Introduction
The Core Surgical Training (CST) recruitment process is one of the most competitive in the UK, and for 2025, the portfolio requirements have undergone significant changes. As an aspiring surgeon, navigating these changes effectively could be the difference between securing your ideal post or facing another round of applications. This detailed guide will break down the key updates to the CST portfolio for 2026, explaining what you need to know to score maximum points and stand out at the interview stage.
For those looking to enhance their portfolio, there’s still time to gain valuable points by completing relevant courses, such as our Train The Trainers course. This course continues to score under the teaching experience domain, providing an excellent opportunity to boost your portfolio before the submission deadline.
We will also discuss how our CST Interview Preparation Course can help you maximise your portfolio score and excel during your interview. With tips on everything from documenting operative experience to presenting quality improvement projects, this guide will ensure you are fully prepared for the 2026 application process.
As the CST portfolio scoring system shifts from a point-based approach to a letter-based evaluation, understanding how to present your achievements is more important than ever. Let’s dive into the changes and how to approach your portfolio with a winning strategy.
Key 2026 Portfolio Changes
Scoring across all domains has transitioned from a numerical point system to letter grades (A to E), requiring different levels of evidence for each grade. A final score is given in interview, based on a combination of evidence submitted and response to questions.
- Operative Experience – maximum points are gained for involvement in 40 or more cases
- Surgical experience – a foundation placement is no longer awarded points. Points can be scored based on a taster week or surgical elective
- QIPs and Audits receive maximum points for both leading, and presenting a closed loop project
- Research and Publication – top points are gained for either winning an academic prize or publishing a paper as first author in a PubMed indexed journal
- Teaching – this domain remains unchanged, with points earned for leading and facilitating a teaching programme to your peers or undergraduates
CST Recruitment Timeline 2025/26
| Event | Date |
|---|---|
| Applications open | 23rd October 2025 |
| Applications close | 4 pm Thursday 20th November 2025 |
| Invitations MSRA | To be confirmed |
| MSRA Window | 6th to 19th January 2026 |
| Evidence upload portal opens | 16th February |
| Evidence upload portal closes | 26th February |
| MSRA scores released to applicants | To be confirmed |
| Invites to interview sent | 13th February 2026 |
| Interview dates | 2nd to 11th March 2026 |
Points Summary
Here’s a summarised table of the A–E grading system across key domains for the 2026 Core Surgical Training (CST) portfolio based on the official documents.
| Domain | A (Highest) | B | C | D | E (Lowest) |
|---|---|---|---|---|---|
| Operative Experience | Involvement in 40+ cases | 30–39 cases | 20–29 cases | 11–19 cases | <10 cases or no evidence |
| Surgical Experience | Completed surgical elective (4+ weeks) or surgical taster week (5+ days) | I have not undertaken a surgical taster/elective/surgical placement | |||
| Quality Improvement Project (QIP) | Lead in all aspects of a surgically themed audit/QIP with demonstrated change | Lead in all aspects of a clinical audit/QIP with demonstrated change | Contributor in a clinical audit/QIP with demonstrated change | Involved in a clinical audit/QIP | No QIP involvement |
| Presentations & Publications | Top prize for oral presentation at national/international meeting or first author PubMed publication (non-case report) | Oral presentation or poster prize or first author of case report/book chapter | Co-author of PubMed publication | First author poster/oral poster | No publications/presentations |
| Teaching Experience | Organised and delivered ≥4 face-to-face teaching sessions | Organised and delivered ≥4 online teaching sessions | Organised <4 sessions | Regular teaching or educational activity | No teaching experience |
Operative Experience
Gaining surgical experience is essential to scoring points within this domain, which can be tricky if you don’t have a surgical rotation. It may mean sacrificing zero days or annual leave, but if you’re clever, try negotiating some time during your day to attend a theatre session. Remember, these cases must be assisting, supervisor scrubbed or above. Once you’ve hit 40+ surgical cases, focus your energy on other aspects of the portfolio.
Criteria
| Details | Criteria |
|---|---|
| Operative Experience Scoring | A: 40+ cases B: 30–39 C: 20–29 D: 11–19 E: <10 or none |
| Required Evidence | Submit a consolidation report via the eLogbook system, including summary and consultant verification. |
| Consolidation Report Must Include | Summary sheet with case counts and date ranges; consultant’s name, signature, GMC number, and date. |
| What Doesn’t Count | Observational roles cannot be reported. |
Surgical Experience
Ideally, candidates will have completed a placement in a surgical specialty before applying, but this isn’t always possible. You can still gain points by completing a surgical elective or using taster days during foundation training.
Scoring Categories for Surgical Experience
| Indicator | Criteria |
|---|---|
| A | Surgical taster week (5+ days) or elective (4+ weeks) |
| B | None of the above |
Surgical Specialties Accepted
- Cardiothoracic Surgery
- ENT Surgery
- General Surgery
- ITU (valid for 2025/26 only)
- Neurosurgery
- Oral & Maxillofacial Surgery
- Orthopaedic Surgery
- Paediatric Surgery
- Plastic Surgery
- Urology
- Vascular Surgery
Evidence Submission
Upload a letter on official letterhead from your supervisor including department, hospital, dates, details of exposure, supervisor name, and GMC number.
Quality Improvement Projects (QIP) and Audit
QIPs and audits are vital to scoring well. Plan to complete two cycles and present your results before submission. Both involvement and presentation contribute to scoring.
Subdomain 1: Involvement in QIP/Audit
| Indicator | Option | Notes |
|---|---|---|
| A | Lead in all aspects of surgically themed QIP/audit with change shown | Must include two or more cycles and a clear intervention. |
| B | Lead in all aspects of clinical audit/QIP with change shown | Participation in all stages and at least two cycles. |
| C | Contributor in a clinical audit/QIP with change shown | Active involvement across multiple cycles. |
| D | Involved in clinical audit/QIP | Assisted with data collection in at least one cycle. |
| E | None |
Submitting Evidence
Provide a presentation or written summary showing improvement, plus a signed consultant letter with their name, GMC number, date, and statement confirming the project met requirements.
Subdomain 2: Presentation of the QIP/Audit
| Indicator | Option | Notes |
|---|---|---|
| A | Presented both cycles or intervention/change data | Evidence via slides and acceptance letter. |
| B | Presented one cycle | As above. |
| C | No presentation |
Submitting Evidence
Provide either a letter of acceptance including title, presenter, date, organiser, or a copy of the programme listing you as presenter.
Presentations and Publications
This domain requires early planning due to long review timelines. Start early, and if original research is difficult, consider review articles or case reports. Academic consultants may provide guidance or opportunities.
Scoring Categories for Presentations and Publications
| Grade | Criteria |
|---|---|
| A | Top prize for oral presentation at national/international meeting or first author PubMed paper (non-case report) |
| B | Oral presentation at national/international meeting, first author case report/editorial, or medical book chapter |
| C | First author of poster/oral poster at national/international meeting |
| D | Oral presentation at regional meeting or collaborative PubMed author |
| E | No publications/presentations |
Important Notes
- Only personally delivered presentations count.
- First authorship must meet ICJME criteria.
- Presentations requiring payment without peer review are invalid.
- Medical meetings must be accredited CPD events.
- You cannot double-claim the same presentation in QIP and publication sections.
Submitting Evidence
Upload appropriate documents depending on type of presentation/publication, such as PubMed ID confirmation, acceptance letters, or conference programmes.
Additional Tips
- Target trainee-oriented national meetings for higher acceptance rates.
- Seek consultant mentorship for writing opportunities.
Teaching Experience
Teaching is an excellent way to strengthen your CST portfolio. To gain maximum points, organise and deliver at least four sessions. Collaborating with peers and attending courses like Train The Trainers can further enhance your experience.
Scoring Categories for Teaching Experience
| Option | Indicator | Notes |
|---|---|---|
| A | Organised and delivered ≥4 face-to-face teaching sessions | Show initiative in identifying needs and designing a structured programme. |
| B | Organised and delivered ≥4 online teaching sessions | Similar to A but online delivery format. |
| C | Organised a programme but delivered <4 sessions | Evidence of design and partial delivery. |
| D | Regular teaching (≥4 sessions/year) or educational activity focused on teaching | Includes bedside teaching or teaching-related training courses. |
| E | No teaching |
Submitting Evidence
Provide a consultant letter confirming your role, with their name, GMC number, and dates. A second letter confirming delivery and feedback review is also required. Alternatively, anonymised feedback forms may be provided.
Important Notes
- Formal feedback is required, verified by a consultant.
- Regional teaching involves delivery across multiple hospital sites.
- Educational activity courses like Train The Trainers can also count as evidence.
Additional Tips
- If opportunities are limited, organise virtual evening webinars.
- Work with undergraduate departments to deliver teaching or events.
Summary and Tips for Maximising Your Portfolio Score
Submitting a strong, well-organised portfolio is crucial. Assessors have limited time, so ensure evidence is clear, concise, and relevant. Follow these tips to maximise your score:
Present Your Evidence Clearly
Keep evidence concise and organised in domain-specific PDFs. Avoid irrelevant documents or overly large uploads.
Seek Advice from Colleagues
Consult those with CST or assessment experience for guidance on evidence structure and content.
Beware of Disreputable Sources
Avoid using evidence from unaccredited or pay-to-present sources. Ensure all courses are CPD accredited (e.g., 12 CPD points for Train The Trainers or Teach The Teachers).
Avoid Electronic Signatures
Use handwritten or verified signatures only. Editable electronic signatures may cause assessors to reject your evidence.
Ensure No Patient Identifiable Data (PID)
Any evidence with PID results in zero points and possible disciplinary action. Always double-check documents.
Carefully Select Supporting Data
Only include directly relevant material. Redact unrelated details to maintain clarity and professionalism.
Submit Domain-Specific Evidence
Upload one clear PDF per domain with relevant, well-labelled evidence. Avoid duplication across domains.
