General surgery
The acute abdomen, hernias, biliary and pancreatic disease, bowel obstruction and anorectal conditions. The AMC wants safe initial assessment, resuscitation and knowing when to call the surgeon.
High-yield points
Appendicitis: periumbilical pain migrating to the right iliac fossa, anorexia, fever; ultrasound first in children and pregnancy, CT in most adults.
Biliary colic vs cholecystitis: fever, raised WCC and positive Murphy's sign suggest cholecystitis; ultrasound is the first test.
Ascending cholangitis (Charcot's triad: fever, jaundice, RUQ pain) needs antibiotics and urgent biliary drainage.
Acute pancreatitis: lipase over 3x the upper limit; common causes are gallstones and alcohol; early fluids and analgesia, severity by organ failure.
Bowel obstruction: 'drip and suck' (IV fluids, NG tube), CT to find cause; strangulation needs surgery.
Irreducible, tender hernia is a surgical emergency (strangulation).
Uncomplicated diverticulitis in a well patient can often be managed without antibiotics; complicated cases need CT and admission.
Mesenteric ischaemia: pain out of proportion to examination, often with AF.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Acute abdomen | Clinical diagnosis with ultrasound; surgery principles as taught. | Largely the same: appendicitis, cholecystitis and obstruction are diagnosed and managed similarly. |
| Infective causes | Abdominal TB, amoebic liver abscess and typhoid perforation are common. | Rare, mainly in migrants or travellers. Hydatid disease can still occur in rural sheep-farming areas. |
| Elective referral | Patient often goes directly to a surgeon. | GP refers. Public elective surgery waiting lists use urgency categories 1-3 (within 30, 90 or 365 days), or private care. |
| Antibiotic prophylaxis | Postoperative antibiotic courses of several days are common. | Single pre-incision dose (usually cefazolin) per eTG; prolonged postoperative courses are not recommended. |
Acute abdomen
India (MBBS)
Clinical diagnosis with ultrasound; surgery principles as taught.
Australia (AMC): what the exam expects
Largely the same: appendicitis, cholecystitis and obstruction are diagnosed and managed similarly.
Infective causes
India (MBBS)
Abdominal TB, amoebic liver abscess and typhoid perforation are common.
Australia (AMC): what the exam expects
Rare, mainly in migrants or travellers. Hydatid disease can still occur in rural sheep-farming areas.
Elective referral
India (MBBS)
Patient often goes directly to a surgeon.
Australia (AMC): what the exam expects
GP refers. Public elective surgery waiting lists use urgency categories 1-3 (within 30, 90 or 365 days), or private care.
Antibiotic prophylaxis
India (MBBS)
Postoperative antibiotic courses of several days are common.
Australia (AMC): what the exam expects
Single pre-incision dose (usually cefazolin) per eTG; prolonged postoperative courses are not recommended.