UCAT Situational Judgement: Getting Started with SJT (What It Tests, Scoring & Ethics)
What Is the UCAT Situational Judgement Section?
The UCAT Situational Judgement section is the final part of the UCAT exam (University Clinical Aptitude Test), which all aspiring doctors and dentists in the UK must take for admission. Unlike the other UCAT subtests that assess cognitive skills, the SJT focuses on how you would respond to realistic scenarios in a medical or dental context. In other words, it measures your capacity to understand real-world situations and to identify critical factors and appropriate behaviour in dealing with them. This means you’ll be presented with hypothetical yet realistic scenarios – often ethical dilemmas or professional situations – and judged on the appropriateness of your responses.
What does this section test?
The SJT assesses key personal attributes and professional qualities crucial to healthcare professionals. According to the UCAT Consortium and guidance from medical schools, the SJT is designed to assess qualities such as integrity, honesty, ethical reasoning, empathy, teamwork, resilience, adaptability, and respect for others. Essentially, it tests whether you demonstrate judgement in line with the values expected of a safe and effective doctor or dentist. For example, do you uphold patient safety and confidentiality? Do you act with fairness and professionalism? Can you work in a team and handle conflicts appropriately? These are the kinds of competencies this section seeks to evaluate. The scenarios and questions are based on the professional standards defined by bodies like the General Medical Council (GMC) and General Dental Council (GDC), reflecting the behaviours expected in the NHS and clinical practice. In fact, many of the ethical principles come directly from the GMC’s Good Medical Practice guidelines, which outline doctors’ duties (e.g. putting patients first, acting with honesty and integrity, respecting confidentiality, and working well in teams). Knowing these principles will give you a strong foundation for the SJT.
Format of the SJT Section – Questions & Timing
The UCAT Situational Judgement Test has a specific format you should be aware of before you start preparing:
Timing: You have 26 minutes to complete the SJT section (after a 1-minute instruction period). It’s a speedily paced section, but many candidates find the timing manageable with practice.
Number of Questions: There are 69 questions in total. These questions are grouped into a series of short scenarios. Each scenario is a short description of a situation (often a few sentences long), followed by a set of 4–6 associated questions that relate to it.
Scenario Topics: Realistic situations a medical or dental student or junior professional might encounter. They can involve ethical dilemmas (e.g., confidentiality breaches, informed consent issues), professionalism challenges (e.g., witnessing unprofessional behaviour), patient interactions (e.g., handling an upset patient), teamwork scenarios, and so on. Each scenario places you in a particular role – for instance, you might be told “You are a first-year medical student…” or “You are a dental receptionist…”. Always pay attention to your given role, as it will influence what actions are appropriate (a response that’s suitable for a qualified doctor might not be appropriate for a student in the same situation, and vice versa).
Question Format: All SJT questions are multiple-choice style, but not in the usual sense of picking one correct answer. Instead, you will usually be rating or ranking responses. There are two common types of questions:
Appropriateness Questions: You will be shown a potential action or response and asked to rate how appropriate that action is in the given scenario. You won’t be “correct/incorrect” in the traditional way; rather you judge the degree of appropriateness.
Importance Questions: You will be asked to rate how important a certain factor or consideration is in deciding what to do next in the scenario.
In both types, you use a Likert-scale rating system. For appropriateness, the standard UCAT scale is: “a very appropriate thing to do”, “appropriate, but not ideal”, “inappropriate, but not awful”, or “a very inappropriate thing to do.” For importance, the scale typically ranges from “very important”, “important”, “of minor importance”, to “not important at all.” Let’s break down what these mean:
✅ “Very Appropriate” – This action is an ideal or excellent response. It would effectively address the situation and is definitely the right thing to do (e.g. reporting a serious patient safety issue immediately to a supervisor).
“Appropriate, but Not Ideal” – This action is acceptable and might help somewhat, but it isn’t the best possible solution. It’s not harmful, but there is likely a better approach (for example, addressing part of a problem but not tackling the root cause).
❌ “Inappropriate, but Not Awful” – This action is not really the right thing to do and generally should be avoided. However, it’s not terrible; the negative consequences would be minor or limited. In other words, it’s a somewhat understandable mistake that wouldn’t cause serious harm (e.g. a small delay in responding when timing isn’t critical).
“Very Inappropriate” – This action is definitely the wrong thing to do. It would likely make the situation worse or breach important professional obligations. Such responses show very poor judgement (for instance, ignoring a patient’s complaint or acting unprofessionally and worsening the conflict).
For importance questions, a similar logic applies: “Very Important” factors must be considered (e.g. ensuring patient safety is always very important), whereas “Not Important at All” factors can be completely disregarded (e.g. personal bias or convenience should not influence your decision). The key is to judge each action or factor on its own merits within the scenario, not in comparison to other possible actions. Every question should be treated independently – it’s possible that multiple actions could be “very appropriate” or “very important” in a single scenario. Your task is to evaluate each one as if it’s the only action being considered, and decide how acceptable or crucial it is.
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How Is UCAT Situational Judgement Scored?
One distinctive aspect of the SJT section is its scoring system, which differs from the other UCAT sections. You won’t receive a numeric score out of 900 for SJT. Instead, your performance is placed into one of four Bands (Band 1 being the highest, Band 4 the lowest). Here’s how it works:
Partial Credit System:
For each question, you earn full marks if your chosen rating exactly matches the correct answer (as determined by a panel of experts). If your response is close but not spot on – for example, you rated an action “Appropriate but not ideal” when the model answer was “Very appropriate” – you receive partial marks for that question. This rewards near-misses, acknowledging that some judgements are on the right track even if not perfect. There is no negative marking – incorrect answers simply earn zero for that item.
Band Outcome:
After all questions are marked, your total raw score is mapped to a Band 1, 2, 3, or 4. Band 1 is the best possible outcome and Band 4 the worst. Along with your band, you’ll often receive a brief description of what that band signifies in terms of performance. Below is an overview of the band interpretations:
Band 1: Demonstrates an excellent level of performance. Your judgment in the scenarios was highly aligned with that of the experts. In most cases, you chose the same responses that experienced professionals deemed appropriate. This reflects a very strong grasp of appropriate professional behaviour and ethics.
Band 2: Indicates a good, solid performance. You frequently showed appropriate judgement, with many of your answers matching the model answers, though not as consistently as Band 1. This suggests you have a reasonable understanding of professional expectations, with only minor lapses or differences in some scenarios.
Band 3: Indicates a moderate performance. You showed appropriate judgment in some situations, but there were significant differences between your decisions and the expert panel’s in others. In other words, your grasp of what is the correct professional response was inconsistent – some answers were on target, but in quite a few cases, your choices did not align with the expected standard.
Band 4: Represents a low performance. Your responses often differed substantially from the ideal judgments in many scenarios. This suggests a limited understanding of the appropriate professional behaviour expected. Band 4 is a red flag, as it implies that in numerous cases, you failed to identify the appropriate or ethical course of action.
What is a “good” SJT score?
In practical terms, for UK admissions, Band 1 and Band 2 are considered strong results, while Band 3 is borderline and Band 4 is poor. In fact, many applicants aim for Band 2 or above. A Band 1 is excellent and can bolster your application (some universities may view a Band 1 as a positive differentiator). Band 2 is generally seen as a good and safe score – in 2024, about one-third of candidates achieved Band 2, making it a competitive and common result. Band 3 isn’t ideal; while it’s not always an automatic disqualification, it may put you at a disadvantage. Approximately another one-third of candidates end up in Band 3, but some medical schools might be cautious with Band 3 applicants, especially if they have many Band 1–2 applicants to choose from. Band 4, however, is usually unacceptable – it’s essentially a red line for many programs. Several UK medical schools explicitly state that applicants who score Band 4 in SJT will not be considered or will be automatically rejected. For example, Keele University’s School of Medicine advises that anyone with SJT Band 4 will not be considered for an interview at all. The University of Manchester also notes that Band 4 applicants are automatically rejected, while Bands 1 and 2 are preferred. Thus, it’s really important to prepare well for SJT – the difference between Band 3 and Band 2, or avoiding Band 4, can be crucial for your application’s success.
Tip: When you receive your UCAT results, you’ll get your Band along with the rest of your scores. Make sure to check the specific admissions criteria of the universities you’re applying to. Some may use the SJT band in different ways. For instance, some may consider it only in tie-breaker situations or for assigning points at interview, whereas others (like Cardiff) place less emphasis on SJT in initial selection. But as mentioned, a Band 4 is universally bad news, so aim higher than that. Generally, Band 2 or Band 1 will keep all your options open.
Applying Ethical Principles from the “Decider’s” Point of View
One key to excelling in Situational Judgement is to think like a professional decision-maker, not just yourself. Students often make the mistake of answering SJT questions based on what they personally would do or feel, but that might not align with what a good doctor or dentist should do. The UCAT SJT is not assessing your personal opinion or life experience; it is assessing your judgement against established medical ethics and professional guidelines. In every scenario, you should step into the shoes of a responsible healthcare professional – essentially, adopt the “decider’s point of view” of the person in the scenario – and ask: “What would the safe, ethical, and professionally appropriate action be in this situation?”
To do this effectively, you need to be familiar with the ethical principles and codes of conduct that govern medical practice. Here are some core principles and how they inform your decision-making in SJT scenarios:
🏥 Prioritise Patient Welfare:
A fundamental rule is that the patient’s well-being comes first. This aligns with the principle of beneficence – acting in the patient’s best interest – and non-maleficence – doing no harm. In practice, this means if an action (or inaction) could harm a patient or put patient safety at risk, it’s likely inappropriate. Conversely, actions that protect patients or address their concerns are often appropriate, and sometimes critical. Always consider: does this response safeguard the patient’s health, dignity, or comfort? If a colleague is acting unsafely, the appropriate action is to speak up or escalate the concern, because patient safety overrides hesitation or loyalty.
🤝 Honesty and Integrity:
The GMC’s guidance makes it clear that doctors must be honest, open, and act with integrity at all times. In SJT terms, this means you should generally own up to mistakes, tell the truth, and avoid deceit. Covering up an error, even with good intentions, is usually very inappropriate. Admitting an error and seeking to correct it, on the other hand, is the right approach (and usually “very appropriate”), as it shows accountability and protects the patient from further harm.
🔒 Confidentiality:
Medical professionals must respect patient confidentiality. Sharing private patient information inappropriately (with people who are not entitled to it) is a serious breach of trust and usually a very inappropriate action in the test. There are only rare exceptions to confidentiality (e.g., if a patient poses an immediate serious risk to others or if legal requirements require it). In most scenarios, maintaining confidentiality is paramount – e.g. discussing a patient’s condition openly in a public area or on social media would be completely unacceptable.
👥 Teamwork and Respect:
Working effectively with colleagues is essential in healthcare. The SJT often tests how you handle conflicts or team challenges. The ideal approach is usually to remain professional, supportive, and communicative. If there’s a conflict with a colleague, an appropriate first step is often to discuss it politely and privately with them to resolve it. You should not ignore issues or gossip, or be aggressive – that would be inappropriate. Showing willingness to help colleagues, admitting when you need help, and respecting all team members (regardless of rank) are traits of good teamwork. Remember that collegiality and respect for others are core professional values. However, if a colleague is doing something that endangers patients or is unethical, you must put aside personal loyalties and address it through proper channels – patient safety comes first.
⚖️ The Four Pillars of Ethics:
It’s useful to remember the four basic pillars of medical ethics, as they provide a framework for many SJT questions:
Beneficence: Do what is in the patient’s best interest (do good).
Non-Maleficence: Avoid causing harm to patients (do no harm).
Autonomy: Respect patients’ rights to make their own decisions. This means, for example, you shouldn’t force a competent patient into treatment they don’t want – providing they have capacity, their informed choices should be respected, even if you disagree. It also means maintaining informed consent and involving patients in decisions about their care.
Justice: Treat others fairly and equitably. This can come into play with scenarios about resource allocation or dealing with colleagues/patients impartially.
When weighing up what to do in a scenario, consider these principles. For instance, if a scenario is about a patient refusing treatment, autonomy and respect become important – the patient has a right to decide, but you’d also consider beneficence (you want the best for them) and make sure they truly understand the consequences (so your response might be to ensure they are informed, rather than simply override their choice or immediately accept it). If a scenario is about a mistake made, integrity (honesty) and patient welfare (non-maleficence) imply you should not hide it, and you should act to prevent harm – perhaps by informing a supervisor and correcting the error.
📋 Follow Professional Guidelines:
Often, the safest approach in a situation is to follow established protocols or get advice. SJT questions sometimes test whether you know when you should escalate an issue. A good rule: when in doubt about something serious, involve a senior or expert. For example, if you’re a medical student who observes a patient’s condition deteriorating, the appropriate action might be to inform a nurse or doctor immediately (since, as a student, you shouldn’t manage it alone). This shows you recognise the limits of your role and competence. On the other hand, don’t overstep your role – e.g., a scenario might tempt you to do something you’re not qualified for out of helpfulness, but that’s usually inappropriate (it could endanger the patient or break rules). Always act within the limits of your training and adhere to local policies (such as infection control rules and consent procedures), which are often the correct thing to do.
In summary, the decider’s point of view requires balancing these ethical principles and professional duties to choose the most appropriate course of action. The SJT is essentially a test of whether you can apply NHS and GMC ethical guidelines in practical situations. A helpful preparation step is to read the GMC’s “Duties of a Doctor” (the first page of Good Medical Practice), which serves as a cheat sheet of core professional values. Also consider the values of the NHS (like compassion, respect, and inclusion). With these in mind, you’ll find that the “right” answers often become clearer – they usually align with being honest, putting the patient first, maintaining professionalism, and exercising common sense within the role you have.
Top Tips for Acing the SJT Section
Finally, beyond understanding content, here are some practical tips and strategies to help you perform well in UCAT Situational Judgement:
Think Like a Clinician, Not a Candidate:
Always frame your thinking from the professional standpoint. Ask yourself, “What would a good doctor or dentist do here?” rather than “What would I do?”. This mental shift cannot be overstated – the examiners want to see judgment that aligns with an ideal practitioner guided by ethics and policy, not personal intuition alone.
Learn the Common Themes:
Certain themes recur in SJT questions – for example, dealing with a colleague’s mistake, handling a patient complaint, facing personal stress, issues of confidentiality, informed consent, and dealing with hierarchy (like questioning a senior’s decision if needed). For each theme, think through the general best approach. Often it involves a stepwise approach: e.g., for raising concerns, usually talk to the person involved first if it’s appropriate, then escalate if unresolved. For conflicts – address privately and politely. For mistakes, admit and rectify; don’t hide. If you internalise the correct approaches to these common scenarios, you’ll be quicker and more confident in answering.
Understand the Answer Options:
Make sure you are crystal clear on what each response option on the rating scale means. In practice, a “very appropriate” action usually ticks all the boxes (ethical, effective, addresses the main issue). An “appropriate but not ideal” action might help somewhat but may not solve everything or be the best practice. If you find an option tricky to categorise, try to imagine the consequences: if an action has no real downsides and some benefit, it’s likely at least “appropriate.” If it has potential downsides or neglects a key duty, it may lean towards “inappropriate.” Having the definitions (like we outlined earlier) fresh in your mind will prevent confusion during the test.
Be Aware of Your Role and Limits:
Always note who you are in the scenario. Are you a first-year med student? A final-year student? A foundation year doctor? A receptionist? The expectations differ. Never perform tasks or make decisions beyond your authority or training – e.g., as a student, independently giving serious medical advice or prescriptions is a no-go (and would be “very inappropriate”). Often, the correct action for a student or junior is to seek help or inform a supervisor, whereas a more senior person might be expected to handle it themselves. The SJT will sometimes intentionally present a scenario in which the same basic situation yields different appropriate actions depending on your role. Practice identifying what your responsibilities are in each case.
Focus on the Action in Question:
Only judge the specific action or response given in the question – not what else you might do or what isn’t mentioned. For example, if a scenario describes that a doctor has made a mistake, and the action to rate is “Apologise sincerely to the patient and explain how you will prevent it happening again,” you might think “I would also inform my senior and document it.” But don’t mark the given action down just because it isn’t the full sequence you’d ideally do. That action (apology and explanation) on its own is still very appropriate – it doesn’t cease to be right just because other steps are not mentioned. The test isn’t asking for a perfect, comprehensive plan; it’s asking you to judge that one action. So avoid the trap of “this isn’t everything I would do, so it’s not ideal” – if the action is good, rate it as such, assuming other appropriate steps could also be taken.
Avoid Extreme or Unprofessional Reactions:
In general, extreme, emotional, or rash responses are usually inappropriate. For instance, ignoring a problem entirely (doing nothing when action is clearly needed) is almost always a “very inappropriate” response. On the flip side, overreacting – like calling the police for a minor issue, or publicly scolding a colleague – tends to be wrong too. The best answers often show a balanced approach: address the issue but in a measured, proper way. Keep your cool in the scenario. If a patient is angry, staying calm and professional is key. If you feel yourself thinking of an extreme action, it’s probably not the right answer.
Use Common Sense and Compassion:
Though it’s rooted in rules, the SJT is also a test of your empathy and common sense. Often, the appropriate action is both kind and sensible. For example, dealing with an upset patient – a common sense compassionate response would be to listen, apologise if appropriate, and try to resolve their concern. A response lacking empathy (like dismissing their feelings) would not align with being a caring practitioner and would be inappropriate. Put yourself in the patient’s shoes as well – how would you expect a professional to behave if you were the patient? The best candidates demonstrate both emotional intelligence and rule-following.
Practice, Practice, Practice:
Finally, one cannot forget the value of practice. While understanding principles is crucial, you should also practice with UCAT-style SJT questions to get used to the format and timing. Use the official UCAT question bank and practice tests (they’re free on the UCAT website), as well as reputable question books or online banks. Timed practice will help you get a feel for how long you can spend per scenario. When practising, review your mistakes carefully – read the explanations, and always link them back to which principle or guideline you missed. Over time, you’ll start noticing patterns (e.g. “Ah, I missed that my role was a student here” or “I underestimated how important that issue was”). By test day, you want to have seen a wide variety of scenarios so that nothing completely surprises you.
Final Thoughts
The UCAT Situational Judgement section may seem daunting at first, especially since it’s not based on academic knowledge but on judgment and values. However, it becomes much easier once you familiarise yourself with the mindset of a good doctor/dentist. Remember, this section is your chance to demonstrate that you have the ethical compass and professional attitude needed for a career in healthcare – not just the book smarts. Admissions tutors take SJT results seriously because they reflect your readiness for real-life clinical situations. By scoring well, you show them that you can prioritise patient safety, work well in teams, handle dilemmas with integrity, and generally behave in a manner befitting a future medical professional.
Approach your preparation proactively: study the guidelines (GMC’s Good Medical Practice, etc.), practise plenty of questions, and perhaps discuss tricky scenarios with peers or mentors to see different perspectives. During the exam, stay calm and trust the principles you’ve learned – don’t go with a gut reaction that conflicts with professional standards. If you’ve prepared thoroughly, your instincts will align with what’s expected.
In summary, Situational Judgement is all about applying ethical reasoning and common sense. With the right preparation and mindset, you can excel in this section. Aim for that Band 1 or Band 2 – not only for the UCAT score, but because it means you’re thinking like the caring, responsible clinician you aspire to be. Good luck! 🍀👩⚕️👨⚕️
References and Further Reading
UCAT Consortium – Official Guide: Test Format and Scoring (Situational Judgement overview and scoring criteria).
Blue Peanut Medical – UCAT Situational Judgement Guide: Banding, Tips & Strategies (Free UCAT course resource).
Keele University School of Medicine – Admissions Selection Process 2026 Entry (Policy stating SJT Band 4 not considered).
General Medical Council – Good Medical Practice (2013) – “Duties of a Doctor” (Core ethical principles for UK doctors).
