Purposeful Practice: Your Guide to IMT Interview Preparation 2026
The Internal Medicine Training (IMT) recruitment landscape has shifted. If you are applying for the 2026 entry, you are facing the most competitive cycle in NHS history. To secure your first-choice deanery, your preparation must go beyond question banks.
The Current State of IMT Competition (2025-2026)
The latest figures from the JRCPTB and Health Education England reveal an unprecedented surge in demand. Between the 2024 and 2025 entry cycles, IMT applications increased by around 40.9%, jumping from 6,273 to 8,841 applicants.
With only approximately 1,678 posts available, the competition ratio has climbed to 5.27:1.
Why Theory Alone Is Not Enough For Top Candidates
Most candidates use high-yield question banks and online theory resources. While these are useful for understanding the clinical and ethical stations, you need to practice and refine your answers and interview technique to help get the best score at the interview. To rank in the top percentiles nationally, you must move from knowing the answer to delivering it with the nuance of a future Registrar.
The 3-Tiered Framework for Improving Your Answers
Effective interview prep is not about volume; it is about Purposeful Practice.
We recommend a three-stage approach:
Self-practice & Recording your answers: Go through your answers and get used to saying them out loud. You can try recording your portfolio presentation to see how it flows and how it would sound to the interviewers.
Structured Peer Critique: Practice the stations with fellow applicants and your colleagues to help refine timing and identify areas for improvement. Seek feedback from your peers and use this to improve your interview approach.
Specialist Coaching: This is the high value step. Practicing with a high-ranking trainee who has already navigated the process can help take your answers to the next level using their knowledge and experience of the IMT interview process.
The value of interview coaching
Working with an experienced, high-scoring coach can help you to:
Identify the high value parts of your CV and include these in your answers, making them clear to interviewers
Practice key techniques and integrate them into your approach to the different sections of the interview
Gain personalised feedback and insights from the experiences of someone who has navigated the process successfully, achieving their top choice of job
Supporting Your Future with MedXStart
At MedXStart, we specialize in high-performance coaching for IMT and specialty interviews. Our mentors are successful trainees who have ranked in the top percentiles nationally. We will work with you to help develop your interview technique, refine your answers and support you in achieving your best possible result at the interview.