The core surgical training interview is thirty minutes online, in two fifteen minute stations with the same panel, and it decides a large share of your ranking. The format is published and the questions recur, which makes it one of the most preparable interviews in surgery. This guide covers the questions that come up in nearly every interview and what the assessors are scoring in each.
The format
Station one is management and clinical: two clinical scenario questions of five minutes each, given to you in the interview, plus a management question. Station two is portfolio: a prepared three minute presentation, two minutes of questions on it, then two portfolio questions of five minutes each on domains the assessors choose. The MSRA contributes a small share of the total; the interview contributes most of the rest, with the management and clinical station weighted heavily.
The clinical scenarios
Two scenarios, five minutes each, pitched at FY2 to CT1 level. The assessors want a safe, systematic approach and an escalation with a clear request, not a consultant's operative plan. The scenarios that recur:
- The seventy year old with abdominal distension, vomiting and no bowel motion for three days.
- The patient three days after a right hemicolectomy with a heart rate of 130, a temperature of 38.5 and abdominal pain.
- The stabbing to the chest with a blood pressure of 80.
- Right upper quadrant pain, fever and jaundice.
- Melaena with a haemoglobin of 70.
- The painful, pale, cold leg.
- The pregnant woman with right iliac fossa pain.
- The head injury on anticoagulants with a GCS of 14.
- The patient on warfarin who needs an emergency laparotomy.
Answer as the surgical SHO: ABCDE, resuscitation, the investigations and why, the likely diagnosis and what you must exclude, the immediate management, and the call to the registrar with SBAR. When the assessors worsen the scenario, go back to ABCDE. Say what you would tell the patient and the family.
The management question
One scenario testing judgement and professionalism rather than clinical knowledge:
- You are the surgical SHO. The registrar is scrubbed, the consultant is in clinic, and a post operative patient is deteriorating. What do you do?
- A consultant shouts at and belittles a trainee in theatre. What do you do?
- A patient's wound dehisced after an operation you assisted on and you believe a technical error was made.
- You are asked to consent a patient for a procedure you have never seen.
- A patient with capacity refuses an operation you believe they need.
- A colleague appears to be operating while impaired.
Patient safety first, then information, then escalation through the right route, then support for the people involved. Say what you would do rather than what should happen, and give the next step when the first fails.
The presentation
A prepared three minute presentation on a title such as why you should be appointed, your most significant achievement, or a case that confirmed your decision to pursue surgery. It is followed by two minutes of questions. One message, three supporting points, a close, and a timing that lands at two minutes fifty. Practise it until it is reliable without a clock.
The portfolio questions
Two questions of five minutes on domains the assessors select from your portfolio: operative experience and the logbook, teaching, audit and quality improvement, research, leadership and management, commitment to surgery. The questions that recur:
- Which achievement best shows you are ready for core surgical training?
- Tell us about your operative experience and the procedures in your logbook.
- Tell us about an audit or QI project you have done and what changed.
- Tell us about teaching you have delivered and how you know it worked.
- What research have you done, and what did you learn from the process?
- Why surgery, and what have you done to prepare for a surgical career?
Each needs a specific example with a result and a line of reflection. The assessors have your portfolio in front of them and will probe: which part of the audit was yours, how many of those procedures were you first operator for, what did the research find.
Preparing
Three weeks out: the nine clinical scenarios, each talked through aloud with the escalation, and the six management scenarios with their next steps. Two weeks out: the presentation written, cut and timed, and one minute answers to the portfolio questions with a specific in each. One week out: full timed runs of both stations with someone who probes, because the assessors will. The candidates who do well are rarely the ones with the biggest logbooks; they are the ones whose answers survive five minutes of questions.