Dealing with Pressure & Stress
Joe Wolfensohn
Teacher
Contents
Dealing with Pressure & Stress
Managing workloads, deadlines, or difficult situations while maintaining good judgement and composure.
Dealing with pressure is the ability to maintain composure, prioritise effectively, and make sound decisions even in demanding situations. In clinical settings, this means managing heavy workloads, tight deadlines, and unexpected challenges while upholding professional standards. The standard is not perfection, but rather self-awareness, adaptability, and knowing when to seek support are key.
Resilient behaviour ensures patient safety, sustains teamwork, and prevents burnout. You’re expected to handle stress not only in crises (like emergencies) but also in routine pressures. You will likely do exams throughout your career and managing that alongside placement/ your job or admitting mistakes under scrutiny are common scenarios where this concept will apply.
The GMC’s Good Medical Practice states that doctors must "provide a good standard of care… even in challenging circumstances" and prioritise patient safety above all. This means seeking help early, using healthy coping strategies, and never letting stress justify unsafe shortcuts. The SJT assesses these principles through scenarios on workload management, teamwork under pressure, and professional accountability.
While the SJT is less time-pressured than other UCAT sections (26 minutes for 69 questions), your responses should reflect the GMC’s emphasis on calm, proactive, and patient-centred decision-making.
Key GMC quote to remember:
"A doctor’s ability to cope under pressure should never compromise patient safety or professional integrity."
Question Types in the SJT
Appropriateness Questions
You’re asked:
“How appropriate is it for [Name] to do this?”
Answer using this scale:
A very appropriate thing to do / Appropriate but not ideal / Inappropriate but not awful / A very inappropriate thing to do
Importance Questions
You’re asked:
“How important is the following factor when deciding what to do?”
Answer using this scale:
Very Important / Important / Of Minor Importance / Not Important At All
Most / Least Appropriate Questions
You’ll be given three actions. Choose:
- One most appropriate action.
- One least appropriate action.
- The third is a null option – it is neither the best choice nor the worst.
Worked Examples
Scenario 1: Appropriateness Question
You’re a final-year medical student on a busy surgical rotation. Your consultant asks you to prepare a presentation for tomorrow’s teaching session, but you’re already behind on patient notes due today. How appropriate are these responses?
Difficulty: Medium
Prioritise completing the patient notes first, then ask the consultant if you can present later in the week.
Answer:
Very appropriate.
Worked Solution:
Ensures patient safety while negotiating deadlines professionally.
Stay up all night trying to do both, even if it means working while exhausted.
Answer:
Inappropriate but not awful.
Worked Solution:
Shows dedication but risks errors and burnout.
Skip documenting the patient notes to focus on the presentation.
Answer:
Very inappropriate.
Worked Solution:
Patient care must never be compromised.
Ask a fellow student to cover your notes so you can prepare the presentation.
Answer:
Appropriate but not ideal.
Worked Solution:
Delegation can help, but patient notes are your responsibility.
Scenario 2: Importance Question
During an understaffed weekend shift, James an FY1 doctor feels overwhelmed by the number of urgent tasks. How important are these factors when deciding how to act?
Difficulty: Medium
The potential risk to patients if tasks are delayed.
Answer:
Very Important.
Worked Solution:
Patient safety is always the top priority.
Whether any tasks can safely be handed over to the next shift.
Answer:
Important.
Worked Solution:
- Proper handover is better than rushed or incomplete work.
- A proper handover ensures patient safety.
The fact that "everyone else is managing" so they should too.
Answer:
Not Important At All.
Worked Solution:
Comparisons ignore individual limits and risks.
The FY1’s confidence in asking for help from seniors.
Answer:
Important.
Worked Solution:
- Seeking support is a professional duty, not a weakness.
- The most important priority currently is to ensure patient safety.
Scenario 3: Most/Least Appropriate Question
A third-year student is about to start an OSCE but realises they’ve forgotten to review a key topic. They feel panicked. Choose the most and least appropriate actions:
Difficulty: Medium
Take a few deep breaths, quickly skim the topic, and focus on staying calm during the station.
Answer:
Most Appropriate.
Worked Solution:
Balances last-minute prep with emotional control.
Rush to another student to ask for a crash summary.
Answer:
Null option.
Worked Solution:
May help slightly but risks increasing panic.
Pretend to feel unwell to postpone the OSCE.
Answer:
Least Appropriate
Worked Solution:
Dishonest and unprofessional.
Worked Examples Video