK Foundation Programme and can make all the difference to your overall score. We’ve compiled our top 10 tips to excel in the SJT, taken from several high scoring applicants in 2018.
1. Start preparing early
You can prepare for the SJT. It’s all about understanding the core material in the GMC’s Good Medical Practice guidelines and studying the practice questions and answers on the official UKFPO website. This exam is as important as any medical exam you have sat, so treat it as such. Dedicate one night a week to it, ideally starting 3 months beforehand.
A study reviewing the use of SJT type tests (more common in USA than the UK) stated that “SJTs might be prone to faking, practice, and coaching effects”, which although a potential problem with the exam format, plays into the hand of a hard-working individual who prepares and practices.
2. Books and courses aren’t essential
Remember that those running courses or writing books do not have any insider knowledge. The practice papers found on the UKFPO website and GMC Good Medical Practice are your most reliable resources. The UKFPO states the SJT is designed to “reduce the effects of coaching”, so take all courses with a pinch of salt.
3. Spend time on the wards
The SJT was originally designed to test your decision-making skills and predict your behaviour on the wards as a doctor. The more time you spend shadowing FY1s on the wards and immersing yourself in their working life, the more familiar the SJT scenarios will be. The SJT assumes that you have already become familiar with the ward environment. The more you see how junior doctors deal with these scenarios, the easier it is to visualise the scenario set in the exam questions, and to decipher good decisions from the bad!
4. Learn GMC Good Medical Practice
To excel in the SJT, you need to think and decide as the GMC thinks and decides. The GMC Good Medical Practice is how those who set the exam decide which questions meet the standard. Know it well! Treat it like a revision textbook. The more familiar you are with its content, the easier it is to rank the responses against its guidance. Ask yourself “What would the GMC model FY1 do based on this information alone?”, and try to identify which of the key attributes required of a junior doctor are being tested in each question.
5. Use the UKFPO website past papers as your revision material
Don’t leave the past papers as one-off practices before the exam. Do them more than once! The rationale given in the answers is also key revision material, so that you can understand what the GMC prioritises. Often candidates find it is easier to choose the most appropriate (1) and least appropriate (5) options, but find the ones in between harder to discern. The past papers answers with their rationale explanations will help you refine this skill by exemplifying GMC priorities. You’ll pick up the common themes quickly.
For example, in the practice papers, any decision which prioritises patient safety comes first. When dealing with difficult colleagues, escalating the situation to a senior always comes after talking to the person directly themselves, unless patient safety is being compromised.
The SJT also prioritises acting to put a situation right if you are able and safe to do so, and not doing anything is always the least appropriate option.
6. Practise using the printable marking sheet
Get familiar with using the marking sheet, which is available on the UKFPO website, and incorporate this always into your timed tests and questions. Remember that the real exam is a paper exam using this marking sheet, so try to replicate this set up when you practice.
7. Practising your timings but don’t rush!
You have 2 hours and 20 minutes to answer 70 questions. Two-thirds of the marks come from section one (usually the first 43 questions), whereas one third come from section two. Some suggest you aim to spend 1 hour 30 minutes on section one, and 40 minutes on section two. This exam is a marathon, not a sprint. If you practise aiming for 90 seconds per question, you will have plenty of time on the day.
8. Read the question more than once
There are a few different types of questions you can be asked in the SJT.
The most common is to rank in order of appropriateness the following responses from “Most Appropriate” (1) to “Least Appropriate” (5). Others question types for section one, as outlined on the UKFPO website, include ranking the order in which task should be done (1- first, 5- last), or the extent to which you agree with a statement about the scenario (1- most agree, 5- least agree). In the second section, the most common question asks you to choose three most appropriate responses from an extended list. However, they may ask you to choose the three most important considerations to take. It is worth taking the time to read the question properly.
9. Useful strategies
When ranking responses in section one, look for a logic flow between your answers. Sometimes adding the phrase “and if not, I would…” can be a helpful way to test this. Another useful strategy for section two is to insert the word “and” between your three answers and seeing if the answers make sense joined together.
10. Beware of decision fatigue
When you’re asked to make so many decisions in a short space of time, your brain suffers from decision fatigue. Those 2 hours and 20 minutes are tiring. Ensure you have plenty of water, and make time for brief 30-second thinking breaks to clear your head. You need your brain to be working effectively for the whole time, so treat it with care!
The SJT is your opportunity to shine in comparison to your peers. If you have spent time on the wards and are familiar with Good Medical Practice, there is no reason you should not excel.
1. Filip Lievens, Helga Peeters, Eveline Schollaert, (2008) “Situational judgment tests: a review of recent research”, Personnel Review, Vol. 37 Issue: 4, pp.426-441, https://doi.org/10.1108/00483480810877598, accessed May 2018