Core Surgical Training (CST) Portfolio Guide - 2024/25
Written by Leo Gundle | Updated 1st Nov 24
Contents
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 2025, 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 2025 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 2025 Portfolio Changes
- Shift to a letter-based system: 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.
- Removal of standalone training in teaching section: The training in teaching category has been merged with the teaching experience domain. Courses such as Train The Trainers still contribute points, but they now count as part of your overall teaching experience.
- Elimination of surgical conference attendance and training qualifications: These sections no longer contribute to the portfolio score from 2025 onwards.
- Operative Experience requirements updated: Candidates are now graded from A (40+ cases) to E (<10 cases) based on the number of surgeries they’ve logged.
- Mandatory formal feedback: For teaching sessions and quality improvement projects, formal feedback is essential to score any points.
CST Recruitment Timeline 2024/25
Event | Date |
---|---|
Advert appears | By 5 pm Wednesday 23 October 2024 |
Applications open | At 10 am Thursday 24 October 2024 |
Applications close | At 4 pm Thursday 21 November 2024 |
Invitations MSRA | No later than (To be confirmed) |
MSRA Window | To be confirmed (January 2025) |
Evidence upload portal opens | Friday 7 February 2025 |
Evidence upload portal closes | Wednesday 19 February 2025 |
MSRA scores released to applicants | To be confirmed |
Invites to interview sent | Thursday 6 February 2025 |
Interview dates | Monday 24 February to Friday 7 March 2025 |
Preferences open date | By 5 pm Thursday 1 February 2025 |
Preferences close date | Tuesday 4 March 2025 |
Initial offers released | By 5 pm Tuesday 25 March 2025 |
Hold deadline | At 1 pm Thursday 3 April 2025 |
Upgrade deadline | At 4 pm Tuesday 8 April 2025 |
Interview scoresheet release date | To be confirmed |
What’s New in the 2025 Core Surgical Training Portfolio?
The 2025 Core Surgical Training (CST) portfolio process has introduced several critical updates that applicants must understand to succeed. The most notable change is the shift from a point-based self-assessment to a letter-based evaluation during the interview. This means that, instead of claiming points before your interview, you’ll now provide evidence for each domain, which will be assessed live by interviewers. Your score will be determined based on how well you demonstrate your achievements during the portfolio station.
The Letter-Based Scoring System
Under the new system, applicants will assign a letter grade (A to E) to each section of their portfolio. The letter grades represent different levels of achievement, with ‘A’ being the highest and ‘E’ the lowest. These grades are used as a guide, but the final assessment will be made during the interview. This means preparing thoroughly and ensuring your evidence is well-organised and easy to present is essential.
Impact on Applicants
This change removes the advantage of pre-assessed scores, placing more emphasis on how you present your portfolio in the interview. While this may seem daunting, it also offers the opportunity to discuss your achievements in real time, potentially allowing you to maximise your score based on the clarity and depth of your presentation. For example, surgical experience and quality improvement projects will be closely scrutinised, so ensure you have robust and verifiable evidence to support your claims.
Points Summary
Here’s a summarised table of the A-E grading system across key domains for the 2025 Core Surgical Training (CST) portfolio based on the details from the official documents.
Domain | A (Highest) | B | C | D | E (Lowest) |
---|---|---|---|---|---|
Operative Experience | Involvement in 40+ cases | Involvement in 30-39 cases | Involvement in 20-29 cases | Involvement in 11-19 cases | <10 cases or no evidence |
Surgical Experience | Completed surgical elective (4+ weeks) or surgical taster week (5+ days) | Completed a foundation surgical placement (12 weeks) | Less extensive taster/elective or planned future experience | Partial surgical experience due to COVID | No valid surgical experience |
Quality Improvement Project (QIP) | Led a surgically themed QIP with demonstrated change (2 cycles or closed loop) | Led non-surgical QIP with demonstrated change | Contributed to multiple cycles of a QIP | Minimal involvement in one cycle of QIP | No QIP involvement |
Presentations & Publications | First author of PubMed-cited non-case report publication; top prize for oral presentation | First author of PubMed-cited case report or presentation at a national/international meeting | First author of a poster or oral presentation at a regional/national meeting | Oral presentation at a regional meeting or named co-author on publication | No publications/presentations |
Teaching Experience | Designed and delivered a face-to-face teaching program with 4+ sessions | Designed and delivered an online teaching program with 4+ sessions | Regular teaching (4+ sessions/year) | Minimal teaching experience or completed a formal teaching course (e.g., Train the Trainer) | 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 (even if it’s just for one case) to attend a theatre session. Remember, these cases must be assisting; supervisor scrubbed or above, i.e., not merely observational. Once you’ve hit 40+ surgical cases, focus your energy on other aspects of the portfolio, as you won’t get more points in this domain even if you’ve hit 100+.
Criteria | Details |
---|---|
Operative Experience Scoring |
|
Required Evidence | Submit a consolidation report via the eLogbook system. Only the summary is needed, not the full logbook. |
Consolidation Report Must Include |
|
What Doesn’t Count | Observational roles (e.g., attending but not scrubbing in) cannot be reported. |
Surgical Experience
Ideally, candidates applying for Core Surgical Training (CST) will have completed a three-month or longer placement in a surgical speciality before applying. However, this isn’t always achievable for everyone. Thankfully, you can still maximise your portfolio points by completing a surgical elective or using the “taster days” offered during foundation years. These experiences allow you to build valuable surgical exposure, even if a dedicated placement isn’t possible.
Scoring Categories for Surgical Experience
Indicator | Criteria |
---|---|
A |
Completion of any of the following:
|
B | None of the above |
*Note: Foundation surgical placements will no longer be valid for points after 2025/26.
Surgical Specialties Accepted
The following surgical specialities are recognised for the purpose of scoring points:
- Cardiothoracic Surgery
- ENT Surgery
- General Surgery
- ITU (only valid for 2025/26 applications)
- Neurosurgery
- Oral & Maxillofacial Surgery
- Orthopaedic Surgery
- Paediatric Surgery
- Plastic Surgery
- Urology
- Vascular Surgery
Evidence Submission
To verify your surgical experience, you must upload a letter from your educational supervisor on the trust’s official letterhead paper. The letter should include:
- The surgical department and hospital
- Dates of the placement or taster
- Evidence of learning opportunities or surgical exposure (e.g., attendance at theatre lists or clinics)
- The name of your supervisor and their professional registration number (e.g., GMC number)
Quality Improvement Projects (QIP) and Audit
Quality improvement projects and audits are a significant part of the CST portfolio, and with careful planning, you can score maximum points by completing a robust project in line with the required standards. If your application deadline is approaching, ensure you can complete two full cycles of your QIP and present the results before submission. Completing both the involvement and presentation aspects of a project will enhance your score in this domain.
Subdomain 1: Involvement in QIP/Audit
This subdomain focuses on your role in designing and carrying out a QIP or audit project. Ideally, the project should include two or more cycles, demonstrating an improvement after an intervention. Here are the scoring categories:
Indicator | Option | Notes |
---|---|---|
A | I was involved as Lead in all aspects of a surgically themed clinical audit or QI project that demonstrated change (e.g., second cycle/closed loop). | You participated in all stages of the audit/QI project (planning, data collection, data analysis, implementing change, and involvement in at least two cycles). |
B | I was involved as Lead in all aspects of a clinical audit or QI project that demonstrated change. | You participated in all stages of the audit (planning, data collection, data analysis, implementing change, and involvement in at least two cycles). The project does not have to be surgically themed. |
C | I was involved as a contributor in a clinical audit or QI project that demonstrated change (e.g., second cycle/closed loop). | You participated actively through multiple cycles but did not take a leading role in the project. |
D | I was involved in a clinical audit or QI project. | For example, you assisted with data collection for the project in at least one cycle. |
E | None/other |
Submitting Evidence
To validate your involvement in a QIP or audit, you need to submit:
- A project presentation or written summary that details the scope and impact of the project, clearly demonstrating the improvement after the intervention.
- A signed letter from the supervising consultant, which should include:
- The supervisor’s name
- The GMC number (or equivalent in your country)
- The date
- A statement confirming that the project met the claimed requirements.
Subdomain 2: Presentation of the QIP/Audit
If you have actively contributed to a QIP or audit and achieved a grade C or higher, you can gain additional points by presenting the project at a meeting. The presentation can be either oral or in poster form.
Indicator | Option | Notes |
---|---|---|
A | Applicant presented both cycles of data or presented the intervention and change aspects of a project at a meeting. | The applicant personally presented the project, evidenced by being the first author in the presentation slides and a letter of acceptance for the meeting. |
B | Applicant presented one cycle of the project at a meeting. | The applicant personally presented the project, evidenced by being the first author in the presentation slides and a letter of acceptance for the meeting. |
C | Applicant did not present any aspect of the project. |
Submitting Evidence
To verify your presentation, you need to provide one of the following:
- A letter of acceptance from the meeting, including:
- The project title
- The presenting author (yourself)
- The date of the presentation
- The name and organiser of the meeting
- OR
- A copy of the meeting programme that includes:
- The project
- The presenting author (yourself)
Presentations and Publications
This domain requires foresight and planning, as getting your work published or accepted for presentation can take time. Journals and conferences often have lengthy review processes, so it’s important to get started early. If you’re not an academic trainee, writing original research as the first author can be challenging, but review articles or case reports may offer a more accessible route. Engaging with academic consultants within your trust or deanery can help you find opportunities for publications or presentations. Additionally, quality improvement projects (QIP) completed for the QIP section can also be used in this category as long as they are presented separately.
Scoring Categories for Presentations and Publications
Grade | Criteria |
---|---|
A | – Top prize for an oral presentation at a national/international medical meeting (organised by an accredited institution). – First author of a PubMed-cited publication (excluding case reports and editorial letters). |
B | – Oral presentation at a national/international medical meeting (organised by an accredited institution). – First author of a PubMed-cited case report or editorial letter. – Author of a book chapter related to medicine (not self-published). |
C | First author of a poster or oral poster presentation at an international or national medical meeting (organised by an accredited institution). |
D | Oral presentation at a regional medical meeting. Cited collaborative author of a PubMed-cited publication. |
E | No relevant publications or presentations. |
Important Notes
- Only oral presentations that were personally delivered (in person or virtually) will count for points.
- First authorship must meet the ICJME criteria, meaning you are listed first on the title page or as a joint first author.
- Presentations made where a fee was paid to present (without peer review) will not count.
- A medical meeting is defined as a conference or symposium where healthcare professionals attend for Continuing Professional Development (CPD) purposes. These meetings can be virtual or in person.
- You cannot claim points for a presentation in this section if you have already claimed it in the QI/Audit (presentation points) section for the same project.
Submitting Evidence
To gain points in this category, ensure you upload the appropriate evidence based on the type of publication or presentation.
Indicator | Option | Notes |
---|---|---|
A | I have won the top prize for delivering an oral presentation at a national or international medical meeting convened by an accredited institution. | Personal delivery of presentation required. |
A | I am first author of a PubMed-cited publication (or in press), not including a case report or editorial letter. | Evidence of PubMed ID number. |
B | I have delivered an oral presentation at a national or international medical meeting convened by an accredited institution. | Personal delivery of presentation required. This does not include “oral poster presentations.” |
B | I am first author of a poster/oral poster presentation presented at an international or national medical meeting. | Personal delivery of presentation required. |
B | I am first author of a PubMed-cited publication of a case report or editorial letter (or in press), or I have written a book chapter related to medicine that has been published (not self-published). | Evidence of PubMed ID number or published book. |
C | I am a named co-author of one PubMed-cited publication (or in press). | |
D | I am first author for a poster or oral poster presentation at an international or national medical meeting convened by an accredited institution. | |
D | I have given an oral presentation at a regional medical meeting. | Personal delivery of presentation required. |
D | I am a cited collaborative author as part of a research collaborative publication. | Does not require named authorship alongside publication title. |
E | None/other |
Additional Tips
- It’s easier to achieve points for poster presentations at smaller or trainee-oriented national conferences, where acceptance rates tend to be higher. Consider submitting abstracts to these meetings.
- Reach out to academic consultants in your department for guidance or potential opportunities to write case reports or review articles. They often have interesting cases that need documentation and are willing to guide motivated doctors.
Teaching Experience
Teaching experience is an excellent opportunity to strengthen your CST application, regardless of whether you see a future in medical education. Opportunities to teach can include peers, medical students, or other healthcare professionals. To score the maximum points, you need to organise and deliver a minimum of four teaching sessions. Importantly, you don’t have to do this alone—working with other trainees to design and implement a teaching programme can be a collaborative way to gain points.
One effective way to enhance your teaching experience is by attending a formal educational course, such as our Train The Trainers course, which will not only give you valuable skills but also contribute to your teaching experience points. This course can be included as evidence of undertaking educational activities aimed at learning to teach.
Scoring Categories for Teaching Experience
Options | Indicator | Notes |
---|---|---|
I have worked with local educators to design and organise a face-to-face teaching programme (a series of sessions defined as 4 or more) to enhance organised teaching for healthcare professionals or medical students And I have delivered at least 4 sessions of that teaching |
A | You have shown the ability to identify a gap in the teaching provided and have worked with local educators to design, organise and deliver a teaching programme. As part of this process, you will have had input into the programme objectives and outline of sessions delivered. |
I have worked with local educators to design and organise a teaching programme (a series of sessions defined as 4 or more) to enhance organised teaching for healthcare professionals or medical students in an online format (please see appendix for definition of online) And I have delivered at least 4 sessions of that teaching |
B | You have shown the ability to identify a gap in the teaching provided and have worked with local educators to design, organise and deliver a local teaching programme. As part of this process, you will have had input into the programme objectives and outline of sessions delivered. |
I have worked with local educators to design and organise a teaching programme (a series of sessions defined as 4 or more) to enhance organised teaching for healthcare professionals or medical students. I have delivered at least 4 sessions of that teaching | C | You have shown the ability to identify a gap in the teaching provided and have worked with local educators to design, organise and deliver a local teaching programme. As part of this process, you will have had input into the programme objectives and outline of sessions delivered. |
I have provided regular teaching for healthcare professionals or medical students over the last year (4 or more sessions/year) Or I have undertaken some educational activity focused on learning to teach |
D | Examples of teaching include but not restricted to regular bedside or classroom teaching, acting as a mentor to a student, acting as a tutor or delivering teaching in a virtual learning environment. This would include any form of educational event focused on learning the skills of teaching – such as a training the trainers course online or otherwise. |
I have not provided teaching | E |
Submitting Evidence
To score points for your teaching experience, you must provide the following:
- A letter from a consultant confirming that you were involved in designing and organising the teaching programme, including:
- The consultant’s name and GMC number
- The dates of the activity
- A second letter from a consultant confirming that you delivered the teaching sessions and that your formal feedback was reviewed and found acceptable.
- Alternatively, you can provide anonymised feedback, such as participant surveys or formal assessments (e.g., ISCP).
Important Notes
- Formal feedback is required for scoring. This can be obtained through participant feedback forms (with scores and number of participants) or a senior observer’s formal assessment. The feedback doesn’t need to be submitted as evidence but must be reviewed and verified by a consultant.
- Teaching at a regional level means delivering sessions across multiple hospital sites or through a regional organisation.
- As noted, completing an educational activity focused on teaching (such as our Train The Trainers course) can help you score points in this domain.
Additional Tips
- If formal teaching opportunities during working hours are limited, consider organising virtual evening webinars for students. Running just four sessions across a placement could be enough to secure the points needed.
- Collaborating with your hospital’s undergraduate department or organising educational events can help you stand out during your CST interview.
Summary and Tips for Maximising Your Portfolio Score
Submitting a strong and well-organised portfolio is crucial for achieving a high score during the CST recruitment process. Remember, the portfolio assessors are on your side and will try to award you the maximum points possible. However, due to the time constraints (only 10 minutes per portfolio), your evidence must be clear, concise, and well-structured. Here are some key tips to help you maximise your score:
Present Your Evidence Clearly
While assessors aim to award the most points they can, they have limited time to review your portfolio. If your evidence is difficult to navigate or includes unnecessary information, this may impact your score. Ensure your portfolio is easy to review by keeping your evidence for each domain in a single, well-organised PDF. Avoid uploading the entire portfolio to each domain—only include relevant documents for the specific domain being assessed.
Seek Advice from Colleagues
Colleagues who have been through the CST process or have experience assessing portfolios can offer invaluable advice. They can help guide you on how to present your evidence to maximise points and ensure your self-assessment aligns with what assessors are looking for.
Beware of Disreputable Sources
Be cautious when including evidence from sources that may not be well-regarded. For example, presentations or courses that require payment without proper peer review could be viewed unfavourably by assessors. Make sure courses are fully accredited and award 12 CPD points (equivalent to 12 hours of work) for courses such as Train The Trainers or Teach The Teachers.
Avoid Electronic Signatures
Electronic signatures can be problematic because some PDF programs allow the text in the signature box to be altered after submission. If assessors cannot verify the signature, they will not be able to award points. Where possible, use handwritten signatures or verified methods to avoid this issue.
Ensure No Patient Identifiable Data (PID)
Submitting evidence containing patient-identifiable data (PID) is a serious breach and will result in a score of zero points for that item. Additionally, candidates submitting PID will be required to meet with the clinical lead. Double-check all your documents to ensure that no PID has been included, even unintentionally.
Carefully Select Supporting Data
When uploading documents, ensure that all the information is directly relevant to your application. If your evidence includes unnecessary information (e.g., meeting minutes that reference your presentation but also contain unrelated details), redact the irrelevant sections to avoid confusion and maintain professionalism.
Submit Domain-Specific Evidence
For each domain, create and upload a single PDF containing only the relevant evidence for that domain. This makes it easier for assessors to find and review your evidence, ensuring you are awarded the appropriate points. Avoid submitting large, unstructured documents that could confuse assessors and reduce your chances of scoring well.
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