How many stations does the CT1 anaesthetics interview have?

Two, according to the Royal College of Anaesthetists CT1 applicant guidance for August 2026: a clinical judgement station and a general interview station. Each lasts 15 minutes, is scored by two assessors, and carries 50 marks, giving 100 in total.

What score is appointable at the CT1 anaesthetics interview?

The applicant guidance states a minimum of 60 out of 100 across the two stations. A global rating of 1 from both assessors in one station triggers a discussion with the clinical lead about a veto, and a candidate can be vetoed even above the cut-off for dangerous decisions.

Should I say a diagnosis before I say what I would do?

Say the first action first, then the working diagnosis. ANRO's clinical judgement descriptors score urgency, structure, prioritisation and a plan of action; a differential list on its own demonstrates none of those, however accurate it is.

Is it a weakness to say I would call for senior help?

No. ANRO's typical descriptor includes 'likely with senior support available' and the outstanding one includes 'seeks team input'. Not calling is what concerns assessors. Name the role you would call and what you would ask them to do.

What if I do not know a drug dose in the scenario?

Say you would check it on the emergency algorithm or with the pharmacist and move on. The station is marked on judgement, reflection and composure, and a wrong dose stated confidently reads as a safety concern rather than a memory lapse.

How do I use the 5 minutes of reading time?

Write the one-sentence headline, the first three actions and the person you will call. Those three notes carry the first minute of the answer, and the applicant guidance allows you to take notes into the station.

Structuring a Spoken Answer — CT1 Anaesthetics Interview Clinical Judgement Answer

A spoken answer at the CT1 anaesthetics interview should open with a one-sentence headline, walk an A to E assessment out loud, name who you would call, and close with what you learned. ANRO's 2026 scoring descriptors reward exactly that shape: structure that is maintained as the scenario develops, correct prioritisation, a contingency plan and calm decisions under challenge.

Key takeaways

The clinical judgement station is 5 minutes of reading and 15 minutes of interview, scored by two assessors on three domains at 5 marks each plus a global rating out of 10, giving 50 marks.
ANRO's Clinical Judgement descriptor for a top score reads 'excellent structure to answer, correctly prioritised tasks, provides clear plan of action', so structure is scored, not just content.
A global rating of 1 from both assessors in one station can veto an otherwise appointable candidate; appointable is 60 out of 100.
The four moves that fit the descriptors: headline answer, A to E out loud, named escalation, reflection.
Say what you would do and who you would call before you say what the diagnosis might be; assessors mark decisions, not differential lists.
anaestheticinterview's bank of 340 questions with AI-marked spoken practice exists to rehearse this shape until it is automatic.

What does the clinical judgement station actually score?

The clinical judgement station scores three domains, Clinical Judgement and Decision Making, Reflective Practice and Working Under Pressure, each out of 5 per assessor, plus a global rating out of 10 per assessor.

The Royal College of Anaesthetists CT1 applicant guidance for August 2026 states each station lasts 15 minutes, with 5 minutes of reading before the clinical judgement station. Two stations give 100 marks, and the interview carries 85 percent of the selection score.

ANRO's 2026 scoring guidance describes a typical candidate as 'working at Foundation Doctor level', and an outstanding one as 'working beyond the level of Foundation Doctor' who 'fully appreciated the urgency of the situation and seeks team input'. That is the bar, and it is not a consultant's bar.

What is the four-move structure for a spoken answer?

Headline, assess, escalate, reflect. A spoken answer to any clinical judgement scenario at the anaesthetics interview can be built from those four moves, in that order, and each move maps to a scored descriptor.

Headline: one sentence that names the problem and the first action. 'This is a patient with a threatened airway in recovery, so I go to the bedside now and call for help while I assess.'
Assess: A to E spoken aloud, treating each problem before moving on, which is the Resuscitation Council UK ABCDE principle.
Escalate: who you call, by name of role, and what you ask for. 'I would call the on-call consultant anaesthetist and ask them to come now.'
Reflect: what you would document, report and learn, which is the Reflective Practice domain in the same station.

In practice, the headline is what most candidates skip. They start assessing before they have said what they think is happening, and the assessors cannot tell whether the candidate has 'appreciated the urgency', which is the first line of ANRO's descriptor.

How do you talk through an A to E assessment without sounding like a checklist?

Attach a finding, a threshold and an action to each letter, rather than listing the letters. The Resuscitation Council UK ABCDE guidance says to treat life-threatening problems before moving to the next part of the assessment, so say the treatment as you go.

For example: 'Breathing: I would count the respiratory rate, and the Resuscitation Council UK guidance calls a rate above 25 a marker of illness, so if it is 30 I give high-flow oxygen at 15 litres a minute now and reassess.'

That sentence shows a decision, a threshold and a reassessment in twenty seconds. A recited 'A, B, C, D, E' with no numbers or actions attached scores as 'unstructured in thought and planning', which is ANRO's descriptor for a 1.

When and how should you escalate in a spoken answer?

Escalate early, out loud, and by role. ANRO's outstanding descriptor for clinical judgement includes 'seeks team input', and the typical descriptor includes 'likely with senior support available', so naming help is scored, not penalised.

Say it in the first minute of the answer, not at the end: 'While I assess, I ask the nurse to fast-bleep the on-call anaesthetic registrar and bring the emergency trolley.' Then keep assessing. Calling for help does not end your answer; it runs alongside it.

Use the Resuscitation Council UK's SBAR structure for the call itself: Situation, Background, Assessment, Recommendation. Assessors often ask you to make the call in the room, and a candidate who can say SBAR in four sentences is demonstrating the communication the global rating describes.

How do you handle the scenario changing halfway through?

Expect the change, name it when it comes, and re-run the headline. ANRO's Clinical Judgement descriptor rewards a candidate who 'always reviewed the situation' and is 'always alert to symptoms and signs which may destabilise patient or developing scenario'.

When the assessor says the saturations have fallen, or a second patient needs you, say what has changed and what it means: 'That is a deterioration despite oxygen, so this is now a peri-arrest patient and I put out a 2222 call.' Then start A to E again from the top.

The Working Under Pressure descriptor for a 5 reads 'maintained calm perspective throughout, clear task prioritisation and decision making'. The change in the scenario is where that mark is won or lost, so slow your voice down rather than speeding it up.

What do the assessors mean by a contingency plan?

A contingency plan is what you will do if the first plan fails, said before it fails. ANRO's descriptor for a 1 in clinical judgement is 'failed to think ahead, no contingency plan', and a 5 is 'demonstrates forward planning'.

The phrase to use is 'if that does not work'. 'I give a 500 ml crystalloid bolus over less than 15 minutes, as the Resuscitation Council UK guidance suggests for a hypotensive adult; if the blood pressure does not respond I repeat it and ask for senior help.'

That is one plan, one fallback and one escalation in a single breath, and it is the difference between 'produced a firm plan' at level 3 and 'decisive and appropriate' at level 5 in ANRO's own words.

How long should each part of the answer take?

Aim for the headline in ten seconds, the first A to E pass in about two minutes, and leave the assessors to steer the remaining time. Fifteen minutes is longer than most candidates expect, and a station usually holds two or three scenario turns plus a reflective question.

Silence while you think is fine for a few seconds; say 'let me think about that' rather than filling the gap. What costs marks is the opposite: talking continuously through a differential while the patient in the scenario is still hypoxic.

Use the 5 minutes of reading time to write three things: the headline sentence, the first three actions, and who you will call. Those notes carry you through the first minute, which is the minute assessors form their impression in.

How do you bring reflection into a clinical answer?

Close the clinical answer with one sentence on what you would document, report and change, and have a real example ready when the assessors ask for one. ANRO's Reflective Practice descriptor for a 4 or 5 asks for an example the candidate has reflected on and 'how they have used reflection to change practice'.

That said, do not force the reflection into the clinical part unasked. The domain is usually tested with its own question, and the descriptor also scores understanding of feedback, sharing learning beyond the local team, and awareness of GMC guidance on being a reflective practitioner.

The example that scores is specific, personal and changed something: an airway that was harder than you expected, what you did, what you now do differently, and who you told. A generic 'I always reflect' scores as ANRO's 'poor example of scenario to demonstrate reflective practice'.

What are the common mistakes in a spoken clinical answer?

The commonest mistake is answering a different question from the one asked: a candidate asked 'what do you do first' who gives a differential diagnosis has not answered. The others are predictable and avoidable.

Reciting drug doses you are unsure of. The station is not a pharmacology test, and a wrong number is worse than 'I would check the dose on the emergency algorithm'.
Never naming who you would call. 'I would escalate' without a role is not a plan.
Losing the structure when the scenario changes, which ANRO scores as 'started with organised thought and structure but was not maintained'.
Claiming you would manage alone. The descriptors reward insight into your own limitations, and a CT1 who does not call is a safety concern.
Being 'hesitant when challenged' or, worse, arguing. The Working Under Pressure descriptor scores 'flexible and calm when challenged' and 'effective strategy to deal with disagreement'.
Speeding up under pressure. Assessors hear the pace before they hear the content.

How this comes up at the CT1 anaesthetics interview

Structuring a spoken answer is not a scenario in itself; it is the vehicle for every scenario in the clinical judgement station, and it is scored through the three domains directly.

Clinical judgement and decision-making: the headline plus A to E with actions attached demonstrates 'excellent structure to answer' and 'correctly prioritised tasks' in ANRO's descriptor.
Reflective practice: a closing sentence on documentation and learning, plus one real example that changed your practice, meets the 'good example of scenario they have reflected upon' descriptor.
Working under pressure: naming the change in the scenario calmly and re-running the structure meets 'maintained perspective through developing scenario'.

Rehearse the four moves aloud on unfamiliar scenarios until the shape survives a change of direction. The 340 questions on anaestheticinterview are built for that, with spoken practice marked against the same domains the assessors use.

Structuring a Spoken Answer for the Anaesthetics Interview