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Surgery (SU)

  • From acute abdominal pain to stoma management, and from post-operative care to the early recognition of surgical emergencies, GPs play an important role in the diagnosis, initial management, and appropriate referral of patients with surgical needs.

    Understanding when and how to refer, working collaboratively with surgical teams, and providing continuity of care before and after hospital interventions are central to ensuring high-quality outcomes for patients.

    By the end of training, trainees should be able to confidently manage common surgical presentations in primary care, recognize red flags requiring urgent attention, and contribute meaningfully to shared care in surgical pathways.

    • SU1. Demonstrate competence in diagnosing and managing a wide range of surgical conditions in primary care.
    • SU2. Identify red flags requiring urgent referral for surgical management.
    • SU3. Perform thorough physical examinations for surgical conditions, including assessment of the abdomen, rectum, breast, and peripheral vascular system, ensuring patient comfort and dignity.
    • SU4. Demonstrate competence in performing suturing for minor surgical wounds.
    • SU5. Manage post-operative care effectively, including pain management, wound care, and the early recognition and management of complications.
    • SU6. Provide effective communication and patient-centred care when obtaining informed consent for surgical procedures, ensuring patients understand risks, benefits, and alternatives.
    • SU7. Collaborate effectively with other healthcare professionals in the management of surgical conditions, ensuring multidisciplinary coordination of care.
    • SU8. Demonstrate knowledge of social welfare certification and driving guidelines relevant to surgical patients, ensuring appropriate advice and documentation.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • the natural history of the condition, including whether acute or chronic
    • the incidence and prevalence, including in different demographic groups
    • typical and atypical presentations
    • recognition of normal variations throughout life
    • risk factors, including lifestyle, socio-economic and genetic factors
    • diagnostic features and differential diagnosis
    • recognition of ‘alarm’ or ‘red flag’ features
    • appropriate and relevant investigations
    • interpretation of test results
    • management, including initial and continuing care, chronic disease monitoring and emergency care
    • patient and carer information and education
    • prognosis

    Signs, Symptoms & Presentations

    • Abdominal Lump
    • Abdominal Pain
    • Acute Urinary Retention
    • Breast Lump
    • Constipation
    • Dysphagia
    • Haematemesis
    • Haematochezia
    • Hip Pain
    • Intermittent Claudication
    • Knee Pain
    • Leg Pain
    • Malaena
    • Mastalgia
    • Pelvic Pain
    • Perianal Pain
    • Perioperative Pyrexia
    • Skin Lesions
    • Testicular Lump
    • Testicular Pain
    • Vomiting

    Common and Important Conditions

    • Abdominal Aortic Aneurysm
    • Abdominal Hernia
    • Acute Abdomen
    • Acute GI haemorrhage
    • Acute Limb Ischaemia
    • Anal Cancer
    • Anal Fistula
    • Aortic Dissection
    • Appendicitis
    • Basal Cell Carcinoma
    • Biliary Colic
    • Bowel Ischaemia
    • Bowel Obstruction
    • Bowel Perforation
    • Breast Abscess
    • Burns
    • Cholecystitis
    • Chron’s Disease
    • Chronic Limb Ischaemia
    • Colorectal Cancer
    • Diverticulitis
    • Dupuytren’s Contracture
    • Epididymo-orchitis
    • Fournier’s Gangrene
    • Ganglion Cyst
    • Haemorrhoids
    • Hiatus Hernia
    • Inguinal Hernia
    • Lower Limb Ulcers
    • Melanoma
    • Necrotising Fasciitis
    • Pancreatitis
    • Perianal Abscess
    • Perianal Fissure
    • Phimosis
    • Pilonidal Sinus/ Cyst
    • Post op Deep Venous Thrombosis
    • Post Op Infection
    • Pseudo Obstruction
    • Rectal Prolapse
    • Renal Calculi
    • Sebaceous Cyst
    • Skin Abscess
    • Squamous Cell Carcinoma
    • Stoma Care
    • Testicular Torsion
    • Testicular Trauma
    • Ulcerative Collitis
    • Umbilical Hernia
    • Varicose Veins
    • Volvulus
    • Wound Infection

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed 

    Useful Websites

    TeachMeSurgery

    Primary Care Surgical Association

    Workplace Based Learning

    GP trainees learn surgery in the workplace by engaging directly with patients presenting with surgical conditions in both primary and secondary care settings. Through supervised consultations, minor procedures, and participation in multidisciplinary care, trainees develop key skills in assessment, diagnosis, and decision-making. In hospital rotations trainees can gain exposure to surgical presentations to Emergency Departments. They can develop suturing skills in minor injuries areas. Once the trainee progresses to the registrar years, they can gain experience dealing with common surgical presentations such as cysts, abscesses, abdominal pain, intermittent claudication. Some GP practices will offer minor surgeries and it is important for trainees in these practices to gain experience by watching these procedures and perhaps carrying out minor procedures such as removal of benign lesions, ingrown toenail removal and suturing under supervision. The trainees can also become familiar with the use of local anaesthetic in these conditions.

    Day Release

    In day release teaching, GP trainees can enhance their surgical knowledge through interactive case discussions, discussion about minor procedures, and focused tutorials on common surgical conditions seen in primary care. These sessions provide a safe environment to explore clinical reasoning, referral pathways, and the GP’s role in pre- and post-operative care. Peer learning and facilitated reflection also help trainees build confidence in managing surgical presentations they encounter in their day-to-day practice.

    Registrar Tutorials

    Registrar tutorials offer a valuable opportunity for in-depth, small-group learning tailored to the needs of GP trainees. When focused on surgery, these sessions can cover practical topics such as assessment of the acute abdomen, management of minor surgical conditions, interpreting imaging reports, and performing joint injections or minor skin procedures. Tutorials may include case-based learning, role-play, and hands-on skills practice, allowing registrars to apply surgical principles in a general practice context. Facilitated by experienced GPs these sessions also provide a space for trainees to ask questions, share experiences, and receive targeted feedback.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 16: Manage investigations

    For EPA 16, arranging appropriate pre-referral investigations, such as FBC and CRP, demonstrates competence in investigation planning and interpretation. Reflection could cover rationale for investigations, communication of results, and appropriate use of resources.

    Core Knowledge Test (CKT)

    • Assessment of acute abdominal pain

    • Management of post-operative complications

    • Wound Management

    Clinical Competency Test (CCT)

    • A patient presenting with abdominal discomfort.
    • A patient booked for pre-op assessment brings in paperwork they don’t fully understand.
    • A patient presenting with an abdominal lump.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.