Posts Tagged ‘RadTips’

RadTips: Further Interview Scenarios

I keep remembering things so I’ll add to this post as they re-emerge in my brain. Similar posts can be found under the RadTips tag.

Some other questions which have come up are of the following type:

How would you perform an OM30 on an uncooperative patient?

Now, I’m something of a pedant, I’ll freely admit that, so when I was asked this, I answered with two questions: how uncooperative are they, and why are they uncooperative? Personally, I don’t think that you can answer the question without knowing this information. Are they drunk? Aggressive? Confused? Suffering from dementia? Drunks can sometimes be reasoned with, as can aggressive patients (in my experience, a new face can sometimes be all it takes to reason with an unfriendly patient) but if they are suffering from neurological problems which they cannot control then you’re probably out of luck (and if they’re suffering from neuro problems due to head trauma then they should probably be going to CT anyway; their facial injuries can be assessed that way). Inappropriate or excessive movement which cannot be prevented is bad; if there’s no chance of getting a diagnostic quality image (the whole point of the damn process) then don’t waste your time. But why are they unable to keep still? Have they been sent round to radiology before having analgaesics? If so, don’t be afraid to send them back! If that was your mum with a facial bone injury, would you be happy for her to press her face up against a cassette without painkillers?

These questions apply to any “uncooperative patient” scenario; before going into robot-mode and rattling through the positioning, make it clear that you would not perform the examination unless you genuinely think you can get a diagnostic quality image. Don’t be afraid to send a patient back for analgaesics, sedation, or even just a coffee to sober up. And never ever put yourself in a position where you feel threatened by a patient.

It’s 2am, you’re working alone when you get a bleep for a trauma series, a NICU portable, and a femoral nailing in theatre. What do you do?

Once you’re done panicking, ring theatre, and tell them you’ll be there after the trauma series. Ask NICU what it’s for, explain the situation and ask if they can wait. It’s probably for NG tube placement, so as long as they don’t desperately need to feed them, they can hold off for a little while. The point of this question is to show both initiative and reasoning; it’s not necessarily about getting the answer right (although you probably ought to) more about proving you’re capable of thinking clearly under pressure. Practically, the trauma series comes first, this should be obvious. The patient’s life is at risk, they are the most urgent in the queue. Theatre is next; this isn’t a planned elective, it’s a trauma call and they can’t do it without imaging. They can, however, prep the patient etc while you finish the trauma series as long as they know that’s what you’re doing. Then, once you’ve got your breath back, trot off up to NICU and see if the feeding tube is in the right place.

The point is, the trauma patient has unknown injuries which could kill them; the theatre patient’s injuries are known, but serious and need treating immediately; and the NICU baby is being constantly monitored and unlikely to starve in the time it takes you to get to them. You need to not only show your reasoning with this, but also demonstrate your communication skills; it’s pointless getting the order right but then fail by not telling theatre or NICU what you’re up to.

Sometimes they like to hit you with something crazy like trauma theatre, #NOF, and a pile up on the motorway- 6 patients with injuries varying from #wrists to c-spine- ambulances are on their way. I’ve never had this in an interview, but my answer would be:

  • Call 2nd cover and ask them to come in. Tell them to avoid the motorway!
  • Tell trauma theatre what’s happening and that another radiographer is coming in.
  • Tell A&E that I’m currently on my own, but that cover is on its way.
  • Ask the A&E referrers to send the patients in priority order.
  • Get the #NOF done if possible while the ambulances are still en route, if that’s impossible, send the patient back to A&E where they’ll be more comfortable. They can sleep and have access to analgaesics if necessary; their injury isn’t life threatening, and their comfort is paramount.
  • Send the 2nd radiographer to theatre when they arrive.
  • Explain the situation to the porters so that they’re able to help.
  • Let A&E make the decisions and prioritise your patients, and examine them accordingly.
  • Ask the 2nd radiographer to assist when they’re done in theatre.
  • Get the #NOF done (if it wasn’t done earlier) once the serious injuries have been examined.

This is a similar concept to the previous question: it’s all about communication. Speak to theatre, A&E, 2nd cover, porters, etc etc. If you explain why you can’t be in theatre right away they won’t be thrilled, but at least they’ll know why. Instead of letting the A&E referrals line up, get them to send them to you in an order of their choosing; they know best.

I’d love to hear some opinions on answering these scenarios; would you say something different? These are heavily based on my (very limited) experience, so I’d be really interested in any new input.



RadTips: The Interview

My post on job hunting and making applications is here.

Ok, first off, not all interviews are the same. The ones I’ve had have varied greatly; the majority involved a series of questions on knowledge, followed by a “tell us about yourself” bit, and then some image interpretation, however one was just an informal chat about me (no fact-based answers at all) and there are even some places which get you to position and image a phantom.

See who’s on the interview panel; do some Googling. If it’s John Smith, who wrote an article in Synergy last year about OPG for trauma, expect an OPG image to come up. If it’s Jane Jones the head CT tsar, revise your cranial bleeds. If you have any friends or contacts within the department, find out what kind of interview it is if you can. If you have any really good friends, maybe even find out what kinds of images they tend to use; are they mostly skeletal trauma? Head CT? Chest pathology? Seriously, it’s competitive out there, use any advantage you have, just don’t take the piss.


The knowledge questions tend to be on the following types of subject:

  • What is IR(ME)R? State the roles and responsibilities
  • What are the HPC’s CPD standards?
  • What is Clinical Governance?
  • What is a Clinical Audit?
  • What is the Data Protection Act?
  • What is NICE/NIHCE?

These are just a matter of learning by rote, unfortunately. There isn’t really a shortcut. Condense each answer into a series of points and get them into your head.


The personal questions can vary a lot, but there’s usually:

  • Why this hospital?

You need to do your research. Perhaps this is a placement site you’ve really enjoyed, or it’s a massive teaching hospital with loads of scope for personal development. Mention other points, such as outstanding infection control (if true!), what kind of Trust is it? If they’re applying to be an FT then you ought to mention this and state why it’s a positive move.

  • How has your degree/placements prepared you for a radiography career?

Quite simple really, have you done night shifts? Rotated between all the modalities? Have your placement sites been dramatically different? Big yourself up.

  • How would you apply your personality to radiography?
  • What do you most enjoy about radiography?
  • Give us an example of your teamworking skills
  • Give us an example of how you dealt with a difficult situation/patient


The only way to pass the image interpretation aspect is to practise. Go through some old OSCEs and familiarise yourself with pathologies and how they appear on radiographs. You’ll need to be able to describe anatomy as well as point out fractures; if you’re given a normal elbow image, they may ask you what fat pad signs you would expect to see if there was a fracture. It’s not just about being able to differentiate between normal and abnormal though; they may give you an awful peg view and ask how you’d improve it. Angle up? Angle down? Open the mouth more? That sort of thing. Try not to react too much to the images though; in one interview I was shown a frankly dreadful lateral ankle and I couldn’t help but raise my eyebrows when I saw it. Instead of commenting on how crap the image is (it might be one of theirs!), explain how you would improve it, and throw in something about patient cooperation, and how you’d only repeat if you think you could achieve a diagnostic quality image. If the image is rubbish but you can still see a particularly bad fracture, it’s worth mentioning that the patient might not have had analgesics (it happens), and this could be why the image is so naff. Patient care is hugely important, don’t waffle on about how you’d reposition the patient if they haven’t had any painkillers yet.

Personally, I think that technique is more important than interpretation. You’re interviewing to be a band 5 radiographer, not a radiologist. Being able to spot and describe a coin lesion is great, but you need to be able to take a decent mobile chest image first.

At some point in the interview, normally towards the end, you’ll be able to ask questions- don’t think for a second that this is of lesser importance than the rest of the interview. This is where you not only get to find out about the post (shift patterns, preceptorship, facilities, equipment etc) but you can also demonstrate your knowledge further. Asking insightful questions is an important part of the interview, and if you’re creative you can really use it to your advantage. Maybe ask what C-arms they use in theatre, and when they answer you can tell them that you’ve used that model on placement, or made a presentation on its features in your first year. Just don’t force an anecdote into a question as it’ll be obvious and really really awkward.

One piece of advice which I cannot stress enough, is the need to appear human. You might be able to cite IR(ME)R word for word and have the image interpretation skills of a trauma consultant, but you’re being assessed on more than that. Bear in mind that they know you’re a new grad, and therefore you’re going to have gaps in your knowledge; that will change with experience. Your personality probably won’t. They’re going to be judging how well you’d fit in their team, and if it’s a small department then this is hugely important. There’s not much you can do about this, just be yourself (or a slightly censored version of yourself) and hope they like you. If they don’t think you’ll fit in, then unfortunately that’s their call.

After the interrogation most places will offer you a tour of the department (this entirely depends on how busy they are, and whether they have anyone available to show you round). This is usually very informal, but remember that the person showing you round is a potential future colleague, so don’t relax too much; assume that they’re going to report everything back to the interview panel, that way you can’t go wrong. You can find out quite a lot about whether you’d want to work there from the tour: ask them how long they’ve worked there, what they enjoy about it, what theatres are like, ask about equipment and practicalities (room 4’s a nightmare, but there’s loads of space for mobiles in resus), whatever comes to mind. Don’t ask which band 7 is the biggest bitch, or who the nicest radiologist is. That would be something of a faux pas at this stage.


After the Interview

You should have been told when you’re likely to hear back from them, if not, don’t leave the room without asking! You’ll end up worrying unnecessarily, thinking you’ve been unsuccessful when in reality they’re not going to make a decision for another week. If judgement day comes and goes with still no word, it can’t hurt to contact them; it shows you’re interested at least, just don’t hassle them. If they said they’d ring by Friday and it’s now Tuesday, it wouldn’t be unreasonable to call. If it’s only Friday afternoon, lay off and chill out.

If you’re offered the job after your first ever interview, then well done! Whether you did it by skill, luck or a combination of both, it doesn’t matter, you did it.

If not, chalk it up as experience and move on, try not to take it too personally. The interview might have been excellent, you could have been the perfect candidate, unfortunately, there could have been 5 other perfect candidates and only two posts. It can be completely galling to come away feeling super positive, only to receive a standard “Dear Candidate” rejection email, and personally I think that’s a pretty crappy way to be turned down, but sometimes that’s how it goes. Any decent employer will give you feedback, and this can be vital; if they’re the kind of employer who won’t give feedback, would you want to work for them anyway? Remember that this is a two way street; they should be trying to impress you as well, after all, you’re going to be spending the majority of your waking hours there.

If, like me, you’ve gone for the “carpet bombing” approach, you’ll hopefully have another interview lined up, so you can use the feedback from this one to adapt your technique. If not, make some notes to remind you when the next one comes up.

Most important of all, try not to get disheartened. This can be really difficult, especially as the rejections pile up and the money runs out. I applied for over 40 posts and attended 7 interviews at a cumulative cost of over £75, but eventually the final three interviews all ended in offers. If I can do it, so can you.

Good luck.


RadTips: Job Hunting and Applications

I haven’t seen much current advice for newly qualified (or near-qualifying) radiographers looking for work, so I thought I’d contribute, hopefully this will give a slightly different perspective to articles written by interviewers or academics.

The economy isn’t in a great state at the moment, and predictably, employment rates suffer. In particular, the current government made a nominal increase to the NHS budget this year, but along with “efficiency savings” and other reductions being made within Trusts, quite frankly, the NHS is facing a financial crisis. This means that the good old days seem to be over for now. You’ve probably heard the stories about radiographers basically being able to dictate where they work, and having job offers before even finishing the course. This doesn’t generally seem to be the case anymore, although the situation is marginally better for therapeutic radiographers. Here is my advice, based solely on my own experience and that of some of my friends. Please bear in mind I won’t be commenting on employment in the private sector; unless you’ve paid your own tuition fees I personally think it would be somewhat unethical not to “give something back” (yes, even if that means waiting longer for a job to appear).

Job hunting can be a full time job in itself; use every tool available to you to make this process easier and more efficient.


The Hunt

Sign up to the NHS Jobs website and create some searches based on where you’re willing to work. If geography isn’t a limiting factor you’ll obviously have more posts to choose from. These searches can be emailed to you, but they tend to get sent at the end of the day, and when I was applying, jobs were opening and closing within hours. In fact, one post I interviewed for was put up at 10am and closed by 2pm because of the number of applications they received. If you have a smartphone I recommend the following:

  • Create some searches based on both locations, key words, and salary (this excludes getting constant emails about band 7 posts etc)
  • Subscribe to these searches as RSS feeds rather than standard emails. This means that instead of getting an email at the end of the day (by which time it might have already closed) you get them as soon as they are posted. I used Blogtrottr to receive instant emails as soon as a job goes live.
  • Apply ASAP! Seriously, don’t wait. Unless you’re not that fussed about getting a job, in which case, why are you reading this?


The Application

Have a generic application form filled in offline somewhere; this means that when you make your first application you can just make some post-specific amendments and then copy and paste it onto the application. This form is then saved for future applications- make sure you change it every time you apply for a different post. You’ve probably heard it a million times before, but it really is important that you make a bespoke personal statement for each post you apply for. Personally for my applications I would change the first paragraph to be specific about the post, and the rest was generic. I researched the local hospitals and wrote introductory paragraphs for each and saved them on my phone; this meant that when I got a Blogtrottr email, I was able to apply for it immediately on my iphone.

The job offer I ended up accepting came about from an application made whilst out riding; we had to canter to the top of a hill in search of a 3G signal so I could press send.

If you’re re-applying for a post, you can go back to your previous application and copy/paste your statement, making the whole process much easier.

If your university offered non-standard extra courses on top of your degree, it’s really important that you mention them in both your statement and in the “training courses” section of the application form, under Qualifications. My uni ran optional courses in FAST and venous access; if you’ve done something similar, show it off! I’ve heard that some particularly competitive employers filter applications by these fields, so if they’re blank you’ll be automatically rejected.

Some Trusts (for whatever reason) advertise posts on NHS Jobs but make you register and apply on their own recruitment websites. This can be a massive pain in the arse as it means re-entering all of your info, but again, if you want the job…


Automated Rejections

Don’t be disheartened if you (sometimes almost instantly) receive an automated rejection. Unfortunately it does seem to be partly a numbers game, so if you apply beyond a certain time, but before they officially close, you might get rejected without anyone even reading your form. Hell, for all I know some of them were rejecting every odd-numbered application.


Invitations to Interview

Woo hoo! Finally you’ve got an interview. Some employers will tell you the date and time, others just give you a date range and make you log on and get allocated a time slot. I accepted every interview almost immediately, meaning that for every one where I had to register for a slot I ended up with an early morning one. Bear this in mind if you’re travelling any distance.


Interview tips are in a separate blog post as I think I’ve droned on enough in this one!


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