Ophthalmology ST1 interview practice: how and with whom
Two stations, up to ten minutes each, talking to somebody playing a patient. There is no version of that you can read your way into being good at.
So this post is about method rather than content: who to practise with, what to practise, and how to tell whether any of it is working. It comes from SmartOST's interview webinar.
Preparation has three parts
The webinar frames preparation as three components that run as a loop rather than a sequence.
- Practice. Volume and repetition, covering topics systematically.
- Feedback. Specific and constructive, so you know precisely what to refine. The presenters single out vague praise as the thing that does not drive improvement.
- Realistic conditions. Under time pressure, with somebody behaving like a patient, at the intensity of the real thing.
Their claim is that all three are required, and that missing any one of them slows you down. That is worth taking seriously, because each is easy to get without the others and none of them works alone.
Volume without feedback rehearses whatever you already do, including the parts that are costing you. Feedback without volume gives you something to fix and no reps to fix it in. And both of those without realistic conditions leaves you having never done the actual task, which is talking to a person who has their own agenda, while a clock runs.
Practising with a peer
Find a buddy or a small group. A peer is the cheapest way to get a second person involved, and a second person is what the feedback component needs.
The webinar attaches an instruction to it: give constructive feedback, not "too nice". Agreeing in advance that the feedback will be blunt is easier than deciding to be blunt in the moment, so agree it in advance.
The slide gives a group three jobs.
Build topic templates together. What a template is for, and when to abandon its order, is covered in the breaking bad news post. Building one with other people is faster and produces a better one, because you are pooling what each of you would have missed.
Rehearse timing. A station runs to at most ten minutes, and knowing what that span feels like from the inside is not something you can reason your way to.
Practise parts of a case, not only whole ones. A whole case exercises everything at once, which makes it a poor way to improve any one thing. The webinar suggests drilling single components instead, naming lay explanations and the ideas, concerns and expectations questions as its examples. The logic is any drill's: isolate the thing you want to improve, so that every repetition lands on it.
Practising alone
You will not always have a partner, and the webinar's second block is what to do without one.
Record yourself and listen back. This is the only way to hear what you actually sound like rather than what you remember saying.
Rehearse lay explanations out loud. Not in your head. The webinar attaches filler words to this one: rehearsing the explanation is what wears them off. The gap between knowing what a condition is and being able to explain it to somebody without your vocabulary only shows up when you try to say it.
Use a mirror for delivery. The webinar recommends it, and in a station held over video your face is doing more of the work than it would in a room.
What an AI patient adds
The third block on that slide is SmartOST's own product.
What it adds is availability. A study partner has a rota and a life, and the practice you can do at eleven at night is the practice that actually happens. It puts a patient on the other side of the conversation without anybody having to agree to play one, and it keeps a record of what you have covered, which is the log below without the discipline.
What it does not replace is the second person. A peer can tell you that you sounded rushed, or cold, or like you were reciting, and that judgement is what the feedback component is for.
Reps and coverage on your own, judgement from a person.
Keep a log
The webinar's advice is to log every case you practise: the topic, which of the two stations it was modelled on, the date, what went well and what to work on.
This sounds like admin, and it is doing something specific. It turns "I have done a lot of practice" into "I have not done a communication and ethics case in three weeks". Coverage is the thing a log protects, and coverage is invisible without one.
Coaching is worth more early than late
The last piece is about timing rather than about coaching itself.
The webinar's argument is that one-to-one coaching is worth having early, because that is when it can identify how you come across on camera and get the fixes embedded into the practice you then do. Leave it late and you get told what is wrong with no time left to retrain the habit.
That applies to anything corrective, not only to paid coaching. The first honest feedback you get is worth more the earlier it arrives, which is an argument for starting the loop above sooner than feels necessary.
Where to start
Pick a partner first. It is the part that needs somebody else's diary rather than your own decision, so it is the part most likely to slip.
Then read what you are practising for: the interview's format for the shape of the day and the constraints it puts on you, and breaking bad news for the structure the communication and ethics station is built around.
SmartOST's interview practice is the third option above, for the repetitions in between.