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So, you want to be a surgeon? Part 1

By Faheem Bhatti

If you know you want to be a surgeon or are considering surgery as a career you are in the right place. This two-part blog post will cover how the application process to get into surgery works and how you can begin to prepare whilst you are still at medical school.

How to become a surgeon in the UK?

The surgical training pathway in the UK begins after the completion of your foundation training and consists of 2 years of ‘core surgical training’ followed by approximately 6 years of further training in the particular specialty you are interested e.g. general surgery, vascular surgery, urology, trauma and orthopaedics etc. Upon completion of this training, many surgeons go on to complete fellowships where they further develop their skills in a particular type of surgery before obtaining a consultant job.

Surgical Training pathway in UK

Foundation Training (FY1 + 2) → Core Surgical Training (CST1 + 2) → Higher specialty training (ST3→8) → Fellowship(s) → Consultant Job.

The first large hurdle is gaining a place on the core surgical training (CST) programme. As of 2021 there were 607 CST jobs and 2528 applicants meaning a competition ratio of 4.15 applicants per job. Different regions of the country or ‘deaneries’ may be more competitive that others, for example, North London is typically one of the most competitive regions to gain a job in. We will focus on what the CST application process involves and how you can get ahead of the game.

How does the CST application process work?

The application process begins in November-December each year, starting with a portfolio self assessment. A portfolio is a collection of all your achievements, spanning several domains from additional degrees to commitment to specialty and research projects to teaching - we will break this all down shortly. You assess your portfolio against a marking criteria to gain a score out of 72. Based on the applications received each year, a threshold score is set, which if you meet or exceed you will receive an interview invitation. This threshold varies year to year but typically falls somewhere in the 40s.

Following completion of interview, you will be given a combined interview and portfolio score which will be used to rank all the interviewees and ultimately guide job allocation. As you can see, the portfolio is extremely important as it dictates whether you are invited to interview and also contributes to the overall score you are given for job allocation. Due to this, we will focus on what the portfolio is all about and how you can start to obtain portfolio points whilst you are still at medical school.

Application process

Portfolio self assessment → Meet portfolio cut-off score→ Invite to interview → Interviews held → Combined score created from interview and portfolio scores → Applicants ranked based on score → Jobs allocated based on ranking and applicants’ preferences for training deanery.

What does the CST portfolio involve?

Each year a new portfolio self-assessment scoring guidance document is released. The 2022 edition can be found on the following website:

Broadly, it consists of the following sections:

  1. Commitment to specialty

  2. Postgraduate degrees, qualifications and additional degrees

  3. Prizes and Awards

  4. Quality improvement and clinical audit

  5. Teaching experience

  6. Training in teaching

  7. Presentations

  8. Publications

  9. Leadership and Management

Now that we have covered the basics on what the application process involves we can focus on what you can do whilst still at medical school to start ticking off some of these sections. Keep an eye out for our next blog post where we’ll go through each section one by one!

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