Intended for healthcare professionals


How to boost your specialty training application

BMJ 2016; 352 doi: (Published 29 March 2016) Cite this as: BMJ 2016;352:i1392
  1. Nilofer Husnoo, CT1 core surgical trainee1,
  2. M Shaan Goonoo, senior house officer2
  1. 1Barnsley District General Hospital
  2. 2Royal Blackburn Hospital
  1. niloferhusnoo{at}, mshaan.goonoo{at}


Nilofer Husnoo and M Shaan Goonoo provide a useful guide to how candidates can win points on specialty training application forms and portfolios.

The application process to specialty training (CT1 and ST1) has several components, but gathering evidence for the application form and portfolio for interviews is the most time consuming part of the process. However, guidance on this is sparse.

Applicants are assessed on a number of generic components in the application form and in the portfolio station at interviews.

Audits and quality improvement (QI) projects

Applicants who have led, managed, and presented audit loops will gain maximum marks. While it is important to be part of projects or audits with large sample sizes, these take a long time to complete, so candidates are advised to complete one audit loop that makes a difference to clinical practice even if the sample size is relatively small. Candidates who complete more than one audit a year may also score more highly.


Generally, international and national presentations attract more points than regional and local presentations, and oral presentations win more points than posters. Candidates for core medical and core surgical training cannot present audits or quality improvement projects in this category.


Applicants who are first named authors will gain more points. Peer reviewed articles score more highly than non-peer reviewed ones. The core medical training application process requires publications to be PubMed cited as proof of peer review and also awards more marks to original research articles. For more competitive specialties, such as cardiothoracics or neurosurgery, publications attract the maximum score when they are relevant to the specialty.

The publication box is often the hardest to tick, but many candidates will not have been published at the time of application. In fact, one study showed that 47% of successful applicants to trauma and orthopaedics ST3 posts in London had no first author publications on PubMed.1


Scores depend on the level of qualification and experience. Applicants with a postgraduate qualification (certificate, diploma, or masters) in education will win the most points. Higher marks are awarded for designing or leading your own teaching programme, rather than merely contributing to an existing programme. However, some universities discourage too many out-of-hours teaching programmes organised by junior doctors. In this case, try to gain experience as faculty on existing programmes. The best way to prove your engagement is to collect written feedback on your teaching sessions.


Points are generally awarded for research projects that lead to publications or presentations. Applicants without formal research experience may find that academic projects that are actually case series or retrospective comparative or cohort studies may have been mislabelled as audits. Try to identify these and highlight them.

Training courses

The courses that attract marks are those that are mandatory in the given specialty. For instance, core surgical training applicants can score marks for attending basic surgical skills, advanced trauma life support, and care of the critically ill surgical patient. Acute care common stem applicants can score for successful completion of advanced life support courses.

Academic achievements and prizes

Candidates who receive honours or distinction in their primary medical qualification will earn points. Distinctions and merits for parts of the medical course are also rewarded, and applicants are advised to keep written evidence or to request a transcript from their medical schools.

Some specialties reward postgraduate degrees separately, with PhDs scoring most highly, followed by MD, MRes, and so on. In particular, cardiothoracic and neurosurgery applicants will score more highly with degrees that are directly relevant to the specialty. Royal colleges and specialty specific associations regularly advertise competitions for medical students, and winning these will be beneficial.

Experience in and commitment to specialty

Medical students need to start planning, because elective experience or student selected modules in the specialty of choice can boost scores. Students who know their chosen specialty could apply to a relevant foundation training post, to win marks and to gain skills.

All technical skill based specialties—surgical specialties, obstetrics and gynaecology, ophthalmology, and emergency medicine—award points according to procedural experience. Applicants should keep a logbook of all procedures they have assisted in or performed.

Applicants who have no experience in their specialty of choice should consider organising taster days. Membership of relevant societies and completion of parts of professional exams can also demonstrate interest. For instance, evidence of commitment to the specialty can gain up to five marks on the scoring framework for core surgery recruitment.

Management and leadership skills

Marks are awarded on the basis of level of involvement in leadership or managerial roles and their impact. Examples of managerial and leadership roles include rota coordinator, lead role within university organisations or societies, or lead role within regional or national bodies.

The NHS Leadership Academy website is a useful source of online modules on leadership skills (

Further information


  • Competing interests: We have read and understood BMJ’s policy on declaration of interests and declare the following interests: none.