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What are the impacts of recent changes in UK core surgical training application on current and prospective applicants?
  1. Carven Yee Shean Chin1,
  2. Tsun Yu Kwan2,
  3. Hse Juinn Lim3,
  4. Chun Hei Li4
  1. 1Department of General Surgery, Cardiff and Vale University Health Board, Cardiff, UK
  2. 2Department of Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3Department of General Surgery, Whipps Cross University Hospital NHS Trust, London, UK
  4. 4Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Hse Juinn Lim, General Surgery, Whipps Cross University Hospital NHS Trust, London, UK; limhsejuinn123{at}


Core Surgical Training (CST) is a 2-year UK training programme, designed to provide junior doctors interested in surgery with formal training and to introduce them to various surgical specialties. The selection process is divided into two stages. In the portfolio stage, applicants submit a score based on a published self-assessment guidance. Only candidates whose scores remain higher than the cut-off after verification will proceed to the interview stage. Finally, jobs are allocated according to the overall performance of both stages. Despite the rising number of applicants, the number of job vacancies remains largely similar. Hence, the intensity of competition has increased over the past few years. The competitive ratio increased from 2.8:1 in 2019 to 4.6:1 in 2021. Hence, several changes have been implemented in the CST application process, with the aim to combat this trend. The recurring changes in the CST application process have sparked considerable discussions among applicants. The effect of the changes on the current and prospective applicants is yet to be explored. This letter aims to highlight the changes and discuss the potential impacts. The CST application from 2020 to 2022 has been compared to identify the changes implemented throughout the years. Specific changes have been highlighted. The impact of changes in the CST application process on applicants has been divided into ‘pros’ and ‘cons’ sections. Recently, many specialties have shifted from portfolio-based assessment to Multiple Specialty Recruitment Assessments. In contrast, CST application preserves its emphasis on holistic assessment and academic excellence. However, the application process could be further refined for more impartial recruitment. This would ultimately help alleviate the challenging situation of staff shortage, increase the number of specialist doctors, reduce waiting time for elective surgeries and most importantly, provide better care for our patients in the NHS.

  • surgery
  • adult surgery
  • education and training
  • medical education & training
  • COVID-19

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  • Contributors CYSC, TYK, HJK and CHL contributed equally in conceptualisation, review and writing of the manuscript. All four authors should be considered as joint first authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.