Key Training Information

It is your decision how you want your medical career to progress and in which specialty you choose to pursue. There are a wealth of specialties to choose from and 2 main ways to become a consultant within the UK. Most consultants have followed a traditional training pathway with applications points either at ST1 or ST3/4 level. Some consultants may have qualified via the CESR or portfolio pathway route. Both are valid training pathways and have their own advantages/disadvantages.

CCT vs CESR:

These are the main training pathways in the UK to become a General Practitioner or Hospital Consultant. They have slightly different requirements and allow you to pick which pathway would work better for you as an individual. These enable you to take up a substantive/permanent consultant post in the UK. You are able to take up locum consultant jobs or specialist posts without this but will need to demonstrate significant skills/knowledge base. The traditional route is through a training programme in order to CCT, alternatively if you have significant experience abroad you may enter the UK system as a junior or senior clinical fellow and obtain a consultant post through the CESR pathway.

CREST forms:

A CREST (Certificate of Readiness to Enter Specialty Training) form is required to apply for any training programme in the UK. It must be signed by a supervising consultant at a hospital where you have worked for at least 3 months. It changes frequently so check the NHS recruitment website to ensure you have the latest version. In regards to surgical training, the CREST form would allow you to apply for ST1 positions but a certificate to enter higher surgical training form would need to be completed and signed by a consultant in order to apply for ST3 training positions through Oriel.

Forms for applying at ST3/4 level:

If you are applying for specialty training at ST3/4 level or subspecialty training at this level and have not completed ST1-2 training in the UK there may be other forms that are required to show competencies required at this level to ensure eligibility for entry at this level.

Specialty Training:

There are a wealth of training programmes available across the UK. Each programme is described in our section on specialties.

                                                        Application Process

All recruitment for UK training programmes take place through Oriel (www.oriel.nhs.uk). The resource bank contains all the key documents for your application.

There are two types of training programmes available in the UK and availability depends on the specialty you are applying for. There is run-through training which enables you to start at ST1 and progress through to CCT provided that you meet the criteria to progress at each stage. Alternatively there is uncoupled training where you apply for core training, for example CT1 Internal Medicine and then re-apply at ST4 for a specific medical speciality such as ST4 Respiratory Medicine.

There are 18 specialties with entry at ST1 level and 47 specialties with entry at ST3 level.

There are 4 specialties for which the recruitment is solely decided by the Multi-Specialty Recruitment Assessment (MSRA) examination which are: General Practice (ST1), Core Psychiatry (ST1), Child or Adolescent Psychiatry (ST1) and Psychiatry of Learning Disability (ST1).

The recruitment team publish the competition ratios for each specialty each year.

• You may wish to use these to influence which specialty to apply for

• Not all applicants will be successful in gaining a place in their first choice specialty and/or region of the UK

• However, remember that:

  • There is no limit on the number of applications doctors can make - some doctors will apply for multiple specialties which can artificially inflate the competition ratio

  • The published figures reflect the previous recruitment year, as specialties change in popularity as does the competition ratio, so last year may not reflect this year.

Recruitment Timelines:

Generally the recruitment timelines remain similar each year, but specific dates may change. Training rotations tend to start in August, however some specialties start in October.

Early October:

Academic Clinical Fellow Recruitment Opens

Late October:

Academic Clinical Fellow Recruitment Closes

ST1 Applications Open

Mid November:

Academic Clinical Fellow Interviews Start

ST1 Applications Close

Early January:

ST1 Interviews Start

Mid-January:

Academic Clinical Fellow Interviews Close

End-January:

Academic Clinical Fellow Initial Offers Released

Academic Clinical Fellow Hold Deadline

Mid-March:

ST1 Interviews Close

Late March:

ST1 Initial Offers Released

Early April:

ST1 Offers Hold Deadline

ST1 Offers Upgrade Deadline

Eligibility Criteria:

There are some eligibility criteria which apply for all training posts which are:

• You must hold a Bachelor of Medicine, Bachelor of Surgery degree (MBBS) or equivalent medical qualification

• You must:

  • Be eligible to work in the UK

  • Be eligible for full registration with, and hold a current license to practise from the General Medical Council (GMC) at the advertised post start date for the vacancy

  • Meet the standards set out in Good Medical Practice and not be subject to fitness to practice conditions which would prevent you taking up the post or performing fully within it

• You must not:

  • Hold, nor be eligible to hold, a Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration (CESR) for this specialty, nor

  • Already be eligible for the specialist register for this speciality

• You must be able to provide complete details of your employment history, including any gaps

• You must complete all sections of the application form fully and truthfully, in accordance with written guidelines

• You must disclose in your application if you are subject to any ongoing fitness to practise proceedings or are subject to any fitness to practise conditions

• If you are currently in training and applying to continue training in the same specialty in another region, you must obtain a Support for Application to another region form signed by the Training Programme Director/Head of School of your current Specialty Training Programme. This must confirm satisfactory progress and be submitted with your application.

• If you have previously resigned, or been removed from, a training programme in any specialty, you must obtain a Support for Reapplication to Specialty Training Form signed by the Training Programme Director/Head of School and Postgraduate Dean from the region you previously undertook training in. This must be submitted with your application.

• If you have previously resigned, been removed from, or relinquished a Foundation post or training programme and failed to gain the award of a Foundation Programme Certificate of Completion (FPCC), or Foundation Achievement of Competence Document 5.2 (FACD 5.2) you must obtain a Dean’s Supporting Declaration proforma signed by the Postgraduate Dean from the region you previously undertook Foundation training in. This must be submitted with your application.

• You must have evidence of achievement of foundation competences in the three and a half years preceding the advertised post start date for the vacancy, via one of the following four methods

  • Current employment in a UK Foundation Programme Office (UKFPO) affiliated foundation programme or,

  • Current employment in a GMC approved Specialty Training Programme holding either a National Training Number (NTN) or Deanery Reference Number (DRN), or

  • A Foundation Programme Certificate of Completion (FPCC) from a UK affiliated foundation programme, or

  • 12 months medical experience after full GMC registration (or equivalent post licensing experience), and a Certificate of Readiness to Enter Specialty Training (CREST)