The Clinical Judgement station in the 2027 anaesthetics CT1 interview is a 15-minute online station, preceded by five minutes of reading, marked out of 50 by two assessors across three domains: clinical judgement and decision making, reflective practice, and working under pressure.
Each assessor gives 5 marks per domain plus a global rating out of 10. A structured A to E answer with a named escalation point is what scores.
Reviewed and updated 10 September 2026. Every interview mark below is taken from ANRO's August 2026 applicant guidance and is the 2026 position; ANRO publishes the 2027 guidance before applications open on 22 October 2026. The 2027 Round 1 dates are confirmed by NHS England.
Key takeaways
- The Clinical Judgement station is one of two 15-minute stations and carries 50 of the interview's 100 marks, which is half of the 85% interview weighting, according to ANRO's August 2026 guidance.
- Two assessors each award 5 marks in three domains (15) plus a global rating out of 10, so 25 each and 50 for the station.
- You get five minutes of reading time before the station and may keep paper notes.
- A global rating of 1 from both assessors in this station, or a station total at or below 25% (12.5 out of 50), makes you unappointable whatever your other score.
- Assessors mark reasoning at the level of a doctor about to start CT1: a systematic A to E assessment, safe first steps, and an explicit point at which you call for senior help.
What is the clinical judgement station in the anaesthetics CT1 interview?
The clinical judgement station is the anaesthetics CT1 interview's clinical scenario station: 15 minutes with two assessors, after five minutes of reading, in which you assess and manage a deteriorating patient and then discuss your decisions.
ANRO's guidance names the three domains as clinical judgement and decision making, reflective practice, and working under pressure. The station is held online on Qpercom, and the scenario is typically a ward or perioperative emergency.
The reading time is five minutes in which you read the scenario before the assessors join. Paper notes are permitted, and the good candidates use the time to plan an answer rather than to re-read.
How is the clinical judgement station marked?
The clinical judgement station is marked out of 50: each of two assessors gives 0 to 5 in each of three domains and a global rating of 0 to 10, scored independently.
| Domain | Assessor 1 | Assessor 2 | Station total |
|---|---|---|---|
| Clinical judgement and decision making | 5 | 5 | 10 |
| Reflective practice | 5 | 5 | 10 |
| Working under pressure | 5 | 5 | 10 |
| Global rating score | 10 | 10 | 20 |
| Total | 25 | 25 | 50 |
These marks are the 2026 position from ANRO's August 2026 guidance, and ANRO's February 2027 guidance repeats them. The station is 50% of the interview, and the interview is 85% of your selection score.
The global rating score is an overall impression mark out of 10 from each assessor, awarded on top of the domains. It is 20 of the station's 50 marks, or 40%.
What do the three domains actually reward?
The three clinical judgement domains reward a safe structured assessment, honest learning from experience, and composure when the scenario gets worse, and assessors score each separately.
What scores in clinical judgement and decision making?
A systematic assessment, sensible differentials, proportionate first-line management and a clear escalation decision. Resuscitation Council UK's ABCDE approach is the structure assessors expect to hear.
What scores in reflective practice?
A real example where something went wrong or nearly did, what you changed, and how you know the change worked. Generic statements about "learning from mistakes" score in the middle.
What scores in working under pressure?
Prioritising when the scenario adds a second problem, delegating specific tasks to named people, and staying calm and audible. The assessors will often add pressure deliberately.
How should you use the five minutes of reading time?
Use the five minutes to write a plan, not a script: the presenting problem, the A to E findings you expect, your first three actions, your escalation point and your differentials.
Write the scenario's numbers down once so you can quote them. Then write the single sentence you will open with, because a confident first sentence steadies the whole station.
anaestheticinterview's 30 clinical judgement scenarios each open with a stem to plan from, so the reading-time habit can be rehearsed rather than improvised on the day.
In practice, candidates who spend the five minutes re-reading arrive with nothing on paper and stall at the first follow-up question.
Worked scenario: post-operative hypotension on the ward
A worked clinical judgement answer looks like this. You are the ward doctor overnight; a 68-year-old man, six hours after a laparotomy, has a blood pressure of 85/50 and a heart rate of 118, and the nurse is worried.
How do you open?
"This is a post-operative patient with hypotension and tachycardia, which is shock until proven otherwise. I would go to see him immediately, ask for help to be called, and assess him A to E."
What does the A to E answer contain?
- Airway: is he talking? If so the airway is patent.
- Breathing: respiratory rate, saturations, chest examination; high-flow oxygen while I assess.
- Circulation: pulse, blood pressure, capillary refill, the wound and drains for bleeding; two large-bore cannulas, bloods including a group and save and crossmatch, a venous gas for lactate and haemoglobin, and a 500 ml crystalloid bolus as NICE's intravenous fluids guideline describes, then reassess.
- Disability: conscious level, glucose, pupils.
- Exposure: temperature, abdomen, calves, and the drug chart for epidural or opioid effects.
Where is the escalation point?
"If he does not respond to the first bolus, or if I find bleeding, I would call the surgical registrar and the anaesthetic or critical care team now, using SBAR, and consider a further bolus while they attend."
Naming the point at which you call is the judgement being marked. Recognising a limit at CT1 level scores; managing alone does not.
What are the differentials?
Haemorrhage, sepsis, an epidural or opioid effect, cardiac causes such as myocardial infarction or arrhythmia, and hypovolaemia from poor intake. Say them, then say which the findings favour. The free anaestheticinterview article on the deteriorating patient in recovery works through the same list.
What does the reflective follow-up sound like?
"I saw a similar patient as an FY1 where I delayed calling because I wanted more information. Since then I call early and gather information while help is on its way." That is reflective practice with a change.
What are the common ways to lose marks?
Candidates lose clinical judgement marks by skipping structure, quoting drug doses they are unsure of, delaying escalation, and answering as a consultant rather than a CT1.
- Jumping to a diagnosis before A to E, then having nothing to fall back on when the assessor changes the picture.
- Bluffing a dose or a threshold. Probity concerns are a veto in their own right; say you would check.
- Escalating "eventually". The assessors want a named trigger and a named person.
- Forgetting the second problem when pressure is added, such as a second sick patient or a missing bed.
How does the global rating interact with the domain marks?
The global rating is awarded separately from the three domains and carries 20 of the station's 50 marks, so a candidate who is structured but flat can score well on domains and lose ground on impression.
However, the two ratings also carry the veto: a 1 from both assessors in the same station makes you unappointable. Safety, honesty and composure protect the global rating.
How do you practise the clinical judgement station?
Practise the clinical judgement station by answering unseen scenarios aloud, timed, with the escalation sentence said out loud every time, and get each answer marked against the three domains.
anaestheticinterview's bank has 30 clinical judgement scenarios carrying 313 questions, marked by AI against the ANRO domains, plus four free knowledge articles including the deteriorating patient in recovery and perioperative anaphylaxis.
That said, the free material takes you a long way: ANRO's guidance, Resuscitation Council UK's ABCDE page and NEWS2 from the Royal College of Physicians cover the structure every scenario needs.