# Practising for General Internal Medicine (ST4) with MedMock

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

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

Physician Higher Specialty Training national ST4 recruitment for higher specialty training in General Internal Medicine — two examiner-led stations: a clinical scenario with suitability/commitment, then an ethical scenario with a one-minute Medical Registrar suitability presentation on managing the acute unselected take. MedMock lets you practise it out loud against an AI interview panel, with examiner-style feedback on any station you finish.

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

- 2025 recruitment round, NHS England figures for General (Internal) Medicine ST4: 191 applications for 17 posts, a competition ratio of 11.24.
- The lead region for general internal medicine is the Midlands.
- General internal medicine is a Group 1 specialty: applicants need to have completed the internal medicine training (IMT) stage 1 programme or equivalent.
- The interview has two stations of 16 minutes each, with four questions of between 6 and 10 minutes, and takes approximately 40-45 minutes.
- The four interview questions cover a clinical scenario, suitability and commitment, an ethical scenario and medical registrar suitability.
- The specialty assesses commitment to specialty as part of shortlisting.
- To be appointable at interview, none of the ten interview scores can be 1/5, no more than two can be 2/5, and the raw interview score must be 30 or above.

Sources: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2025-competition-ratios https://www.phstrecruitment.org.uk/specialties/general-internal-medicine

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: Physician Higher Specialty Training Recruitment (PHST), checked 2026-09-24).
All General Internal Medicine (ST4) dates: https://medmock.com/exams/general-internal-medicine-st4#dates

## Stations you can practise

- **Station 1** — Question 1 – Clinical scenario (~8 min): a written acute medical scenario with examiner-led probes on steps, treatments, further information and communication with patients/family/colleagues. Question 2 – Suitability and commitment (~8 min): focused on commitment to higher GIM training and expansion on the application form. Two marks: clinical responses, and communication skills with patients/colleagues/interviewers.
- **Station 2** — Question 1 – Ethical scenario (~6 min): hypothetical moral/ethical/legal scenario reviewed briefly then discussed. Question 2 – Medical Registrar suitability (~10 min): one-minute unaided presentation on your experience managing the acute unselected medical take (roles, supervision, MDT size, patient numbers, non-clinical duties), followed by questions on managing an acute unselected take and managing a multi-disciplinary team including effective discharge planning (the two named CiPs from the Internal Medicine Stage 1 curriculum).

## Sample General Internal Medicine (ST4) questions

- *Station 2:* ED has 8 medical referrals waiting; you have a peri-arrest on a ward and an SHO struggling with a sick patient. Discuss your acute take prioritisation and team management.
- *Station 1:* You are the medical registrar on a Saturday take. A 70-year-old presents with severe community-acquired sepsis, lactate 4 and BP 80/50. Talk me through your initial assessment, immediate management and escalation decisions.

## Example scenarios

- *Station 1:* You are the medical registrar on a Saturday take. A 70-year-old presents with severe community-acquired sepsis, lactate 4 and BP 80/50. Talk me through your initial assessment, immediate management and escalation decisions.
- *Station 2:* A 78-year-old with capacity is refusing IV antibiotics for severe sepsis and wants to self-discharge. Discuss the ethical issues and how you would approach this as the medical registrar.

## 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 General Internal Medicine ST4 stations?

Yes. You can pick either station 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