Guidance

Breast screening: guidance on overseas radiographic recruitment

Updated 20 September 2021

Introduction

This guidance helps address the workforce shortfall in mammography by supporting the process of radiographer recruitment into the NHS Breast Screening Programme (NHS BSP). We recommend that you consider both local and international recruitment.

The questions and assessments provided below are to encourage a standard interview process for all candidates, whether applying from home or abroad. You should ask the same questions to all candidates, whatever their background. However, as candidates may or may not already hold the relevant postgraduate qualification, the questions are in 3 groups to help differentiate between them.

The interview process should be stringent to reassure the employer that they are suitable for a role in the NHS BSP. For candidates who cannot demonstrate they are already trained to this standard, the interview should also offer assurance that the individual could achieve the qualification.

Recruiting managers should use this guidance in conjunction with national and local employer policies.

NHS Employers has useful guidance on:

• their code of practice for international recruitment
• how to attract and recruit the best people

The Society of Radiographers has advice on working as a radiographer in the UK.

Minimum requirements

To work in mammography in the NHS BSP radiographic practitioners must:

• hold or be prepared to undertake a UK Regulated Qualifications Framework (RQF) level 7 postgraduate qualification in mammography or
• hold an equivalent level of training from their country of education

Candidates without a postgraduate qualification will need to undertake the qualification regardless of whether they are experienced in breast imaging. However, elements in the module may be considered for accreditation of prior experiential learning (APEL). The individual may also be fast-tracked based on previous clinical experience and knowledge gained.

More information on qualifications is available in the guidance for breast screening mammographers.

Assessing the application

You should prioritise applicants who:

• are educated to BSc(Hons) degree in Radiography (level 6) or equivalent with current (or intention to obtain, in the case of international applicants) Health and Care Professions Council (HCPC) registration
• have mammography-related post-registration qualifications

Where applicants with international qualifications apply, the employer will need to evidence equivalency of their qualifications to those in England. UK ENIC is the national agency that carries out recognition and comparison of international qualifications and skills against UK requirements. There is a charge for this service.

Interview structure

You should assess a candidate’s suitability using:

• a presentation with questions and answers
• a short timed written assessment
• set interview questions

Presentation

We recommend asking candidates to give a formal presentation. This allows assessment of verbal and written communication skills alongside knowledge of the subject area. It also allows them to demonstrate critical analysis in the presentation and in the subsequent questions and answers.

When offering a candidate an interview, you should provide details of the presentation requirements so they can prepare. We recommend they produce the presentation in a format that they can display on a computer screen and that leave you a copy of this. The duration of the interview should be 5 to 10 minutes, plus time for questions from the interview panel.

Potential presentation topics may include:

• whether there is a difference between symptomatic mammography versus screening mammography
• what their understanding is of equality in screening mammography
• the complexities around communication in breast screening
• describing a breast screening service
• what are the pros and the cons of the NHS Breast Screening Programme
• what makes a good radiographer in a breast screening service
• the issues around gaining consent in breast screening

Written assessment

As part of the interview, we suggest you ask candidates to type a brief response to a question. This allows you to assess their written skills and ability to respond under time pressure, typically 15 minutes. It will also assess whether the candidate is capable of successful postgraduate writing.

If the interview is conducted by video-conferencing facility, this element of assessment should be undertaken in full view of all panel members and then emailed to the panel.

You will need to ascertain if any candidates have dyslexia or require additional support. If they do, follow local policy to make reasonable adjustments, such as giving extra time.

Suggested questions

1. How would your colleagues describe you?
2. What would your referees say about you?
3. How do you respond to criticism professionally and personally?
4. How would you describe yourself as a radiographer?
5. What experience have you had so far that has prepared you for this role?
6. Why do you want to specialise in mammography? (if applicable)

Interview questions

You are likely to get a wide range of applications, from the newly qualified to individuals with a high level of experience within the field of mammography. The panel should ask the same questions to all candidates. While the level of knowledge and experience may not be comparable across all candidates, we recommend selecting some more testing questions. These will identify:

• depth of knowledge in more experienced candidates
• natural aptitude in less experienced candidates

This should enable a valid comparison between candidates as part of the selection process.

Introductory questions for all candidates

All candidates should be capable of answering the following questions. Poor answers to these questions may indicate an unsuitable candidate. The interview panel should select a few questions from the following.

1. What do you know about this specific breast unit and why do you want to work here?
2. What skills and knowledge does a mammographer need in comparison to a general radiographer?
3. Do you consider mammography a specialist field?
4. How did you prepare for the interview?
5. Can you give evidence of any research and audit you have undertaken?
6. What is the role of the operator under Ionising Radiation (Medical Exposure) Regulations (IRMER)?
7. What do you understand by skill mix in mammography?
8. What is the role of the practitioner under IRMER in mammography?
9. How does the role that you have applied for fit within the team working in a breast screening unit?
10. How would you explain the benefits of screening to a very anxious client?
11. Where do you see yourself in 5 years’ time?
12. Describe the radiographic career structure within English breast screening.
13. Screening is a 2-stage process. What equipment is used in England to obtain a breast cancer diagnosis?
14. What makes a good breast screening experience?
15. If you were screening on a mobile facility and 2 women arrived for screening at the same time, how would you handle the situation?
16. What challenges would you envisage coming to work here?
17. How would you deal with a challenging client or colleague?

Questions for qualified radiographers with experience in radiography/mammography

Applicants who have been qualified as radiographers with some experience in radiography and/or minimal experience in mammography practice should answer these questions well.

1. What would you do if a client asked for a thyroid shield during a screening procedure?
2. How would you respond to the following question: Will my mammogram give me cancer?
3. How would you maintain good working relations in a culturally diverse team?
4. How would you ensure meeting the needs of culturally diverse clients?

Questions for candidates to assess their level of experience

These questions help to differentiate between radiographers who claim more experience and who may have worked in mammography at home or abroad. They should be answered well by candidates who claim significant experience or knowledge.

Those with less experience should show an ability to recognise issues beyond their knowledge base and provide suggestions for how they would manage the situation. They should also explain how they would acquire the knowledge for future similar situations.

These questions help to demonstrate analytical skills, demonstrate relevant continuing professional development (CPD) and awareness of current issues around breast screening.

1. If a woman asks you about how dense her breasts are, how would you respond?
2. What do you know about the relevance of breast density to breast cancer risk?
3. How would you respond to a query from a woman asking why the breast screening service doesn’t measure breast density?
4. What advice would you give to a woman asking about her risk of breast cancer?
5. How might risk stratification impact on the breast screening programme?
6. What technologies are likely to impact most on breast screening in the near future?
7. There is a workforce crisis in the field of breast screening. What actions can the service take to improve workforce numbers?
8. How is quality assurance managed nationally for breast screening, and why is this important?