The Public Health ST1 SJT: format, marking and how to prepare
Last updated 9 October 2026
The SJT is the longest paper at the Public Health ST1 assessment centre and the only one written specifically for public health. This page sets out the format and the marking as NHS England describes them, then gives two practice questions with full explanations.
The situational judgement test is the third and final paper on test day, sat after the Watson-Glaser and RANRA and an optional five-minute break. It runs for 100 minutes and contains 53 scenarios. Every scenario puts you in the role of a Public Health Specialty Registrar and asks what you should do, not what you know. If you are preparing for the January 2027 sitting, this is the paper to leave the most time for.
Format: two kinds of question
| Part | What you do | Share of paper |
|---|---|---|
| Part 1: Ranking | Rank five possible actions from 1 (most appropriate) to 5 (least appropriate) | Around half |
| Part 2: Multiple choice | Choose the three most appropriate actions from a minimum of eight options | Around half |
NHS England says the options are realistic responses, the best response is always included, and completely implausible responses are left out. That matters for technique: you are rarely choosing between an obviously right and an obviously wrong action. You are usually separating a good action from a slightly better one, and a poor action from a worse one.
Where a scenario names a setting, such as a local authority or a health protection team, NHS England says the setting is there only to provide context. The judgement being tested is the same whichever setting it is placed in.
How the SJT is marked
Each answer is compared with a predetermined key. For ranking questions the marking is what NHS England calls a near-miss approach: the closer your order is to the key, the more marks you receive, and you do not need every option in exactly the same position to score well. For multiple-choice questions your three choices are compared with the three in the key. There is no negative marking, so NHS England strongly recommends attempting every question.
The exact point values are not published. In our practice tests we use a model where each option in a ranking question earns full marks in the correct position and partial marks one position away, and each correct choice in a multiple-choice question earns a mark. Your percentage on a practice test is a guide to your judgement, not a prediction of the real score.
NHS England also says that your performance on the test as a whole is used to decide your level of situational judgement. You need to reach a minimum standard on this paper and on the other two, and candidates who pass all three are ranked to decide who goes forward to the selection event.
The four competencies
The SJT assesses four of the competencies in the person specification:
- Professional integrity. Honesty, accuracy, taking responsibility for errors, handling confidential information, and keeping political or personal interests out of professional advice.
- Coping with pressure. Managing competing priorities, deadlines and mistakes without cutting corners or passing problems on.
- Managing others and team involvement. Working with colleagues, supervisors and other agencies, supporting junior staff, and escalating appropriately.
- Communication skills. Giving clear, accurate information to colleagues, councillors, the public and the media, and knowing when not to speak.
Many scenarios touch more than one competency. A question about correcting a published error is about integrity, but the best answers also show good judgement about who to tell and how.
Practice question 1: ranking
Coping with pressure
Yesterday you presented a cancer mortality analysis to the ICB Population Health Committee, quoting a 95% confidence interval as a definitive statement of fact rather than a range. This morning you realise the way you communicated this could have led the committee to believe the difference was more certain than it was. The meeting minutes have not yet been circulated.
Rank the following actions from most (1) to least (5) appropriate.
Show the answer and explanation
Answer: A, C, D, E, B.
Miscommunicating statistical uncertainty to a decision-making committee, in a way that may have influenced its conclusions, is an accuracy matter that should be corrected before the minutes become the formal record.
- A (1st): informing the line manager and agreeing a corrective approach before the minutes go out is the right first step.
- C (2nd): a clarifying note to the chair for inclusion with the minutes is a proportionate correction through the proper channel.
- D (3rd): reflective logging is a sound learning exercise but, on its own, corrects nothing.
- E (4th): emailing every committee member a statistical explanation bypasses the chair and is likely to cause confusion and disproportionate concern.
- B (5th): waiting to see if anyone notices is passive and lets a potentially misleading record be circulated.
Practice question 2: choose three
Communication skills
After presenting a needs assessment on homelessness and health to the council's Adults Scrutiny Committee, a councillor asks you in open session: "What is your personal view on whether the council should fund a new specialist GP practice for homeless people?" You have not been briefed on whether the DPH wants public health staff to express a policy preference on this.
Choose the THREE most appropriate actions.
Show the answer and explanation
Answer: A, C and D.
In a formal committee setting a registrar should not express a personal policy preference without DPH guidance, particularly on a contested commissioning question. The appropriate responses decline politely while still being useful: offer the evidence, point to the needs assessment, and promise a proper written answer after consulting the DPH.
- B gives a personal commissioning preference without DPH guidance. E is probably untrue and unhelpful. F puts the chair on the spot in open session. G is good evidence but does not answer the question that was asked. H is needlessly abrupt in response to a legitimate question.
These two questions are taken from our Full Test 2. The real paper has 53 of them, so stamina and pace matter as much as judgement.
How to prepare
Learn the role, not the facts. You answer as a registrar in training: someone with real responsibility but a supervisor, an educational supervisor and a Director of Public Health above them. Most best answers involve the right person at the right time. Most worst answers either hide a problem, act unilaterally when escalation was needed, or escalate so far that a small problem becomes a formal one.
Rank from both ends. On ranking questions, find the best action and the worst action first. The middle three are where near-miss marking is most forgiving, so spend your time on the ends.
For choose-three, think "complete response". The three correct options usually work together, for example acknowledge, correct, and inform. An option can be a sensible thing to do and still be wrong for the question because it does not respond to what was actually asked.
Practise under time. 53 scenarios in 100 minutes is about 110 seconds each, at the end of a three-hour sitting. Do at least one full-length mock in a single session before test day.
Use the official material too. NHS England's sample questions page and Pearson VUE's example PDF both include worked rationales. Read them for the examiners' tone: measured, proportionate, and always respectful of the chain of responsibility.
The other two papers are covered in our Watson-Glaser guide and RANRA guide. All the 2027 dates are on the timeline page.
Frequently asked questions
How long is the Public Health ST1 SJT?
100 minutes for 53 scenarios, which is under two minutes per question. It is the last of the three papers at the assessment centre, after an optional five-minute break.
What formats does the SJT use?
Around half the questions ask you to rank five actions from most to least appropriate. The other half ask you to choose the three most appropriate actions from at least eight options.
Is there negative marking in the SJT?
No. NHS England states that there is no negative marking and strongly recommends attempting every question.
How is a ranking question scored?
Your order is compared with a predetermined key using a near-miss approach. The closer your order is to the key, the more marks you get, so you do not need every option in exactly the right place to score.
What competencies does the SJT assess?
Four: professional integrity, coping with pressure, managing others and team involvement, and communication skills.
Do I need public health knowledge for the SJT?
It is not a test of knowledge. You answer as a Public Health Specialty Registrar, and a glossary of terms and abbreviations is available during the exam for those less familiar with the UK public health system.
Where are the official sample questions?
NHS England publishes free sample questions with rationales, and Pearson VUE publishes an example question PDF. Both are linked in the sources at the end of this page.