The ST3 Plastics Clinical Scenario Station

Two five-minute cases, a consultant plastic surgeon asking the questions, and a patient who may deteriorate part-way through. The clinical station of the ST3 Plastic Surgery interview is where your safety and clinical reasoning are tested most directly, and safety is the one thing the marking never forgives.

What actually happens

The examiner reads a short case stem, asks a question, and goes quiet. That silence is deliberate. You’ll get the occasional “Right” or “Go on”, but no nod to tell you you’re on track, and no teaching. If you propose something unsafe, the most you’ll hear is a flat “Are you sure about that approach?”

Part-way through, expect a twist: a new result, a deterioration. The examiner wants to know whether your plan can change under pressure, or whether you memorised a script.

What gets you marks

• Safety first. Recognise the emergency, resuscitate, and escalate before anything else.
• A systematic approach. History, examination, investigations, then management before, during and after the operation, then rehabilitation and follow-up.
• The right frameworks. ATLS for trauma, EMSB and Parkland for burns, and the reconstructive ladder for defect coverage.
• Guideline awareness. Knowing the relevant standards signals depth: BAD margins in skin cancer, BSSH for hand injuries, LRINEC and the Sepsis Six in necrotising fasciitis.

Where candidates lose marks

Three ways, mostly. Missing the emergency or proposing something unsafe, which caps the whole station at 0–1 however polished the rest was. Jumping straight to the operation instead of working the patient up. And needing a prompt for every step, because the examiner marks what you produce on your own.

Common topics

The two cases are drawn from across the plastics curriculum. Prioritise the emergencies, then breadth:

• Emergencies: necrotising fasciitis, compartment syndrome, high-pressure injection injury, extravasation, free-flap compromise.
• Hand trauma: flexor tendon injury, replantation, fingertip amputation, nerve injury.
• Burns: acute assessment, inhalation injury, escharotomy.
• Skin cancer: BCC, SCC, melanoma, Marjolin’s ulcer, sentinel lymph node biopsy.

How to prepare

Reading cases silently will not get you there. This station is a spoken conversation on a clock, and the only way to get comfortable is to rehearse whole cases out loud on a five-minute timer, always closing the loop from presentation to definitive plan and follow-up. Drill the emergencies until the safe first steps are automatic. You can rehearse the clinical station with an AI examiner on Reviva, which runs the same format on the same clock and scores you against the marking criteria.

Frequently asked questions

What happens in the ST3 plastics clinical station?

A consultant plastic surgeon gives you a clinical case and works you through it, from initial assessment to investigations to initial and definitive management. There are two five-minute scenarios on distinct topics. A twist, such as new information or a deterioration, may be added to test how you adapt.

What do examiners assess in the clinical station?

A safe, systematic approach: recognising urgency, assessing methodically, ordering sensible investigations, and giving a clear management plan. Safety is decisive. A missed emergency, an unsafe plan, or a failure to escalate caps the mark at 0–1 regardless of the rest.

How do I prepare for the clinical scenarios?

Rehearse cases out loud, under the five-minute clock, using a consistent structure: assessment, then investigations, then management before, during and after, then rehabilitation and follow-up. Know the emergencies cold, and practise escalating clearly.

Sources. Based on the ST3 Plastic Surgery selection format modelled by Reviva and the national selection marking scheme. Educational only. Confirm the current format against the official national recruitment portal.