# Practising for Rheumatology (ST4) with MedMock

Canonical page: https://medmock.com/exams/rheumatology-st4

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

Rheumatology ST4 national recruitment interview, run online by Physician Higher Specialty Training: three separate 10-minute stations with five scored areas. Station 1 is a brief written clinical scenario, with communication marked separately. Station 2 is medical registrar suitability, opened by a one-minute presentation on managing the acute unselected medical take. Station 3 is a written ethical scenario, then your suitability for and commitment to rheumatology. Rheumatology trains alongside General Internal Medicine and recruits after Internal Medicine Training stage 1. MedMock lets you practise it out loud against an AI interview panel, with examiner-style feedback on any station you finish.

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

- 2025 recruitment round, NHS England figures for Rheumatology ST4: 240 applications for 51 posts, a competition ratio of 4.71.
- All rheumatology trainees now undertake a four-year programme to dual accredit with general internal medicine (GIM), and it is no longer possible to train in pure rheumatology over four years.
- The London Recruitment Office is the lead region for rheumatology.
- The rheumatology interview has three stations of 10 minutes each, with a separate pair of interviewers scoring each station. It takes approximately 40-45 minutes including the time between stations.
- Station 3 includes a question of approximately 5 minutes on suitability for and commitment to training in the specialty, giving applicants the opportunity to expand on their application form.
- Rheumatology assesses commitment to specialty as part of shortlisting.
- Interview areas are weighted 2.0 for the clinical scenario and for suitability and commitment, 1.5 for medical registrar suitability and the ethical scenario, and 1 for communication.

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

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 Rheumatology (ST4) dates: https://medmock.com/exams/rheumatology-st4#dates

## Stations you can practise

- **Station 1 – Question 1 – Clinical scenario** — Pre-read brief 2–3 sentence rheumatology clinical scenario followed by 10 minutes of examiner-led discussion. Scored on (a) clinical management — steps you would take, further information you would gather, treatments, escalation — and (b) communication skills with patients, colleagues and the panel.
- **Station 2 – Question 1 – Medical registrar suitability** — One-minute candidate presentation summarising experience managing the acute unselected medical take as the medical registrar (roles/duration, supervision level, MDT size, patient volume, non-clinical duties), followed by examiner probes on the IMT Stage 1 Capabilities in Practice: managing the acute unselected take and managing the MDT including effective discharge planning. No slides or screen sharing; notes for personal use only.
- **Station 3 – Question 1 – Ethical scenario** — Question 1 (about 5 minutes): a brief written ethical scenario to review, then discussion of its moral, ethical and legal issues. Question 2 (about 5 minutes): your suitability for and commitment to training in rheumatology, expanding on your application form.

## Sample Rheumatology (ST4) questions

- *Station 2 – Question 1 – Medical registrar suitability:* Walk us through your structured approach to taking handover at the start of a take, and how you run a board round to catch deterioration during the take. Name the frameworks you use.
- *Station 3 – Question 1 – Ethical scenario:* A consultant surgeon stops you in the corridor and asks you to prescribe colchicine for his wife's gout attack 'since you're the expert', without seeing her. What are the issues here and how would you approach this?

## Example scenarios

- *Station 1 – Question 1 – Clinical scenario:* A 68-year-old presents with new bitemporal headache, jaw claudication and transient monocular visual loss. Walk us through your immediate management, the further information you would gather, and how you would communicate the plan to the patient and the on-call ophthalmology registrar.
- *Station 2 – Question 1 – Medical registrar suitability:* Give us your one-minute summary of your experience leading the acute unselected medical take — roles, supervision, MDT size, patient volume, and non-clinical duties — then describe a specific take where you had to escalate a deteriorating patient while running a complex discharge in parallel.
- *Station 3 – Question 1 – Ethical scenario:* A 27-year-old woman with lupus nephritis needs mycophenolate but says she will not use contraception. What are the issues here and how would you approach this? Then: what have you done to test your commitment to rheumatology?

## 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 Rheumatology 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