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CST – Application Guide 2025
CST – Application Guide 2025
A Complete Guide to the 2025 CST Application Process
Written by Leo Gundle
Introduction
The CST Application process commences around November each year when the self-assessment scoring criteria (or ‘portfolio’) is released and applications can be submitted via Oriel.
Applicants typically spend a year or two perfecting their portfolios ahead of submission, as it’s the only domain where you can guarantee marks. That being said, having a weaker portfolio by no means precludes from securing a CST place.
Your overall CST ranking is based across the following domains, with weighting as follows:
| Domain | Weighting |
|---|---|
| MSRA Exam | 10% |
| Self Assessment (Portfolio) | 30% |
| Interview | 60% |
Eligibility Criteria
There are several criteria candidates must fulfil before being offered a CST job. We have summarised the most relevant points below:
- Foundation Competencies
Applicants wishing to apply for Core Surgical Training must have demonstrated their ‘Foundation Competencies’, within 3.5 years before the post commencing. This can be done by completing the UK Foundation Programme with certification. If you have not completed the UK Foundation Program, you may prove Foundation Competencies by submitting a Certificate of Readiness to Enter Specialty Training (CREST) form, signed by a consultant supervisor. More information can be found here.
- GMC Licence
All doctors wishing to apply for CST must have a valid GMC licence. Information on joining the GMC medical register can be found here.
- England Language Skills
Candidates must have demonstrated proficiency in the English language.
- Right to work in the UK
Candidates must have the right to work in the UK with the relevant visa approved.
The full eligibility criteria can be found here.
Competition Ratios
Competition for CST has always been fierce, with last year being no exception. The importance of preparation cannot be overstated. By ways of indicating this, the competition for CST posts last year is as follows:
Applications: 2539
Posts: 609
Competition Ratio: 4.17
Applicants typically spend a year or two perfecting their portfolios ahead of submission, as it’s the only domain where you can guarantee marks. That being said, having a weaker portfolio by no means precludes from securing a CST place.
Your overall CST ranking is based across the following domains, with weighting as follows:
Recruitment Timeline
| Event | Date |
|---|---|
| October | |
| Advert appears | 5pm on Wednesday 25 October 2023 |
| Applications open | 10am on Thursday 26 October 2023 |
| November | |
| Applications close | 4pm on Thursday 23 November 2023 |
| December | |
| Invitations to Multi-Specialty Recruitment Assessment (MSRA) | No later than Tuesday 19 December 2023 |
| January | |
| MSRA Window | Thursday 4 January to Tuesday 16 January 2024 |
| February | |
| Evidence upload portal opens | Thursday 8 February 2024 |
| Evidence upload portal closes | Wednesday 14 February 2024 |
| MSRA scores released to applicants | Thursday 8 February 2024 |
| Invites to interview sent | Thursday 8 February 2024 |
| Interview dates | Monday 19 February to Wednesday 28 February 2024 |
| Preferences open date | By 5pm on Tuesday 13 February 2024 |
| March | |
| Preferences close date | Tuesday 5 March 2024 |
| Initial offers released (on behalf of all regions) | By 5pm on Tuesday 26 March 2024 |
| April | |
| Hold deadline | 1pm on Thursday 4 April 2024 |
| Upgrade deadline | 4pm on Tuesday 9 April 2024 |
| Interview scoresheet release date | To be confirmed |
NB Subject To Change
The MSRA Exam
The Multi-Specialty Recruitment Exam (MSRA) is used to shortlist candidates, with approximately the top-scoring half or third being invited to interview. The MSRA is 170 minutes in length and there are 2 parts:
- Clinical Problem Solving (CPS) questions:
- 75 minutes
- 86 questions
- Professional Dilemma (PD) questions
- 95 minutes
- 50 questions
The clinical content of CPS questions is comparable to final year medical school exams, with the Professional Dilemma section being comparable to the Situational Judgement Test, which many UK-trained doctors will be familiar with. We recommend taking the MSRA seriously, as whilst it’s only worth 10% of the overall CST score, it is used for shortlisting, so a poor score precludes you from moving further in your application.
CPS items are based in 12 clinical topic areas relevant to general medicine. Each test paper includes a balance of scenarios which cover all 12 topics. The topics covered include:
- Cardiovascular
- Dermatology / ENT / Eyes
- Endocrinology / Metabolic
- Gastroenterology / Nutrition
- Infectious disease / Haematology / Immunology / Allergies / Genetics
- Musculoskeletal
- Paediatrics
- Pharmacology and therapeutics
- Psychiatry / Neurology
- Renal / Urology
- Reproductive
- Respiratory
The scenarios are all relevant to the Foundation (FY2) training programme.
The Professional Dilemmas (PD) paper is a Situational Judgement Test (SJT). An SJT is an assessment method which measures how a candidate believes they should behave when posed with a challenging professional dilemma.
The PD paper is not a test of knowledge of problem-solving ability but rather aims to assess professional attributes (domains or competencies) which are considered to be important for successful progression through training and performance in one’s job role.
To prepare we recommend the following:
- Use your final year medical school exam notes to prepare for the clinical questions. Question banks can also be found online. You should aim to spend several weeks or months preparing, depending on your revision style.
- Example Professional Dilemma and Situation judgment test questions, with explanations, can be found on the MSRA and UKFP websites. We recommend using these and reading through the answers carefully to understand the approach the exam wants you to take.
The Self Assessment (Portfolio)
The 2024 Self-Assessment has been released and can be found on our website. This document specifies achievements which candidates can claim points for ahead of interview, as long as they can demonstrate sufficient evidence. Achievements include publications, conferences attended and involvement in teaching.
You will need a lot of time to review your portfolio and work towards improving it according to the mark scheme. It can take several months or even years to earn points in certain areas of your portfolio, such as publications, so you should be looking at building your score up well in advance.
However, fortunately, there are some ways to boost your portfolio score that can be done much more quickly. One way to do this is through completing courses. These can be clinical courses, such as Basic Surgical Skills, or teaching courses such as Training the Trainers.
We have written the Medset CST Portfolio Guide, taking you through each area of the portfolio and describing how maximum marks can be achieved.
We strongly recommend reading the required evidence carefully. Candidates have lost marks for insufficiently evidencing their achievements, such as not providing their consultant supervisor’s GMC number, or failing to include the confirmation email for a publication’s acceptance.
The Interview
After sitting the MSRA, candidates achieving a sufficiently high score will be invited to interview. We have written an extensive guide on the CST interview here, with a full explanation, example scenarios, tips and tricks, to maximise marks.
There are three parts to the interview, with scores and time allocations broken down as follows:
| Domain assessed | Time allotted | % of marks |
|---|---|---|
| Leadership | 5 mins | 25 |
| Manangement | 5 mins | 25 |
| Clinical | 10 mins | 50 |
Online Format
Since the pandemic, interviews have been delivered online via Microsoft Teams. Before your interview, you are sent a Teams link. The choreography of the interview as of 2023 was as follows:
- Join Teams link. You are greeted by a friendly administrator who checks your ID and ensures there is no one else in the room with you. Once this is complete, you are invited to join a ‘Breakout Room’ on Teams, where the interviewers are waiting.
- You enter the ‘Breakout Room’ with three people in front of separate cameras: two examiners and a lay observer. The administrator is also present with their camera off.
- You are not asked to introduce yourself; an interviewer will immediately invite you to commence your pre-prepared leadership speech (discussed later in this course). Interviewers promptly guide you through the interview after each section has been completed.
- Once the interview is completed, you are invited to either exit the Teams call in its entirety, or exit the ‘Breakout Room’ into the original room if you wish to discuss anything with the administrator (e.g. raise concerns or address any technical issues).
How Do I Prepare For The CST Interview?
We recommend the following steps to maximise your chances of success in the interview, and gaining a high rank:
- Start early
Candidates often take weeks, months, or years to build and perfecting their portfolios, however, this is only half as valuable as the interview. We recommend preparing for the interview as if it were an exam: start early (e.g. two months in advance) and work consistently.
- Find a partner
Delivering answers which make you sound confident is a skill which can be practised. Likewise, there is a difference between knowing an answer and verbalising it in a high-pressure situation. We recommend therefore finding a fellow CST candidate and practicing as a pair to help both supplement your learning and practice delivering your answers confidently. Medset also offers bespoke interview coaching and mock interview sessions. Click here to find out more.
- Study the material
Just as for an exam, study and learn common interview questions, such as those presented in this course. You will also need to familiarise yourself with common surgical pathologies, presentations and complications. Once you know the material back to front, you can shift your strategy to focus on confident delivery or include details which add flair to your responses.
- Checkout the Medset CST Interview Course.
Key Reading
- Core Surgical Training Person Specification
- ATLS guidelines – Primary Survey will be most crucial but specifics such as chest trauma, haemorrhage and burns do come up
- CCrISP guidelines
Our comprehensive Core Surgical Training Interview course is a high-quality resource to support you in your preparation. If you familiarise yourself with the content and give yourself plenty of time to practice, you will maximise your chances of scoring highly.
Summary
Success in the Core Surgical Training application process is about early preparation, good practice and solid application of the basics. Look at the portfolio marking scheme early and remember that items like courses and audits can help you boost your score quickly.
When it comes to the interview, you will not be expected to manage complex clinical or management scenarios completely independently and none of the required knowledge should be above Foundation Year 2 level. What they are looking for are junior doctors who can structure their answers logically and coherently, manage situations safely and escalate issues appropriately. Check out the comprehensive Medset CST Preparation Resources to make sure you are fully prepared for your CST application and interview.
About The Author
Leo is a widely-published and international prize-winning Core Trainee in Cardiothoracic Surgery at Guys’ and St Thomas’ Hospital, London. He has a passion for teaching, mentoring and career development.
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Article Last Updated – April 2024
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