The situational judgement test (SJT) tests your way of thinking and isn’t something you can cram for with intense revision a few days before the test. It assesses your capacity to understand real-world situations and to identify critical factors and appropriate behaviours in dealing with them. Questions do not require procedural or medical knowledge but do require a certain mindset as the test assesses certain key themes such as integrity, raising concerns, taking initiative, personal bias, pressure and prioritisation. SJTs are used widely in the medical and dental selection, including the selection of Foundation Doctors and Dentists, GPs and other medical specialities and hence it is important to develop the way of thinking required for this test very early on in your medical career as it stays with you for life.
Most universities will require at least a band 3 in this section of the UCAT, however, having a band 1 can give your application a boost if you are planning on applying to some of the top universities.
About the section
This section has
- 69 questions
- 22 scenarios
- Each scenario may have up to 6 questions associated with it
- 26 minutes
- Roughly 70 seconds per scenario
- About 23 seconds per question
Types of questions
This section is made up of ranking style and Multiple-choice questions (MCQs)
The MCQs are of the following two types.
- Appropriateness: After each scenario, you’ll be presented with certain responses. Each response to the scenario needs to be rated according to how appropriate it is in the context of the scenario.
You can be asked to choose one of four possible options-
- Very appropriate
- Very inappropriate
Or you can be asked to choose one of two possible options-
- Importance: Similarly, to appropriateness, you’ll get several responses/actions after each scenario, and you need to rate them on how important they are in the context of the scenario.
You can be asked to choose one of four possible options-
- Very important
- Of minor importance
- Not important at all
Or you can be asked to choose one of two possible options-
- Not important
- Example scenario: Beth is asking Grace (a third-year medical student) for medical notes of a patient who happens to be Beth’s friend as she is worried about her friend.
How appropriate would it be for Grace to give the notes to Beth?
Answer: Very inappropriate
This is because according to GMC guidelines, patient confidentiality should not be broken without patient consent. Handing over the notes would be unethical and would breach data protection laws. It could also lead to disciplinary action from the medical school. Confidentiality should only ever be broken when
- Required by law
- In the public interest
- To protect others from harm
You can read more about patient confidentiality and when to break it in this document.
Certain questions will require that you rate each response from four possible and others will require that you rate each response from only two possible options (four being the most common one). A few questions will also ask you to choose the most and least appropriate action to take in response to the situation, from the three actions provided. Since the SJT section tests your behavioural decision-making skills and your thought process, there is no clear-cut way to study for the SJT other than altering your way of thinking for the exam by starting practice about at least a month before the exam.
Tips to score highly in SJT
Go through the General Medical Practice handbook for medical students
Most of the themes in the SJT are picked up from this guide and the easiest way to get an idea of what sort of mindset you need to have for the test is to read the book. It shouldn’t take too long and it is not necessary to memorise each and every point but rather to get a general gist of what each point roughly means.
This document is almost like a blueprint for the situational judgement test as many of the themes present here are found in the SJT as well, so it is highly recommended to find some time to skim through it at the very least.
Make sure you understand the question and the underlying theme
With regular practice, you should eventually figure out the main themes such as confidentiality, professionalism, empathy, capacity, consent, team working, etc.
Even though you will have limited time in the test, make sure you take a few extra seconds out if required to properly understand the questions and whatever issue they might be highlighting. When reading the question, try to clarify what specifically is the element that needs your attention. Simply skimming through the scenario without properly figuring out what the issue is, will result in you being in a weaker position to tackle questions.
Don’t think of what you would do
The questions would usually give a scenario stating things like you are ‘a medical student’ or ‘a dental student’ or ‘a nurse’ or ‘a consultant’, etc. Ensure that you read the question thoroughly and then think from the point of view of whatever person the question says you are. For example, as a medical student you might not be able to do certain things (such as give a diagnosis) that a doctor can do, so be aware of this. Often the course of action that you would normally do might not be listed as an option, however, don’t let this distract you from the question. You have to focus on what is given and ensure you pick the option that seems the most ethical. Also, usually students tend to get the answers wrong when they make assumptions so be wary of doing this. Try to only focus on the information that is given and try not to use any prior knowledge about the subject.
Analyse the responses that are given and focus on how effective and appropriate they are.
Rate the response, not the scenario
Sometimes, SJT scenarios can be negative or positive, but the response might have the opposite effect. So, you have to ensure you don’t fall into the trap of rating your answer based on what the scenario says rather than the response. This section tests what your response would be to certain situations, thus highlighting whether or not you have the necessary skills to be a doctor if you are able to demonstrate key themes such as honesty, integrity, confidentiality, etc.
For example, the scenario says that a medical student messed up patient notes causing there to be confusion and distress on both the patient and the medical staff’s side. However, the response might say that the student acknowledged his mistake and apologised for the trouble caused. Even though the scenario itself was negative, this response demonstrates honesty and integrity (one of the key themes) and so is very positive.
Don’t think it’s the only action taken
Each scenario can have several responses that may vary in appropriateness or importance. However, you are not being asked what the absolute most important or appropriate thing to do would be but how appropriate or important a particular response would be, so don’t compare that response to other possibilities. For instance, in a certain scenario, you may think that doing something immediately to protect the patient’s dignity or safety is most important, however, for the patient’s treatment itself, something else would be more appropriate, but patient treatment might not be what the response is actually about so treatment is irrelevant to the scenario.
It’s easy to get caught in trying to figure out the ‘perfect’ answer to ensure you get the answer right, however, doing so will only end up wasting precious seconds you could have spent towards figuring out the next question. Remember, it’s about answering as many questions as possible and not about answering a few questions correctly. Questions can sometimes be very straightforward, and this tends to confuse students into thinking it could be a trick question so don’t mull on any question for too long as it can be easy to argue for and against any option based on different factors. If you are confused, just put in the answer you think is most appropriate at the time, flag the question, and move on. Once you have moved on from the question, don’t dwell on it and push it away from your mind as otherwise it will distract you from the next question and you might end up getting stuck in that as well.
Read the scenario you are given and go with what you think is the best option and move on. You are given half marks for being on the ‘right side’ (appropriate or inappropriate, important or not important) so as long as you are able to work out that, you will get at least half marks for the question.
If you have time remaining, you can always come back to the flagged questions and try to figure out the answer.
Last but not least…Practice, Practice, Practice!
The UCAT is your chance to show medical schools that you have what it takes to be a medical student and eventually a doctor one day. This is a test that does not particularly require a lot of prior knowledge so even if you didn’t do too well in your GCSEs or A levels, you can still ace the UCAT with enough practice and dedication. But remember that in one admission cycle, you can only sit this test once, so be sure you feel as prepared as you can be before you sit it.
The SJT mainly tests your judgement of different ethical or team scenarios and compares them to what actual doctors would be expected to do in each situation. So, the closer you get to this, the higher a band you get.
Even though SJT practice is usually passed on for practice in other sections like Quantitative Reasoning, it can be one of the easiest sections to improve in with enough practice. You can even find some podcasts online to listen to while you’re getting ready to go out or on the bus. A couple of helpful podcasts that go through example scenarios and how to ethically think about these are “Ethical Decision Making with the GMC” Part 1and Part 2. In the podcast, they go through some GMC guidelines and how to apply these to scenarios.
- There is no negative marking, so always have a stab at an answer.
- Allow at least one minute at the end of the section to at least make some quick guesses if you didn’t have time to get through all the questions.
- After you are done with a subsection of the test, forget about it once you move on to the next one. Thinking that you could have answered something differently will only eat into your time for the next section and do nothing to help you.
- Be ruthless with your time management, if you don’t know the answer, make a quick guess and move on. Actually finishing the section is more likely to get you a higher result than doing a few questions correctly.
- You can flag the question number and come back to it if you have time.
- You’ll be doing the exam on a computer, so practice on a computer – it’s more taxing on the eyes. It feels different and it is different.
- Mimic the conditions of the exam as much as possible! When you are practising, make sure to time yourself.
To summarise, Situational Judgement questions can seem tricky as it can be very hard to tell what the right answer would be but the trick is to not think about what you think is the right answer and to instead think about what the GMC/medical school would think is correct. This section can feel time-pressured if not enough practice and importance is given to the section beforehand. A lot of people focus more on the other sections of the UCAT as they believe SJT isn’t important enough, however, this does form part of your application to medical school and will be looked at. Therefore, with some time and effort spent on this section, you should be able to get a band 1 and help your application stand out. My best advice would be to join a formal course and do some practice questions from there.
Generally speaking, a competitive UCAT score would be getting 700+ in all 4 sections (verbal reasoning, decision making, quantitative reasoning, abstract reasoning) and a band 1 in SJT. If you want to have a competitive score on your UCAT, check out our brand new ‘Ace the UCAT’ course, which includes:
- 200+ lessons
- 20 hours of video lessons
- 350+ practice questions, with Dr Hilton walking you through the answers and the best way to tackle them
- Lots of support and help with the UCAT
- UCAT advice
If you want help getting into your dream university then also be sure to check out our Elite Coaching Programme. As part of this programme, students get in-depth help with the entire application process from whatever stage they join at till they get into the medical school of their choice. This is done through 1-on-1 mentoring and the founder of the course, Dr Ashley Hilton is always available for any questions. You can find out more about the Elite Programme here.
However, if you choose not to join the FutureDoc team and this article is the last time you engage with us then best of luck for the future and I hope you’re able get into the medical school of your choice!
Written By Muskaan Sharma