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Home › Specialties › General Surgery

General Surgery Training Pathway

How to become a general surgeon in Australia — the RACS SET program run through General Surgeons Australia, how national selection actually scores you, and what general surgeons earn.

The bottleneck isn't the SET program — it's getting onto it. Most applicants spend years as unaccredited service registrars building the CV, operative logbook and references selection demands, all before SET 1 begins. Selection is national and weighted heavily toward the interview.

General Surgery
RACS / GSA · Royal Australasian College of Surgeons · General Surgeons Australia
Training length
5–6 (SET)
Competitiveness
High
Exams
GSSE + Fellowship Examination
Lifestyle
Demanding — heavy operating and on-call
Fellowship
FRACS (General Surgery)
Time to qualify
10+ years from graduation (estimate)

Why general surgery

You assess, work up and operate on the full breadth of abdominal and soft-tissue surgical disease — acute abdomens, hernias, gallbladders, bowel, breast and endocrine, trauma and emergency general surgery — across clinics, theatre lists and the on-call take. It's a craft specialty built on operative decision-making and technical skill.

✓ Draws
  • Broad operative scope and a clear craft skill set
  • Strong demand and high earning ceiling, especially subspecialised
  • A clear, structured 5–6 year program once you're on SET
  • Acute, decisive work with tangible outcomes
⚖ Trade-offs
  • Getting onto SET is the hard part — often years unaccredited first
  • Heavy on-call, overtime and operating hours
  • Long total training time and a demanding Fellowship Examination
  • Geographic flexibility needed to take a training post

Subspecialties

Colorectal surgeryUpper gastrointestinal & bariatric surgeryHepatobiliary & pancreatic surgeryBreast & endocrine surgeryTrauma & emergency general surgerySurgical oncology

The training pathway

The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.

Fastest route
~8+ years from graduation
Onto SET early with the prerequisites done first time — SET itself is five to six years. RACS publishes no official time-to-fellowship, so any PGY here is an estimate.
Internship + residency
PGY1–2
General registration and early hospital experience.
Pre-SET surgical experience
PGY2–3+
General surgery and critical-care rotations, operative logbook, and the GSSE passed — the prerequisites to apply.
Selection onto SET
national round
One national application through GSA/ABiGS; CV, references and a structured interview decide it.
SET 1–5 (General Surgery)
5–6 years
Accredited training in public hospitals, rotating through the subspecialties.
Fellowship — FRACS
Qualified (estimate ~PGY10+)
Fellowship Examination passed; consultant general surgeon.
Realistic route
10+ years from graduation (estimate)
Typical — several unaccredited service-registrar years before selection, then five to six years on SET. RACS publishes no average time to fellowship, so this is an estimate.
Internship + residency
PGY1–2
General registration.
Unaccredited / service registrar years
often several years
The real bottleneck — building operative experience, publications, courses and consultant references while reapplying. The number of years is not published.
Prerequisites complete
before applying
≥26 weeks general surgery + an 8-week critical-care rotation, verified procedural log, GSSE passed, and four consultant supporters.
Selection onto SET
national round
Competitive — see Competitiveness section for published figures.
SET 1–5 (General Surgery)
5–6 years
Accredited training across the subspecialties; EMST required during SET.
Fellowship — FRACS
Qualified (estimate)
Fellowship Examination (written + clinical/viva) passed; consultant general surgeon.

How competitive is it?

GSA publishes real figures. GSA's own 2024 General Surgery Selection Review (2025 intake) reports 235 applications, 227 deemed eligible and 182 interviewed, from which 122 offers were made and 120 accepted — an offer rate of about 67% of those interviewed. RACS accredits posts rather than creating them, so the number selected tracks vacant accredited posts; the size of the national unaccredited-registrar pool isn't published.

Unaccredited time: Yes — in practice most applicants spend years in unaccredited service-registrar posts building the operative experience, references and CV that selection demands before they get onto SET. RACS does not publish how many years this typically takes.

Sources: RACS — General Surgery (Australia) selection page, RACS — Activities Report (applicant & offer tables), General Surgeons Australia — selection.

Selection criteria & how to apply

General Surgery selection is national — one application through General Surgeons Australia and the Australian Board in General Surgery, not a state-by-state process. Four components make up your score out of 100, and the interview dominates:

Interview50%
A national structured panel interview — five short panels, two structured questions each, scored on competency, ethics, communication and safety. Held in several cities for logistics but run as one process.
Curriculum vitae20%
Scored on qualifications, presentations, publications, scholarship and teaching, and Indigeneity/ethnicity — double-marked by two assessors.
Referee reports20%
You nominate 15+ referees; ABiGS selects five primary referees who rate you across ten areas against your peers. Five valid reports are required.
Rurality10%
Points for rural education, rural origin and rural/remote surgical experience, scored via the Modified Monash Model.

Key documents: General Surgeons Australia — selection regulations & process, RACS — General Surgery (Australia) eligibility & selection.

Where you'd train, state by state

Selection is national, but training is local. You apply once and are scored the same wherever you live; what you choose is a training region. Applicants rank up to four of five regions — NSW/ACT, Queensland, South Australia, Victoria/Tasmania and Western Australia — with the Northern Territory served by rotations from NSW, SA and Victoria. Pick your state below.
NSW

Who runs selection: Part of the NSW/ACT training region — the largest, spanning Sydney teaching hospitals and rural networks. Selection is national; this is where you'd be placed, not who selects you. NSW also runs rotations that service the Northern Territory.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: The biggest pool of accredited posts and unaccredited registrar jobs in the country. At consultant level, NSW general surgeons work as salaried staff specialists or as sessional/fee-for-service VMOs.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

VIC

Who runs selection: Part of the Victoria/Tasmania training region, covering Melbourne teaching hospitals and regional Victorian networks. Selection is national; Victoria also runs rotations servicing the Northern Territory.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: Large metropolitan training base. Consultants are salaried specialists under the AMA Victoria agreement or work sessional/VMO arrangements alongside private practice.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

QLD

Who runs selection: A standalone Queensland training region, from Brisbane teaching hospitals through large regional and rural centres. General Surgeons Australia is headquartered in Brisbane. Selection is national.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: Strong regional and rural surgical footprint. Consultants work as salaried staff specialists/SMOs under the Queensland Health agreement or as VMOs.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

SA

Who runs selection: A standalone South Australia training region centred on Adelaide teaching hospitals with rural rotations. Selection is national; SA also runs rotations servicing the Northern Territory.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: A smaller region with a tight set of accredited posts. Consultants are salaried specialists under the SA agreement or VMOs.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

WA

Who runs selection: A standalone Western Australia training region across Perth teaching hospitals and a vast remote footprint served by the WA Country Health Service. Selection is national.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: Geographically isolated, with rural and remote rotations. Consultants work as salaried WA Health specialists or sessional VMOs alongside private practice.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

TAS

Who runs selection: Trained within the Victoria/Tasmania region, with Tasmanian teaching hospitals (Hobart, Launceston) providing accredited posts. Selection is national.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: A small number of posts grouped with Victoria. Much of the state is rural for training and rurality-scoring purposes.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

ACT

Who runs selection: Trained within the NSW/ACT region, with Canberra teaching hospitals providing accredited posts. Selection is national.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: A small metropolitan training base grouped with NSW. Consultants work as salaried Canberra Health Services specialists or VMOs.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

NT

Who runs selection: The Northern Territory has no standalone region — its accredited posts are serviced by rotations from the NSW, South Australia and Victoria training regions. Selection is national.

Where to apply: GSA / ABiGS national application — application portal.

Worth knowing: Distinctive remote and Aboriginal-health surgical exposure, delivered through rotations from southern regions rather than a local training program. Strongly rural for rurality-scoring purposes.

Links: RACS — General Surgery (Australia), General Surgeons Australia.

How to optimise your application

The honest read: The program is capped by accredited posts and the interview is worth half your score, so the work is front-loaded: build the operative experience, references and CV that get you selected, then perform in the interview — most of it during the unaccredited years before SET 1.
  • Pass the GSSE early (tied to Eligibility, start PGY1–2) — It's a hard gate — you must pass the Generic Surgical Sciences Examination before the application closing date, so sit it well ahead of applying.
  • Build the operative logbook and references (tied to CV (20%) + Referees (20%), start unaccredited years) — Verified procedural experience and strong, specific consultant references are scored directly — line up the four consultant supporters early.
  • Prepare hard for the interview (tied to Interview (50%), start pre-application) — Half the score sits here. Practise structured, scenario-based answers on competency, ethics and safety.
  • Use rurality if it fits (tied to Rurality (10%), start early) — Rural education, origin or surgical experience scores points and rural rotations are built into training — worth weighing if it suits you.

Key documents & official links

FAQ

Is general surgery hard to get into?
Yes. The program is capped by accredited posts and selection is national and competitive (see figures in the Competitiveness section). The harder part for most is the years spent as an unaccredited service registrar building the CV and operative experience needed to be selected.
How long does it take?
The SET program is five to six years once you're on it, on top of internship, residency and the pre-SET years. RACS doesn't publish an average time to fellowship, so any total is an estimate — realistically a decade or more from graduation.
How is selection scored?
Out of 100: interview 50%, CV 20%, referee reports 20% and rurality 10%. It's one national process run by General Surgeons Australia and the Australian Board in General Surgery.
What exams are there?
You must pass the Generic Surgical Sciences Examination (GSSE) before you can apply for SET, then sit the Fellowship Examination (written plus clinical/viva) towards the end of training. The standalone RACS Clinical Examination — which General Surgery selection never used — has been discontinued (final sitting February 2026), so it forms no part of the General Surgery pathway.
Do general surgeons earn a lot?
They're among the highest earners in medicine. The ATO's 2023–24 Taxation Statistics put average taxable income for the occupation 'surgeon (general)' (code 253511) at $438,505 across 1,900 taxpayers, with a median of $335,144. These are taxable incomes after deductions, not salaries, and they vary widely with subspecialty, case mix and how much private work you do.

Trained overseas? (IMG pathway)

How overseas-trained general surgery doctors get recognised

Overseas-trained surgeons are recognised through the RACS Specialist International Medical Graduate (SIMG) assessment. After an interview you're rated substantially comparable (up to 12 months of clinical assessment, exam possibly waived), partially comparable (up to 24 months and usually the Fellowship Examination), or not comparable. General Surgery SIMG registration is handled with General Surgeons Australia.

See the RACS SIMG assessment for international medical graduates and our IMG internship guide.

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Last reviewed 2026-06-09.

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