Doing well in the core surgical training interview is very achievable, provided you put in sufficient preparation and practice. Starting earlier gives more opportunity to get the points on the portfolio station, leaving plenty of time to practice clinical and leadership scenarios. The template below is a basic outline of targets to set yourself when approaching CST interviews. We’ve also developed our Core Surgical Training Interview Question Bank to help you prepare for the big day!
FY1 year/ year before
This is the year to really maximise your portfolio. Start by reading the scoring criteria in the portfolio section of this site, and set yourself realistic goals of what to achieve in the 12 months. Remember, CST applications open early into FY2, therefore most of the opportunities for scoring points will come in FY1 year.
Realistic portfolio goals for FY1 (more details in the portfolio section):
• MRCS Part A (Spring attempt, with 4-6 months revision prior)
• At least 2 surgical courses (One of which can be funded by study budget – BSS will help a lot when assisting)
• Design, lead and implement change through a QI project (ideally surgically themed). The earlier you start this the better, as it will provide more opportunity to present at a conference (and gain maximum points!)
• Organise a teaching programme – there will be plenty of opportunity for teaching medical students on the wards
• One poster/ oral presentation – if you ask around, there is more than likely opportunity to get involved in a project that will lead to a presentation.
• FY1 rep role
• Surgical Logbook – nearly every FY1 post will have a surgical rotation. This is the time to get into theatre, and assist as much as possible. Build up the logbook, and you may even get the opportunity to carry out your own minor procedures.
• Become an affiliate member of RCS
• Publish a paper – can be a case report, quality improvement project or full research article. Ask around for suitable academic supervisors, there should be plenty of projects available!
• Medical/ Surgical prize – try entering any research/ QI projects/ audits/ essay competitions that you see available
6 months to interview
Starting FY2, it is a good idea to begin building up the physical portfolio for interviews. Collect evidence from courses/ teaching/ clinical activities, which can be entered into a professional and practical folder. Try to get this complete a few months prior to interviews taking place, as you do not want to be stressing over missing documents/ evidence at this time.
With 6 months to go, it is also a good idea to begin planning your preparation strategy. Identify resources you are going to use, study partners, and time you will set aside. Some suggested resources are below:
• ISC Medical – Medical Interviews: A relatively detailed book with extensive guidance on how to answer questions using a structured format. Also has model answers on portfolio questions, motivation questions and up-to-date topics. A great resource for learning how to structure answers, however many of the questions/ answers are not relevant to CST interviews.
• Core Surgery Interview – The Definitive Guide: A good resource for providing structure on Portfolio, Management/ Leadership and Clinical Questions. However only a limited number of Clinical cases provided.
• Online Question Banks – Essential adjunct for revision purposes in order to bolster the number of clinical/ management cases encountered.
3-4 months to interview
Now comes the main preparation phase. Set yourself 1-2 hours of preparation per day, building up more nearer the interview.
One way of structuring this preparation has been detailed below, but is by no means the only way to successfully prepare:
• First 2 months: Reading from the books/ online question bank. Develop a broad idea of how to structure answers to each of the common questions, including examples from your own experience where appropriate. Read up on ATLS approach to trauma, along with common post-op clinical scenarios. Most of the theory should already be provided in model answers from these question banks.
• Final 2 months: Practice answering unseen questions with friends/ colleagues. Build an outline of your 3 minute answer to the presentation question. Becomes familiar with your portfolio, and how to navigate through it with ease.
Many people spend the majority of their time preparing for the Clinical station, as there is a lot to learn for it. The Leadership and Management station is often perceived as being difficult to revise for and can get neglected. It is true that there is less ‘content’ to learn for the leadership station, however, to score highly in this station you will need to practice answering the common questions over and over again.
With regard to the presentation – make sure it has good structure (e.g. intro, point 1, point 2, point 3, summary) and it is under the time limit by a reasonable amount. They may start timing from the moment you knock on the door, so you could have up to 20 seconds less time than you thought! It is not so much the content that is important, but the way in which you deliver it (read the above resources for more information).
On the interview day, you will inevitably meet people with larger portfolio’s, more surgical experience and more impressive suits/ ties! Try not to get put off by this, remember most of the points at interview are based on your own attributes and clinical approach, not how much experience you have had in the past. It can be helpful to select an interview slot early in the day, to avoid nervous waiting around.
The Clinical station lasts 10 minutes and you’ll usually be given two scenarios to work though. They tend to use similar topics each year and they are often based around emergency and post-operative scenarios. This interview station can be imagined as having two separate parts, although there is no break inbetween:
• Part A: Candidates are often given a short scenario to read prior to going into the interview room – e.g. “a patient arrives at A&E with a deformed leg after falling off a ladder”. The interviewers will then proceed to ask a series of questions based on this scenario.
• Part B: The second part of this station will likely involve an ‘unseen’ scenario – e.g. the interviewers will tell you “a patient post-op laparoscopic cholecystectomy has spiked a temperature”, followed by a series of questions on investigation, differentials etc.
When practicing emergency cases, get into the habit early on of saying you would start by using an ABCDE approach (you’ll be sick of saying this by the end). As a rule, you can generally get enough marks to be deemed appointable by going through the ABCDE process logically and then escalating to a senior. It’s important that your answer is fluent and concise, as this will put the examiners at ease and allow you to quickly get onto the harder questions which will decide whether you get the top marks. Detailed run through of the ABCDE approach is unnecessary, so try and summaries each step concisely.
For post-op clinical scenarios, it is important you are familiar with common operations and their complications (all of which should be covered in suggested reading/ online question banks). The amount of revision you will need to do will depend on what jobs you have had in your foundation years. If you have done a general surgery or urology job you are likely to require less background reading that someone who hasn’t done any surgical jobs. Bear this in mind when planning your revision schedule.
The follow-up questions you get in the last 1-2 minutes of each scenario can be unpredictable and are often dependent on the examiners and their impression of you. This is why having a good understanding of the principals of all the key topics is important. You should have at least a working understanding of the aetiology, presentations, disease processes and management of all the conditions you revise.
Time is of the essence in this station, so with a small group of candidates, practise repeatedly answering questions about the core conditions in the run up to the interview.
ATLS Course Manual
CCRiSP Course Manual
Core Surgical Training Person Specification
Leadership and Management Station
Similarly to the clinical station, this interview segment is split into two parts.
• Part A: 3 minute presentation on a ‘seen’ topic, followed by 2 minutes of questions from interviewers regarding this presentation.
• Part B: ‘Unseen’ management/ leadership scenario, followed by questions. E.g. “You notice your registrar smells of alcohol, what would you do?”.
Make sure you start preparing for the Leadership station early. If you leave it to the last minute, even if your answers contain the right content, you won’t come across fluently and you won’t get the top marks.
This station is best prepared for in small groups of other candidates. The key to scoring highly is answering the questions concisely and bringing in your own examples. We would recommend writing down the examples that you would like to use and making sure you can describe them quickly.
You should be able to summarise examples such as the time you showed leadership/saw bad leadership etc. and then quickly move onto the reasons why it was good/bad leadership and what you learned from it.
When it comes to the management scenarios you should be practised in approaching each scenario using common frameworks such as SPIES, CAMP and STAR. You should get your fellow candidates to make up management scenarios for you, and then practise applying those frameworks.
Overall, it is perfectly achievable for anyone to get a Core Surgical Training Post, provided they put in the time to prepare for the interview. The clinical and leadership stations are worth two thirds of the marks, so even with a below average portfolio you can still score highly
If you have any specific questions, please do get in touch. You can access our other interview resources in the Core Surgical Interview section of the website.