Core Surgical Training
Core Surgical Training (CST) is a two-year postgraduate training program in the UK designed to provide junior doctors with the foundational surgical skills and competencies needed to progress into higher surgical training (ST3+). It is a competitive and structured program under the General Medical Council (GMC) and the Joint Committee on Surgical Training (JCST).
Eligibility Requirements for CST
To apply for Core Surgical Training, applicants must meet the following criteria:
Medical Qualification
Possess a primary medical degree (MBBS or equivalent) recognized by the GMC.
Hold full GMC registration with a license to practice.
Foundation Training (or Equivalent)
Completion of the UK Foundation Programme (FY1 and FY2) or an equivalent program outside the UK.
Alternative: Applicants with overseas training must demonstrate equivalent competencies through a Certificate of Readiness to Enter Specialty Training (CREST).
Evidence of Surgical Interest & Experience
Surgical-themed foundation placements or relevant experience.
Evidence of participation in audits, quality improvement projects, and case presentations in surgery.
Basic surgical skills (e.g., logbook with surgical cases, procedural competencies).
Portfolio Requirements
Clinical and operative experience (logbook, work-based assessments like DOPS, CBDs, Mini-CEX).
Teaching experience (delivering teaching sessions, courses attended).
Audit & Quality Improvement (at least one completed audit cycle).
Research & Publications (posters, presentations, publications in peer-reviewed journals).
Leadership & Management (committee roles, organisational experience).
Examinations
Completion of the MRCS Part A (desirable but not mandatory at the time of application; required before ST3 entry).
Additional Courses
Basic Surgical Skills (BSS) Course (recommended).
Advanced Trauma Life Support (ATLS) Course (advantageous).
Application Process
Oriel Application
Applications are made via Oriel, the UK’s online application portal for postgraduate training.
Typically opens in November for posts starting in August the following year.
Shortlisting
Based on the self-assessment score submitted by candidates, which considers experience, portfolio, and additional achievements.
Interview Process
Candidates are invited for national interviews (held between January and February).
The interview comprises:
Clinical Scenario (tests decision-making and clinical judgment).
Management & Portfolio Station (assesses leadership, communication, and portfolio achievements).
Ranking & Offers
Candidates are ranked based on their interview performance and preferences.
Successful candidates receive offers for placements across different deaneries.
Core Surgical Training Structure (CT1 & CT2)
CT1 (First Year): Exposure to various surgical specialties (e.g., general surgery, vascular, plastics, ENT, trauma & orthopaedics).
CT2 (Second Year): More specialized training, often leading to increased operative responsibility.
Work-based Assessments: Regular DOPS, CBDs, Mini-CEX, and an Annual Review of Competence Progression (ARCP).
MRCS Exam: Candidates must pass the full MRCS (Part A & Part B) to progress to higher surgical training (ST3).
Progression to Higher Surgical Training (ST3+)
Completion of Core Surgical Training with a satisfactory ARCP outcome.
Full MRCS qualification.
A strong surgical portfolio with operative logbook evidence.
Competitive application for ST3 posts in a chosen specialty (General Surgery, Plastic Surgery, Neurosurgery, etc.).
Competition & Alternative Routes
CST is highly competitive, with over 1,000 applicants for ~600 posts annually.
Some candidates opt for "Trust Grade" or "Non-Training" surgical posts to strengthen their portfolio before reapplying.
Another option is the Academic Clinical Fellowship (ACF) route, combining surgical training with research.
A well-structured portfolio is crucial for a strong Core Surgical Training (CST) application. The portfolio is assessed during the application scoring and interview, influencing your ranking and likelihood of securing a training post.
Below is a breakdown of key portfolio components and how to maximize your score in each category:
1. Postgraduate Degrees & Qualifications (5 points)
How to Maximise Score:
A Master’s (MSc, MRes, MPhil, etc.) or PhD in a relevant field (e.g., Surgery, Anatomy, Medical Education) earns full marks.
If a full degree is not feasible, consider:
PGCert or PGDip in Surgical Science or Medical Education (some points awarded).
Research an affordable MSc that allows part-time/distance learning.
2. MRCS Exam (6 points)
How to Maximise Score:
Passing MRCS Part A before application guarantees 6 points.
If not passed, prepare early (best to take it in January or September before CST applications open).
3. Clinical Experience (9 points)
How to Maximise Score:
Having more than 12 months in a surgical job scores full points.
If possible, do an F2 year with a surgical rotation.
If your foundation rotations lacked surgical posts:
Work as a Surgical Trust Grade (SHO) for additional experience.
Seek Clinical Fellow or LAS (Locum Appointment for Service) posts in surgery.
Gain hands-on exposure and log operative procedures (assist, suture, close skin).
4. Procedural & Surgical Skills (6 points)
How to Maximise Score:
Log procedures in the Intercollegiate Surgical eLogbook.
Keep evidence of:
Independent completion of common procedures (e.g., abscess drainage, suturing, chest drain insertion, appendicectomy assist).
DOPS and WBAs (work-based assessments) signed off by consultants.
Basic surgical skills courses (e.g., Basic Surgical Skills (BSS) Course).
5. Audit & Quality Improvement (6 points)
How to Maximise Score:
Full points: Lead a closed-loop audit (where changes were implemented and re-audited).
Take initiative:
Identify simple audits (e.g., WHO checklist compliance, post-op infection rates).
Close the loop by presenting results and implementing improvements.
Collaborate with consultants and registrars for impactful projects.
6. Teaching Experience (6 points)
How to Maximise Score:
Full points: Organize and lead a regular teaching program for medical students/junior doctors.
Get involved in:
Medical school clinical skills teaching.
Surgical skills workshops (e.g., suturing, knot-tying).
Teaching within surgical societies or formal hospital training sessions.
Certificate of Medical Education (PGCert) if time allows (extra points).
7. Presentations (6 points)
How to Maximise Score:
Full points: Present at a national or international conference.
Aim for:
Oral or poster presentations at surgical society meetings (ASiT, RCS, BAPRAS, AUGIS, etc.).
Hospital grand rounds, regional teaching days.
Keep evidence: Conference programs, feedback, and certificates.
8. Publications (6 points)
How to Maximise Score:
Full points: At least one PubMed-indexed journal publication.
Strategies to publish:
Case reports (easier to publish, submit to BMJ Case Reports, Annals of RCS).
Literature reviews or systematic reviews in surgical topics.
Join ongoing research projects (ask registrars or research teams).
If struggling, aim for letters to the editor, editorials, or non-PubMed-indexed articles (these still earn points).
9. Leadership & Management (6 points)
How to Maximise Score:
Full points: Hold an official leadership role for more than 6 months.
Examples:
President/committee member of a surgical society.
Rotational Representative for junior doctors.
Founder of a teaching program or hospital initiative.
10. Additional Courses (4 points)
How to Maximise Score:
Attend at least two of the following:
Basic Surgical Skills (BSS)
Advanced Trauma Life Support (ATLS)
Surgical skills workshops (e.g., Laparoscopic skills, Trauma skills)
Medical Education courses
Final Tips
Start early – Begin building your portfolio before FY2.
Keep a folder – Store all certificates, assessments, and logs.
Be proactive – Seek research, audits, and leadership roles.
MRCS Part A – Pass it before applying for bonus points.
Seek mentorship – Ask CST trainees or registrars for guidance.
