Surgeon

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

• Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
• Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
• Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
• Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
• Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

• Attributes post-operative tachycardia, fever, new or worsening pain or a failing recovery to pain, anxiety or atelectasis without examining the patient and investigating for an anastomotic leak, bleeding or other surgical complication.

  An unrecognised leak or bleed becomes septic shock or death in hours, and every hour of delay to source control increases mortality.

• Would start an operation without a completed time out, or proceed while a discrepancy in patient, procedure, side, site or consent is unresolved, or would override a team member who stops the case.

  Wrong-site, wrong-procedure and wrong-patient surgery are never events that the time out exists to stop, and the harm cannot be undone.

• Obtains consent without disclosing the material risks or the alternatives including not operating, plans to perform a non-emergency procedure the patient did not consent to, or takes consent from a patient who lacks capacity.

  An operation without informed consent is battery in law, and a patient who did not know a risk cannot have accepted it.

• Hands over without naming a patient they know is at risk of a surgical complication overnight, or without the time-critical check or result on that patient and what to do about it.

  The covering clinician cannot act on a risk they were never told about, and the first they hear of a neck haematoma or a leak is the emergency.

• Allows a trainee to perform a critical portion of an operation without being present, leaves without being immediately available or naming a backup surgeon, or attests to presence or supervision they did not provide.

  The patient consented to an operation under that surgeon's responsibility, a trainee without help in a crisis is a patient without help, and a false attestation is fraud.

Knowing where the role stops is part of the standard. Going past it is not extra credit.

• A spoken assessment

  An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

• Five dimensions

  Each answer is read against the expectations above and rated on the same four-level scale.

• The 70 bar

  Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

• Safety first

  Crossing one of the safety red lines holds a pass back, however strong the rest was.

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed September 19, 2026.

• Surgery Milestones 2.0Accreditation Council for Graduate Medical Education, 2019
• WHO Guidelines for Safe Surgery: Safe Surgery Saves LivesWorld Health Organization, 2009

Cited as sources. Not an endorsement by the organizations named.