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Applying for Surgical Education and Training (SET training) is one of the biggest milestones in a surgical career. It’s long, competitive, and often emotionally draining. Every pathway looks different — but the preparation themes are universal. Getting onto SET training reflects years of commitment, resilience, and deliberate professional growth.
Here are the eleven things I wish someone had told me before I applied.
## The Application
## **1. Familiarise Yourself Early with the SET Training Selection Guidelines**
Understand the CV scoring system for SET training in detail.
Understand exactly which:
* examinations
* clinical rotations
* conferences
* journals
* presentations
…actually contribute to points.
There’s no advantage in submitting abstracts or papers that don’t add to the score. Research and presentation portfolios take time to build, and the criteria can change each year. Always work from the latest guidelines. Building your research and presentation portfolio takes time, and the selection criteria can change each year.
## **2. Treat Everyday Work as an Interview** for SET Training
Every ward round, clinic, case discussion, and operating list shapes your reputation. Consultants remember:
* how you present cases
* whether you follow through
* how engaged you are
* how you function in a team
* your reliability on after-hours shifts
These impressions directly influence your referee reports. Make every theatre list count and demonstrate steady, safe skill progression.
## **3. To Gap Year or Not to Gap Year?**
Both pathways are valid.
I went straight through, entering SET training at PGY7 after two years of general surgical residency and four years as an unaccredited vascular registrar. Balancing research and clinical work was demanding, but it accelerated my readiness.
A gap year gives time for:
* research
* teaching
* higher degrees
* portfolio development
Continuing clinical exposure builds judgement, confidence, and surgical maturity. Choose the path that best supports your growth — not what others tell you is “standard.”
## **4. Choose Your Referees Wisely**
Referee selection begins long before you apply. The units you work in — and the consultants you build rapport with — play a significant role. Some centres are well known for supporting trainees and producing SET training candidates. Talk to current trainees and recent applicants to learn where strong mentorship and training culture exist. These relationships are often the foundation of your application.
## The Interview
The following 6 points relate to the SET interview preparation itself. The SET interview is, without doubt, the most challenging part of the entire application process.
I was successful on my third application and second interview attempt — and the biggest difference between those two attempts was preparation. My first interview was, in hindsight, almost unprepared. I underestimated the depth, breadth, and structure that the process demands.
## **5. Give Yourself at Least Six Months of Structured Preparation**
The SET Interview is the hardest part of the process.
For my successful attempt, I dedicated solid six months purely to preparation.
On my successful attempt, I dedicated **six months** to preparation:
* the first two building structured answers
* the next three internalising them
* the final month practising flexibility and adaptability
All the way through, I was practising answering questions and recording them to evaluate and improve my process. Forcing yourself to practice is fundamental to a successful outcome.
Resources I found helpful included:
* _General Surgery SET Interview: The Ultimate Preparation Guide_ (Amanda Nikolic) – yes, I was applying for vascula,r but there is a lot of overlap
* _Medical Interviews – A Comprehensive Guide to CT, ST and Registrar Interview Skills_ (ISC Medical)
* past interview questions and insights from current trainees
A strong, memorable opening line for each question made an enormous difference — a tip I owe to my coach, Dr Anthony Llewellyn.
## **6. Practising Your Time Management Is Crucial**
Preparation for the SET training interview is a marathon, not a sprint. During my preparation period, I was fortunate to have a fellow unaccredited registrar — and a senior SET trainee — to practise with almost daily. Even so, finding consistent time around clinical work was incredibly challenging. After a long day of ward rounds, theatre, and after-hours calls, it’s difficult to muster the energy to revise interview questions.
I had a long daily commute, so I used to listen to my recorded answers while driving, or call my colleague to take turns asking each other practice questions. My coach emphasised that consistency was far more important than intensity. I found that regular short sessions, even 20–30 minutes, made a significant difference over time.
Also, practise with multiple partners if you can. Different people will challenge your thinking in different ways, and help you build adaptability. Don’t worry if your first few attempts feel awkward or “awful” — everyone starts there. The key is to keep going. You’ll find that your delivery, confidence, and flexibility improve dramatically with repetition.
## **7. There’s Lots of “Wrong” Answers But Rarely a “Right” Answer**
Even when an interview question sounds binary, there’s usually no single correct answer — unless it relates to patient safety or a critical incident. Early in my preparation, I often struggled to decide what the “most right” answer was. Over time I realised the key is to base your response on what you would actually do in a real clinical setting, or what you’ve seen done effectively by senior colleagues.
Unless it’s a patient safety scenario, most questions test judgement, not recall.
Your goal is to:
* demonstrate safe, structured reasoning
* show how you make decisions under pressure
* base your answer on real clinical behaviour
* reflect at least SET trainee / registrar-level judgement
Asking consultants how they would approach certain questions gave me clarity about what “good” looks like.
## **8. Practise Explaining Your Clinical Reasoning Out Loud**
It’s not enough to _know_ what to do — you must be able to articulate it clearly.
Interview panels want to hear:
* how you prioritise
* how you stabilise
* when you escalate
* how you think and problem solve when faced with uncertainty
Practice until your explanations are calm, stepwise, and fluent. A safe, de-escalatory mindset is more important than chasing obscure diagnoses.
## **9. Be Rock-Solid on Core Clinical Management**
Before you worry about rare complications, know the fundamentals cold.
Examples (for vascular) include:
* DRSABCD
* the CCrISP framework
* managing diabetic foot sepsis
* describing limb ulcers
* prioritising emergency lists
* stabilising a deteriorating post-op patient
* appropriate early escalation
Panels rarely ask about highly specialised operative details — they test safe, structured, bread-and-butter decision-making.
For instance, be able to run through DRSABCD and the CCrISP framework without hesitation. In vascular surgery, know how to describe ulcers, manage diabetic foot sepsis, and stabilise a post-operative patient and appropriately escalate. You’re unlikely to be asked about the nuances of anatomical reconstruction for aorto-iliac occlusive disease, but it’s very reasonable for an examiner to test your approach to a deteriorating patient. Mastering these bread-and-butter situations demonstrates safe, structured thinking.
## **10. Confidence and Presence Matter More Than You May Think**
Confidence is everything. I still remember how one of my interview panels seemed disengaged barely a minute into my first answer — and that’s when I truly understood the importance of a strong opening sentence.
A strong opening sentence sets the tone.
If you come across as hesitant or flat early on, it’s hard to recover.
On the day:
* greet the panel properly
* speak clearly
* maintain eye contact
* show controlled energy
* project competence and kindness
Panels want the registrar they’d trust in their unit at 2am. Bring that version of yourself.
## **11. Use a Coach — It Significantly Improves Outcomes**
This is a point I wish I’d known much earlier.
A good coach helps you with:
* keeping you accountable for your practice
* structured interview answers
* refinement of your opening lines
* identifying blind spots
* practicing under realistic pressure
* ensuring your examples align with core themes
* improving presence, clarity, and confidence
* understanding what panels _actually_ want
SET interviews aren’t intuitive. They’re structured, high-stakes assessments of judgement, reasoning, and behaviour. The right coach collapses months of trial-and-error into a targeted strategy.
If you’re preparing seriously, coaching is one of the highest-yield investments you can make.
Good luck!
### Interested in Exploring Coaching for Surgical Training
Book a Strategy Call with Dr Melody Koo
Book a Call
## Related Questions
### **1. How long should I prepare for the SET interview?**
According to my coach, most applicants need **4–6 months** of structured preparation to perform well. This includes building strong, flexible answers, practising clinical reasoning out loud, rehearsing with partners, and refining your delivery. Many successful candidates begin preparation in January or February of the year or even the year prior.
### **2. What matters most for a competitive SET application?**
The most influential factors are:
a strong CV aligned to the formal scoring system
high-quality referee reports
consistent performance as an unaccredited registrar
clear, safe clinical reasoning
a confident interview presence
Understanding the guidelines early and building relationships with supportive units make a significant difference.
### **3. Is it worth using a coach for SET Interview preparation?**
Yes. SET interviews are highly structured and test judgement, reasoning, and behavioural competence under pressure. A good coach helps you develop strong openings, sharpen your examples, identify blind spots, and rehearse in a realistic, pressure-tested way. Many candidates report a major improvement in their second attempt after coaching.
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