Core Surgical TrainingCT1 / CT22025/26 Recruitment
CST Application Guide
Complete 2025/26 portfolio scoring guide based on official NHS England criteria. Includes domain-by-domain evidence requirements, grade descriptors, tips, and pitfalls.
Key changes for 2025/26, read before applying
ITU removed as surgical specialty
ITU no longer counts as a recognised surgical specialty from 2025/26 onwards.
Foundation placements removed
Foundation placements no longer count as surgical experience. Only undergraduate electives or taster weeks qualify.
Portfolio assessed at interview
No more self-assessment on Oriel. Portfolio is now a dedicated interview station, assessors review evidence for 15 minutes then ask you questions on 2 domains.
Index page is mandatory
You must submit an index page using the official template. Without it, your entire portfolio scores zero, no exceptions.
Letter grades A–E replace numerical scores
Each domain is now graded A–E. Grade A = highest evidence. Assessors award a score based on the grade plus your interview answers.
QI/Audit presentation rule
Your project must have been presented in the area where change was intended. Presenting only at a national conference without a local presentation first may not score fully.
Score split: MSRA 10% / Portfolio 45% / Interview 45%
The management and clinical interview stations together make up 45%. Portfolio station makes up 45%. MSRA contributes 10%.
Final score breakdown
10%
MSRA (Multi-Specialty Recruitment Assessment)
Shortlisting tool, must clear threshold to be invited to interview
45%
Portfolio station
15 min evidence review by assessors + questions on 2 domains
45%
Management + Clinical stations
3 stations: portfolio, management, and clinical, each 10 minutes
⚠ Index page, mandatory
→Download the official index page template from the NHS England medical recruitment website
→Complete it honestly, this is a legally binding declaration of the accuracy of your evidence
→Use letter grades A–E for each domain based on the tables above
→Upload the completed index page as the first document in your portfolio submission
→Any portfolio submitted without an index page scores zero, no exceptions and no appeals
→The index page is your self-assessment, assessors use it as a guide then verify your evidence and may challenge you on it at interview
Portfolio domains, grade descriptors and evidence
Building your application, timeline
Medical school
→Surgical elective (min 4 weeks), get a formal supervisor letter
→Surgical society committee role
→Begin logbook early
→First case report draft
FY1
→Set up elogbook, log every procedure from day one
→Lead QI/audit project, present locally first, then regionally
→Arrange surgical taster week (min 5 days), get supervisor letter
→ATLS or BSS course
FY2
→Close the audit loop, re-audit, re-present locally
→National conference presentation (abstract submission)
→Publish first article in PubMed-indexed journal
→Design and deliver formal teaching programme (4+ sessions)
→Train the Trainers course
Application window
→Download and complete the mandatory index page
→Verify elogbook consolidation sheet, consultant signed every page
→Confirm all publications have PubMed IDs
→Check no PID in any uploaded document
→References confirmed and briefed
→Mock interviews ×6 with scored feedback
→MSRA preparation, 4–6 weeks structured revision
Source: NHS England Medical Recruitment, Core Surgical Training Portfolio Guidance for Candidates 2025/26. Always verify current criteria at medical.hee.nhs.uk before applying as requirements change annually.