What are the CST clinical scenarios?

Two five-minute cases within the Management & Clinical station, given to you on the day. You are presented with an acutely unwell surgical patient — usually a post-operative complication or a surgical emergency — and asked to think on your feet.

What level are the CST clinical cases pitched at?

At a core surgical trainee, not a registrar. Recognising when something is beyond your level and escalating appropriately — with a structured SBAR handover — is a marked strength, not a weakness.

How do I prepare for the CST clinical station?

Drill a safe, systematic approach: an A–E assessment, sensible initial investigations and management, clear prioritisation, and early escalation. Practise the common surgical emergencies across the specialties out loud, on the clock.

The CST Clinical Scenarios

The two clinical scenarios sit within the Management & Clinical station of the Core Surgical Training interview: five minutes each, given on the day, testing whether you can safely assess and manage an acutely unwell surgical patient at core-trainee level.

How the station runs

The examiner reads a short case stem — for example a patient a few hours after surgery who is tachycardic and hypotensive — then asks how you would approach it, one question at a time. The examiner stays neutral: they will not confirm whether you are right, and they will not teach. If your plan is unsafe, they will not correct you, but they may ask a neutral “Are you sure about that?” — and safety weighs heavily on the mark.

What examiners are looking for

Safe immediate care. An A–E assessment and resuscitation before anything else.
Clear reasoning and prioritisation. Sensible investigations and management, in the right order.
Escalation. Recognising your limits and escalating early to the registrar or consultant with a structured SBAR handover.

Common topics

Cases span the surgical specialties. Common ones to rehearse:

General surgery: post-operative bleeding, anastomotic leak, upper GI bleed, small bowel obstruction, perforated peptic ulcer.
Urology: testicular torsion, acute urinary retention, renal colic with urosepsis.
Orthopaedics/trauma: compartment syndrome, cauda equina, septic arthritis, the limping child.
Vascular / other: ruptured AAA, acute limb ischaemia, tension pneumothorax.

How to prepare

Rehearse whole cases out loud on a five-minute timer, always starting with A–E and finishing with a clear escalation. Frameworks like CCrISP and ATLS give you a reliable scaffold. You can rehearse the CST clinical scenarios with an AI examiner on Reviva.

Frequently asked questions

What are the CST clinical scenarios?: Two five-minute cases within the Management & Clinical station, given to you on the day. You are presented with an acutely unwell surgical patient — usually a post-operative complication or a surgical emergency — and asked to think on your feet.
What level are the CST clinical cases pitched at?: At a core surgical trainee, not a registrar. Recognising when something is beyond your level and escalating appropriately — with a structured SBAR handover — is a marked strength, not a weakness.
How do I prepare for the CST clinical station?: Drill a safe, systematic approach: an A–E assessment, sensible initial investigations and management, clear prioritisation, and early escalation. Practise the common surgical emergencies across the specialties out loud, on the clock.

Sources. Based on the Core Surgical Training selection format modelled by Reviva and the official HEE national recruitment guidance. Educational only — confirm the current format against the official national recruitment portal.