Practice Set 9: Time-Pressured Decision Scenarios

The SJT gives you 26 minutes for 69 questions — roughly 23 seconds per question. This practice set trains you to make sound professional judgements quickly. Time-pressured decision scenarios in the SJT often feature urgency: a patient is deteriorating, an emergency arises, or a decision must be made immediately without all the information you would ideally want.

The SJT tests your ability to act decisively under time pressure while still being safe and professional. The correct answer is usually the one that takes immediate, proportionate action and involves the right people. Hesitation, over-analysis, and trying to gather perfect information before acting are not rewarded when time is critical.

Under time pressure, the SJT expects you to: (1) address the most urgent safety issue first, (2) communicate clearly and briefly, (3) involve senior help as early as possible, and (4) avoid acting beyond your competence even when the pressure to "just do something" is intense. A medical student who calls for help immediately is always rated more highly than one who attempts a procedure they are not trained for.

Practice reading SJT scenarios quickly. Focus on identifying the core ethical or professional issue in the first sentence or two, then evaluate the options against the standard decision framework. Do not overthink — the SJT rewards instinctive professional judgement that has been trained through practice, not academic analysis of every nuance.

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Quick-Reference Decision Framework

Time-Pressure Scenario	Immediate Action	What NOT to Do
Patient collapsing	Call for help immediately; start basic life support if trained	Do not attempt procedures you have not been trained in
Fire alarm sounds during a ward round	Follow evacuation procedures; assist patients	Do not ignore the alarm or wait to see if it is a drill
Colleague asks for urgent help while you are with a patient	Assess which situation is more urgent; communicate to both parties	Do not abandon either without informing someone
You realise you have made an error that could harm a patient imminently	Inform the supervising clinician immediately	Do not try to fix it alone or wait until later
An aggressive patient is threatening staff	Remove yourself from danger; call security	Do not physically confront the patient

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