5 Anesthesiologist Interview Questions and Answers

Introduction

Resident anesthesiologists in South Africa often work across public and private sectors where equipment availability and senior backup may vary. This question assesses clinical judgment, mastery of airway algorithms, improvisation with limited resources, and patient safety prioritisation.

How to answer

• Start with a brief statement of your initial assessment (risk factors for difficult airway) and preparation before induction.
• Outline a clear stepwise plan aligned with accepted airway algorithms (e.g., Difficult Airway Society / AAGBI principles) including oxygenation strategies, positioning, and attempt limits.
• Describe use of basic adjuncts first (e.g., better positioning, oral/nasal airways, bougie) and when you escalate to supraglottic airway devices.
• Explain decision points for awake techniques or postponing surgery if possible, and how you would communicate this to the surgical team and patient.
• Include contingency plans for surgical airway and how you'd mobilise available help (calling senior anaesthetist, ENT surgeon or transfer considerations).
• Address documentation and debriefing afterwards, and how you'd use the event for local process improvements or training.

What not to say

• Claiming you would proceed without checking or improvising without a plan.
• Relying solely on advanced devices (video laryngoscope, fibreoptic) without mentioning alternatives if they are unavailable.
• Focusing only on intubation technique and neglecting oxygenation or haemodynamic stability.
• Avoiding mention of communicating with the team or escalating to senior help.

Example answer

“Before induction I'd confirm risk factors (limited mouth opening, BMI, neck pathology) and ensure pre-oxygenation. My plan: pre-oxygenate with high-flow oxygen and position optimally. If direct laryngoscopy is difficult, I would limit attempts to two, use a bougie and optimise external laryngeal manipulation. If intubation fails but ventilation is possible, I'd insert a supraglottic airway and call for senior support. If neither ventilation nor oxygenation is achievable, I'd proceed to emergency cricothyroidotomy per protocol while asking theatre staff to prepare surgical help. Throughout I'd communicate with the surgeon and nursing staff about pausing the case and obtaining consent when relevant. After stabilising the patient, I'd document the event in the anaesthesia record and arrange a debrief with the team to identify equipment or system improvements for our district hospital.”

Introduction

Anesthesiologists frequently lead perioperative resuscitations. This situational question evaluates ability to perform ACLS/CPR, coordinate the team, manage reversible causes (e.g., hypovolaemia, tension pneumothorax), and make time-critical decisions in the South African operating-room context.

How to answer

• Use a structured approach (e.g., ABC/CPR/ROSC algorithm) and state immediate life-saving actions first (compressions, airway, oxygenation, effective ventilation).
• Describe how you would simultaneously assign roles (compressions, drugs, airway, IV/IO access, recorder) and maintain clear leadership and closed-loop communication.
• List steps to identify and treat reversible causes specific to the scenario (massive haemorrhage: control bleeding, massive transfusion protocol, IV/IO access, warm fluids, tranexamic acid).
• Mention advanced interventions you might initiate (external pacing if indicated, emergency thoracotomy in trauma if within protocol and resources).
• Explain how you would coordinate with surgical and blood-bank teams, request immediate blood products, and document timing of interventions and drug doses.
• Include post-resuscitation care considerations and plans for debriefing and communicating with the family and hospital administration.

What not to say

• Describing actions in a disorganised sequence without leadership or delegation.
• Ignoring reversible causes (e.g., focusing only on drugs rather than stopping bleeding).
• Failing to mention communication with the surgical team or blood bank in a haemorrhage scenario.
• Saying you would wait for a consultant to arrive before initiating resuscitation.

Example answer

“My immediate priority is high-quality CPR and securing airway/oxygenation. I would call for 'code blue' and clearly assign roles: someone on compressions, one person managing airway/ventilation, one for drugs/IV access and another to contact blood bank and prepare transfusion. Because the arrest follows major haemorrhage, I'd ask the surgeon to control bleeding urgently, activate the massive transfusion protocol, give tranexamic acid early, and warm IV fluids and blood. I'd follow ACLS algorithms for drug therapy while monitoring rhythm and end-tidal CO2 to assess CPR quality. If a reversible cause such as tension pneumothorax is suspected, I'd instruct immediate decompression. After ROSC, I'd focus on haemodynamic optimisation and transfer to ICU for ongoing care. Finally, I'd lead a debrief to review systems issues (timeliness of blood delivery, availability of equipment) and ensure the family is informed through the surgical/anaesthesia team as per hospital policy.”

Introduction

Resident anesthesiologists have an important role in education and maintaining safe care. South African hospitals often have steep hierarchies and high workloads; this behavioral/leadership question assesses teaching approach, professionalism, and ability to foster a safe learning culture.

How to answer

• Use the STAR format (Situation, Task, Action, Result) to structure your response.
• Describe the clinical setting, the learners' level and the competing demands (e.g., high throughput list, limited senior supervision).
• Explain how you ensured patient safety while providing supervised learning opportunities (direct supervision, graded responsibility, checklist use).
• Detail specific teaching methods you used (briefings, debriefings, bedside teaching, simulation, procedural demonstration) and how you adapted to learners' needs.
• Discuss how you managed hierarchical tensions and encouraged open communication and escalation when necessary.
• Quantify outcomes if possible (improved competency, fewer complications, positive feedback) and mention any lasting changes you implemented.

What not to say

• Claiming you prioritised training over patient safety or vice versa without showing balance.
• Giving vague descriptions without concrete examples of actions or outcomes.
• Saying you avoided addressing hierarchical issues or conflict.
• Overstating personal achievements without acknowledging team contributions.

Example answer

“At Groote Schuur Hospital, I supervised interns on a packed theatre list. Situation: the interns needed exposure to spinal anaesthesia but we had limited time and variable patient complexity. I briefed the team before each case to set learning objectives and safety checkpoints. For initial cases I performed the procedure with the intern watching, then progressed to supervised attempts with my hands nearby, using a time and attempt limit for safety. I introduced a simple checklist for consent, monitoring, and sterile technique so nothing was missed in the rush. I encouraged interns to speak up if they had concerns and modelled open escalation to seniors. As a result, interns' confidence scores improved on end-of-rotation feedback and there were no procedure-related complications during that period. We kept the checklist and briefing routine as part of our unit’s orientation for new learners.”

Introduction

Attending anaesthesiologists must act decisively during rare but life‑threatening intraoperative events. This question assesses clinical technical knowledge, situational leadership, communication under pressure and ability to follow protocols (including ANZCA guidelines and hospital emergency procedures).

How to answer

• Use a concise STAR structure: Situation (what happened), Task (your role/responsibility), Action (specific steps you took clinically and in leadership), Result (patient outcome and system changes).
• Start by naming the crisis and immediate clinical signs so interviewers know you recognised it promptly (e.g., rapid rise in ETCO2 and temperature for malignant hyperthermia).
• Describe the evidence‑based interventions you initiated (e.g., dantrolene administration, stopping triggering agents, high‑flow oxygen, active cooling for MH; intramuscular epinephrine, airway management for anaphylaxis; massive transfusion protocol for haemorrhage).
• Explain how you directed the team: role allocation (airway, IV/vascular access, medication preparation, blood bank liaison), clear verbal commands, closed‑loop communication and use of checklists or crisis resources.
• Mention documentation, communication with the surgical team and the family, escalation to ICU if relevant, and follow‑up (investigations, reporting to drug/device safety bodies, morbidity review).
• Quantify outcomes where possible (patient stabilized, transferred to ICU, duration of ventilation, survival) and describe any changes you implemented afterwards (protocol updates, simulation training).
• Reference local practice standards if relevant (ANZCA statements, hospital massive transfusion protocol, Australian Blood Service procedures).

What not to say

• Focusing only on clinical steps without describing how you led the team or communicated under pressure.
• Claiming sole credit and ignoring contributions of nurses, ODPs/anaesthetic technicians, surgeons and ICU staff.
• Failing to mention following established protocols or escalating when needed.
• Providing vague or theoretical answers without concrete, time‑bound actions or outcomes.

Example answer

“During a laparotomy at a tertiary public hospital in Melbourne, the patient developed sudden hypoxia, bronchospasm and a rapid increase in airway pressures after antibiotic administration — consistent with anaphylaxis. I immediately called for the emergency trolley and adrenaline, stopped the likely trigger, instructed the anaesthetic nurse to establish a large bore IV and request 1:10,000 adrenaline per ACLS guidance. I directed one team member to secure the airway and another to prepare second‑line vasopressors and crystalloids. Using closed‑loop commands I confirmed drug doses and monitored response; after two boluses of intravenous adrenaline the haemodynamics stabilised and bronchospasm resolved. I arranged urgent notification of ICU and the blood bank was informed as a precaution. The patient was extubated the following day and we reported the reaction to the hospital's adverse events system and the TGA. We later led a department debrief and modified our pre‑op allergy checklist and antibiotic administration pathway. This reinforced the value of early recognition, team coordination and systems learning.”

Introduction

Senior anaesthesiologists are expected to lead quality improvement (QI) initiatives that improve patient outcomes, safety and system efficiency in Australian public and private hospitals. This question evaluates systems thinking, change management, data literacy and ability to implement sustainable improvements aligning with ANZCA and hospital governance.

How to answer

• Frame the problem with baseline data (incidence, variation, adverse events) and why it mattered for patients and the service (wait times, cancellations, complications).
• Describe stakeholder mapping: who was involved (nurses, surgeons, theatre managers, ICU, pathology, hospital executive) and how you gained support.
• Explain the chosen QI methodology (e.g., PDSA cycles, root cause analysis, Lean, Six Sigma) and why it was appropriate.
• Detail the intervention components (process changes, checklists, education, electronic order sets, escalation criteria) and how you piloted them.
• State specific measurable outcomes, how you collected data, the timeframe and statistical or practical significance of results.
• Describe sustainability actions: embedding into policy, training, audit schedule, and how you reported to governance committees.
• Address barriers encountered and how you overcame them (resource limits, stakeholder resistance, IT constraints).

What not to say

• Describing a project without data or measurable outcomes.
• Claiming success without acknowledging team contributions or governance processes.
• Choosing unrealistic interventions or ignoring cost/resource implications in the Australian public health context.
• Failing to address sustainability and how change was embedded long term.

Example answer

“At a regional NSW hospital I led a QI project to reduce day‑of‑surgery cancellations for elective orthopaedic cases due to inadequate pre‑operative optimisation. Baseline data showed a 12% cancellation rate, mostly for unoptimised anaemia and uncontrolled diabetes. I formed a working group with surgical leads, pre‑admission nurses and corrective services. We used PDSA cycles to implement a pre‑admission anaemia screening and iron‑infusion pathway, standardised blood glucose optimisation protocols and an electronic pre‑op checklist linked to the patient administration system. Over six months cancellations dropped from 12% to 4%, average theatre utilisation improved and patient satisfaction scores increased. We presented the results to the hospital board and integrated the pathway into the pre‑admission clinic protocol, with quarterly audits to maintain improvement. Key success factors were multidisciplinary buy‑in, simple measurable processes and executive sponsorship.”

Introduction

Attending anaesthesiologists frequently make decisions about risks and perioperative goals with patients and families. In Australia, clinicians must adhere to legal and ethical standards around consent, capacity and advance care planning. This question tests communication, ethical reasoning, and cultural sensitivity.

How to answer

• Start by outlining legal/ethical principles: capacity assessment, voluntariness, disclosure of material risks, and documentation under Australian law and local hospital policy.
• Describe a structured approach: pre‑op review, explaining risks/benefits and alternatives in plain language, checking understanding, and eliciting patient values and goals.
• Explain processes when capacity is limited: involve an appointed substitute decision‑maker (e.g., medical treatment decision maker or enduring guardian), follow state laws, and consult the hospital ethics or legal service if needed.
• Address how you handle complex family dynamics: set up a private meeting, use neutral language, acknowledge emotions, seek common ground, and, where appropriate, involve social work or cultural liaison services (e.g., Aboriginal liaison officers).
• Mention documentation: detailed consent forms, contemporaneous notes of the discussion, and advance care directives where applicable.
• Give examples of shared decision‑making and how you balance respecting patient autonomy with promoting patient safety.

What not to say

• Overemphasising paternalism (making decisions without adequately involving patient/family).
• Using medical jargon or giving vague risk descriptions (e.g., 'rare' without context).
• Ignoring legal processes for substitute decision‑makers or advance directives in Australia.
• Failing to escalate to ethics, geriatric medicine or liaison services when needed.

Example answer

“For a frail 82‑year‑old patient with COPD and moderate dementia booked for emergency hip fixation, I arranged a pre‑op family meeting with the surgical team and the patient’s enduring guardian. I assessed capacity and documented that the patient had fluctuating capacity; therefore decision‑making rested with the guardian. I explained the anaesthetic options (regional vs general), the specific risks given comorbidities (respiratory failure, prolonged ventilation), and the likely postoperative trajectory including risks of ICU admission. I asked about the patient's previously expressed values and whether life‑sustaining treatments would be consistent with those goals. The family prioritised pain relief and return to baseline mobility rather than prolonged ICU interventions, so we planned a spinal anaesthetic with sedation and a clear escalation plan. Everything was documented, and the plan was communicated to theatre and ICU. The approach combined respect for legal requirements, clear risk communication and alignment with patient values — reducing the chance of conflict and unexpected interventions post‑op.”

Introduction

Senior anesthesiologists must rapidly diagnose, resuscitate, and coordinate the team during massive hemorrhage. This question assesses clinical decision-making, leadership in crisis, and familiarity with blood-management protocols common in Canadian tertiary centres.

How to answer

• Start with a brief structured summary of the patient context (comorbidities, baseline labs, type of surgery) to set the scene.
• Use the ABCs/algorithmic approach: airway, breathing/ventilation adjustments, circulation with hemorrhage control priorities.
• Describe immediate resuscitation steps (two large-bore IVs or rapid infuser, call for help, activate massive transfusion protocol (MTP), tranexamic acid if indicated, permissive hypotension considerations).
• Explain monitoring and diagnostic actions (arterial line, point-of-care blood gas, hemoglobin/hematocrit trends, TEG/ROTEM if available) and how results guide transfusion targets.
• Include coordination with the surgical team (temporary hemorrhage control measures), blood bank (product ratios, component therapy), and ICU/vascular surgery/hematology if needed.
• Discuss post-resuscitation management: reversal of coagulopathy, temperature management, metabolic correction, documentation and family communication.
• If relevant, mention adherence to institutional protocols (e.g., MTP at Sunnybrook/Toronto General) and provincial blood availability considerations in Canada.

What not to say

• Giving a purely theoretical answer without specifying concrete actions (e.g., 'I would give fluids' without details).
• Failing to mention activation of massive transfusion protocols or engaging the blood bank.
• Ignoring monitoring/diagnostic steps (no arterial line, no point-of-care testing) or transfusion thresholds.
• Portraying the event as a single-person effort rather than team coordination and communication.

Example answer

“In a 65-year-old with ischemic heart disease undergoing a colectomy who suddenly develops brisk bleeding, I would first confirm airway and ventilation are stable and request immediate help. I would call for the massive transfusion protocol, request two large-bore IVs or place a rapid infuser, and insert or confirm an arterial line for continuous BP monitoring. I would give TXA per guidelines unless contraindicated and start balanced crystalloid judiciously while aiming for permissive hypotension if tolerated. Simultaneously I would ask surgery to apply temporary hemostatic measures (suture/compression/packing) and coordinate with the blood bank for 1:1:1 product delivery while using point-of-care ROTEM to guide targeted therapy for fibrinogen and platelets. I would manage temperature, correct acidosis and hypocalcemia, and prepare for possible ICU transfer. Throughout, I would maintain closed-loop communication with the team, document actions, and ensure the family is updated via the surgeon and ICU team. At my previous role at St. Michael’s Hospital I led a similar event and by promptly activating MTP and using ROTEM-directed therapy we stabilized the patient and avoided delayed coagulopathy.”

Introduction

Senior anesthesiologists must advocate for patient safety while maintaining collaborative relationships. This behavioral/situational question evaluates communication, conflict resolution, professional judgement, and ability to escalate concerns appropriately within Canadian hospital culture.

How to answer

• Use the STAR framework: Situation, Task, Action, Result to structure the response.
• Clearly state the clinical concern and why it posed a safety or ethical issue (e.g., inadequate pre-op optimization, airway risk, lack of consent).
• Explain the specific steps you took to communicate your concern (evidence-based rationale, referencing guidelines or risks).
• Describe how you sought collaboration (alternative plans, consulting colleagues, involving surgical lead or department head if needed).
• Mention escalation pathways used in Canada (anesthesia lead, perioperative patient safety committee, or ethics consult) if resolution stalled.
• Conclude with the outcome and what you learned about maintaining patient safety and interdisciplinary relationships.

What not to say

• Portraying the conflict as a personal attack or bragging about being confrontational.
• Saying you backed down without advocating for patient safety.
• Failing to provide a concrete example or outcome.
• Suggesting you would unilaterally cancel procedures without attempting collaborative solutions.

Example answer

“At a tertiary centre in Toronto I was scheduled to anesthetize a frail 78-year-old for urgent hip fixation. The surgeon wished to proceed under general anaesthesia with neuraxial block withheld due to antithrombotic therapy; however the patient had severe COPD and prior difficult ventilation. I raised my concerns privately with the surgeon, outlining the airway risk and suggesting an awake regional-first approach with sedation as an alternative, referencing CSANZ/Canadian Anesthesia Society guidance and the patient’s pulmonary status. When we couldn’t agree initially, I arranged a brief multidisciplinary huddle including the surgical lead and regional anesthesia colleague; we reviewed risks and the patient’s preferences. We agreed to proceed with a combined approach: awake fascia iliaca block and monitored sedation with standby GA and fiberoptic intubation plan if needed. The case proceeded uneventfully. This taught me the value of early, evidence-based communication and using collegial escalation to align on patient-centred plans.”

Introduction

Senior anesthesiologists play key roles beyond the OR: designing protocols, leading QI projects, and improving patient outcomes. This competency/motivational question assesses initiative, knowledge of perioperative pathways, and experience with change management in the Canadian healthcare context.

How to answer

• Begin by stating which specific system-level area you’ve worked on (ERAS, opioid reduction, perioperative glucose control, etc.) and why it mattered for patients.
• Describe your role (project lead, working group member, data analyst, educator) and the stakeholders involved (surgery, nursing, pharmacy, administration).
• Explain the methods used: baseline data collection, PDSA cycles, protocol development, education sessions, order-set or EMR changes, and measurement of outcomes.
• Provide specific, quantifiable outcomes (reduced length of stay, opioid morphine equivalents, readmission rates, compliance rates) and timelines.
• Discuss barriers encountered (resource constraints, clinician buy-in) and how you addressed them.
• Finish with lessons learned and how you would apply them in a Canadian provincial hospital setting.

What not to say

• Giving vague claims of involvement without measurable outcomes.
• Implying change was implemented single-handedly without multidisciplinary input.
• Overlooking regulatory or resource context in Canadian hospitals (provincial funding, staffing limitations).
• Focusing only on clinical details without mentioning data and continuous improvement methodology.

Example answer

“At Vancouver General Hospital I co-led an ERAS implementation for colorectal surgery as the anesthesia lead. We started with a baseline audit showing median LOS of 7 days and high perioperative opioid use. I convened a multidisciplinary working group (surgery, nursing, pharmacy, physiotherapy, and QI specialists), developed standardized order sets in the provincial EMR, and ran weekly PDSA cycles. We emphasized multimodal analgesia (regional blocks, acetaminophen, NSAIDs where appropriate) and opioid-sparing protocols. Over 12 months median LOS dropped to 4 days, average opioid consumption decreased by 45%, and surgical site infection rates declined slightly. Key to success was targeted education, easy-to-use order sets, and continuous feedback to providers. I would bring the same pragmatic, data-driven approach and stakeholder engagement to any Canadian centre aiming to improve perioperative care.”

Introduction

As Chief Anesthesiologist in a French hospital system (e.g., AP-HP or a CHU), you must ensure high standards of perioperative safety and lead multidisciplinary responses when things go wrong. This question evaluates clinical leadership, systems thinking, and your ability to translate adverse events into durable improvements.

How to answer

• Use a clear structure (brief context, actions, results, lessons) similar to STAR.
• Start by succinctly describing the adverse event, patient impact, and immediate clinical response (without breaching confidentiality).
• Explain how you led the investigation (root cause analysis, involvement of hygiene/risk management/HAS recommendations) and who you engaged (surgeons, nursing, pharmacy, perfusionists, quality team).
• Detail concrete interventions you implemented (protocol changes, checklists, simulation training, equipment changes, medication safety systems) and how you prioritised them.
• Quantify outcomes where possible (reduction in incident rate, compliance with checklist, audit results, time to recognition of deterioration).
• Describe how you communicated with staff and patients/families, how you ensured follow-up, and how you embedded monitoring (dashboards, morbidity & mortality meetings).
• Conclude with lessons learned and how you prevented recurrence (policy changes, culture shifts, and continuous improvement mechanisms).

What not to say

• Overemphasising individual blame or claiming single-handed resolution without team input.
• Giving vague answers with no measurable outcomes or follow-up mechanism.
• Avoiding mention of involving the hospital's risk management or regulatory guidance (HAS).
• Describing only clinical steps and ignoring systems, communication, or education aspects.

Example answer

“At my former CHU, an unplanned awareness event during a complex ENT case prompted an immediate response. I convened a multidisciplinary review, engaged the hospital's quality unit and followed a structured root-cause analysis aligned with HAS guidance. We found gaps in drug labelling and a non-standardised monitoring setup for anaesthesia depth. I led implementation of three interventions: standardised pre-induction drug labelling and double-checks, introduction of routine BIS monitoring for specific high-risk procedures, and quarterly simulated crisis drills for the OR team. Over 12 months audits showed a 90% adherence to new labelling procedures and no further awareness incidents in similar cases. We shared results at the regional clinical governance meeting and integrated the changes into resident training. The experience reinforced the need to address both technical and cultural contributors to safety.”

Introduction

This situational question assesses your operational decision-making, resource allocation, coordination with hospital administration (direction des soins), and capacity to balance clinical priorities under pressure—key responsibilities for a Chief Anesthesiologist in the French health system.

How to answer

• Start by describing how you would gather real-time data (ICU occupancy, ventilator availability, surgical urgency categories) and who you would consult (ICU director, surgical leads, hospital crisis cell, medical director).
• Explain your prioritisation framework (urgent/emergent surgeries, cancer and limb-threatening procedures, postponable elective cases) and reference national/regional guidance if applicable.
• Describe short-term measures to expand capacity: redeploying anaesthetists to ICU, using anaesthesia machines as ventilators with respiratory physiologist support, mobilising senior residents, and cancelling or rescheduling non-urgent lists in a transparent manner.
• Discuss staff wellbeing and rostering: fair rota changes, limiting consecutive high-stress shifts, ensuring PPE and psychological support, and clear communication channels.
• Cover equipment logistics: inventory of ventilators, maintenance checks, coordinating with biomedical engineering and procurement, and tracking consumables (sedatives, neuromuscular blockers).
• Address stakeholder communication: informing surgeons, patients (consent and rescheduling), regional health agency (ARS) if escalation needed, and documentation of triage decisions.
• End with monitoring and contingency planning (daily capacity meetings, triggers for further restrictions, and criteria for reinstating elective activity).

What not to say

• Claiming you would simply cancel all electives without a prioritisation plan or communication strategy.
• Ignoring staff safety, burnout risk, or legal/ethical considerations for triage.
• Failing to reference collaboration with ICU and hospital leadership or regional health authorities (ARS).
• Relying on improvisation without real-time data and escalation thresholds.

Example answer

“I would start by convening the perioperative-ICU coordination group for a rapid situational assessment (ICU occupancy, ventilator stock, scheduled oncology or time-sensitive surgeries). Using a transparent prioritisation rubric (life/limb/organ-saving, oncologic urgency, functional outcomes), we'd defer truly elective procedures while preserving cancer and urgent trauma lists. To increase ICU capacity, I would redeploy experienced anaesthetists to support ICU teams and coordinate with biomedical engineering to validate selected anaesthesia ventilators for prolonged ventilation, ensuring respiratory physiologist oversight. I would implement shorter, staggered OR lists to reduce staff fatigue, ensure backup shifts, and request surge support from regional partners through ARS if needed. Communication would be proactive: surgeons and patients receive clear rationales and rescheduling plans, and we would monitor key metrics daily with predefined triggers to scale up or down. This approach balances patient safety, fairness, and staff wellbeing.”

Introduction

This motivational question explores alignment with the role's breadth—clinical excellence, training of future anaesthetists (internes and DES), and hospital leadership—and whether your values and career goals fit the demands of a departmental head in the French healthcare environment.

How to answer

• Explain personal and professional drivers: patient care, improving systems, mentoring the next generation, and contributing to hospital strategy.
• Give concrete examples of past experiences that show a sustained interest in leadership or education (teaching at the DES level, organising on-call rotas, leading audits or research with INSERM links).
• Connect motivations to the role's impact on patients and staff (improving safety, shaping departmental culture, influencing regional practice through ARS/HAS collaboration).
• Describe how you balance clinical practice with administrative tasks and maintain competence (protected clinical sessions, continuing professional development, peer review).
• Mention long-term goals for the department: training excellence, research collaborations, implementing evidence-based protocols, or improving perioperative pathways.

What not to say

• Focusing solely on prestige, salary, or career advancement without patient or team-centric reasons.
• Saying you dislike administrative work or intend to delegate all non-clinical tasks.
• Providing generic motivations without concrete past examples or plans for balancing duties.
• Ignoring the French system's specific responsibilities (DES training obligations, liaison with ARS/HAS, public hospital constraints).

Example answer

“I'm motivated by the opportunity to improve perioperative outcomes at scale while staying actively involved in clinical anaesthesia. Throughout my career at a regional CHU, I led a resident training programme that improved trainee pass rates for DES examinations and introduced regular simulation-based crisis training. I also chaired an ERAS implementation group that reduced median length of stay after colectomy. I enjoy mentoring young anaesthetists and influencing systems—working with nursing leadership and the hospital executive—to deliver safer, more efficient care. In this Chief role I would protect clinical sessions to maintain hands-on skills, allocate time for educational leadership, and prioritise initiatives that yield measurable patient benefit and strengthen our department's teaching and research profile.”

Introduction

As Director of Anesthesia you must balance clinical quality, resource allocation and regulatory compliance across operating theatres and intensive care units (often across multiple hospital sites or departments in Italy's Azienda Ospedaliera system). This question evaluates leadership, operational management and patient-safety focus.

How to answer

• Use the STAR structure: set the scene (context), explain the task you faced, describe the actions you took, and conclude with quantifiable results.
• Start by describing the specific Italian context (e.g., public hospital, regional constraints, staffing models, or recent surge such as COVID-19 pressures).
• Explain how you assessed current state: metrics used (OR utilisation, turnover times, PACU/ICU bed availability, adverse events, staff rostering), stakeholder interviews, and guideline review (Ministero della Salute, SIAARTI recommendations).
• Describe concrete changes you implemented: staffing reallocation, schedule redesign, standardised protocols (checklists, handoffs), escalation pathways between OR and ICU, and training or simulation sessions.
• Detail how you engaged multidisciplinary teams (surgeons, ICU physicians, nursing, perfusionists, hospital administration) and how you addressed union/collective bargaining or labor rules if relevant.
• Provide measurable outcomes (reduced turnover time, increased on-time starts, reduced cancellations, decreased complication rate, improved staff retention) and any follow-up monitoring or continuous improvement steps.
• Reflect on lessons learned and how you would scale or adapt the solution to other Italian hospitals or regions.

What not to say

• Focusing only on high-level strategy without giving measurable outcomes or concrete steps.
• Claiming you made unilateral decisions without stakeholder engagement (takes sole credit).
• Ignoring the regulatory, union or budgetary constraints typical in Italian public hospitals.
• Overemphasising technical clinical details without addressing process, communication and safety systems.

Example answer

“At an Azienda Ospedaliera in Milan experiencing elective-surgery cancellations and ICU bed shortages, I led a cross-disciplinary review. We mapped OR utilisation and PACU/ICU bottlenecks and introduced a staggered scheduling model and standardised anaesthesia-to-ICU handover checklists based on SIAARTI guidance. I reallocated two experienced anaesthesia teams to peak hours and implemented weekly surge plans with hospital management. Within three months on-time starts increased from 68% to 88%, elective cancellations due to ICU unavailability dropped by 60%, and staff-reported handover safety scores improved. We used the same metrics to sustain improvements and presented results to the regional health authority for wider adoption.”

Introduction

ERAS protocols require multidisciplinary coordination, evidence-based anaesthesia techniques, and data-driven monitoring. For a Director of Anesthesia in Italy, successful implementation improves outcomes, reduces length of stay and aligns with national quality initiatives.

How to answer

• Begin by outlining your approach to stakeholder alignment: engage surgical leads, nursing, physiotherapy, dietitians, and hospital administration.
• Describe selection and adaptation of ERAS elements relevant to anaesthesia (e.g., multimodal analgesia, opioid-sparing strategies, normothermia, fluid management, PONV prevention, early mobilisation) and reference evidence or guidelines.
• Explain the implementation plan: pilot sites, staff training (including simulation), protocol documents in Italian, and integration into electronic health records/order sets.
• Detail a monitoring framework: key performance indicators (length of stay, opioid consumption, time to ambulation, readmission rates, patient-reported outcomes), data collection methods and dashboard reporting frequency.
• Address change management: how you’ll handle clinician resistance, continuous education, and use of small tests of change (PDSA cycles).
• Include considerations for Italian-specific factors: regional reimbursement incentives, regulatory reporting, and language/cultural adaptation for patient education materials.

What not to say

• Saying you'll 'just instruct clinicians' without describing education, pilot testing or metrics.
• Ignoring how to measure impact or sustain the program over time.
• Proposing a one-size-fits-all protocol without adapting to surgical specialty needs.
• Underestimating logistical issues such as perioperative nursing roles or IT integration in the hospital.

Example answer

“I would start with a multidisciplinary ERAS working group involving leads from anaesthesia, orthopaedics, colorectal surgery, nursing and physiotherapy. We would select evidence-based anaesthesia elements—pre-emptive multimodal analgesia, regional nerve blocks for orthopaedics, minimised intraoperative opioids, strict temperature and fluid management—and create standardised order sets in the hospital EHR. We’d pilot ERAS in one orthopaedic and one colorectal pathway, deliver targeted training sessions in Italian, and provide patient education leaflets adapted to local language and expectations. Monitoring would be via a dashboard tracking length of stay, opioid use (morphine equivalents), PONV rates and 30-day readmissions, reported monthly to clinical governance. After demonstrating improved outcomes and reduced average LOS by two days in the pilot, we’d scale the program hospital-wide with ongoing PDSA cycles and continuous staff feedback.”

Introduction

Regional crises demand rapid operational decisions that balance clinical need, ethical triage, workforce safety and coordination with regional health authorities. This situational question assesses crisis leadership and systems thinking in the Italian healthcare environment.

How to answer

• Describe initial assessment steps: situational awareness (case numbers, ICU occupancy, ventilator/ECMO availability), staff capacity, and shortfalls.
• Explain triage and prioritisation principles: clinical criteria for ICU admission, ethical frameworks, and legal/regulatory considerations under Italian regional health directives.
• Outline operational actions: creating surge capacity (repurposing ORs/recovery areas), redeploying anaesthesia staff with appropriate supervision and rest cycles, fast-track training for non-ICU staff, and supply chain coordination for consumables and PPE.
• Discuss regional coordination: real-time data sharing with regional health authority, transfer agreements between hospitals, and use of referral centres (e.g., specialised ECMO centres like San Raffaele or Humanitas when relevant).
• Address staff welfare: psychological support, occupational health measures, and transparent communication about rostering and risks.
• Conclude with monitoring and de-escalation criteria and how you'd document decisions for legal and ethical accountability.

What not to say

• Suggesting indiscriminate redeployment without supervision or training for anaesthesia staff working in ICU roles.
• Failing to mention ethical triage principles or regional coordination mechanisms.
• Overlooking staff safety, rest periods and psychosocial support.
• Claiming to make unilateral decisions without involving hospital leadership or regional authorities.

Example answer

“Facing a regional surge, I would first convene an emergency operations group to gather real-time data on ICU occupancy, ventilator and ECMO capacity, and staff availability. Using established ethical triage frameworks and regional directives, we would prioritise critical care for patients most likely to benefit and expand capacity by converting recovery rooms to temporary ICU bays. I’d redeploy experienced anaesthesia intensivists to supervise mixed teams, run rapid upskilling sessions for OR nurses, and institute 12-hour shift limits with mandatory rest and psychological support. Simultaneously, I would coordinate transfers to specialised centres (e.g., San Raffaele) when necessary and share capacity dashboards with the Regione. All actions would be documented and reviewed daily with criteria to scale down as admissions fall.”