Core Generalist#



Discuss the diagnosis and initial/non-surgical management for conditions that require surgical treatment


Describe standard precautions and sterile technique


Identify infection control practices


Illustrate knowledge of anatomy, physiology and pathology for common surgical conditions


Discuss common surgical procedures and techniques



Demonstrate elementary surgical skills, including;

  • scrub, gown and glove
  • standard precautions
  • instrumentation
  • using sutures, surgical knots, needles
  • surgical wounds and tissue handling
  • insertion and care of wounds and drains
  • splinting and immobilisation
  • local anaesthetic


Competently perform a range of minor surgical procedures and investigations and provide post-operative management:

  • suture and repair of lacerations
  • curettage of skin lesions
  • removal of palpable and foreign bodies
  • incision and drainage of cutaneous abscess
  • wound management including debridement and dressings
  • cauterisation or freezing of skin lesions
  • incision biopsy of skin lesions
  • punch biopsy of skin lesions
  • toenail ablation
  • wedge excision of toenail bed
  • removal of a toenail
  • drain a perianal haematoma/abscess
  • drain a thrombosed pile
  • removal of foreign body from auditory canal
  • syringe external auditory canal
  • aural toilet
  • insert wicks into ear canal
  • examine the nares with a speculum and distinguish between anterior and posterior bleeding
  • manage epistaxis
  • remove foreign body from nose
  • management of a surgical drain, including vacuum assisted
  • removal of skin staples
  • nasogastric drainage
  • intercostal underwater seal drain insertion
  • pleural tap


Diagnose and determine appropriate management plans for hospital in-patients with surgical conditions, depending on the condition and local clinical services capabilities:

  • local management
  • local management with consultation
  • further investigations
  • undertake conservative measures as appropriate
  • undertake operative measures as appropriate
  • arrange for referral and transfer


Perform the following skills:

  • primary and secondary trauma survey
  • cannulation
  • fluid replacement
  • electrolyte balance assessment and replacement
  • blood transfusion
  • blood gas analysis


Manage the pre and post-operative care for a patient undergoing surgery locally


Recognise, stabilise and, as appropriate, arrange transfer and evacuation of patients with surgical emergencies and severe trauma








Advanced Specialised#



Detail anatomy and physiology relevant to domains of surgical practice in the curriculum


Discuss selection criteria, protocols, principles and limitations of the diagnostic procedures tests and interpret their results


Describe basic principles for:

  • emergency ultrasound
  • procedural sedation
  • endoscopy
  • surgical technique
  • laparoscopy
  • laparotomy


Identify potential surgical complications including possible failure of the surgical procedures listed in this curriculum, describe the signs and symptoms of these complications and outline appropriate rescue plans


Discuss management plans and algorithms for common potential variations for common procedures eg when an ovarian pathology or bowel cancer is found for a case that was thought to be appendicitis



Provide general management of surgical illnesses and complications:

  • fluid and electrolyte balance
  • standard ABCDE prioritisations
  • nutrition
  • management of shock
  • wound management and wound healing
  • pain management – pre-emptive, operative, post-operative and emergency
  • fracture/dislocation management including principles of fixation
  • recovery and mobilisation planning.
  • maintain or re-establish basic bodily functions


Order or perform a range of diagnostic procedures:

  • basic blood tests
  • Focused Assessment with Sonography for Trauma (FAST) ultrasound of abdomen
  • plain x-rays – interpretation for emergency purposes pending definitive reporting, including adult and paediatric chest, spine, abdomen and extremities
  • CT scans – interpretation to help guide emergency treatment pending a definitive report (considerations around emergency use of contrast)
  • ultrasound examination of the pregnant uterus and pelvis, including diagnosis of acute emergency events such as ectopic pregnancy and ruptured viscera
  • lumbar puncture
  • endoscopy


Undertake a judicious pre-surgical assessment that considers both surgical and non-surgical factors, including:

  • age, weight and health of patient
  • degree of urgency
  • local clinical services capabilities
  • own skill set
  • if surgical intervention is required
  • possible alternative diagnoses or pathologies
  • whether to refer or manage locally
  • whether to liaise with specialist surgeon regarding management options
  • retrieval services available and likely time to definitive care, should a retrieval be considered


Consider alternative diagnoses and their implications for care in current medical setting


Perform appraisal of whether surgical care should be undertaken and if this should be non-definitive (intermediate) or definitive surgical care


Perform damage control techniques to control haemorrhage, prevention of contamination and protection from further injury, for presentations where surgical intervention is not safe, eg in the following presentations:

  • intra-abdominal haemorrhage
  • appendicitis
  • open fracture


Consider the appropriate mode of anaesthetic for the case, consulting with the Anaesthetist as required


Recognise and implement a management plan for surgical complications, including:

  • management of post-operative haemorrhage and infection
  • management of incision wound infection/abscess
  • management of wound dehiscence
  • identification and management of vascular insufficiency or deep vein thrombosis, including appropriate preventative strategies
  • management for complications such as pulmonary embolus
  • perforation/obstruction, pneumothorax, spinal headache, pressure sores
  • medical complications following surgery – respiratory (eg infective pneumonia, aspiration), cardiac (eg arrhythmias, MI) renal (eg ARF, hyper and hypo kalemia), neurological (eg CVA, delirium), GI (eg ileus, constipation)
  • complications of therapeutics – allergy/anaphylaxis, toxicity, drug interactions, GI bleeding, dystonic reactions, neuroleptic malignant syndrome, transfusion reactions, under or over-hydration, over-anticoagulation


Demonstrate basic skills:

  • emergency ultrasound
  • procedural sedation
  • gastroscopy & colonoscopy - required to fulfil requirements of the Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy (CCRTGE)
  • surgical technique
  • laparoscopy
  • laparotomy
  • surgical audit
  • risk assessment


Manage abdominal presentations:

  • Abdominal wall mass or pain: hernia repair
  • Acute right and left lower quadrant pain: appendicitis, adnexal/ovarian disease, diverticular disease, constipation
  • Gastrointestinal bleeding (upper and lower)
  • Gastrointestinal screening and surveillance (upper and lower)
  • Perianal presentations haemorrhoids, infections, warts, pilonidal sinuses, anal fissures


Manage non-abdominal presentations:

  • Integumentary lesions: skin, nail, subcutaneous lesions, ganglia, lipoma, digital amputation, burns cellulitis, skin flap and skin graft closure
  • Wound: dressings, excision and suture, drainage and debridement, drainage and packing
  • Fertility: vasectomy
  • Genitourinary disease: acute testicular torsion, epididymitis, phimosis, circumcision
  • Breast lump: triple assessment and referral
  • Hand/limb: carpal tunnel release, hand trauma/infection, extensor tendon repair, compartment syndrome upper and lower limb


Consider also undertaking DRANZCOG advanced training during or after Fellowship training to be able to manage complications of pregnancy, including:

  • Complications of labour and delivery: operative vaginal delivery, caesarean section, perineal trauma, uterine inversion, postpartum haemorrhage, retained placenta, advanced labour and risk management, neonatal resuscitation
  • First trimester pain and bleeding: uterine bleeding: dilation, curettage and hysteroscopy (pregnant and non-pregnant), ectopic pregnancy, and
  • Tubal ligation


Obtain specific approval and training from supervisor before undertaking new procedures


Undertake special training or accreditation as required to perform additional skills to address community needs








Conditions requiring surgical treatment#

  • Skin: benign and malignant skin lesions, skin infections (impetigo, cellulitis, abscesses, boils, haematomata)
  • Acute abdomen: appendicitis, biliary colic, cholelithiasis cholangitis, pancreatitis, oesophagitis/G.U./D.U., inflammatory bowel disease, renal causes, aortic/vascular aneurysm disease, diverticulitis/ischaemic colitis, acute infective diarrhoeal illness, perforate viscus, strangulated hernia, visceral perforation and peritonitis
  • Anorectal: perianal haematoma, perianal abscess, tumours of the colon
  • Respiratory: pneumothorax, upper and lower airway obstruction, pleural effusion and haemothorax, pericardial effusion, perforated oesophagus/Boerhaave’s syndrome, rib fractures
  • Urinary: acute urinary retention, renal tract tumour, renal tract calculus, renal trauma, urinary tract infections, torsion of testis
  • Neurosurgical: closed head injury, acute and chronic subdural haematoma, tumours of the central nervous system (CNS), vascular disasters of the CNS, berry aneurysm, arteriovenous malfunction, trauma to the spinal cord and peripheral nerves, intracranial haemorrhage
  • Ophthalmological: sudden loss of vision, non-penetrating ocular trauma, corneal foreign bodies, corneal abrasion, hyphema, lens dislocation, retinal detachment, penetrating eye wounds, eyelid and skin tumours, trauma and infections
  • Vascular: acute peripheral vascular occlusive disease/threatened limb, deep vein thrombosis, varicose veins, abdominal aortic aneurysm, venous ulceration and deep venous incompetence
  • ENT: tympanic perforation, aural foreign bodies, otitis externa, tumours of the ear, nasal foreign bodies, nasal polyps and tumours, sinusitis, maxillary, and other sinuses, medical nasal conditions, throat and pharynx conditions, uvular oedema, tonsillitis/quinsy, glottic and pharyngeal foreign bodies, epiglottitis, acute and chronic sinusitis
  • Fractures: skull, cervical spine, orbit, zygoma, face, jaw, thoracic and lumbar spine, clavicle, ribs, pelvis, neck of humerus, supracondylar humerus, head of radius, mid forearm, distal forearm including Colles’, Smith’s, metacarpals especially scaphoid, digits, femur, tibia, Potts fracture, calcaneus, metatarsals
  • Crush injuries: systemic complications (fat embolism), compartment syndrome
  • Dislocations: jaw (temporomandibular joint), shoulder - anterior/posterior, patella, interphalangeal joints, lunate, femur, ankle
Last updated on by acrrmbot