Station 1: Clinical Issues

You are about to perform an operation which you are unfamiliar with, with a
consultant you have not worked with before. Outline how you would prepare for this?

Describe your surgical approach to the hip joint with reference to the important
structures you would take care to avoid and what layers you would split to gain
access.

Correct side/site surgery is important, how would you go about ensuring this?

During an operation you encounter significant bleeding. How do you manage intra-
operative bleeding?

What issues can arise when using tourniquets in theatre?

How would you monitor a patient on the ward for blood loss?

How do you go about obtaining informed consent from a patient?

Avoiding infection is an important part of orthopaedics, how would you approach

this?

Station 2: Personal Development & Assessment

It is important that surgeons maintain high standards. How would you go about
ensuring this? (surgical audit, know the 5 steps in the audit cycle)

Do you think on-going education and training is important for a surgeon? Do you
think this should be mandatory for surgeons post fellowship? If so, why? If not, why
not?

What do you consider to be your most significant achievement within medicine and
outside medicine?

What do you plan to do in the future, both within medicine and outside it?

Define important qualities in leadership and how would you rate yourself on a scale of
1 – 10.
Station 3: Communication skills

How do you go about obtaining informed consent?

How would you deal with a patient who made an accusation against you?

What is your process for dealing with conflict?

If you were selecting trainees for the orthopaedic program what qualities would you
look for?

Station 4: Multiple Choice Anatomy Exam (as much as I can recall)

Muscles/structures in medial compartment of thigh

Movements of ankle and nerves/muscles involved
Structures in anterior compartment of calf
Joints involved in head movements
Location and innervations of radial nerve
Joints in spine and their relation to movements
Boarders of anterior triangle
Muscles in thenar eminence

Station 5: Ethics

You notice that a fellow registrar is unsafe in theatre. How would you manage this
situation?

How do you evaluate and critique the strength of research when someone presents to
you?

What do you consider to be the most important quality for an orthopaedic trainee?

What is one of your weakness?

Describe an ethical situation you have dealt with in the past?

What have you learnt from the research you have done?

Is it possible to have both and academic post and a clinical career and is this
something you would like to do? (yes and yes)
Station 6: Clinical Issues

You are the registrar in outpatients and when you check the routine bloods on patient
you discover he is unexpectedly HIV and HEP C positive. He is due for the removal
of a tibial nail in one week. How do you manage this situation? (ensure you refer to
STD clinic, notify Dept of Health and seek advice regarding operation from infectious
diseases. Inform patient you need to report this, and also inform surgical team).

In the above situation, can the patient still have is operation? (I think yes, but need to
seek input from Infectious Diseases to ensure he his still fit for surgery).

In the above situation, once the surgical team in notified, will the staff use any
additional precautions that they usually would not use? (In reality, no. They usually
use gloves, glasses, gowns, etc for every patient. However, they may choose to double
glove and take extra care with this patient but really nothing should change).

What is the most difficult surgical case you have managed and why? What have you
learnt from it? (DHS in demented patient, complicated by bleeding and ethical issues)

You notice there is a lot of blood in the wound drain of a patient post operatively.
How do you assess and manage this? (history, inspection, observations, examination,
Hb. Manage according to medical co morbidities, age, clinical condition, amount of
blood loss, etc. Options include IV fluids, blood transfusion, take to theatre to control
bleeding, or nothing).