Surgical selection in the UK

The role of the SACs in surgical selection

The JCST, via its component Specialty Advisory Committees (SACs), is responsible for designing the selection processes for specialty training posts. The selection processes are managed and delivered on behalf of the four nations by Health Education England (HEE) via a lead recruiter based in one of the Local Offices.  

A member of each SAC is designated ‘Selection Lead’ and is responsible for co-ordinating and refining the selection process for their specialty. In conjunction with the specialty’s lead Local Office, they are also responsible for defining the requirements that applicants must meet in order to be eligible for an interview. 

The JCST holds an annual Selection Leads Meeting, inclusive of all specialty Selection Leads and relevant stakeholders, which aims to promote commonality where appropriate across the selection processes.

The structure of surgical recruitment

Surgical recruitment takes place at two principal stages: 

Core-level (CT1/ST1)

Most surgical trainees will undertake two years of Core Surgical Training (CT1 and CT2) prior to entering specialty surgical training at ST3 level. Core Surgical Training provides a generic surgical training, along with options available for trainees to undertake more complex training in their specialty of choice. The Core Surgical Training Curriculum is available on the ISCP website.

Neurosurgery is a predominantly ‘run through’ specialty, with the majority of trainees entering the training programme at ST1 level. As a run through specialty, Neurosurgical trainees complete their Core-level training as a component of the specialty training programme, completing ST1 and ST2 level training before progressing to ST3 subject to satisfactory ARCP outcomes and passing the MRCS examination. All neurosurgical trainees must have completed the ST1 and ST2 competencies as described in the neurosurgical specialty curriculum, which requires development of understanding, clinical experience and competence in basic and applied clinical neurosciences, basic neurosurgical care, neuro-intensive care and emergency medicine.

Run-through training options are also available in the specialties of Cardiothoracic Surgery and Oral & Maxillofacial Surgery (OMFS), alongside ST3-level recruitment.  

Pilots of run-through training in Otolaryngology (ENT), General Surgery, Urology and Vascular Surgery have completed. Pilots will continue to be delivered for Trauma & Orthopaedic Surgery and Paediatric Surgery until their pilot end date. Further details on the current position (April 2023) are available on JCST website.  

Specialty-level (ST3)

The majority of surgical specialties recruit at the specialty-level (ST3) after surgical trainees have completed the Core Surgical Training programme. The exception is Neurosurgery, where applicants must complete the requirements of the ST1 and ST2 competencies described in the Neurosurgery specialty curriculum in order to be appointable at ST3 level. 

Applicants for ST3 surgical posts should bear in mind that undertaking Core-level training in posts that have not been prospectively approved by the GMC may have a bearing on their specialty certificate type. You can find further information on certification types on the JCST website. 

Academic training opportunities

It is possible to pursue academic training in most surgical specialties from ST1-level onwards via appointment to Academic Clinical Fellowship (ACF) training posts. For further information on recruitment to ACF posts, please consult the National Institute of Health Research (NIHR) website.

The surgical recruitment processes

Surgical recruitment at both the Core-level and specialty-level takes the form of a structured interview process, including a formal application, preparation of a portfolio of surgical and medical experience, and progression through a number of structured interview stations. The interview processes are delivered by the specialty’s lead Local Office. Applicants are invited to apply for national selection via the NHS’s online applications system Oriel.

This document provides an overview of the selection process for each specialty and helps to explain some of the stages involved, along with examples of the type of selection centre stations you may encounter.

For information on a range of topics relating to selection, including information for applicants, person specifications and competition ratios, you can access HEE’s Medical and Dental Recruitment and Selection website. 

The surgical training pathway

This diagram provides an overview of the surgical training pathway within each surgical specialty – it includes details on specialty-specific requirements, highlights selection and benchmarking stages, and shows the training journey available in each specialty for uncoupled and run-through training, as well as the IST pilot programmes.