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Getting into Surgical Training

"You always knew you wanted to be a surgeon; you knew it since the day you entered

an operating theatre"

Does the above sound familiar? Most surgeons find it difficult to answer why they chose surgery as a career; they just know it is what they want to do! To become a consultant surgeon in the UK, there are two traditional pathways.

a) Training pathway: Complete training until you complete Specialty Training Year 8 (ST8) and gain your Certificate of Completion of Training (CCT)

b) Non-training pathway: Pursue a non-training job in a surgical specialty of your choice and gain your Certificate of Eligibility for Specialist Registration (CESR)

The pathway taken by most UK graduates is as follows:

Medical School - Foundation Year 1 - Foundation Year 2 - Core Surgical Training (2 years) - Specialty Training (6 years) - Consultant

This whole process takes roughly 10 years from when you graduate medical school to when you become a consultant.


It is rather common these days to take a year out before applying for core surgical training (often called the FY3 year) or before specialty training (called the CT3 year). Many surgical trainees also take years out to pursue a post-graduate degree such as an MSc, MD or a PhD.

The alternative pathway is as follows:

Medical School - Foundation Year 1 - Foundation Year 2 - Non-training jobs (10-15 years) - Consultant

Which pathway is better?

The training pathway has the obvious advantages of being more organised, more senior-guided, and takes far less time to complete. It however has the disadvantage of not being able to choose which hospital you work in (it is selected by the deanery).

The non-training pathway is highly self-led. You are responsible for creating your own

training opportunities. In most cases, you will not get preference over a trainee for operative lists as the hospital is contracted to provide training to surgical trainees over non-training doctors.

How to enter the UK surgical training pathway:

There are two entry stages to surgical training:

A. Core Surgical Training (CT1/ST1):

Applications are usually open online in late October and November on the Oriel website and the interviews are from January to February. Job offers are released in March. The job starts in August of the same year as the interview.

B. Higher Specialty Training (ST3):

Applications are usually open online in late November and December on the Oriel website and interviews are from March to April. Job offers are released in April or May. The job starts in October of the same year as the interview.

Requirements for your application:

a) Core Surgical Training:

  1. CREST (Certificate of Readiness to Enter Specialty Training) form signed

  2. MSRA Exam score - Introduced from 2022 application for 2023 entry year

  3. Surgical portfolio to display your commitment to surgery

b) Higher Specialty Training:

  1. CREHST (Certificate of Readiness to Enter Higher Specialty Training) or ARCP outcome evidence from Core Surgical Training

  2. MRCS Exam Completion evidence

  3. Logbook to display your surgical experience

The competition ratio for core surgical training is around 1:4 while that for higher specialty training varies greatly

based on the sub-specialty. We will be discussing more about how to ace your surgical training interview in the article to follow!

Best wishes!

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