UCAT SJT Teamwork Scenarios: Conflict, Hierarchy, and the Junior Doctor Problem

You are an FY1 doctor. A registrar two grades above you has prescribed a medication you are fairly sure is contraindicated for the patient’s renal function. The consultant is in theatre. The pharmacist has gone home. What do you do first?

This is the shape of roughly one in three SJT questions on UCAT 2026, and it is where high cognitive scorers consistently lose band 1 placement. The VR–DM–QR sections reward speed and pattern recognition. SJT teamwork scenarios reward something different — a working model of how junior doctors actually behave inside a hospital hierarchy.

Most 17‑year‑olds applying to Monash, UNSW Sydney or the University of Adelaide have never set foot in that environment, so they default to instincts learned from school group projects. Those instincts are wrong about 40% of the time.

This guide walks through:

• How the UCAT Consortium frames teamwork
• The principles that produce band 1 answers
• Three worked teamwork scenarios
• The specific places students misjudge the appropriate response

How UCAT frames the medical team

The SJT section is 69 questions in 26 minutes — roughly 22 seconds each. About a quarter of those questions sit inside teamwork and integrity domains. The Consortium publishes its scoring rubric on ucat.ac.uk, and the framing is consistent across years.

You will almost always be cast as a junior member of the team:

• Medical student on placement
• FY1 (first‑year doctor)
• Occasionally a senior medical student

You are rarely the most senior person in the room. Other characters fall into a predictable hierarchy:

• Consultants and senior registrars – high authority, often unavailable
• Junior registrars and SHOs – your direct seniors
• Nurses and ward staff – lateral colleagues with their own expertise
• Patients and relatives – the people you serve
• Fellow students and FY1s – peers you may need to challenge

The teamwork questions are not testing whether you can spot a “team player”. They are testing whether you understand that:

The team exists to keep the patient safe, and hierarchy is a safety tool, not a social pecking order.

Students who treat hierarchy as a social structure (who is more important, who you don’t want to upset) score poorly.

Speaking up vs going over a senior’s head

This is the single most common SJT teamwork pattern:

A senior colleague has done something you think is wrong. What is the appropriate first step?

The UCAT Consortium’s guidance (and the official UCAT Tour videos) use a tiered escalation model:

1. Speak to the person directly, privately, and without accusation
2. If unresolved or unsafe, escalate to their immediate senior
3. If still unresolved, escalate further up the chain
4. Use formal reporting when informal channels fail or the issue is severe

Common mistakes

• Jumping straight to step 2 or 3 because it feels “decisive”
  • On SJT, going over someone’s head without first speaking to them is almost always inappropriate unless there is immediate patient harm.
  • The rubric sees this as a failure of professional courtesy and a breakdown of trust.
• Saying nothing because they are senior or because “I’m just a student”
  • This is rated highly inappropriate when there is a safety concern.
  • Junior status never cancels your duty to flag potential harm.

The sweet spot: raise the concern directly, respectfully, and early.

Handling underperforming colleagues

Another common scenario type: a peer or colleague is not pulling their weight.

Examples:

• A fellow medical student is late every day
• An FY1’s notes are consistently sloppy
• A colleague seems burnt out and is making small errors

Principles to apply

1. Understand before judging
   • First move is almost always: “Ask if everything is okay”.
   • A struggling colleague is a welfare/clinical issue before a disciplinary one.
2. Consider impact and risk
   • Sloppy notes with no current harm ≠ repeated medication errors.
   • Higher risk → faster and higher escalation.
3. Document patterns
   • SJT rarely wants you to formally report a peer first.
   • It does reward keeping a factual record if there is a pattern.

Where students go wrong

• Sideways gossip: “I would mention it to the other FY1s.”
  • This is almost always inappropriate.
  • Sideways communication doesn’t fix the problem; it just spreads it.
• Skipping the conversation: going straight to the supervisor.
  • Unless there is clear risk, this is usually too escalatory for a first step.

The pattern the rubric likes: private chat → support → escalate if needed.

The “speak to them first” default principle

If you take one heuristic into the SJT, take this:

When a question involves conflict, a mistake, or concern about another team member, the band 1 answer almost always includes speaking to that person directly before any other action.

This includes when the other person is more senior.

You do not march up and accuse them. You ask:

“I noticed the patient’s eGFR is 32. I wanted to check whether the dose accounts for that?”

Why this works:

• Preserves the senior’s dignity
• Opens a conversation instead of a confrontation
• Creates a record that you raised the concern

Two key exceptions

“Speak to them first” does not apply when:

1. Immediate patient harm is in progress
   • If someone is about to give the wrong drug right now, you stop the action first, then discuss.
2. Safeguarding / serious misconduct
   • Suspected abuse, illegal activity, or impairment (e.g. colleague drunk on shift) → go straight to the senior on call.

Outside these, direct conversation is step one. Making this your default is the single highest‑yield SJT habit.

Three worked teamwork scenarios

Scenario 1: The contraindicated prescription

You are an FY1. The registrar prescribes a medication you believe is contraindicated by the patient’s kidney function. The consultant is in theatre. The pharmacist has gone home.

Best first action:

• Speak to the registrar directly, framing it as clarification:
  • “Could you walk me through the dosing? I want to make sure I understand the eGFR adjustment.”

If the registrar dismisses you and you remain worried:

1. Seek lateral expertise (on‑call pharmacist, senior nurse, or another doctor), or
2. Escalate to the next‑most‑senior available doctor.

Going straight to the consultant in theatre is inappropriate unless the patient is about to receive the dose imminently and no other safe option exists.

Scenario 2: The late student

A fellow medical student on your rotation has been arriving 30 minutes late for three weeks. The consultant has not noticed yet. Other students are starting to resent it.

Best first action:

• Speak to the student privately and ask if everything is okay.

Why other options are worse:

• “Report them to the rotation supervisor” → too escalatory as a first step.
• “Tell the other students to stop complaining and let it go” → ignores impact on team and patients.

Preferred path:

1. Private chat
2. Offer support / explore reasons
3. If behaviour continues or risk appears → escalate appropriately

Scenario 3: Public disagreement with a nurse

A senior nurse contradicts you in front of a patient about a small procedural detail. You believe you are correct. The patient looks confused.

Best first action:

• Defer in the moment to maintain a united front.
• Clarify privately afterwards with the nurse.

Arguing in front of the patient is inappropriate because:

• It undermines trust in the whole team.
• The patient doesn’t benefit from watching staff disagree.

This scenario tests whether you understand that patient confidence in the team is itself a clinical asset.

Patient safety as the tiebreaker

When two answers both look reasonable, ask:

Which option keeps the patient safer in the next 15 minutes?

That option almost always scores higher.

The rubric consistently prefers:

• Safety > politeness
• Safety > rigid hierarchy
• Safety > perfect procedure

Working through official practice questions on ucat.ac.uk shows this pattern repeatedly: when in doubt, immediate patient wellbeing wins.

Where students misjudge the appropriate response

Patterns that drag scores down:

1. Over‑escalating

• Going straight to the consultant, dean, or formal reporting.
• Feels like “taking it seriously”, but the rubric sees skipped steps.

2. Under‑acting on safety

• Waiting, observing, or hoping it resolves when a patient is at risk.
• This is often scored more harshly than over‑escalation.

3. Confusing politeness with professionalism

• Picking options that minimise social friction.
• The SJT rewards being professional, which often means having a difficult direct conversation.

4. Treating hierarchy as social ranking

• Deferring to seniors because they are senior, not because they are the right person for this issue.
• Example: escalating a nursing concern to a senior registrar instead of a senior nurse or ward manager.

5. Picking the “heroic” answer

• You personally fix everything, override colleagues, or act independently.
• The rubric sees medicine as a team sport; lone‑wolf behaviour is usually inappropriate.

FAQ

How many SJT questions are teamwork‑focused?

The Consortium doesn’t publish exact numbers, but analysis of official practice papers suggests roughly 20–30% of the 69 SJT questions involve teamwork dynamics. Because integrity scenarios overlap heavily, in practice about a third of your SJT time is spent on this domain.

Does SJT band matter for Australian med schools?

It depends on the school:

• Monash, UNSW Sydney – heavily weight the four cognitive sections; SJT is more of a threshold or tiebreaker.
• University of Adelaide, University of Western Australia – have historically given SJT more visible weight.

Always check each school’s current admissions page for 2026 entry; weightings can change year to year.

Can you game SJT by always picking the “safe” answer?

No. The rubric distinguishes between:

• Very appropriate
• Appropriate

Related articles

• UCAT SJT Integrity Scenarios: What 'Very Appropriate' Actually Means
• Free UCAT SJT Practice Online: How Many Real Scenarios You Actually Get for $0
• UCAT SJT Banding Explained: How a Band 2 Becomes a Band 1
• UCAT SJT Empathy Questions: Reading Patient Distress Correctly
• UCAT SJT Professionalism: The Behaviours Examiners Reward