General surgery: NHS Consultant Interview Questions

The general surgery questions that sit on top of the consultant appointments core: clinical scenarios, the system and governance questions specific to the specialty, and presentation titles.

Updated 7 November 2026

The structures these questions are marked on

  • SAFER See the patient, Assess systematically with ABCDE, Fix what you can and decide, Escalate with a clear request in SBAR or ISBAR, Review: the patient told, the handover, the documentation and what you would do if the first plan failed. Full guide →
  • The What it is in a sentence, Why it matters with a fact, What it means for this organisation and specialty, What I would do at my level and how I would measure it. Full guide →
  • STAR Situation in a sentence, Task: what you had to do, Action: what you did in the first person, Result: the outcome with a number where there is one. Add Reflection for STARR. Full guide →

Clinical scenario

Decide and explain the decision. Own the complication plainly, describe the change and how you checked it worked. Be honest about gaps in your training and how you will close them; panels respect candour and distrust claims of complete readiness.

  1. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    An 80 year old from a nursing home has a perforated viscus. How do you decide whether to operate?

    See the patient and the family yourself. Assess frailty, the risk score and what the patient would have wanted. The decision is the Fix: operate, or palliate well, with the reasoning. Involve the anaesthetist and intensive care, and lead the conversation with the family. Review: documentation, and how you would deliver palliation if that is the decision.

  2. Asked in most interviewsUsually asked by the consultant colleague in the specialtySAFER

    Your registrar has a leak after an anastomosis they performed under your supervision. What do you do?

    The patient first: resuscitation, the decision on theatre or drainage, and you there. Then honesty with the patient and family. Then the registrar: support, debrief, no blame. Then the morbidity and mortality presentation and your own reflection on the supervision.

  3. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    You are on call, the emergency list has five cases and one theatre. How do you prioritise?

    Assess each case by urgency using the national classification, speak to the anaesthetist and the theatre coordinator, make the decisions, escalate for a second theatre if patients are being harmed, and tell the patients who are waiting why.

  4. Often askedUsually asked by the consultant colleague in the specialtySAFER

    A colleague's complication rate is higher than the department's. How do you approach it?

    Check the data and the case mix first. A private, collegial conversation. If there is a real concern, the clinical director and the trust's process, with the patients' safety first and support for the colleague.

  5. Often askedUsually asked by the clinical director or clinical leadSAFER

    A patient asks to have their operation done by you rather than a trainee. How do you respond?

    Respect the request, explain how training and supervision work, and agree what will happen. Document it. Patient choice matters, and so does training; most patients are reassured by an honest explanation.

System knowledge

Read the trust's strategy, annual plan, CQC report and staff survey before the interview and quote their themes back. For waiting lists and productivity, name the levers a consultant actually has and how you would measure progress. Keep proposals to what one person can deliver in a first year.

  1. Asked in most interviewsUsually asked by the chief executive or deputySYSTEM

    How would you help reduce the elective waiting list in general surgery here?

    The levers: day case rates, surgical hubs, list utilisation, pre assessment, pooled lists, validation, and the GIRFT recommendations. Know the trust's numbers and give one realistic change.

  2. Often askedUsually asked by the medical directorSYSTEM

    What has NELA taught us, and how should emergency general surgery be organised?

    Consultant presence, risk assessment, time to theatre, intensive care for high risk patients, and the emergency surgical ambulatory unit.

Governance, safety and quality

Describe the incident, your part, how the patient or family were told, what the investigation found and what changed. For QI, give the problem, the measure, the change, the result and whether it stuck. An answer with no mistake in it is the worst answer.

  1. Asked in most interviewsUsually asked by the medical directorSTARR

    Tell us about a complication you were responsible for and what you changed.

    Own it plainly: the patient, the disclosure, the review, the change and how you checked it held.

  2. Often askedUsually asked by the clinical director or clinical leadSTARR

    What outcome measures would you use for your own practice, and how would you share them?

    National audits and registries, complications, readmissions, length of stay, patient reported outcomes, and openness about them in appraisal and the department.

Presentation

Answer the title set, not a general one. Signpost a structure with a recommendation, use facts about this trust, finish inside the time, and prepare for the questions that follow. Most panels now limit or ban slides, so practise speaking without them.

  • Your vision for general surgery at this trust over the next five years.
  • Reducing the general surgery waiting list without additional theatre capacity.
  • Improving outcomes for emergency laparotomy at this trust.

Contribute to the bank

Recently interviewed? Tell us what you were asked. Every reported question goes into the ranking that decides which questions appear here and how often they come up in practice sessions.