Core Surgical Application Process – 2022

A detailed review of the 2022 application process covering steps such as the dates for the application, interviews, ranking process and job offer options.

What will we cover?


The core surgical training or CST involves a two-year placement, rotating through various surgical specialities. Trainees usually have scheduled operating sessions, clinics and ward sessions.

Who needs to do CST?

Currently, to specialise in most of the surgical specialities (except neurosurgery and cardiothoracics), you need to go through CST. Upon completing CST, you will need to apply again for speciality training (ST) and do another 4-5 years before becoming a consultant.

What are the requirements to apply to CST?

You need to:

  • Have completed your undergraduate medical degree
  • Have full GMC registration
  • Have 12 months of NHS experience after fully registering with the GMC
  • Be within 3.5 years of completion of the Foundation programme and the start date of your CST job

Some other general requirements can be found here.


What is the competition ratio?

The competition ratio for CST places varies year to year. The competition ratio was 4.6 in 2021 (vs 2.5 in 2017). This means out of almost every five candidates applying, only one secured a training place in 2021. The high number of candidates to places could be for a range of reasons. Firstly, some people apply for multiple specialities and ‘try their luck’ to see what offers they receive. The latest publicly available data (2017) showed 75% of the candidates applied for one speciality, whilst 25% applied for two or more. Moreover, many foundation doctors decided against taking years out for travelling due to the uncertainties around the pandemic.


It is undeniable that there are more candidates applying (1500 in 2017 vs around 2500 in 2021). This increase in number has created a selection dilemma, leading to higher requirements from candidates’ portfolios. Currently, the portfolio is used to shortlist candidates for interviews. In 2021, only 35% of the candidates applying got an interview. Out of those, 63% secured training posts. So if you make it to the interview, you are more than halfway there.

How do you apply to CST?

Applications are made nationally through a website called ORIEL.

What is the application process?

Due to the pandemic, the application process is now completely virtual. Below is a summary of the steps.

Oriel application

Don’t underestimate this part. It is an online form that you will need to fill in. But it will take a long time, at least a couple of hours, including the time you need to gather all your information.  You are required to provide information such as previous jobs, your previous degrees, your assessment of the portfolio and three references. Make sure you ask for references early on as consultants are busy people and take a long time to reply to your emails. You will also score your own portfolio against a set of pre-defined criteria. The self-assessment is marked out of 72.


Self-assessment validation

Out of 2500 people, roughly the top 1300 candidates will be invited to upload their evidence. The last day to upload evidence is around the 30th of December. The evidence uploaded will be reviewed by two consultants to give you a final score. You will be informed of this score in the first couple of weeks of January, and you will have 72 hours to contest any changes. If you do contest, a third consultant will re-mark your entire portfolio and this will be your final mark. It is important to note that you cannot upload any new evidence when you are asking for a remark. 


Around 1100 will be invited for an interview. The interviews are around the first couple of weeks of February.

The first round of offers

You will then hear your ranking in the last couple of weeks of March before having to rank your jobs.

What options do I have when I get offered a CST job?

You will then hear your ranking in the last couple of weeks of March before having to rank your jobs.

Alternatives to CST

There are other routes such as IST (improved surgical training) into surgery. IST was designed to improve the training, making more opportunities accessible through different means. For example, you are guaranteed to have 60% of your rota time during the daytime, giving you access to more elective operating opportunities. It also comes with a better study budget and is a run through programme, meaning you don’t have to go through another bottleneck at the ST3 level. IST posts have been paused in England in 2021, whilst they are continuing in Scotland and Wales. 

Another way of applying for speciality training is by taking F3 and F4 years before directly applying for ST3 training. This is a more complicated route and requires you to achieve the competencies achieved by others going through the CST route. 

Final words

This process will likely change over the coming years as more data will become available on alternative pathways such as the IST pilot. Also, the competition ratio varies year to year and do not let that put you off from applying. Lastly, use even if you are not 100% sure you want to go straight into training after foundation years. If you get offered a job, you don’t have to accept it. You can think of it as an excellent free mock interview.

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