The PESCI Interview: GP Nightmare?: IMG guide for UK practice (2026)

Key points

PESCI is a structured, scenario-based interview assessing whether an IMG can practise safely in a specific GP position; the report is position-specific and not generally transferable.
If you’re an IMG on the Standard/Competent Authority pathway applying for provisional/limited registration to work in general practice, a PESCI is typically required.
Prep should be role-matched: your job’s scope, supervision level, location risks (rural/underserved), escalation pathways, and Australian guideline-aligned management.

The “secret”: PESCI is a fitness-for-task assessment

PESCI is not a generic exam — it is tailored to a specific position. Panels assess your training, knowledge, clinical experience, and attributes against the demands of the role, factoring in orientation and supervision available.

How to prep (without wasting time)

Obtain the exact position description (and annotate it)

Highlight: patient mix, after-hours expectations, procedural scope, proximity to ED/support services, and escalation pathways. Your answers must match what you will actually be doing, not what you did abroad.

Build a “scenario spine” for your role

Create a repeatable structure for any scenario: triage + red flags → immediate actions → investigations you can justify → initial management → safety-netting → escalation/transfer → documentation. Practise until it’s automatic.

Memorise local pathways (not textbooks)

Panels look for safe, guideline-aligned decisions: when to manage vs refer, when to call retrieval/ambulance, what you can do within scope, and how you communicate uncertainty.

Rehearse supervision language

High-scoring candidates explicitly use supervision: “Given my scope and the supports available, I would discuss with my supervisor / arrange urgent transfer / document and safety-net.” That line shows insight, not weakness.

Treat it as high-stakes (because it is)

Many IMGs describe PESCI as challenging because the standard is “safe in this job, in this system.” Don’t wing it. Mock it with someone who will pressure-test your escalation decisions and documentation habits.

Your learning path

Save your place and choose what comes next

Work through this guide (5 steps)

Use the actions from this article to track what you have worked through.

Obtain the exact position description (and annotate it)
Highlight: patient mix, after-hours expectations, procedural scope, proximity to ED/support services, and escalation pathways. Your answers must match what you will actually be doing, not what you did abroad.
Return to this section
Build a “scenario spine” for your role
Create a repeatable structure for any scenario: triage + red flags → immediate actions → investigations you can justify → initial management → safety-netting → escalation/transfer → documentation. Practise until it’s automatic.
Return to this section
Memorise local pathways (not textbooks)
Panels look for safe, guideline-aligned decisions: when to manage vs refer, when to call retrieval/ambulance, what you can do within scope, and how you communicate uncertainty.
Return to this section
Rehearse supervision language
High-scoring candidates explicitly use supervision: “Given my scope and the supports available, I would discuss with my supervisor / arrange urgent transfer / document and safety-net.” That line shows insight, not weakness.
Return to this section
Treat it as high-stakes (because it is)
Many IMGs describe PESCI as challenging because the standard is “safe in this job, in this system.” Don’t wing it. Mock it with someone who will pressure-test your escalation decisions and documentation habits.
Return to this section

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