General Surgery Interview Questions & Answers

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About this NHS interview question bank

To prepare for a general surgery NHS interview, expect questions on assessing the acute abdomen on the take, recognising the septic or deteriorating post-operative patient, consent after Montgomery, the WHO checklist and never events, theatre prioritisation and how you supervise juniors. Build short spoken answers around real cases from your own practice, and know GMC Good Medical Practice, the RCS standards for surgeons and the pressures your trust faces with emergency surgery and elective waiting lists.

This bank contains 40 original practice questions with first-person model answers written for doctors applying for general surgery Clinical Fellow and Specialty Doctor posts, including internationally trained doctors starting out in NHS surgery, with a selection pitched at specialist grade and consultant level. It covers the surgical take, emergency laparotomy and NELA, anastomotic leak, sepsis, consent, duty of candour, safeguarding, theatre safety, elective recovery, teamwork with surgical care practitioners, supervision, the surgical logbook and the portfolio pathway. Every question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the guidance worth reading, so you can practise answers that sound like you rather than a textbook.

 

What this question bank covers

• Motivation for general surgery
• Clinical Fellow and Specialty Doctor roles
• Working as an international medical graduate
• NHS values and the NHS Constitution
• Elective recovery and waiting lists
• The surgical take and acute abdomen
• Sepsis and the deteriorating post-operative patient
• Emergency laparotomy and NELA
• Anastomotic leak
• Consent after Montgomery
• Duty of candour
• WHO Surgical Safety Checklist and never events
• Theatre prioritisation and NCEPOD
• Working with surgical care practitioners
• Supervising and teaching juniors
• Safeguarding adults and children
• Equality and interpreters
• Confidentiality and knife wounds
• Clinical photography and record keeping
• PSIRF and morbidity and mortality meetings
• Quality improvement
• Surgical logbook and portfolio pathway
• Resilience after poor outcomes

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why do you want to work in general surgery, and why at this grade?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine reason for choosing general surgery that goes beyond enjoying operating. They are also checking that you understand what a Clinical Fellow or Specialty Doctor post involves, including the take, ward work and clinics, and that you have a realistic plan for how this job fits your development.

 

Model answer

The honest answer is that I like the whole arc of a surgical patient, not just the operation. I still remember a night on call early in my career when a man in his sixties came in with a few hours of severe abdominal pain. He looked grey, his abdomen was rigid and his lactate was climbing. Within a couple of hours we'd resuscitated him, got a CT, and my consultant and I were in theatre dealing with a perforated ulcer. Seeing him sitting up and grumbling about hospital food a week later is the reason I'm in this specialty.

What I've come to value about general surgery is that the operating is only part of it. Most of the difference you make happens before and after theatre: spotting the patient on the take who's sicker than they look, picking up the tachycardia on day four that might be a leak, and having a proper conversation about whether surgery is even the right thing for a frail patient.

As for this grade, I see a Clinical Fellow post as the right next step for me. I want to consolidate my emergency general surgery, become safe and confident running the take with consultant support, and build my operative experience in a structured way, logging everything in my eLogbook. I also want to work in a department where teaching juniors is part of the job, because I've found I really enjoy it.

Longer term I'm thinking seriously about either a training number or the portfolio pathway, and I know the first step for either is to become a reliable, safe pair of hands that the consultants and the nurses trust. That's what I want to be in this department.

 

Why this answer works

It opens with a specific, believable case rather than a cliche about loving theatre. It shows an understanding that general surgery is mostly about judgement before and after the operation, and it ties the grade to a realistic development plan without sounding as if the post is just a stepping stone.

 

Key points to include

• A specific moment that drew you to the specialty
• Understanding that surgery is more than operating
• Why this grade suits you now
• A realistic plan for operative and take experience
• Interest in teaching and team working
• A sensible longer term direction

 

Common mistakes to avoid

• Talking only about enjoying operating or using your hands
• Sounding as if the post is just a stepping stone to something else
• Overstating your independent operative experience
• Giving an answer that could apply to any specialty

 

NHS values and standards

Commitment to quality of care; Improving lives; Compassion; GMC Good Medical Practice: knowledge, skills and development

 

Further reading

• GMC Good Medical Practice
• Royal College of Surgeons of England: Good Surgical Practice
• NHS Constitution for England

 

 

Question 2: You are the first on-call doctor on the surgical take. A 72-year-old woman is referred from ED with abdominal pain and a NEWS2 of 6. How do you approach her?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel wants to see a safe, structured approach to an unwell surgical patient that puts resuscitation before diagnosis. They are listening for an ABCDE assessment, early sepsis recognition, a sensible differential for the older patient, appropriate imaging, timely senior escalation and attention to frailty and ceilings of care.

 

Model answer

The NEWS2 of 6 tells me this lady needs to be seen straight away, so I'd prioritise her over less urgent referrals and go to her rather than reading the notes first. I'd introduce myself, check she's comfortable enough to talk and start with a full ABCDE assessment, because in an older patient the abdomen can look deceptively soft while she's quietly becoming very unwell.

I'd be looking for tachycardia, hypotension, new confusion, mottled skin and poor urine output. I'd make sure she has good IV access, bloods including a lactate, gas, cultures, group and save and clotting, and I'd start fluid resuscitation thoughtfully, watching her response. If she fits the picture of sepsis I'd follow the trust sepsis pathway and give antibiotics promptly rather than waiting for a diagnosis.

Then the history and examination. With a woman of her age I'd be thinking about perforation, ischaemic bowel, obstruction, a complicated biliary problem and diverticular disease, but also about things that aren't surgical, like an inferior MI or a leaking aneurysm. Pain out of proportion to the examination would particularly worry me for mesenteric ischaemia. I'd ask about her baseline function, medications, especially anticoagulants, and what matters to her.

In most cases like this she'd need a CT with contrast quickly, and I'd discuss it directly with radiology. I'd also catheterise if needed and keep a close eye on her output.

I'd escalate to my registrar or consultant early, not after the scan. If this turns out to be a surgical emergency, the decisions about surgery, critical care and her escalation plan need senior input, and if she's frail I'd want the conversation about what she would want to happen early, while she can take part in it. I'd document clearly, hand over to the nurses what I'm worried about and how often I want observations, and go back to see her myself.

 

Why this answer works

The answer puts resuscitation and sepsis recognition first, which is what keeps patients safe. It shows a wide differential that includes the dangerous non-surgical causes, recognises that older patients present atypically, and escalates early while keeping the patient's own wishes in view.

 

Key points to include

• See her promptly and assess with ABCDE
• Recognise and treat sepsis using the trust pathway
• A broad differential including vascular and cardiac causes
• Early CT and direct discussion with radiology
• Early senior escalation and escalation planning
• Clear documentation, nursing plan and reassessment

 

Common mistakes to avoid

• Jumping to a diagnosis before resuscitating
• Delaying antibiotics or senior review until after imaging
• Forgetting atypical presentations in older patients
• Not asking about anticoagulants, frailty or the patient's wishes

 

NHS values and standards

Commitment to quality of care; Compassion; Respect and dignity; GMC Good Medical Practice: recognise and work within the limits of your competence

 

Further reading

• NICE guideline on suspected sepsis: recognition, diagnosis and early management
• Royal College of Physicians: NEWS2
• National Emergency Laparotomy Audit reports and recommendations
• Royal College of Surgeons of England: The higher risk general surgical patient

 

 

Question 3: How do you take consent for an operation, and how has the Montgomery judgment changed your practice?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel is checking that you understand consent as a dialogue rather than a signature, and that you know the legal standard set by Montgomery. They want to hear about material risks, reasonable alternatives including doing nothing, capacity, the right person to consent and documenting the discussion well.

 

Model answer

I think of consent as a conversation that starts in clinic or on the ward and ends with a signature, not the other way round. Montgomery made the legal position clear: I have to tell the patient about any material risk, meaning a risk that a reasonable person in their position would think significant, or one I know or should know this particular patient would care about. I also have to talk about reasonable alternatives, including not operating.

In practice, take someone coming in for a laparoscopic cholecystectomy. I'd start by asking what they already understand and what's important to them. I'd explain what the operation involves and the common and serious risks, like bleeding, infection, bile leak, and the small but serious risk of a bile duct injury, and that we might need to convert to an open operation. Then I'd ask about their life. If someone is a self-employed builder, the recovery time and lifting restrictions might matter more to them than anything else. The alternative of managing symptoms and waiting needs to be a real option in that conversation, not a throwaway line.

I'd check their capacity, use plain language, offer written information and give them time to think, ideally consenting well before the day of surgery for elective cases. If they don't speak English well, I'd use a professional interpreter.

I'd also only consent for procedures I understand well enough to explain and answer questions about, in line with GMC guidance and local policy. If I'm not sure, I'd ask my senior to do it or join me.

Finally, I'd document the discussion itself in the notes, including the specific risks we talked about and the questions they asked, not just the form. If anything is unclear on the morning of surgery, I'd go back and talk again rather than proceed.

 

Why this answer works

The answer explains the Montgomery test accurately and then shows what it looks like with a real patient. It covers alternatives, capacity, interpreters, the competence to consent and good documentation, which is exactly what a surgical panel wants to hear from someone who will consent on their lists.

 

Key points to include

• Consent is a dialogue focused on the individual patient
• Material risk as defined in Montgomery
• Reasonable alternatives, including no operation
• Capacity, interpreters, time and written information
• Only consent for procedures you understand
• Document the conversation, not just the form

 

Common mistakes to avoid

• Reciting a list of complications without tailoring it
• Leaving out the option of not operating
• Taking consent on the morning of surgery as routine for elective cases
• Consenting for procedures beyond your knowledge

 

NHS values and standards

Respect and dignity; Everyone counts; GMC Good Medical Practice; GMC Decision making and consent

 

Further reading

• Montgomery v Lanarkshire Health Board (2015)
• GMC Decision making and consent
• Royal College of Surgeons of England: Consent: Supported Decision-Making
• Mental Capacity Act 2005

 

 

Question 4: Talk us through the WHO Surgical Safety Checklist. Have you ever seen it make a difference?

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel wants to know that you see the checklist as a genuine safety tool rather than a box-ticking exercise, and that you know its stages. They are also listening for your understanding of never events, speaking up in theatre and the culture that makes the checklist work.

 

Model answer

The checklist has three main points: sign in before induction, time out before the knife touches the skin, and sign out before the patient leaves theatre. Most theatres also add a team brief at the start of the list and a debrief at the end, and local safety standards based on NatSSIPs build on it. The point of it is simple. It stops us relying on memory and assumptions at the moments where errors cause the most harm, like wrong site surgery, missing antibiotics, or a swab left behind.

I have seen it make a difference. On an afternoon list we had a patient booked for a left inguinal hernia repair. At time out the scrub nurse said she couldn't see the site mark. The registrar was keen to get going because the list was running late, and I'll admit there was a moment of tension. We stopped, checked the consent form, the clinic letter and spoke to the patient, who'd been marked in the anaesthetic room but the mark had been wiped off with the skin prep. It turned out everything was correct, but if the documentation had been wrong, that pause would have prevented a never event.

What stayed with me was how much depended on the scrub nurse feeling able to speak up. I now make a point of introducing myself properly at the team brief and saying that I want people to stop me if anything doesn't look right. I also try to make sure the sign out actually happens with the whole team listening, especially the swab and instrument count and the specimen labelling.

If something did go wrong despite the checklist, I'd make sure the patient was safe, tell my consultant, report it through the trust's incident system and be open with the patient under the duty of candour.

 

Why this answer works

The answer shows accurate knowledge of the checklist and links it directly to the harms it prevents. The example is realistic and honest about pressure in theatre, and the reflection on psychological safety and team culture shows maturity beyond simply reciting the stages.

 

Key points to include

• Sign in, time out and sign out, plus brief and debrief
• What harms the checklist prevents, including never events
• A real example where a pause mattered
• Encouraging everyone in theatre to speak up
• Counts and specimen labelling at sign out
• Reporting and candour if something goes wrong

 

Common mistakes to avoid

• Listing the stages without any example
• Describing the checklist as paperwork
• Implying it is someone else's job to lead it
• Ignoring the human factors and team culture behind it

 

NHS values and standards

Commitment to quality of care; Working together for patients; GMC Good Medical Practice: patient safety

 

Further reading

• WHO Surgical Safety Checklist
• National Safety Standards for Invasive Procedures (NatSSIPs)
• NHS England Never Events policy and framework
• Patient Safety Incident Response Framework (PSIRF)

 

 

Question 5: It is day four after an anterior resection. The nurse calls because the patient is tachycardic, feverish and has new abdominal pain. What do you do?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel wants to see that you recognise a possible anastomotic leak early and do not get falsely reassured. They are looking for prompt assessment, sepsis management, appropriate investigation, early escalation to the operating consultant and clear communication with the patient and team.

 

Model answer

My first thought would be that this is an anastomotic leak until proven otherwise. Tachycardia, fever and new abdominal pain around this point after a bowel resection is the classic picture, and the danger is that we put it down to a chest infection or pain and lose valuable hours.

I'd tell the nurse I'm coming now, ask her to repeat a full set of observations and get the sepsis screen started. When I arrive I'd do an ABCDE assessment. I'd look at the trend in the observation chart and fluid balance, check for new atrial fibrillation, which can be an early sign, look at the drain if there is one, and examine the abdomen properly, including the wound. I'd look at whether his bowels have started working or if he's developed an ileus.

I'd take bloods including CRP, lactate, cultures and a gas, and compare them with the previous days. A CRP that keeps rising rather than settling would add to my worry. If he's septic, I'd follow the sepsis pathway with fluids and antibiotics in line with local guidance, and make him nil by mouth while we sort things out.

I'd escalate early to my registrar and the operating consultant. They need to know, and the decision about a CT with contrast, a return to theatre or radiological drainage is a senior one. If he's unstable or not responding to resuscitation, I'd involve critical care as well.

I'd also speak honestly with the patient. He's probably frightened, and I'd explain that we're worried about a leak from the join in the bowel, what we're doing to check and that the senior team is involved. I'd document my assessment, timings and plan clearly and make sure the nurses know exactly what to escalate. Then I'd go back and reassess within the hour.

 

Why this answer works

The answer names the most dangerous diagnosis and shows the candidate will not be reassured by an alternative explanation. It combines a structured assessment with the subtle signs of a leak, early sepsis treatment and prompt escalation to the consultant, which is what keeps these patients alive.

 

Key points to include

• Think leak until proven otherwise
• ABCDE and look for subtle signs such as new AF
• Bloods, trends in CRP and lactate, sepsis pathway
• Early escalation to registrar and operating consultant
• CT or return to theatre as a senior decision
• Honest communication, documentation and reassessment

 

Common mistakes to avoid

• Blaming a chest infection or wound pain without excluding a leak
• Waiting for the morning ward round to escalate
• Not looking at trends in observations and bloods
• Forgetting to talk to the patient

 

NHS values and standards

Commitment to quality of care; Compassion; Working together for patients; GMC Good Medical Practice

 

Further reading

• NICE guideline on suspected sepsis
• Royal College of Physicians: NEWS2
• Association of Coloproctology of Great Britain and Ireland guidance
• Royal College of Surgeons of England: The higher risk general surgical patient

 

 

Question 6: A patient on the waiting list for a hernia repair rings, angry that his operation has been cancelled twice. How would you respond, and what does this tell you about the NHS today?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel wants to see that you can respond to frustration with empathy and honesty while keeping safety in mind. They are also checking whether you understand elective recovery pressures, waiting list prioritisation and how individual surgeons can help, rather than blaming the system.

 

Model answer

First, I'd hear him out. Being cancelled twice is genuinely awful. He's probably arranged time off, childcare, maybe lost income, and he's been living with pain. I'd say that clearly and apologise that it's happened, because he deserves that whatever the reason.

Then I'd try to find out how he is now. A hernia that's becoming more painful, harder to push back, or associated with vomiting needs to be seen urgently, so I'd check for symptoms of obstruction or strangulation and tell him exactly what to do if they happen. If his symptoms have changed, his clinical priority on the list might need to change too, and I'd make sure the consultant knows.

I'd be honest about what I can and can't promise. I wouldn't give him a date I can't guarantee, but I'd take responsibility for getting an answer, speak to the waiting list coordinator or the consultant's secretary, and make sure someone rings him back when they said they would. I'd also tell him about PALS if he wants to raise it formally, without making it sound like I'm passing him on.

As for what it says about the NHS, waiting lists grew a great deal after the pandemic, and elective recovery is one of the biggest priorities for every surgical department. Emergency work, bed pressures and staffing all lead to cancellations. In England, patients have a right under the NHS Constitution to start treatment within eighteen weeks of referral, and many people are waiting longer than that.

I think surgeons at my grade can help in practical ways: being on time so lists start promptly, helping with day case pathways and surgical hubs where they exist, running extra lists when asked and making sure pre-op assessment is done properly so patients aren't cancelled on the day for avoidable reasons.

 

Why this answer works

The answer balances empathy with safety netting, which is the clinically important part of this question. It shows awareness of elective recovery and the NHS Constitution without quoting numbers that might be wrong, and it ends with practical things the candidate can personally do.

 

Key points to include

• Listen and apologise sincerely
• Safety net for obstruction or strangulation
• Re-prioritise if symptoms have changed
• Be honest and take ownership of follow-up
• Understand elective recovery and the eighteen week right in England
• Practical ways you can help reduce cancellations

 

Common mistakes to avoid

• Getting defensive or blaming management
• Promising a date you cannot guarantee
• Missing the clinical safety net
• Quoting statistics you are unsure of

 

NHS values and standards

Compassion; Respect and dignity; Everyone counts; Commitment to quality of care

 

Further reading

• NHS Constitution for England
• NHS England elective recovery plans
• Getting It Right First Time (GIRFT) general surgery report
• Royal College of Surgeons of England: Good Surgical Practice

 

 

Question 7: How do you work with surgical care practitioners and advanced practitioners in the surgical team?

Teamwork question  ·  Teamwork

 

What the interview panel is assessing

The panel wants to know that you value non-medical practitioners as skilled colleagues and understand how their roles fit the team. They are listening for respect, clarity about scope and supervision, and an awareness that training opportunities and patient safety both need to be managed fairly.

 

Model answer

I've worked in a department where surgical care practitioners were a big part of the team, and I'll be honest, they taught me a lot. Our senior SCP had assisted on hundreds of laparoscopic colectomies and knew the consultant's preferences better than anyone. On my first few cases she quietly showed me how to hold the camera so the consultant didn't have to keep correcting me.

I see SCPs and advanced clinical practitioners as experienced colleagues with their own scope of practice, training and governance. On the ward, an ACP might run the post-op reviews, request investigations and prescribe within their competence, which frees the doctors to cover the take or theatre. In theatre an SCP might assist, close or perform defined procedures under supervision agreed locally. My job is to know what each person's scope is in this trust and to work with them, not around them.

Clarity matters most for safety. On the ward, I'd make sure we agree at the start of the day who's reviewing which patients and how they'll escalate to me or the registrar. If an ACP is worried about a patient, I'd treat that exactly as I would a call from a doctor.

Training opportunities can be a source of tension, and I think it's better to talk about it openly. When I was a junior I sometimes felt I missed out on cases, but the answer was speaking to the consultant about the list plan rather than resenting a colleague. Now I'd try to make sure that on any given list we've thought about who's getting what learning, including the SCP's own development.

Ultimately the patient benefits when a team has the right mix of skills, and I want to be someone who makes that team work well.

 

Why this answer works

The answer shows genuine respect for SCPs and ACPs with a believable example, and it is clear about scope, governance and escalation. It handles the sensitive issue of training opportunities honestly and constructively rather than ignoring it.

 

Key points to include

• Respect for SCPs and ACPs as skilled colleagues
• Knowing local scope of practice and governance
• Clear allocation and escalation on the ward
• Treat their concerns as seriously as any doctor's
• Fair, open planning of training opportunities
• Focus on patient benefit

 

Common mistakes to avoid

• Treating non-medical practitioners as juniors or helpers
• Being vague about scope of practice
• Complaining about lost training without offering a solution
• Ignoring their own development needs

 

NHS values and standards

Working together for patients; Respect and dignity; Commitment to quality of care; GMC Good Medical Practice: working collaboratively

 

Further reading

• Royal College of Surgeons of England: Curriculum framework for the Surgical Care Practitioner
• Health Education England: Multi-professional framework for advanced clinical practice
• GMC Good Medical Practice

 

 

Question 8: A woman admitted with abdominal pain has bruises of different ages on her arms. Her partner answers every question for her. What would you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel is checking that you recognise possible domestic abuse and coercive control in a surgical setting and know how to respond safely. They want to hear about seeing the patient alone, asking sensitively, keeping her safe, documenting carefully and involving the safeguarding team, while still managing her surgical problem.

 

Model answer

The pattern you describe would worry me: bruises of different ages, and a partner who doesn't let her speak. That could be domestic abuse or coercive control, and I'd want to give her a safe chance to talk, without putting her at more risk.

Her abdominal pain still needs managing, so I'd assess and treat that properly. But I'd find a natural reason to see her alone, for example when she goes for a scan, or by saying it's our routine practice to examine patients on their own. I wouldn't confront the partner or make any suggestion of abuse in front of him, because that can escalate danger for her.

When she's alone, and with a professional interpreter if needed, never a family member, I'd ask gently and directly. Something like, 'I noticed some bruises on your arms. Sometimes people get hurt by someone close to them. Is anyone hurting you or frightening you at home?' Then I'd listen. If she does disclose, I'd thank her, believe her, and ask what she wants and whether she feels safe going home. If she's an adult with capacity, she has a right to make her own decisions, but I'd explain the support available and contact the hospital safeguarding team or IDVA service for advice.

I'd document carefully and factually, describing and ideally drawing the injuries, using her own words, and making sure the notes don't become a risk to her if the partner sees them. If there were children at home or someone else at immediate risk, I'd follow child safeguarding procedures and that may mean sharing information without consent.

Even if she says nothing, I'd let her know there's help available and that she can talk to any of us. I'd hand this over carefully to the nursing team and my registrar.

 

Why this answer works

The answer balances the surgical problem with the safeguarding concern and shows practical skill in creating a safe space to talk. It respects the autonomy of an adult with capacity while recognising when children or others at risk change the picture, and it uses specialist safeguarding support.

 

Key points to include

• Recognise possible domestic abuse and coercive control
• Find a safe, natural way to see her alone
• Ask sensitively and directly, using professional interpreters
• Respect her choices while offering support
• Involve the safeguarding team or IDVA
• Factual documentation and consideration of children at home

 

Common mistakes to avoid

• Confronting the partner
• Using the partner or a relative to interpret
• Ignoring it because the admission is for abdominal pain
• Making decisions for a capacitous adult without involving her

 

NHS values and standards

Compassion; Respect and dignity; Everyone counts; GMC Good Medical Practice: protecting patients

 

Further reading

• Care Act 2014
• Domestic Abuse Act 2021
• NICE guideline on domestic violence and abuse: multi-agency working
• GMC Adult safeguarding guidance and protecting children and young people

 

 

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