Cracking the ACCS Interview: Structure, Preparation and Practice Tips

Introduction

The Acute Care Common Stem (ACCS) interview is the gateway to entering training in Emergency Medicine, Anaesthetics, Acute Internal Medicine or Intensive Care Medicine. Competition is intense, and candidates need to demonstrate clinical aptitude, ethical reasoning and commitment to the specialty.

This guide outlines the ACCS training pathway, details the interview format and scoring, and provides preparation strategies to help you stand out.

Understanding the ACCS Training Pathway

The ACCS programme is a four‑year training route that forms the foundation for acute specialties. The first two years focus on:

• Emergency Medicine
• Anaesthetics
• Acute Internal Medicine

The final two years provide specialty‑specific training.

Application Process:

• ACCS (Emergency Medicine): Apply via Oriel. Shortlisting includes the MSRA.
• ACCS (Anaesthetics): Long‑listed via the application form. No MSRA required.
• Interview invites are based on MSRA (Emergency) or application scores (Anaesthetics).

Interview Structure and Scoring

ACCS Emergency Medicine:

• Virtual interview (~35–40 mins)
• Three stations, ~10 mins each:
  • Prioritisation (e.g. triage, multiple acute scenarios)
  • Clinical/Ethical Scenario (e.g. professional judgement)
  • Communication Task (e.g. counselling a patient or relative)
• Each station has two examiners using standardised criteria
• Final score = Interview + MSRA

ACCS Anaesthetics:

• Online interview (~40 mins)
• Two stations:
  • Clinical Scenario (e.g. airway emergencies, perioperative care)
  • Ethical/Communication Scenario

Core scoring categories:

• Clinical decision‑making
• Communication and professionalism
• Ethical reasoning and governance
• Commitment to specialty
• Reflective practice and teamwork

Build a Strong Portfolio

Though the interview structure is standardised, a strong portfolio shows commitment and experience. Include:

• Audits and QI projects
• Teaching and leadership roles
• Courses (ALS, ATLS)
• Reflections on clinical learning

Keep your portfolio up to date and ready to present if requested.

Prepare for Common Scenarios

Systematic scenario practice is key. Common examples include:

• Managing a crowded ED with multiple priorities
• Leading a cardiac arrest resuscitation
• DNACPR discussions with families
• Anaesthetic induction in a difficult airway
• Responding professionally to a medication error

Practice strategy:

• Rotate roles (candidate, patient, examiner)
• Focus on structure:
  • Identify the problem
  • Gather information
  • Communicate clearly
  • Plan and justify decisions
  • Reflect using STAR (Situation, Task, Action, Result)

Master Communication and Professionalism

Communication is critical. To improve:

• Speak clearly and maintain eye contact
• Listen actively and use empathetic language
• Avoid jargon—use lay terms
• Respect autonomy, confidentiality and duty of care

In ethical situations:

• Show honesty and ownership
• Offer solutions and acknowledge responsibility
• Practise delivering bad news sensitively

Use High‑Quality Interview Resources

A question bank can fast-track your prep. Quesmed’s ACCS Interview Qbank includes:

• 50+ realistic scenarios
• Model answers and walkthroughs by high‑scoring trainees
• Videos demonstrating tone, body language, pacing
• Progress tracking across domains
• Offline mobile access
• Group study features for collaborative prep

Develop a Strategy for the Day

Before the interview:

• Ensure strong Wi‑Fi and a quiet space
• Dress smartly and test tech early
• Keep your portfolio and certificates handy

During the interview:

• Read each scenario carefully
• Plan your response before speaking
• Use signposting to guide examiners
• Apply core values: safety, evidence, empathy, professionalism
• If you make a mistake, acknowledge it and recover

After the interview:

• Reflect on performance
• Identify what went well and what to improve
• Use feedback to grow regardless of the outcome

Conclusion

The ACCS interview is a competitive but rewarding step toward acute care training. You can excel by:

• Understanding structure and scoring
• Building a strong, reflective portfolio
• Practising scenarios systematically
• Honing communication and professionalism

Quesmed’s ACCS interview resources offer realistic preparation, detailed answers and structured feedback to boost your confidence.

With thorough preparation, self-reflection and calm execution, you can secure your place in an acute care specialty.