The management station in an ST3 surgical interview is where the assessors find out what kind of registrar you will be to work with. The scenarios are about the list, the team and the culture of theatre, and they are scored on patient safety, professionalism, communication and leadership. Candidates who have prepared only the clinical scenarios are caught out by how much judgement these require. This guide covers the scenarios that recur and the structure that scores.
The overbooked list
You are the registrar. The theatre list is overbooked, the consultant is in clinic, and the anaesthetist is refusing to start a case they consider unsafe. What do you do?
The trap is to treat the anaesthetist as an obstacle. Patient safety first: you do not pressure them. Find out the concern; it is usually a specific one about the patient, the equipment or the time. Address what can be addressed. Phone the consultant with the situation and a proposal. Then reorganise the list: which cases must happen today, which can be rescheduled, who tells the patients and how. Say that you would speak to the theatre coordinator and the ward, and that the patients being cancelled deserve an honest explanation from you, not a message from the nurse.
The assessors score whether you respect the anaesthetist's veto, whether you involve the consultant appropriately, and whether you lead the reorganisation rather than freezing.
The consultant belittling a trainee
You witness a consultant surgeon shouting at and belittling a trainee in theatre. What do you do?
In the moment: if the patient or the trainee is at risk, say something calm and specific that lowers the temperature, such as suggesting a pause. Afterwards: speak to the trainee privately, support them, and find out whether this is a pattern. Then the reporting route: the trust's freedom to speak up guardian, the educational supervisor, the clinical director, and the college's position that this behaviour is not acceptable. Say what you would do if the consultant were your own supervisor, because the assessors will ask. The common failure is the candidate who would do nothing because the consultant is senior.
The struggling junior
A junior on your team is not coping and patients are affected. Patient safety first: check what is outstanding and cover it. Then speak to the junior privately and early, find out what is going on, and offer practical help with the workload. If it continues or if there is a wellbeing concern, involve their supervisor. Say how you would make the junior feel supported rather than targeted, and what you would do if they refused help.
The technical error you believe you saw
A patient's wound dehisced after an operation you assisted on and you believe a technical error was made. The patient's care first. Then honesty: tell the consultant what you observed, take part in open disclosure with the patient, present at the morbidity and mortality meeting. Do not speculate to the family about blame. The assessors are testing whether you will speak up about a senior's error and whether you know the process.
The impaired colleague
Patient safety means the colleague does not operate today. Say so kindly, keep them from the clinical area, tell the consultant and the clinical director, and support the colleague. Know the GMC's guidance and the duty to act.
Consent for a procedure you have never seen
You do not consent. Consent requires understanding the procedure, its risks and its alternatives; explain why to whoever asked and find someone who can. Say how you would learn the procedure for next time.
The structure for all of them
Patient safety first. Then information: what is actually going on. Then escalation through the right route, with the consultant involved appropriately. Then support for everyone involved, including yourself. Then the next step if the first does not work, because the probe is always "and if that did not resolve it?".
What the assessors score
Whether you keep patients safe, whether you lead rather than defer, whether you respect colleagues across professions, whether you would speak up, and whether you know the processes. A registrar who manages the list well, protects the trainee and reports the error is the colleague every department wants.
Practising
Talk each scenario through aloud with the next step ready, then have someone play the consultant who denies it, the anaesthetist who will not explain, the junior who refuses help. The assessors will push, and the ability to stay calm and structured under that pressure is the mark of the top band.