Applying to Core Surgical Training (CST)

Surgical training has a variety of work to get involved in as well as having many sub-specialties within it. The field is constantly advancing with the use of robotic surgery etc. and is certainly a specialty that those who like visual elements to their work, will enjoy. In this article, we discuss surgical training including how you can apply and how to put in a competitive application.

Why surgery?

There are so many reasons! Some of these include:

  • Short ward rounds. You get to wear scrubs! Lots of practical procedures and seeing real life anatomy.
  • Lifelong learning
    • Always a new skill to learn
    • Simulated learning as well as real life
  • Variety of work (ward/theatre/clinic). Huge scope of practice (lots of specialties to work in, including a variety of ages).
  • Can have a good work life balance (if you pick a sub-specialty with less on call commitments). There is increasing flexibility in training (less than full time i.e. LTFT).
  • Team working – multidisciplinary team (MDT) approach used: Can work in leadership roles and there can be huge diversity when working in teams.
    • Huge impact on patients’ lives:
    • Patient can wake up and problem be ‘fixed’. You have immediate results and it can be very rewarding!
  • Innovative – good use of evolving techniques
    • Robotic surgery, 3D printing etc…

Training Pathway

Two routes

  • Core surgical training
    • Two-year programme, where you work in a range of specialties
    • Can be ‘themed’ or ‘un-themed’ (matched to a specialty or not)
    • Following CT1 and CT2, you will then apply for specialty training
  • Improved surgical training
    • Run through programmes ST1-ST8 as long as meets competencies
    • Currently pilots in: ENT/T&O/Gen surg/vascular/urology
    • Will have to re-apply if wanting to change specialties  

How to build your portfolio

  • Download portfolio requirements early and start completing points (it’s never too early)
  • Show people you are keen and they will be willing to teach you
  • It does take time to build your portfolio, so everything you do, make sure you collect evidence for it at the time

Commitment to surgery

MRCS Part A  Prepare for exams (the earlier you do them after medical school, the easier!)  Pick a quiet rotation (e.g. GP/psych and spend 3-4 months studying). Just booking the exam will score you some points.
Surgical coursesMust attend at least 2 for maximum points (provide attendance certificate). Can cost a lot of money – use courses that will be useful in future, like ATLS/BSS (requirement CST2). Free courses: national catheter education programme.
Surgical experienceLog cases: Sign up to E-log book (free) and log everything you see. Near your interview, download the summary page (with no patient information) and get your supervisor to sign it.
Surgical tasterMust be at least 4-5 days, with a reflection to maximise points. There are no points for working in a surgical rotation, so don’t worry if you are not allocated a surgical job.
Surgical electiveMust have evidence and reflection. Try to write reflections at the time.
Postgraduate degrees/qualifications/additional degrees
PhD/MD score most points – not many people will have this
– Apply for prizes – surprisingly small number of people apply so you often have a good chance
– Scholarships and bursaries at medical school count”
Quality improvement Project/Clinical audit
– Try to complete a QiP in a leadership role (you will have lots of people asking you to take part in audits – be selective, take the ones that will require the least time)
– Use exact words from portfolio scoring and write letters asking consultants to sign. Do this as soon as you complete a project/audit so you don’t spend time near your interview trying to collect evidence (eg. Dr Smith, designed lead and implemented an audit…).
Teaching experience
– Take teaching courses when offered (lots of universities/foundation schools offer these for free)
– Help with teaching for medical students (suturing classes/bed-side teaching)
– Teach when possible! Make sure you get feedback so you can include this in your portfolio
– Submit early! Often takes months to present at a conference
– Be selective in where you submit – national/international conferences score more points
– Publications must be on PubMed to score points
Leadership and management
Sign up to a leadership role (society/mess/rota coordinator)

Application process

  • Run nationally via Oriel, interviews in London (these were completed remotely on zoom in 2021)
  • Application made of three parts (each equally [1/3] weighted)
  • Combined score used to rank candidates
1/3 Portfolio (self-scoring) - Score used to determine selection to interview
– Extra degrees
– Points for dedication to surgery (courses, exams, taster weeks)
– Teaching (courses, and evidence of your teaching)
– Prizes
– Audit/QIP
– Research (must have PubMed ID)
– Presentations
– Leadership roles

Face-to-face interview (20 mins)
Two interviewers both score you and average mark is given

1/3 Clinical station (10 mins)
Two scenarios generally:
1) ATLS principles
2) Care of the Critically Ill Surgical Patient (CCrISP) principles (unwell patient)
1/3 Leadership station (10 mins)
– 3 minute pre-prepared verbal presentation on your role as a leader in a team and why this will make you a good core trainee.

Title usually released a few weeks before the interview
– 2 minutes of questions on your presentation and difference between leaders/managers
– 5 minute scenario on ethical/management scenario

We hope you found this article useful and wish you every success with your application!

Useful resources

Written by Roisin Johnson (CST1)

Exclusive 10% discount code for Medibuddy’s Application Resources

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