UK Core Surgical Training (CST) Interview - What to expect at each station

The Clinical Scenario station

In this station you will be expected to discuss the management of two or three commonly encountered clinical scenarios. The first scenario will be written out on a card outside the station which you can read and you can decide on how to manage the condition. The second (and third) scenario will be given to you by one of the interviewers during the station.

Apply CCrISP and ATLS principles (depending on the scenario). Come up with as many logical differentials as possible. Remember common things are common. Keep your answers structured, logical and precise. Do not waffle as they do not score you points! Do not hesitate to ask questions e.g. what were the observations, past medical history, social history if you think it would be relevant to the scenario.

Sample scenarios include:

    • Post-operative complication – post-operatively short of breath patient, post-op confused patient, post op patient with low BP

    • Paediatric patient - fractures (remember NAI, green stick fractures), torsion, appendicitis

    • Abdominal pain - don't forget AAA as differential for any patient with acute abdomen, revise history, differentials, investigations (urinalysis, pregnancy test) and management

    • Trauma with head/chest/limb injuries

    • A telephone conversation to a senior colleague about a patient and receiving information from a nurse about an unwell patient, what questions to ask, remember SBAR

     We recommend the Core Surgical Interview Guide pdf and ATLS book to help prepare for this station.

    The Management station

    This station comprises of the leadership speech you prepare in advance, and then followed by a test of your knowledge and experience on ethical, legal issues, communication skills to a certain degree and principles of safe surgery. This station is designed mainly to check if you are a ‘safe’ doctor.

    Sample scenarios include:

    • EWTD and working hours - E.g. Do you stay over if the colleague taking over you after an on-call is unavailable? The initial answer is yes, as leaving without arranging cover will compromise patient safety. However do not say you would just stay and do your colleague’s work as that is also unsafe – you need to first ensure patients are safe/stable and then take steps to arrange cover (contact site manager, rota coordinator, seniors – they might need to pull in extra people in clinic or theatre)
    • Consent: dos and don'ts
    • Know about the chain of command – Who do you go to if you have concerns about anything? Within the trust, it would be your clinical/educational supervisor à departmental lead à director of surgery à medical director à chief executive. Within the deanery, it would be clinical/educational supervisor à surgical tutor à programme director à head of the deanery)
    • Ethical scenarios e.g. a senior colleague turns up to work under the influence of alcohol, you have to cancel a few cases due to bed pressures

    • WHO checklist. Know the components of it.

    • How would you surgery make safe? - Talk about pre-assessment, op day, operating theatre and post op safety measures. More importantly what they looking for is the WHO checklist. Know the components of it.

    • How can you improve surgical training? - Talk about different work based assessments (DOPS, CBD, Mini-CEXs), simulation training, courses etc.

    We recommend the book ISC medical interviews to help prepare for this station


    The Portfolio station

    Make sure your portfolio is up to scratch and you know your CV by heart. Organisation of portfolio counts and you get points for this. Having done the basics (MRCS, BSS, ATLS) will also get you points in this station. Don't put anything in your CV which you haven't supported with evidence in the portfolio. Be ready to talk about everything you have put down on your CV. Here you may be asked about:

    ·        The courses you have done and/or plan to do

    ·        Exams/attempts

    ·       Research

    ·         Audit and/or whether or not you have completed the audit cycle

    make sure you know the definition of an audit

    ·         Logbook – what you have done, what you lack, why you are lacking and what you plan to do about it

    ·         Assessments from your portfolio – select and rank any assessments you are proud of and can discuss

    ·         Teaching experience

    You can be asked generally what your portfolio’s shortcomings are. After giving them a well thought out answer, you need to immediately tell them how you plan to improve it.

    This station is something that you could control. The more you have done to show your commitment, the more you can talk about them and keep control of the interview and highlight important things for the interviewers.

    General tips: do not exaggerate, always be humble, show you are keen to learn, to teach and that you know you have a lot to learn. They are looking for someone who could get along with their colleagues, a good team player, who respects their seniors and who are keen to carry on all the way.

    Good luck!

    Updated by: Miss Yanyu Tan | Last updated: 05/09/2018