Foundation Programme Application System: Situational Judgement (FPAS SJT)

The FPAS SJT is super hard to pass

If you are looking to apply for a training position in a hospital, then the FPAS SJT is a great way to go about doing so. However, it’s also extremely tough to pass! In this blog, we’ll give you a full breakdown of exactly what the FPAS SJT is, and how it works.

What is FPAS?

FPAS stands for Foundation Programme Application System. This is an online system used within the UK, to help final year medical students apply for training positions. The FPAS is run by the UK Foundation Programme Office. To gain a place with the Foundation Programme, you will first need to complete an application form, which is done online. In this form, you will need to answer a number of mandatory application form sections. There are 10 sections in total, in which you will need to fill in details about your personal information, qualifications, education, references and preferences.

Assuming you meet the required entry standards, you will then be eligible to sit the Situational Judgement Test.


Situational judgement is a common form of assessment. It is used by many employers these days, to ascertain whether a potential employee is the right fit for their organisation.
Situational judgement tests will evaluate your decision making, and allow potential employers to see whether your code of ethics and values match up with theirs. The majority of situational judgement tests do not have right or wrong answers, and simply come down to how an employer assesses the answers of the candidate against their own behavioural/organisational expectations. However, the FPAS SJT does have right and wrong answers, along with a specific mark scheme.

The FPAS Situational Judgement Test (FPAS SJT) will provide you with medical based scenarios. These questions will focus around testing your medical principles and ethics, and focus on qualities such professionalism, bedside manner, teamwork and your ability to cope whilst under pressure. You will not need a sustained level of clinical knowledge to complete these questions.
In order to find out what date the test will be run on, for the year that you are applying, you should speak directly to your medical school, or contact the UK Foundation Progamme themselves. They will also be able to provide you with advice on how to book your test.

FPAS SJT Questions

In total, there are 70 questions in the examination, and you will be given 2 hours and 20 minutes to complete the exam. The test is scored out of 50.00, and the majority of candidates will score between 20.01 and 50.00.

The exam is split into two sections:

Section 1. In this section, you will be provided with a medical scenario, and 5 answer options. Your job is to rank these answer options, with 1 being the most appropriate and 5 being the least appropriate. There is a total score of 20 available for each question, with each correct ranking being scored 4 points, and 3 if you score one answer lower by one (for example, if you put option A as 2, when it should have been 1). The further off you are on each option, the lower you will score. This is one of the things that makes the test so challenging. If you rank one answer option wrong, then you’ll get another one wrong too, and therefore one wrong answer can snowball and greatly impact the rest of your marks for that question. Section 1 accounts for approximately 2/3rds of the entire test.

Section 2. In this section, the questions are slightly different. Once again you will be given a medical scenario, but now you will be given 8 answer options. Your job is to choose the best 3 answers. There is a total of 12 marks per question here, with each correct answer being worth 4 marks.

To gain a training position, you'll need to pass the FPAS SJT

How to Answer

In this section, we’ll give you some basic tips on things to consider when answering the questions, which should helpfully make your life much easier.

The central aim of the FPAS SJT is to establish whether you have the decision making skills to work within a hospital, and whether your ethics and principles are in line with what would be expected. When ranking the answers from 1-5, you’ll need to take into account a range of factors, including medical ethics, professionalism and consent. Each question will present you with different things to assess and consider, before coming to a decision. For this reason, it can be hard to establish a precise system for weighing up the value of answer options. In some questions, you might be presented with 4 awful options and just 1 good option, and you’ll then need to assess which of the bad options is ‘the least bad’. Similarly, you might be given 4 great options and 1 terrible option – again you would need to assess which of the good options is the best. Sometimes, placing the top and bottom answer is easy, but ordering the answers in the middle can prove to be quite tricky. With this in mind, here are some guidelines on how to go about breaking down difficult scenarios:

1. Is the patient safe, or will this harm them? Patient safety should always be your number one priority. If you are making a decision that will impact upon a patient, then you should make the decision with the intention of benefitting their care. If you feel that one of the answer options will harm or negatively impact the patient, then this should go (at the very least) near the bottom of your answer order. There will be a number of questions focusing around topics such as confidentiality, and respecting patient decisions.

2. Try and think about the wider implications of each decision. For example, if you have a patient thrown out by security, then how is this going to impact them, how is it going to impact the hospital, and how is it going to impact you?

3. Think about how your decision could impact the behaviour and feelings of your colleagues, if appropriate. Could this upset those around you? Could it have a negative impact on them?
It’s important that you can demonstrate good teamwork, and be a supportive outlet for your colleagues.

4. Consider your level of expertise when working as a junior doctor. Are you qualified to make this decision, or would it better to consult someone more senior? The assessors want to be able to see that you have the wisdom and foresight to understand your own limitations, and not to try and take on tasks that you aren’t prepared or ready for. Try and be pragmatic. Think about whether the action that the answer option is demanding is realistic and possible at that time.

When answering the second part of the test, you should take a similar approach. In this test, you won’t need to rank the options, but you will still need to provide the three best responses – and the above framework should help you to do this.

It’s extremely important, when taking the FPAS SJT, that you answer the questions based on established medical ethics, and the guidelines laid out by the General Medical Council (GMC). You can read all about these principles via the foundation programme page.

Along with this, you are also expected to have some knowledge of medical law, and essential criteria that you would use when making decisions, such as the mental health act and the mental capacity act. Again, the above link should provide you with sustained information about all of these factors.

You'll need to prepare thoroughly for the FPAS SJT