Interview Course

CORE SURGICAL INTERVIEW

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INTERVIEWS

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INTERVIEWS

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GENERAL TIPS

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Dress smart

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Arrive in plenty of time

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Ensure portfolio is well organised and presented

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Do not be put off by other candidate’s portfolios

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Prepare for the leadership presentation well in advance

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Revise

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Speak clearly and appear conﬁdent

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MANAGEMENT STATION

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Conﬁdence is key

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Knowledge of law and ethics

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Try to use examples if possible

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It sounds like the easiest station but

don’t be fooled…

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MANAGEMENT STATION

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Ethics

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Consent

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Data protection

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Surgery speciﬁc

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WHO

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NCEPOD

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Risk

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Sterilisation

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Interpersonal skills

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Conﬂict resolution

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Decision making

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Taking initiative

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Statistics

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Incidence/Prevalence

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Screening

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ETHICS

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‘Good medical practice’ GMC

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Four pillars

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Autonomy

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Non maleﬁcence

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Beneﬁcence

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Justice

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Four pillars can conﬂict with each other eg.

Jehovas witness

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ETHICS

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Consent

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Informed decision

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Forms

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You are the surgical Senior House Ofﬁcer (SHO)

on call. You are informed by the staff nurse that

your consultant has asked for you to consent the

patient who is next on the operating list because

both he and the registrar are busy with the current

case which is already one hour late. You have no

knowledge of the procedure that you have been

asked to seek consent for. What do you do?

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ETHICS

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You are the CT1 for a general surgical

ﬁrm. You walk into your consultant's

ofﬁce to ﬁnd his secretary viewing a CT

scan on the computer - her sister is a

patient under another team at the

hospital and the CT shows metastatic

colorectal cancer, the results of which

you are aware have not yet been

communicated to the patient.

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What do you do?

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ETHICS

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Clarify

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Empathy

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Explain

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Escalate

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Attempt to resolve

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ETHICS

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Data protection act 1988

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Storage of information

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Must not be kept longer than

necessary

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Relevant, accurate and not excessive

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Can access your own information

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WHO CHECKLIST

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CEPOD

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CEPOD

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Impact

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Improves safety

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Non urgent operations do not take

place out of hours

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RISK

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Does not take into

account age

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Systemic disease only

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APACHE II and APGAR

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STERILISATION

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Sterilisation = eradication of all

organisms and viruses

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Disinfection = spores and viruses

survive

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Cleaning= removal of dirt

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STERILISATION

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Heat

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Dry or steam

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Chemical

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Formaldehyde, Ethylene oxide

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Radiation

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INTERPERSONAL SKILLS

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You are a surgical SHO on the ward.

Your consultant arrives to start the

afternoon ward round. You can smell

alcohol on his breath, he is visibly off

balance and he is slurring his words.

How do you proceed?

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INTERPERSONAL SKILLS

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Patient safety is always ﬁrst priority

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Know your limits - get help

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Try to resolve the situation

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Escalate

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Think of the consultant!

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Document

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INTERPERSONAL SKILLS

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Cancelled theatre list

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Safety

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Resolution

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Escalate

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The patient

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Document

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INTERPERSONAL SKILLS

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What is the most difﬁcult decision you

have had to make?

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You are working more bank holidays

and on calls than your colleagues, what

do you do?

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How will you ensure you get suitable

training with the restrictions of the

European work directive?

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STATISTICS

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Incidence = new number of cases in a

speciﬁc time period

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Prevalence = all cases in a population

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STATISTICS

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Sensitivity = probability of a true positive

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Speciﬁcity = probability of a true

negative

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Positive Predictive Value = proportion of

positive results who have the disease

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Negative Predictive Value = proportion

of negative results who do not have the

disease

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SCREENING

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Should be an important health condition

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Should be treatable

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Facilities for treatment and diagnosis

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Should have a latent phase

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An acceptable test

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Agreed policy of who to treat

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Cost effective

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A continuous project

MANAGEMENT STATION

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Leadership question:

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“Reﬂect on your experience of leadership when working as a team

member and how this will be useful as a core trainee”

MANAGEMENT STATION

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Leadership question

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Make three points

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Three separate

qualities of a leader

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Summarise

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PRACTICE

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CLINICAL STATION

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Common surgical scenarios

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Usually one emergency and one stable

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Looking for conﬁdent but accurate answers

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Structure

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Safe

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Do not panic if you do not know the specialty

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CLINICAL STATION

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Trauma

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Post op pyrexia

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Abdo pain

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Complications

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Urology

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ENT

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Paeds

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Burns

CLINICAL STATION

TRAUMA

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ATLS - ABCDE

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Investigations

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Trauma CT - not in penetrating injury with haemoinstability

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C-spine XR

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GCS <8

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Speciﬁc injury management

CLINICAL STATION

HEAD INJURY

CLINICAL STATION

FRACTURE

CLINICAL STATION

FRACTURE

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How would you relocate a hip dislocation?

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Non accidental injury

CLINICAL STATION

PYREXIA

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ALS - ABCDE

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Escalate as necessary

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Differentials

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Risk factors

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Pre, peri and post operative

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Always remember the op note

CLINICAL STATION

PYREXIA

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Sepsis 6

CLINICAL STATION

ABDO PAIN

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ALS - ABCDE

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History and examination

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Bloods - justify

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Urine dip

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AXR or CT

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Management

CLINICAL STATION

ABDO PAIN

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Appendicitis

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Bowel obstruction

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Perforation

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Loin pain - think AAA

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Anastomotic leak

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Oesophageal rupture

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Pancreatitis

CLINICAL STATION

COMPLICATIONS

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Wound dehiscence

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Assess patient

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Assess the depth of wound

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Do not reduce the bowel

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Pre, peri and post operative risk factors

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Jenkins rule

CLINICAL STATION

COMPLICATIONS

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Compartment syndrome

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You are the orthopaedic surgical SHO at a District General

Hospital. You are called to see a 32 year old gentleman who

sustained a closed fracture of the left tibia and ﬁbula in a

motorcycle accident ten hours previously. His fracture has been

reduced and put in a cast. However, he now complains of

throbbing left foot pain and numbness.

CLINICAL STATION

COMPLICATIONS

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Compartment syndrome

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Pain

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Paraesthesia

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Pallor

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Pulseless

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Pressure

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Paralysis

CLINICAL STATION

COMPLICATIONS

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Compartment syndrome

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Thorough examination

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Handheld doppler

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Escalate and prep for theatre

CLINICAL STATION

COMPLICATIONS

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Confusion

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ABCDE

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ABG

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Causes

CLINICAL STATION

UROLOGY

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Painless haematuria

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Loin pain

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Testicular pain/swelling

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Rule out torsion

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Tumour markers - do not biopsy

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Urinary retention

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Gleason score

CLINICAL STATION

ENT

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Epistaxis

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First aid

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Stabilise

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Packing & admit

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Neck lump

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History

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Examination

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Know TFTs

CLINICAL STATION

PAEDS

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Hernia

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Umbilical close spontaneously

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Projectile vomiting

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Age

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Redcurrent jelly stool

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Hypochloraemic

hypokalaemic acidosis

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Fracture

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Fluids

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NAI

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SUFE

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AP pelvis and frog lateral

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Remember joint below

CLINICAL STATION

BURNS

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Rule of 9s

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ABCDE

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14% or more needs ﬂuids

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24hrs= 4 x Weight x % burn

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Give half in ﬁrst 8hrs

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Grafts

PORTFOLIO STATION

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Structure in the exact order of the checklist

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Clear headings

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Summarise your evidence clearly in each section

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Clearly show your audit cycles

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Do not pollute with evidence you wont get marks for

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