Intended for healthcare professionals


Demystifying the specialty training application process

BMJ 2016; 355 doi: (Published 13 December 2016) Cite this as: BMJ 2016;355:i5853
  1. Ciara Deall, junior registrar in plastic surgery,
  2. Sandip Ghosh, consultant physician in diabetes
  1. Queen Elizabeth Hospital, Birmingham
  1. ciara.deall{at}


Choosing and securing a specialty training place can be a daunting task. Ciara Deall and Sandip Ghosh describe a programme to help juniors at this key point in their careers.

Each step in a medical career carries its own challenges and stresses. One such step is graduation from the foundation programme into specialty training, determined by competitive interview halfway through foundation year 2 (FY2). Applications, portfolios, and interviews require long and careful preparation, with statistics showing that rushed, ill considered, or late applications are rarely successful.1 Genuine insight into specialty training and targeted mentoring are invaluable at such a life changing point in a doctor’s career.

Trainee run workshops

We found that while foundation teaching programmes often offer generic advice of varying quality, peers who have been successful in the preceding few years can greatly help FY2 applicants choose and secure their place. New trainees have recently been through the process and have a fresh understanding of what worked and where they could have improved.

Over the past three years we have been running an initiative to support foundation doctors through the application process in two regional foundation programmes. This year’s course will be the biggest yet—run by 30 trainees for 90 FY2s.

The initiative is organised by a lead core surgical trainee, who liaised with faculty, recruited specialty facilitators, and advertised the programme to foundation doctors—who then signed up to attend. One region offers part of the course within its teaching programme, the other is standalone.

This has been a grassroots initiative that stemmed from the recognition of a genuine need. The foundation schools have been impressed with our ideas and were happy to provide logistical support such as printed materials and space.

Junior trainees, in conjunction with the postgraduate education and career teams, run a programme of workshops which focus on writing Oriel applications, assembling compelling portfolios, and handling specialty interviews. The workshops consist of an introductory presentation on the particular topic, followed by specialty breakout groups led by trainee facilitators. Follow-up notes are provided and resources, such as the extensive bank of BMJ Careers articles, are signposted. Personal follow-up mentoring is also available. We have recruited facilitators from up to 10 different specialties, with their portfolios to hand where appropriate.

The challenge of preparing

These peer led events, while rigorous and well researched, are also accessible and informal. Most of those who have attended our workshops found that they demystified the specialty training application process while highlighting the challenge of preparing and performing. Attendees value the opportunity to see successful portfolios, ask questions, and receive advice and support. More participants are also asking questions about time out (the so called FY3 year) and less than full time training.23

The 150 doctors who have taken part in the workshops so far have answered written feedback questions about knowledge, understanding, confidence, and preparation on the workshop topics both before and after the sessions. They were also invited to comment on how useful they found the event. On a 10 point scale, the average improvement was rated at 3 to 5 points. Responses from both foundation doctors and facilitators have been overwhelmingly positive. Facilitators said that they would have benefited greatly from these workshops at the time of their application.

A smaller number of participants responded to a feedback request after the selection process was complete. Without exception they registered their gratitude for the workshops and how aspects of the sessions had been significant in their success and the choices they made.


Our experience so far has shown that our programme is highly valued, particularly at this career point for foundation doctors. The feedback also suggested that applicants would like the programme to be available as early as possible in foundation training to give them more time to put their learning into practice. Such low cost regional events can be more effective than national generic workshops, involving significant travel and little or no follow-up.

A supportive learning environment with an active postgraduate department and enthusiastic trainees are the keys to the success of this initiative. Our experience provides strong evidence for embedding such a model into foundation teaching programmes.

At a time when the word “crisis” is often linked with the NHS, along with staff shortages and low morale, it is important that trainees can inform and encourage their juniors about the specialties that they are considering. An added bonus is that this may help to stem the attrition rate in later training.


  • We have read and understood BMJ’s policy on declaration of interests and declare that we have no competing interests.