11 Things I Wish I Knew Before Applying For SET Training

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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!