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IMT · Station 1

IMT ethics, professionalism and governance

The published ethics function starts with an unseen hypothetical and may test how you apply GMC principles in your own clinical workplace.

Last verified: 6 October 2026Parent guide: IMT

The current 2027 structure includes ethics, professionalism and governance in Station 1. Original scenarios below are not recalled or official interview questions. Teaching additions: sources checked on 14 October 2026; the inherited article retains its existing verification date.

ContentsHow to approach it

How to approach it

What a strong answer needs to show

Define the immediate risk

Separate what needs action now from what needs investigation or later governance review.

  • Check the patient and immediate facts before debating principle.
  • Recognise capacity, consent, confidentiality, candour and discrimination where relevant.
  • Do not promise secrecy if safety or a professional duty requires disclosure.

Name the route to help

The answer should work in a real hospital: supervisor or consultant, nurse in charge, safeguarding lead, clinical governance team or local policy as appropriate.

  • Say whom you would contact and what you would ask them to decide.
  • Escalate serious patient risk promptly while keeping within your competence.
  • Document facts and the advice or actions taken, with appropriate information sharing.

Close the loop after safety

A difficult situation may require candour, a record, incident reporting, team learning or support for a colleague.

  • Explain what the patient needs to know and who should communicate it.
  • Avoid a reflexive incident form as the whole answer.
  • Reflect on systems without excusing an unsafe individual action.

A refusal and a lack of capacity are different findings

Start by identifying the particular decision, its urgency and the patient's reasons. An adult's apparently unwise choice does not by itself establish that they lack capacity.

  • Offer reasonable support to participate, including appropriate information and communication help. Assess capacity for this decision at this time if there is reason to doubt it, using the relevant jurisdiction's legal test.
  • Capacity assessment is a clinical skill, not an automatic referral to psychiatry. Seek senior or specialist support for a complex or disputed judgement; consider whether a decision can wait if capacity may return.
  • The law differs across the UK. Apply current law and local procedures where you practise; these principles are not a substitute for advice on a difficult individual case.

Choose the record that serves the task

Clinical documentation, incident reporting and reflection have different purposes. Completing one does not complete the other work.

  • The clinical record needs the facts, assessment, relevant discussion and current care plan so the next clinician can act safely.
  • Use the local incident process when indicated to report the concern and known facts; patient care and necessary escalation continue alongside it.
  • An anonymised reflection describes learning and future actions. It does not replace factual records, appropriate disclosure or review of an unresolved safety concern.

Original practice questions

Questions worth practising aloud

These are original preparation prompts written around published domains and entry-level expectations. They are not recalled interview questions.

  1. A colleague asks you to enter observations you did not personally check. What do you do?
  2. You discover a delayed critical result after handover and the patient has left the ward. What are your priorities?
  3. A competent patient declines a treatment their family requests. How would you proceed?
  4. A colleague appears unwell and their clinical decisions concern you. How do you protect patients and support them?

Common mistakes

Where otherwise good answers lose clarity

  • Listing four ethical principles without resolving the scenario.
  • Vague escalation to 'the senior' with no immediate safety step.
  • Quoting a local policy you have not checked.
  • Conflating respect for a colleague with silence about risk.

Preparation plan

How to practise this deliberately

  • Read GMC Good Medical Practice and relevant local escalation routes.
  • Practise an unknown scenario with a five-minute timer.
  • Say the immediate action, reasoning, advice route and follow-through.
  • Use the related achievements guide to keep Station 1 communication concise.

Continue into practice

Practise the answer, not just the reading

Spoken IMT practice is launching soon. At launch, choose a Question bank prompt, work on your answer and use structured feedback to improve it. Explore the practice experience while you prepare with these free questions.

Explore IMT practice

Official source

Check the live recruitment guidance

Interview formats can change between cycles. This focused guide should be used alongside the official source below and the full IMT guide.

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