Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)
The Four Domains Scoring Every Answer You Give — Even When The Question Never Mentions Them
Most IMG doctors prepare for NHS interviews by rehearsing answers to questions. That's necessary, but it isn't sufficient, because it misses something structural about how panels actually score.
Every answer you give, regardless of which question prompted it, is being mentally filtered through the four domains of Good Medical Practice. This is the GMC's own framework for what it means to practise medicine safely and professionally in the UK, and trained panel members are listening for it whether they say so or not.
One. Knowledge, Skills and Performance. Not just "do you know the clinical facts" — do you keep your knowledge current, recognise the limits of your competence, and know when to escalate rather than push past what you're actually trained for.
Two. Safety and Quality. Do you contribute to a culture of safety — incident reporting, learning from errors, participating in audit — rather than treating these as paperwork imposed on you.
Three. Communication, Partnership and Teamwork. Not generic "I'm a good communicator." Specific evidence of working across a multidisciplinary team, communicating clearly with patients and relatives, and respecting colleagues' expertise even when you disagree with them.
Four. Maintaining Trust. Honesty, fairness, and acting with integrity — including the Duty of Candour question covered this morning.
Here's what changes once you actually internalise this: instead of preparing twelve separate answers for twelve possible questions, you prepare evidence — real clinical stories from your own practice — and you learn to map any one of those stories onto whichever domain the question is actually probing.
A strong candidate can take the same underlying experience and use it to answer a teamwork question, a patient safety question, or a professionalism question, because they understand which domain each question is really testing.
This is the difference between memorising answers and understanding what's actually being assessed.
DM me "DOMAINS" and I'll send you the full framework mapped against common interview questions.
Post 3 at 11am: why "I want to work for your Trust because it's a great Trust" is the single most common answer that scores a 1 — and exactly what replaces it.
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