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(HEE has currently paused run through trianing in England and Wales)

How to build your portfolio

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 elective or surgical JobTo score max points a 4 week surgical elective or a 4 month rotation during foundation training is required
Surgical tasterMust be at least 4-5 days, with reflection. Will not score as many points as above but a good back up

Other portfolio categories

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…).
– If you go on to present your audits this will score you more points! (top tip: always try to maximise eveything you can from a project i.e. submit it for conferences and publications
Teaching experience
– 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
– Try to teah with any associated universities at the hospital. Orgainsed teaching courses will score you more points than ad-hoc on the ward sessions
Leadership and management
Sign up to a leadership role (society/mess/rota coordinator)
– Leadership no longer counts towards portfolio points but will be assessed at interview

Application process

  • Shortlisting for interview for 2023 will be based off MRSA scores with the top 1200 being selected – MRSA scores will count for 10% of overall ranking
  • Portfolio will make up 30%
  • Interview will count for 60%
– Points for Commitment to surgery (conferences, operative experience, taster weeks)
– Teaching (courses, and evidence of your teaching)
– Audit/QIP
– Research (must have PubMed ID)
– Presentations

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)

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