# Practising for Emergency Medicine (ST4) with MedMock

Canonical page: https://medmock.com/exams/emergency-medicine-st4

## What is the Emergency Medicine ST4 interview, and how do you practise for it?

Emergency Medicine ST4 national recruitment interview, coordinated by NHS England North East and Yorkshire: three 10-minute stations — Prioritisation, Clinical/Ethical Scenario and Communication — each after 5 minutes of reading time when a document is shared with you, about 45 minutes in all. You need at least 60% of the final weighted interview score to be appointable, and the Communication station breaks ties first. The scoring domains are not published. Pitched at ACCS-EM trainees entering ST4. MedMock lets you practise it out loud against an AI interview panel, with examiner-style feedback on any station you finish.

## About Emergency Medicine (ST4) recruitment (official sources, checked 2026-10-13)

- 2025 recruitment round, NHS England figures for Emergency Medicine ST4: 104 applications for 71 posts, a competition ratio of 1.46.
- The Emergency Medicine interviews are online and consist of 3 stations of 10 minutes each: Prioritisation, Clinical/Ethical Scenario and Communication.
- To be eligible for ST4 Emergency Medicine, applicants must have completed the core elements of ACCS Emergency Medicine training by the intended start date.
- By the initial offers date, applicants must hold MRCEM (Primary, Intermediate and OSCE) or have completed the FRCEM Intermediate Certificate (Primary, Intermediate and SJP).
- If application numbers exceed interview capacity, self-assessment scores are used to shortlist for Emergency Medicine.

Sources: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2025-competition-ratios https://www.yorksandhumberdeanery.nhs.uk/recruitment/national-recruitment/national-emergency-medicine-st4-recruitment https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/person-specifications/person-specifications-2026/emergency-medicine-st4-2026

Recruitment dates: Applications 19 November 2026 to 10 December 2026 (national Round 2); Interviews within the national Round 2 window, 11 January 2027 to 9 April 2027 (source: NHS England Medical Specialty Recruitment, checked 2026-09-24).
All Emergency Medicine (ST4) dates: https://medmock.com/exams/emergency-medicine-st4#dates

## Stations you can practise

- **Clinical/Ethical Scenario Station** — After 5 minutes of reading, a 10-minute examiner-led discussion of a realistic ED clinical or ethical dilemma — paracetamol overdose with capacity refusal, fragility hip fracture under MCA, NAI safeguarding, refusal of PCI in STEMI, status epilepticus, eclampsia, etc. Tests Mental Capacity Act 4-pillar fluency, RCEM Best Practice citation, safeguarding pathway, Duty of Candour vs PSIRF separation, and registrar-grade escalation thresholds.
- **Prioritisation Station** — After 5 minutes of reading, a 10-minute examiner-led discussion of prioritising patients, staff and resources under pressure. METHANE major-incident declaration, JESIP bronze-silver-gold command, Triage Sieve / Sort / JumpSTART, reverse triage with named-clinician handover, OPEL 1-4 escalation, full-capacity protocol, competing-acuity resus decisions. Anchored in RCEM major-incident standards and the Civil Contingencies Act 2004 Cat 1 Responder framework.
- **Communication Station** — The handbook names this station but does not describe it. Here, after 5 minutes of reading, you speak to a role-player — a patient, relative or colleague — about a difficult emergency department conversation. It is the first tie-break station.

## Sample Emergency Medicine (ST4) questions

- *Clinical/Ethical Scenario Station:* An 85-year-old nursing home resident is admitted with severe aspiration pneumonia and septic shock. He has advanced frailty and no documented advance care plan. Discuss your management and how you would decide on ceilings of treatment.
- *Communication Station:* A 40-year-old woman with signs of sepsis secondary to a urinary infection is refusing IV antibiotics because she 'doesn't like hospitals' and wants to go home. Assess her capacity to refuse treatment.

## Example scenarios

- *Clinical/Ethical Scenario Station:* A 22-year-old is brought in by police 90 minutes after ingesting 32 grams of paracetamol with vodka, claiming she wants to leave. She is alert, tearful and refuses bloods. Walk me through your approach.
- *Prioritisation Station:* It is 02:00. The ED is at 280% capacity, ambulances are queuing in the car park, and you have just been told the on-call ITU bed has been given to a transfer from another hospital. Discuss your management.
- *Communication Station:* A 34-year-old woman was sent home three weeks ago with a wrist sprain. A radiologist has now found a scaphoid fracture on her original X-ray, and she has come back with ongoing pain. Explain what has happened.

## How a practice session works

1. **Choose a station** — Choose the kind of question or scenario you want to rehearse — ethics, motivation, a role-play, and more.
2. **Have the conversation** — Speak naturally, out loud. The AI interviewer listens and asks the demanding follow-ups, just as a real interviewer would.
3. **Get instant feedback** — The moment you finish, you get specific, examiner-style feedback and a score — what you did well, what cost you marks, and precisely what to fix before the next attempt.

## Price

Start with a one-off £5 taster: 30 credits (30 minutes of speaking practice), not a subscription. After that, or instead, £69 per month for 350 credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Cancel at any time. Full details: https://medmock.com/pricing

## Frequently asked questions

### How does the feedback work?

When you finish a station you can have it marked, and the scorecard comes back in seconds — what you did well, what cost you marks, and exactly what to work on next. Scorecards, mark schemes and model answers are included at no extra credit cost.

### Can I practise specific Emergency Medicine ST4 stations?

Yes. You can pick any of the 3 stations to drill a weak area, or run a mixed set to simulate the real interview.

### How much does it cost?

You can start with a one-off £5 taster: 30 credits, which is 30 minutes of speaking practice, with no subscription. After that, or at any time, you can choose a monthly plan, which includes a monthly credit allowance. Current prices are on the pricing page.

## About MedMock

MedMock is a web app for practising the spoken parts of UK medical and dental exams and interviews out loud. The candidate talks; an AI patient, examiner or interview panel answers in real time by voice; and when the station ends MedMock marks the performance against that exam's assessment domains and shows the model answer.

It covers 104 spoken exams and interviews — OSCEs, vivas, structured oral exams, simulated consultations, and specialty-training and consultant interviews. It does not cover written or multiple-choice papers, and it is not a question bank.

It was founded by Mr Sam Nahas, MBBS BSc MEd FRCS (Tr & Orth), a practising consultant orthopaedic surgeon in the UK, with co-founder and CTO Arjan Jandu. It is operated by VirtualPatients Ltd (company no. 16303492).

Pricing: a one-off £5 taster of 30 credits to try it (not a subscription, one per account), and a monthly subscription from £20 to £129 depending on the exam (student exams cost least, fellowship exit exams and consultant interviews most), or £199 to £275 for the Intensive plans, which carry more credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Subscriptions can be cancelled at any time.

It runs in a web browser on a laptop or phone; spoken practice needs a microphone. There is no public demo: practice needs an account with credits, usually from the taster or a monthly plan.

MedMock is for adults aged 18 or over. Sign-up asks every new account to confirm it.

MedMock is a revision tool. The patients, examiners and cases are fictional and AI-generated; it is not clinical guidance and is not affiliated with or endorsed by any Royal College, the GMC, the GDC or any examining body.

Start with the £5 taster: https://medmock.com/auth/signup