Core surgical training (CST) is a 2-year programme

that prepares junior doctors for a career in surgery.

By the end of CST a candidate will have completed
24 months of surgical training and should have the
necessary expe- rience to apply to specialty
training. As of 2014, recruit- ment to CST became a
national process for the first time. Currently, the
Core Surgery National Recruitment Office (CSNRO)
manages applications for CST in England,
Wales, Scotland and Northern Ireland. Make sure
you preregister with the CSNRO; this ensures you
receive reg- ular updates and reminders from the
CSNRO regarding deadlines and that you are kept
informed about the progress of your application.
Recruitment to CST has al- tered drastically in
recent years and further changes may well occur.
Checking the CSNRO website will offer the most upto-date information. All candidates who meet the
eligibility criteria are guar- anteed an interview. The
first round of offers can be ac- cepted (with the
possibility of an upgrade to a higher- ranked post),
rejected or held for a fixed period of time
(if candidates are waiting for offers from other
specialties). If you are not made an offer in the first
round, do not be too disheartened; further rounds
of offers will occur as and when other candidates
reject offers. Any remaining nfilled post will enter a
clearing process. THE APPLICATION FORM Although

the offer of a place in CST is primarily depen- dent

on your interview performance, the application
form is your first chance to differentiate yourself
from your fel- low candidates. Read the person
specification carefully, as it will help you to format
the answers in your appli- cation form. Aim to meet
the desired and the essential criteria. Some
aspects of the form require you to
upload documents in support of your application
for example, your certificate for completing
Foundation training or achieving full General
Medical Council registration. Allow plenty of time to
identify and source these documents. The most
important part of the form is the three
self-assessment questions. These assess your
experience in audit, research and teaching. Make
sure you choose the answer that best describes
your achievements, as each higher level is worth
another point in your appli- cation. Whatever level
of experience you declare will need to be
supported by entering a short summary in the
free- text boxes on the form. Focus on specific
examples that demonstrate the level of experience
you have selected. Your answers will also dictate
what interviewers will be expecting to see in your
portfolio during your interview. You can also use
the self-assessment questions to identify areas of
weakness and use the remaining time before

submission to improving these areas, maybe

by completing an audit cycle, submitting an
abstract to a meeting or offering to help out at a
regional teaching day.
maintaining high standards of care across the
Na- tional Health Service (NHS) while seeking ways
to en- sure continued improvement. Have your own
way of describing what you feel clinical governance
is. Describe its relevance in patient care for
example, through regular audit, and critical
incident reporting. Be aware of examples in your
own practice where you have been aware of how
clinical governance has af- fected patient
care. What teams have you worked in during your
clinical prac- tice? What skills do you have that
make you a partic- ularly good team worker? This
question gives you the opportunity to show
your teamworking skills, such as communication
skills, reliability and commitment. Try to use a
specific
example, such as a research or audit project
youve been involved in, or the management of a
very unwell patient. Avoid listing adjectives of
what you think contribute to a good team worker.
Instead, pick two or three features of teamworking
and describe in detail how you display them with
examples. Can you tell me about a time you made
a mistake as part of your work? What was your
reaction and how did you rectify this? Always

prioritise patient safety, taking appropriate

reac- tion as soon as possible. This may include
approach- ing a senior to escalate the
situation. Show how you learnt from your mistake
and reflect on how you will avoid a similar situation
arising in the future. Others can also learn from
your mistake through critical incident
reporting. Show that you are honest and prepared
to take respon- sibility for your actions. By
discussing a difficult topic you can build rapport
with the interviewers. Nursing staff at a busy clinic
request that you consent a patient for an operation
you are not familiar with. How would you approach
this? It will not be appropriate for you to consent
the patient, but explain how you are going to
rectify the situation by enlisting the support of
seniors. Explaining why you feel unable to
consent and also how you could learn from the
situation so that you are pre- pared for next time
will display initiative. You can highlight your
communication skills in this
scenario by describing how you would approach
the issue with the nursing staff and the rest of your
team. What is capacity? How would you determine
if a patient is competent to consent to a
procedure? Remember that a patient may be able

to consent to some treatment but not others. For

a patient to have capacity, he or she needs to be
able to comprehend the information provided,
retain that information and give a considered
response. Prepare by reviewing General Medical
Council guidance, and let the examiners know you
are safe by saying you would seek help if the
situation is complex. What would you do if, at the
end of a night shift, no one comes to relieve you of
your bleep? How do you think his might affect
training? Think about who you would contact in
this situation (consultant on-call, human
resources/rota coordi- nator, divisional director) to
resolve this. Remember, your priority is always
patient safety, so offering to stay on to work is not
always appropriate, as tired doctors make
mistakes. The key is to find someone who can hold
the bleep for now, while you help coordinate a
replacement. Try to think who is missing out on
training opportunities here (such as the person
missing the on-call day shift, the replacement
trainee who will be missing elective work). If you
were my core trainee, how would you
approach ensuring that you learnt from attending a
busy weekly

outpatient clinic? This sort of question addresses

a key part of being en- rolled on a training
programme: taking responsibility for your training
and ensuring you are progressing while recognising
the demands of the NHS as a ser- vice. A good
start would be to identify which patients you could
see unsupervised and which patients you
may need to discuss or shadow a senior
for. Suggesting that you complete work-based
assessments on challenging cases in clinic will
show an awareness of the training programme and
an opportunity to de- velop your own knowledge.