General surgery: Specialty Training Interview Questions

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

Updated 28 October 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 →

Motivation

Point to things you have done rather than feelings you have: tasters, audits, courses, exams, conferences. Name what you will find hard, honestly. Know the curriculum, the stages and the exams, and have an answer for what you would do if unsuccessful this year.

  1. Asked in most interviewsUsually asked by the consultant colleague in the specialty

    Why general surgery, and what have you done to prepare for higher training in it?

    Evidence: the core rotations, the emergency and elective experience, the logbook, the courses, the MRCS, the research, the audit. Say what each taught you about the job and which subspecialty interests you and why.

  2. Asked in most interviewsUsually asked by the clinical director or clinical lead

    What do you know about the general surgery curriculum, the subspecialty interests, and the emergency general surgery commitment?

    The length, the subspecialty years in colorectal, upper gastrointestinal, hepatobiliary, breast, endocrine, transplant or vascular where it remains, the emergency general surgery component throughout, the exams, and the indicative procedure numbers. Two accurate sentences, then what will be hardest.

  3. Often askedUsually asked by the consultant colleague in the specialty

    Emergency general surgery is a large part of the job and the on call is heavy. How will you sustain a career in it?

    A real strategy: the on call and recovery, the balance of emergency and elective work, life outside, and what you would do if you noticed the signs of burnout.

Clinical scenario

Go to see the patient, assess with ABCDE, treat what can be treated, escalate early and clearly, and say what you would do afterwards. Assessors are scoring judgement, prioritisation and escalation rather than knowledge; a safe answer that asks for help early beats a clever one that does not.

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

    A patient three days after a right hemicolectomy has a heart rate of 130, a temperature of 38.5 and abdominal pain, and the CT shows a leak. What do you do?

    • Follow-up: The consultant is two hours away and the patient is deteriorating.

    Resuscitate, the sepsis bundle, and the decision: back to theatre tonight, radiological drainage, or intensive care first, with the reasoning. Phone the consultant with the assessment and the decision, speak to the patient and the family honestly, and present at morbidity and mortality. Say what you would do if the consultant were two hours away.

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

    An 80 year old with dementia from a nursing home presents with a perforated viscus. How do you approach the decision to operate?

    A conversation, not a plan: the baseline and the frailty, what the patient would have wanted, the family and the nursing home, the consultant and the anaesthetist, and whether an operation is in the patient's interests. Say that you would be comfortable with palliation if that is the decision and how you would deliver it.

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

    A patient with a massive upper gastrointestinal bleed cannot be controlled at endoscopy. What do you do?

    Resuscitate with the massive haemorrhage protocol, interventional radiology for embolisation if available and the patient can wait, theatre with the consultant if not, and the decision made in minutes. Say who you would call and what you would tell the family.

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

    A patient on warfarin needs an emergency laparotomy. How long do you wait for reversal?

    Reverse with vitamin K and the concentrate on haematology advice, crossmatch, and do not delay the laparotomy for a perfect INR if the patient is bleeding or septic. Say who you would involve and what the anaesthetist needs to know.

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

    A 45 year old woman presents with right upper quadrant pain, fever and jaundice, and becomes hypotensive overnight. What do you do?

    Cholangitis with septic shock: the sepsis bundle, intensive care, antibiotics, the clotting, and urgent biliary decompression by the route available, endoscopic or radiological, with the consultant. Say what would make you take her to theatre instead.

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

    A 30 year old woman at 20 weeks pregnant presents with right iliac fossa pain. How do you assess and manage her?

    Appendicitis until proven otherwise with the obstetric team involved from the start, the ultrasound first and the magnetic resonance imaging if available, the decision about theatre with the consultant, and the recognition that delay harms both. Say how you would consent her and what you would tell her about the risks to the pregnancy.

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

    A trauma patient has a pelvic fracture and is hypotensive. What do you do?

    The pelvic binder, the massive haemorrhage protocol, the trauma CT if stable enough, and the decision between the angiography suite and theatre for packing with the consultant and the orthopaedic and radiology teams. Say what would make you go to theatre first.

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

    A patient develops a leak after an anastomosis you performed. How do you recognise and manage it, and what do you say to the family?

    The early signs, the CT, the management by the leak's severity, and the honesty: tell the consultant what you observed, open disclosure with the patient and the family without speculation about blame, the morbidity and mortality presentation, and the reflection on the operation.

System knowledge

Name three current pressures and link each to your specialty and your own experience. Know how your training is governed: the ARCP, the curriculum, the college and the GMC.

  1. Often askedUsually asked by the clinical director or clinical leadSYSTEM

    What are the biggest challenges facing general surgery in the NHS, and how do they affect training?

    The waiting list and surgical hubs, emergency general surgery workforce and the consultant delivered service, theatre productivity, the loss of training opportunities to service, and the subspecialisation of the field. Link each to what you have seen.

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