The Royal Australasian College of Surgeons assesses surgeons and selects trainees against a set of competencies, and the five station SET interview scores against them explicitly. Candidates who know the competencies can frame answers so that assessors find the competency in them, which is easier to score than an answer the assessor has to interpret. The competencies are the surgical adaptation of the CanMEDS framework and they overlap with the roles used by other colleges.
The competencies
Medical expertise. The surgical knowledge and clinical skill. Tested in the clinical stations: obstruction, biliary sepsis, trauma, the deteriorating post operative patient.
Judgement and clinical decision making. Deciding when to operate, when not to, when to transfer, when to wait. Tested in every clinical station through the decision point and the probes: the consultant two hours away, the patient who refuses.
Technical expertise. Operative skill and its development. Tested through the logbook questions, the account of your operative experience, and your honesty about what you can and cannot do.
Professionalism. Ethics, conduct, honesty, reflection. Tested through the dehiscence you believe was an error, the impaired colleague, consent for a procedure you have never seen, and the error you made.
Communication. With patients, families and the team. Tested through the family conversations in the clinical stations and the communication examples.
Collaboration. Working with the theatre team, anaesthetists, nurses, other specialties. Tested through the anaesthetist refusing to start, the teamwork examples, and conflict with a senior.
Management and leadership. Running a list, a ward, a team, a project. Tested through the overbooked list, the struggling junior, the leadership example, and the audit.
Health advocacy. Advocating for patients and populations, including rural and Aboriginal patients. Tested through the cultural safety question and the rural rotation question.
Scholarship and teaching. Research, audit, teaching, lifelong learning. Tested through the research question, the audit, and teaching experience.
Cultural competence and cultural safety. Added as a named competency and tested directly: how you provide culturally safe surgical care, with actions rather than a definition.
How to prepare
Write the competencies down. Under each, prepare one STAR example and one scenario answer with your own actions and an outcome. Map the clinical stems to medical expertise and judgement, the non technical scenarios to professionalism, collaboration and management, and the cultural safety question to its own competency. In the station, name the competency in your signpost where it is natural: "This is a judgement question about when to operate, and I would..."
In the SET interview
Five stations of ten minutes with two minutes reading time, two panel members each, three clinical and two non technical, two questions plus probing. The assessors score each station independently against the competencies the station targets. Using the reading time to identify the competency being tested, and structuring the answer to show it, is the single most useful habit.
Other colleges
ANZCA uses roles in practice with similar content; the physician colleges use professional qualities; emergency medicine uses curriculum domains. The ANZCA roles page covers the anaesthetic version.
Practising
Have someone read a station stem and ask you to name the competencies before you answer, until the mapping is automatic. Then run the stations against the clock with probing.