The Public Health Assessment Centre is 190 minutes in length and there are 3 component parts:

• A critical thinking paper (Watson Glaser).
• A numerical reasoning paper Rust Advanced Numerical Reasoning Appraisal (RANRA).
• Situational Judgement Test (SJT) paper.

What's in the Situational Judgement Test (SJT) Paper?

Aims of the Situational Judgement Test (SJT) paper

A Situational Judgement Test (SJT) is an assessment method which measures how a candidate believes they should behave when posed with a challenging professional dilemma.

The Situational Judgement Test (SJT) paper is not a test of knowledge of problem-solving ability, but rather aims to assess professional attributes (domains or competencies) which are considered to be important for successful progression through training and performance in one’s job role. There is no negative marking used.

Number of questions

The Situational Judgement Test (SJT) paper has 53 questions.

Context and setting

As the Situational Judgement Test (SJT) is a measure of aptitude for entry to specialty training, it is set within the context of the Specialty Training programme with the candidate assuming the role of a Public Health Specialty Registrar.

Although you are asked to assume the role of a Public Health Specialty Registrar, each scenario is reviewed by Subject Matter Experts (SMEs) to ensure that the scenario does not contain any knowledge of procedures or policies that would only be applicable in certain localities or that are very UK-specific, as this would disadvantage certain candidates (such as International Medical Graduates).

To ensure the Situational Judgement Test (SJT) paper is relevant to those applying from any relevant background, and to increase the overall face validity of the test, the blueprint also requires that items are based within a range of contexts and situations that a Public Health Specialty Registrar would realistically find themselves in. Therefore, there is a mixture of items based in a variety of placements.

Even where a setting is specified in the question, this has only been chosen to provide a context. The judgement required to answer the question is not specific to that setting.

Target domains

The Situational Judgement Test (SJT) covers 4 core competencies.

Professional integrity

Behavioural indicators linked to this competency.

  • Demonstrates probity (displays honesty, integrity, aware of ethical dilemmas, respects confidentiality)
  • Capacity to take responsibility for own action
Coping with pressure

Behavioural indicators linked to this competency.

  • Capability to operate under pressure and awareness of own limitations
  • Demonstrates initiative and resilience to adapt and respond to changing circumstances, timescales, organisational structures and systems
Managing others and team involvement
  • Capacity to work effectively in partnership with others and demonstrate leadership where appropriate
  • Demonstrates a facilitative, collaborative approach and respects others’ views
  • Demonstrates capability and willingness to work in multi-disciplinary teams and respects multi-agency contribution to health
Communication Skills
  • Capability to communicate effectively in written and spoken English to a wide variety of audiences, adapting language to the situation as appropriate
  • Capability to listen, build rapport, persuade and negotiate with individuals and groups

Item types and formats

There are 53 scenarios in the Situational Judgement Test (SJT) paper. Around half of the questions ask candidates to rank options in order and the other half are multiple choice. There is no negative marking, so you should attempt to answer all questions.

Responses to scenarios are usually actions taken to address the situation. Response options will be realistic, and the "best response" will always be included. For scenarios where you are asked to consider the appropriateness of actions (whether ranking or multiple choice), there will be a mixture of good, acceptable and poor responses to the situation, as judged by the Subject Matter Experts (SMEs). Completely implausible responses are not included as options.

Academic Supervisor A senior individual responsible for supporting students within a study programme (for example, during a Master's degree).
Bullying and Harassment Policy A policy that outlines rights and responsibilities relating to acts of unwanted conduct or behaviour designed to cause harm or distress to others.
Director of Public
The most senior member of the Public Health team, with overall
responsibility for          Public Health services and staff within an
Educational Supervisor A senior individual responsible for making sure trainees receive the appropriate training and experience, and assisting in personal and professional development.
Health Protection
A document outlining guidance on outbreaks of infectious diseases
and environmental incidents that may harm health.
Health Protection
Responsible for dealing with outbreaks of infectious diseases and
environmental incidents that may harm health.
Information Governance policy An organisational policy that sets out how information can be securely stored, effectively managed and lawfully used.
Integrated Care Board (ICB) An NHS organisation responsible for developing plans to support meeting the health needs of the population.
Learning outcomes The statements that describe core elements of learning that a
registrar will be required to obtain whilst in training.
Local Medical Committee (LMC) Local Medical Committees (LMCs) are local representative committees of NHS GPs.
Multi-agency Several different organisations working together towards a shared aim or goal.
On-call rota A document that sets out responsibilities for responding and
managing urgent enquiries / incidents both during business hours
and out of hours (evenings and weekends). This may be clinical or managerial in nature.
Primary Care
Organisation with responsibility for the planning and securing of health services (primary and secondary care) and improving the health of a local population.
An experienced, middle-grade public health specialist, who would typically have 2 or 3 public health practitioners reporting to them, and who themselves would be line-managed by a public health consultant.
Prophylaxis The treatment given or action taken to prevent disease.
Providers Organisations who have been commissioned under a contract to provide specific health and care support and/or interventions. This can be preventative or treatment. Examples might include a community group providing weight management services, a mental health helpline, a hospital, or care home.
Sabbatical An extended period of time away from work.
Smoking cessation A service which encourages users to stop smoking.
Steering Group A group of individuals that use their experience, skills and knowledge to share the decision making.
Tonsillectomy Surgery to remove tonsils.
Individual who has overall responsibility for the Public Health training programme in a region.
Tripartite meeting A meeting between 3 parties.
Part 1: Ranking Questions

You will be asked to judge the appropriateness of 5 independent actions and, for example, might be told: "Rank in order the following actions in response to this situation (1 = Most appropriate, 5 = Least appropriate)". These scenarios require you to think about the appropriateness of each of the different options presented. For these scenarios the actions are discrete actions and should not be thought of as chronological.

Example 1

You are four weeks into a placement with the Health Protection Team*. In your previous placement you worked very much independently. In this Health Protection Team, the workload is shared amongst the team, whilst being led by the team consultant. You have observed that the team are very engaged with each another and often swap work between themselves. You are concerned that since starting this placement, you have been completing your work alone and feel that the other team members do not engage with you as much as they do with each other.

Rank in order the following actions in response to this situation.

1= Most appropriate

5= Least appropriate

  • a. Share any challenges with the work you are completing with the rest of the team
  • b. Ask the team consultant for advice on how to engage more with the team
  • c. Inform your team members that you are there to help if needed
  • d. Inform the team consultant that the other team members are not engaging with
  • e. Continue to complete your work independently

Correct key: BACDE


Fitting into a new team can often be challenging for the new team member as they learn to adjust to the team dynamic and their work styles. This adaptation period can often feel isolating. However, learning to work in a team and adapting are important skills to develop and therefore, identifying the appropriate individual, and communicating issues in a polite and constructive way, is crucial.

  • B is the most appropriate response because it demonstrates that you have identified the appropriate individual to discuss your issue with, which in this case is the team lead. As this is a new team, it is particularly appropriate to speak to the lead as they know their team best and can help you to appropriately respond to the issue. You have also taken initiative by communicating the problem politely, without placing the blame on your team, and have shown that you intend to act on the problem to resolve it.
  • A is an appropriate response as you are making an effort to engage with the team more rather than staying quiet and sticking to old habits and working independently. By sharing challenges, you are directly making them aware of the issues
  • C is somewhat of an appropriate response. While you are attempting to engage with the team more which is a positive, you are not directly addressing the issue of feeling excluded from the group. The team may not be aware that you feel that they don’t engage with you as much as they do each other.
  • D is not an appropriate response. Although it is directly communicating how you feel, it is likely to look as though you are placing the blame on your team members. It is also not a useful response as there is no clear indication that you would like to resolve the issue.
  • E is the least appropriate response as it does not resolve any of the issues and will not improve communication or teamworking within the team.

Example 2

You have just been handed over a project working with Cancer services from a fellow Public Health trainee, Lynne, who is leaving your team to start a new placement. Lynne spent most of her time working on this project and liaised daily with the local providers* of Cancer services, producing lots of reports. You only work three and a half days a week and have been told by your supervisor that your priority is to complete a different project. You are concerned that the stakeholders involved within the Cancer services project may have different expectations than what you can provide.

Rank in order the following actions in response to this situation.

1= Most appropriate

5= Least appropriate

  • a. Inform the Cancer services project stakeholders that this project is not your priority
  • b. Discuss with your supervisor how you will manage your workload and the stakeholders’ expectations
  • c. Explain to the Cancer services project stakeholders how you plan to manage the project
  • d. Inform the Cancer services project stakeholders that your working hours differ to that of Lynne’s
  • e. Arrange a meeting with the Cancer services project stakeholders to negotiate how you can work together on the project going forward

Correct key: BECDA


Taking on a new project can be challenging as the individual gets to grips with the details of the work, while also building a relationship with the stakeholders and managing their expectations. Juggling the demands of a new, unfamiliar project can feel overwhelming so it is important to communicate clearly and honestly with the stakeholders, setting realistic expectations. These are important skills to develop as a public health trainee.

  • B is the most appropriate response as it demonstrates an understanding that your supervisor is available to support you with your workload, ensuring that it is appropriately balanced and managed. It also demonstrates an awareness of your position as a Public Health trainee and that you can recognise when it is appropriate to ask for help from a senior.
  • E is an appropriate response as you are communicating directly and collaboratively with the stakeholders to set realistic expectations regarding your work on the project. Communicating professionally and clearly with the stakeholders will ensure that they are aware of what they can expect from you and you are aware what is expected of you.
  • C is neither appropriate nor inappropriate. Through doing this you are giving information on what can be expected from you, however, this information is indirect, insensitive, and potentially unclear. You are not considering what expectations they might have of you and your role.
  • D is an inappropriate response. This is not relevant information for the stakeholders as there is no clear indication of what this means for their project. The action in isolation does not help to resolve the issue. It could also be misinterpreted to mean that the project is not as important to you as it was your colleague.
  • A is the least appropriate response. The response is abrupt and does not resolve any of the issues. It may also detriment the relationship that you are building with the stakeholders.

Example 3

You and other members in your team are on the on-call rota*. Each of you have a designated slot on the on-call rota, during which time you must be available outside of regular office hours. Recently you have been experiencing difficulties with arranging childcare for your young children and you are finding it difficult to fulfil your duties on the on-call rota. You feel that the out-of-hours shift is harder for you as you are the only one in your team who has caring responsibilities.

Rank in order the following actions in response to this situation.

1= Most appropriate

5= Least appropriate

  • a. Inform your supervisor that you can no longer work the on-call rota shifts
  • b. Discuss alternative working arrangements with your supervisor to help you fulfil your on-call rota requirements
  • c. Discuss with your supervisor your current personal challenges with meeting the requirements of being on the on-call rota
  • d. Call in sick when you are on the on-call rota so that you can attend to your personal issues
  • e. Ask your other team members if they are available to support you by swapping some of your on-call rota shifts

Correct key: BECAD


Working as a public health trainee often involves working long hours and requires flexibility. Whilst it is your responsibility to complete these shifts, they can be challenging as they may interfere with home life. These situations are unavoidable and therefore, it is important to learn how to professionally manage them, through open and honest communication.

  • B is the most appropriate response as it provides a proactive, long-term solution to the problem. It is a great demonstration of professionalism and integrity as you are communicating the issue to the appropriate individual (your supervisor), whose job it is to ensure your workload is manageable, openly and honestly. It also demonstrates that you are aware of your duties as a Public Health trainee, but also of the importance of balancing work
    and home life.
  • E is an appropriate response as you are taking responsibility for the issue, demonstrating an understanding of your trainee responsibilities. However, it is not as appropriate as option B as it could lead to further disruption later. Additionally, your supervisor would remain unaware of the issue when they may be able to assist.
  • C is neither appropriate nor inappropriate. Whilst you are informing your supervisor of the issue, which is appropriate, this response alone is not helpful in resolving the problem that you are presented with.
  • A is not an appropriate response as you are not effectively and honestly communicating the issue and do not demonstrate an openness to resolve it. It also demonstrates a lack of knowledge of your responsibilities as a Public Health trainee.
  • D is the least appropriate response. It does not resolve the issue at all and demonstrates poor integrity and dishonesty.
Part 2: Multiple Choice Questions

You will be asked to select 3 most appropriate actions to take in combination, out of a total of 8 plausible actions.  For example, 'Select the 3 most appropriate actions to take in this situation'.

Example 1

You have been working on writing a paper with two fellow Public Health trainees, Ravi and Haley. Each of you spend some time working from home and have different working patterns. When you have tried to contact Ravi or Haley about the paper by email, they have not responded. The last email you sent to both of them was a week ago. The paper has a deadline of two months’ time, and you are worried that they are not interested in helping to write the paper as first agreed.

Choose the three most appropriate actions to take in response to this situation.

  • a. Remind Ravi and Haley of the two-month deadline for the paper
  • b. Send Ravi and Haley a list of outstanding actions left to complete on the paper
  • c. Ask Ravi and Haley if they would like to arrange a short call for all of you to discuss the paper together
  • d. Try to complete the paper on your own
  • e. Tell Ravi and Haley that they have not been doing their share of the workload for the paper
  • f. Ask Ravi and Haley if they have any challenges in completing their parts of the paper
  • g. Inform your supervisor of the personal challenge that you are facing with progressing the paper
  • h. Inform Ravi and Haley that you believe that they are not interest in completing the paper.

Correct key: CFG


The stem details the issue of differences in communication and work styles. It is important to consider individual differences whilst also acting professionally to resolve any communication issues. The stem is concerned with responding appropriately to the issue of receiving no response to your email, proactively resolving it while also considering reasons your colleagues have not responded and the potential impact your actions could have on them.

  • C is an appropriate action as it demonstrates a proactive, collaborative approach to resolving the issue, with the overall aim of progressing the paper.
  • F is an appropriate action as it demonstrates empathy, as you understand that there may be specific reasons that your colleagues have not responded to your email, it also gives you information about whether there has been any progress with the paper. It also gives you the necessary information you need to support them with any of their outstanding tasks.
  • G is an appropriate action to take as it demonstrates an awareness of the importance of open communication with your supervisor and that your supervisor may have some useful advice on how to approach the situation sensitively and appropriately and progress the paper to meet the deadline.

Options A and B are inappropriate as they may be considered rude and unnecessarily directive.
Options D and E are inappropriate as they show a lack of communication and teamworking skills and do not provide a solution to the issue. They also assume that the work is not being done by your colleagues which is not known to be true at this stage. Option H is judgemental and presumptuous.

Example 2

A colleague, Jamie, tells you that whilst he was working on some health protection cases yesterday, he accidentally sent a letter about an individual’s diagnosis to the wrong email address. When you ask Jamie what he did after, he informs you that he is not going to tell anyone else and that he will be more careful in the future. You are unsure if Jamie is aware of how serious this is. You have both completed Information Governance* training, which outlines that this is not in line with the organisation’s privacy policy.

Choose the three most appropriate actions to take in response to this situation.

  • a. Explain to Jamie how serious his error is, signposting him to the Information Governance policy*
  • b. Encourage Jamie to inform the Information Governance* manager of the error
  • c. Tell Jamie to delete the wrongly sent email
  • d. Reassure Jamie not to worry as this will not impact anyone directly
  • e. Inform your supervisor of Jamie’s error
  • f. Check the Information Governance policy for how serious the error is
  • g. Explain Jamie’s error to a colleague to get their opinion
  • h. Agree with Jamie that he needs to be more careful in the future

Correct key: ABE


Professional integrity is a crucial competency for every doctor to develop. It is very important to adhere to best practice guidelines for patient confidentiality and safety. In this stem your colleague has admitted to you that he has made a mistake and intends not to adhere to the correct procedures. While this was an accident, it still involves a serious patient confidentiality breach. It is important to respond appropriately to this knowledge.

  • A is an appropriate action as it demonstrates an understanding of the severity of a confidentiality breach and the importance of patient focus. You are also not assuming that your colleague is aware of the severity of the mistake and are actively educating him so that he can take appropriate action in the future.
  • B is an appropriate response as it demonstrates that you have an understanding of Information Governance policies and appropriate action to take following a confidentiality breach. The action is polite and helpful in pushing your colleague to put the patient first and take ownership of his mistake.
  • E is an appropriate response. A breach in patient confidentiality is a serious concern and it is very important that appropriate action is taken. As you are now aware of your colleague’s mistake, it is your duty to inform your supervisor so that the error is addressed appropriately. Your supervisor will be able to support in taking the correct next steps to resolve the situation.

Option C is an inappropriate action as it is encouraging poor practice and does not resolve the issue.
Option D is inappropriate as it is untrue. The error is a breach of patient confidentiality and could not only have a negative impact on patient safety but also on their well-being and trust in the system.
Options F, G and H are inappropriate as, on their own, they are passive and not resolving the issue.

Example 3

You are chairing a one-hour meeting and have a lot of agenda items to go through, many of which need decisions in order to progress the item after the meeting. You are facilitating discussions between a variety of stakeholders and one stakeholder in particular, Martine, continues to raise thesame point repeatedly on a certain agenda item and is not giving other stakeholders a chance to speak. There are only 20 minutes of the meeting left and you still have five key agenda items to discuss.

Choose the three most appropriate actions to take in response to this situation.

  • a. Inform the group that there are still five agenda items to discuss and only 20 minutes of the meeting left
  • b. Thank Martine for sharing her thoughts
  • c. Ask the group to collectively prioritise the remaining agenda items for discussion with the remaining time left
  • d. Allow Martine to continue talking
  • e. Advise Martine that you are running out of time
  • f. Ask the group if they would like to contribute their thoughts on the remaining agenda items
  • g. Allow the meeting to run over
  • h. Offer to schedule another meeting

Correct key: ACF


It is likely that you will work with people with strong opinions, sometimes different to your own, during your career. This can sometimes be challenging to manage, particularly if you are also under time pressure. However, the ability to manage difficult conversations and situations effectively and efficiently is a crucial skill to develop as a Public Health trainee.

  • A is an appropriate action as it is directly addressing the root of the issue. It is polite and non-confrontational as you are addressing the whole group rather than singling out one individual. It demonstrates an ability to effectively communicate and manage the group.
  • C is an appropriate response as you are politely refocusing the discussion to the points that must be made a priority and are involving the whole group rather than singling out one individual. It demonstrates good communication skills and addresses the problem, whilst also effectively coping with time pressure.
  • F is an appropriate response. It demonstrates the ability to refocus the discussion effectively, focusing in on the remaining topics that should be made a priority. It directly resolves the issue without singling your colleague out.

Options B, D are inappropriate actions as while they are polite, they may further exacerbate the issue and encourage the current discussion. Therefore, it is not effective in resolving the issue. Option E is inappropriate as it may put a negative focus on the stakeholder and make her feel uncomfortable.
Option G is not a good response as it does not resolve the issue of your colleague repeatedly bringing up the same point and it shows a lack of respect for other people’s time. Option H is not appropriate as although it is providing an opportunity for conversations to continue, it will delay you being able to proceed with actions following the meeting.

Item development

A team of item writers develop new content year on year. Some of this content is then piloted alongside the tests used live.

The development process is summarised below:

Item writing
  • Development of content by Subject Matter Expert (SME) item writers
Item review
  • Review of content by Work Psychology Group (WPG) item writing experts
  • Review of newly written items conducted by Subject Matter Experts (SMEs)
  • Identification of levels of agreement between experts on the scoring key for each item, where Subject Matter Experts (SMEs) complete the items from a Public Health Specialty Registrar perspective
  • Finalisation of content, including language review to ensure fairness for all candidates
  • Piloting of content alongside operational test
  • Psychometric review of item performance
Operational use
  • Scenarios which have performed well will be transferred to the operational bank
  • Psychometric analysis is conducted annually to ensure the robustness of the test

Scoring process

Situational Judgement Test (SJT) scenarios are scored against pre-determined keys that have been determined throughout the development process. This means the scoring of the test is standardised and fair to all candidates.

Scoring ranking scenarios

The items in the ranking section (Part 1) require you to rank a series of options in response to a given situation. Answers are marked by comparing your response to the pre-determined key. The closer your response is to the pre-determined key; the more marks are awarded. You do not need to get every option in the same order as the pre-determined key to obtain a good score on an Situational Judgement Test (SJT) item. Given that there is no negative marking, and the way the scoring convention works, it is strongly recommended that all questions are attempted.

Scoring multiple choice scenarios

The items in the multiple-choice section (Part 2) require you to select 3 response options from a minimum of 8 possible responses, which together are the most appropriate response to the given situation. As with ranking items, answers are marked by comparing a candidate’s response to the pre-determined key. There is no negative marking therefore it is recommended that all questions are attempted.