What structure should I use for a clinical scenario in a surgical interview?

Work through it in order: recognise and resuscitate (A–E), assess systematically, investigate in a targeted way, manage (before, during and after), escalate appropriately with an SBAR handover, and plan follow-up. Leading with safety and never jumping straight to the operation is what separates strong answers.

What is the most common mistake in clinical stations?

Jumping to definitive management (“I’d take them to theatre”) before assessing and resuscitating the patient, and failing to escalate. Examiners want to see a safe, systematic approach and clear recognition of your limits.

How to structure a clinical scenario answer in a surgical interview

Clinical scenario stations — in both the ST3 Plastic Surgery and the Core Surgical Training interviews — reward structure above almost everything else. Candidates rarely fail because they don’t know the condition; they lose marks because they answer in a scattered order, jump to the operation, or forget to escalate. Here is a structure that works for any acute case.

The structure

Recognise and resuscitate. State the red flags, and begin an A–E assessment with resuscitation as you go. If it’s an emergency, say so out loud and act on it first.
Assess systematically. Focused history and examination — what you want to know and why, not a checklist recited from memory.
Investigate in a targeted way. The bedside, bloods, and imaging that will actually change your management — and what you expect them to show.
Manage — before, during, and after. Immediate management, definitive management, and the plan for afterwards (including reconstruction as a ladder, in plastics).
Escalate. Recognise your limits and escalate early to the registrar or consultant, with a structured SBAR handover. In an interview, escalating is a strength.
Follow-up and rehabilitation. Close the loop — monitoring, rehab, and follow-up.

Why it works

The order mirrors how a safe surgeon actually thinks, and it stops you skipping the steps examiners are specifically marking. It also gives you something to fall back on when a twist is added: you simply re-enter the structure at the relevant point (“given that new result, I’d reassess A–E and escalate”).

Common mistakes to avoid

Going straight to definitive management before assessing and resuscitating.
Not saying, explicitly, that this is an emergency when it is one.
Failing to escalate — or escalating without a clear handover.
Reciting facts instead of prioritising and justifying decisions.

How to practise it

Pick a handful of core emergencies for your specialty and rehearse each one out loud, on a five-minute timer, always moving through the structure and finishing with escalation and follow-up. Getting comfortable thinking in this order under time pressure is the whole game — you can rehearse timed clinical scenarios with an AI examiner on Reviva and get scored feedback on exactly this.

Frequently asked questions

What structure should I use for a clinical scenario in a surgical interview?: Work through it in order: recognise and resuscitate (A–E), assess systematically, investigate in a targeted way, manage (before, during and after), escalate appropriately with an SBAR handover, and plan follow-up. Leading with safety and never jumping straight to the operation is what separates strong answers.
What is the most common mistake in clinical stations?: Jumping to definitive management (“I’d take them to theatre”) before assessing and resuscitating the patient, and failing to escalate. Examiners want to see a safe, systematic approach and clear recognition of your limits.

Note. General preparation advice for educational use — always work to the current guidelines and your local protocols, and confirm the interview format on the official national recruitment portal.