You are called to A&E to see a patient with generalised peritonitis. Describe your approach.
- What this tests: Recognition of peritonitis as a surgical emergency requiring urgent senior involvement; systematic assessment and resuscitation; knowledge of common causes (perforated viscus, ischaemic bowel, perforated appendix); understanding that the patient is likely to need a laparotomy; appropriate pre-operative preparation including NELA risk scoring.
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How to approach this Surgery interview question
This quality improvement question is common in Surgery NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "You are called to A&E to see a patient with generalised peritonitis. Describe your approach." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.
What the panel is testing
A strong quality-improvement answer uses method as well as enthusiasm. Be clear about the problem, baseline measurement, intervention, re-measurement, and how the change was made sustainable. For surgery, connect operative or peri-operative decision-making with patient safety. Consent, escalation, theatre priorities, post-operative complications, and clear communication with seniors often matter.
- Separate audit, QI, research, and clinical governance clearly so the panel can follow your reasoning.
- Use a real cycle: baseline, intervention, re-measurement, learning, and sustainability.
- Link the project back to patient safety, service reliability, or measurable outcomes.
How to structure your answer
For a quality improvement prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.
- Open by naming the main issue in the question.
- Give a structured response rather than a memorised script.
- End with escalation, documentation, learning, or follow-up.
Common mistakes to avoid
The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.
- What this tests: Recognition of peritonitis as a surgical emergency requiring urgent senior involvement; systematic assessment and resuscitation; knowledge of common causes (perforated viscus, ischaemic bowel, perforated appendix); understanding that the patient is likely to need a laparotomy; appropriate pre-operative preparation including NELA risk scoring.