Orthopaedic Registrar in London, surgical director of MedCourse, and founder of The London Course - interview courses for core and higher speciality training programmes.
Updated for the 2027 cycle (October 2026) using NHS England's published 2027 interview format: two 15-minute online stations, 1–10 March 2027.
The Core Surgical Training (CST) interview is the final hurdle you will have to go through before you can get your hands on the prestigious CST training number.
But despite scoring well enough in your MSRA exam to get a slot, the CST interview is still a difficult and competitive process. Don’t let all the hard work that has gone into your CST application and MSRA revision go to waste!
Since 2020 the competition ratio for CST has climbed from under 3:1 in 2019 to 8.57 in 2025 (5,399 applications for 630 posts), so expect serious competition.
In this article, we will go through the CST interview, including the process, format, and marking scheme.
Hints and Tips by Mr Ash Ahluwalia
I’m Ash, an ST5 Trauma and Orthopaedics Registrar on the UCLH rotation.
After obtaining my first choice Core Surgical Training job in London and completing a PGCert in Medical Education, I created The London Course, which helps core and higher speciality trainees secure their first-choice job.
We run the London Core Surgical Training Interview Course, now in its 5th year, giving candidates a chance to learn new structures for their interview, as well as providing mock interview for candidates to hone their skills.
Competition ratio figures from NHS England appear here on the live page.
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Published by NHS England on 5 October 2026 — "all dates are subject to change".
Key dates
Vacancy advertised
By 5pm Wednesday 21st October 2026
Applications open
Thursday 22nd October 2026 at 10am
Applications close
Thursday 19th November 2026 at 4pm
MSRA invitations
December 2026 — date to be confirmed
MSRA Exam
Between Tuesday 5th January and Monday 18th January 2027
Interview Invites
Tuesday 16th February 2027
Evidence Upload
Friday 19th February to Wednesday 24th February 2027
Preferencing
Dates to be confirmed
Interviews
Between Monday 1st March and Wednesday 10th March 2027
Initial Offers out
By Tuesday 6th April 2027 at 5pm (NHS England's timeline page, updated October 2026; its interviews page still says 23rd March, so check Oriel)
Hold Deadline
9am on Friday 9th April 2027
Upgrade Deadline
4pm on Wednesday 14th April 2027
Post start date
August 2027 — exact date to be confirmed
Ash’s Tips – When Should I Start Preparing?
Preparation must be well underway. The weight of this interview can’t be underestimated as your core surgical training will determine where you are for at least the next 2 years, if not longer.
Your preparation should consist of:
Individual Work
This is both reading and preparing answers for the 2 stations. Beyond clinical reading, you should be able to answer common interview questions in the management station. You must also practice scenarios in front of a camera, give yourself feedback then repeat. Once you get past the cringe moment of watching yourself back, you will find this to be the highest-yield form of preparation.
Group Work
Make a small group and practice. The interview is virtual so your sessions should be virtual. Try to replicate the interview as much as possible, being formal when in a mock scenario. The more you practice like this, the more comfortable you will feel in the interview. Make sure your group is of a similar standard and don’t be afraid to be critical. Your partner will thank you when they secure their first-choice job.
Interview Courses
Interview courses with mock interview circuits are the highest-yield practice. To be able to verbalise your answers succinctly under pressure is the key to a successful interview. You can only get this from a mock interview with a senior who is familiar with the interview. The feedback you receive here will be gold dust.
The CST Interview Process
The Core Surgical Training interview is held every year around March — in 2027 between Monday 1 and Wednesday 10 March, online for all candidates.
Previously, interview shortlisting was determined via the portfolio self-assessment score. However in 2023 the MSRA exam was introduced as the tool for shortlisting candidates. NHS England says that "approximately the top 1200 candidates will be invited to interview and upload evidence for the portfolio station" (5,399 people applied in 2025), and that "Any candidates who fail to upload evidence for their portfolio will have their interview slot cancelled". The Medical Training (Prioritisation) Act applies to 2027 recruitment at the shortlisting and offer stages, but it does not change how you are scored or ranked at interview: "Prioritisation does not affect the rank applicants receive following interview; ranks are based on performance in the selection process only."
On confirmation of your interview offer, you will be asked to book an interview spot via Oriel. With interviews being held online, there is no need to worry about where your interview will be held, only the timing of the interview.
Interview slots are offered on a first come first served basis, so it’s worth booking as soon as you can to make sure you get a slot that works for you. The interview will take place on the Qpercom video platform, with a link to join the interview sent after you have booked your interview spot.
The interview link you are sent will be functional right away (albeit minus the interviewers!) – check that the link works on the device you’re using for the interview as soon as you can. If you are having trouble with the link, contact PGMDE support via their online portal.
Ash's CST Interview Webinar
This recorded webinar by Ash goes through everything you need to know about the CST interview, including some real life examples.
https://youtu.be/TBYouuagBTU
How Competitive is the CST Interview?
There were 630 CST posts in 2025; 2027 post numbers have not yet been published. If around 1,200 candidates are interviewed for a similar number of posts, roughly half of those interviewed can expect an offer.
There will be a small number of candidates who decline their job offer following success at interview, as they have also applied to other training programmes. This means that candidates who miss out narrowly may still be offered a job.
Ash’s Tips – General Interview Advice
This is an interview, not an exam! Having theoretical surgical knowledge is the minimum requirement, and being able to verbalise your answers in a succinct manner is essential.
When preparing for the interview, you must practice answering questions with a colleague or in front of a camera. Giving others (or yourself) feedback should focus not only on the knowledge aspects but also the communication skills.
Structure your answers, whether it be for simple closed questions or open questions. The more your practice these, the more comfortable you will be answering all types of questions in the interview, even if it’s a question or scenario you haven’t practised.
The London Core Surgical Training Interview Course consists of lectures focusing on structures for the Clinical and Management stations followed by mock interviews led by the highest scoring trainees providing individualised feedback.
Remember, don’t spend all your time learning clinical knowledge. Divide your preparation time between the two stations and make sure you're constantly saying your answers, not just reading!
Search Interview Courses
The CST Interview Format - Online
The CST Interview for the 2027 application will take place online on the Qpercom video platform. You can join using the link sent after you have booked a slot.
You should join 5+ minutes before the scheduled time and will first have your identity confirmed by a member of admin staff. Make sure that you have photo ID to hand (your passport or UK driving licence) and that you are alone in the room you are interviewing from.
For 2027 the CST interview consists of two 15-minute stations:
Management and Clinical station – 1 management scenario question and 2 clinical scenario questions, with 5 minutes allowed to answer each. The questions are provided during the interview. 2 panel members.
Portfolio station – a pre-prepared 3-minute presentation, 2 minutes of questioning on it, then 2 portfolio questions of 5 minutes each on two domains selected by the assessor. 3 or 4 panel members, and there may also be a lay representative.
The portfolio station replaces the old Oriel self-assessment score: your portfolio evidence (uploaded 19–24 February 2027 with an A–E index page) is now scored live at interview and is worth 45% of your final score.
You will not be given advance notice of the scenario questions, though there are general themes that come up frequently. The presentation is the only pre-prepared element.
Following your interview, your score will be adjusted to make up your overall CST application score, which is weighted as follows:
45% Portfolio station
45% Management and Clinical station
10% MSRA score
= an overall selection score out of 100
Ash’s Tips – Top 3 Tips For Interview Day
Technology - There is no excuse to not have your tech in order. Make sure you have good WiFi, good lighting and are in a quiet room with no disturbances. You should look into the camera throughout (not the screen) and make sure you are positioned appropriately with a neutral background. Don’t use a phone, use a computer or tablet.
Plan - Make sure you are off on the day of the interview. Try and take off at least the day before. Try not to be coming off nights to your interview. You should do everything you can to make the run in to your interview in your own hands. Juggling work and interview preparation in the run up to the interview is difficult and you want to minimise distractions as you get closer to the interview.
Speaking - If your interview is in the morning, make sure you have spoken before your interview. It is very easy to be in silence until you’re in the interview and that morning crackling voice will be evidence to your interviewer.
The Portfolio Station
Presentation – 3 minutes, plus 2 minutes of questions
The portfolio station opens with an opportunity to show off your leadership and management experience with a 3-minute pre-prepared presentation, followed by 2 minutes of questioning on it.
Details of the presentation topic come with your interview invitation — in previous years it was sent around two weeks in advance. It usually focuses on leadership and management experience, as it relates to the CST person specification.
To score well on this part of the interview you should try to avoid just listing your experience, and instead focus on 2-4 achievements or specific examples of where you have demonstrated your leadership and management experience. Examples of relevant roles include membership of the junior doctors' forum, mess committee, or national speciality training organisations.
Try to give examples which fulfil the “desirable criteria” of the person specification, demonstrating:
Involvement in management appropriate for your current stage of training
Leadership of and work with the MDT (doctors, nurses, and AHPs within your team)
Good understanding of NHS management and resources
Leadership within and outside of medicine
You will then have 2 minutes of questions on your presentation from your interviewers. Take some time before the interview to go over the examples you give in your presentation and think about what your interviewers might ask.
Your interviewers will score three areas out of 6:
The content of your presentation
Your presentation skills
Your ability to answer their questions.
Portfolio Questions – 5 minutes x 2
After the presentation, the panel asks two portfolio questions of 5 minutes each, on two of the portfolio domains — "These questions are selected by the assessor", so you cannot choose which domains come up. Each is scored on the 0–6 scale for your skills and knowledge. Know your own evidence cold: what you did, what it showed, and what you learned, for every domain on your index page. See our CST portfolio scoring guide for the domains and bands.
The Management and Clinical Station
Management Question – 5 minutes
In the Management and Clinical station you will be given a management scenario related to ethical, professional, and personal dilemmas which are common to surgery. The interviewers will ask you a question and give you 5 minutes to answer this.
This will involve some thinking on your feet, as you will not be given the scenario until you are in the interview.
Example Scenario - Management Question
“You are the FY2 working on a busy colorectal surgery ward. Your registrar approaches you to tell you that your consultant has asked them to consent a patient for an emergency laparotomy, but they do not have the time to do it. They ask you to consent the patient.
You have not seen or performed this surgical procedure being performed before, though you have some experience shadowing your consultant on a list of routine procedures.
How would you approach this situation?”
While you may be used to this type of scenario from the MSRA professional dilemmas paper, you must find a way to answer the question with a structured approach such as SPIES:
S – Seek information. Find out all the info you’ll need to assess patient safety, carry out the initial steps, and discuss with a colleague.
P – Prioritise & Patient Safety. Summarise how you would prioritise the issues in the scenario. Address any potential patient safety concerns as your number one priority.
I – Initiative. Take some initial steps that are appropriate for someone of your level of responsibility.
E – Escalate. Discuss the dilemma with an appropriate colleague, highlighting your main concerns and any suggested interventions.
S – Support. Offer your support to help your colleagues with the scenario.
Example Scenario - What to Consider
S – Gather information about the urgency of the situation, why your registrar feels unable to prioritise this task, and what your current workload is like.
P – Prioritise your workload – does this task need to be done right away or are there tasks with a higher priority? Consider how urgent the task is, as well as the consequences if you were to prioritise another task. Explain to the interviewer that, given you do not have experience in this procedure, that it would be inappropriate for you to consent the patient. Consider the risk to the patient if they are not consented immediately, and how you can mitigate that risk.
I – Take initiative and look for alternative solutions, whereby the patient can be consented by someone with appropriate experience in the procedure without causing a delay to the patient’s care. You could offer to read up on the subject and fill in all the sections of the consent form which you believe you have adequate experience for.
E – Escalate the situation to a senior. Before going over your registrar’s head, you should explain the situation to them and that it would be inappropriate for you to consent the patient. Tell them that you have filled the consent form, but would need someone with appropriate experience to consent the patient. If this fails, you can consider escalating to other registrars in your team, or your consultant.
S – Support your registrar by dealing with all of the tasks that are appropriate for your level of experience. You could also offer to help out your registrar in other areas so that they have less on their to-do list and therefore can find time to consent the patient.
Your interviewers may add additional information and prompts as you work your way through the scenario or might let you talk through what you would do and ask questions at the end.
Some common scenarios you may wish to familiarise yourself with are:
Do not resuscitate orders – when these should be considered, the rights of the patient and family, and how you would approach this if refused.
Confidentiality – what information must be kept confidential, when you can pass on confidential information, and when you have the right to break confidentiality despite the patient’s wishes.
Conflict – how to deal with arguments, complaints, and abuse from patients, relatives, and colleagues.
Capacity & consent – when it is appropriate for you to consent a patient, how to determine capacity, and what options you have when the patient does not have capacity.
Probity issues – How to deal with colleagues who are not meeting GMC Good Medical Practice.
If you find yourself finishing with time to go and the interviewers aren’t giving you any additional prompts, think about the three scoring criteria below and whether you could add anything that would gain you some extra marks in these.
Your interviewers will score three areas out of 6:
Your probity, professional integrity, and understanding and awareness of safety and ethics
Your judgement and prioritisation skills under pressure
Your communication skills
Ash's Tips - Management Section
Give this station the respect it deserves. “Straightforward” questions such as “What is the difference between leadership and management?” Need to be prepared for. These are differentiator questions and having a well-prepared, succinct answer will hold you in good stead.
Your leadership presentation is entirely in your hands. Use the 3 minutes to the full. Every sentence should be a different point and contain a buzzword. Nothing will kill your presentation like waffle.
Have a structure for the ethical scenario. SPIES is popular but adapt it to your scenario.
Front-load your answer. If patient safety is potentially compromised, highlight this as your key concern in your first sentence.
In the same station you will be given two clinical scenarios. NHS England states that "These questions are provided during the interview", so do not expect to see them in advance. Each scenario is marked separately and lasts 5 minutes.
The scenarios given will likely be surgical in nature, and will often be common acute or emergency scenarios, such as trauma calls, post-operative complications, or unwell ward patients.
Example Scenario - Clinical Section
“You are the core surgical trainee on urology rotation. You are called urgently to the ward by a staff nurse on the urology ward. The nurse is concerned about a patient who appears to be drowsy and unwell.
You are told that the patient is a 36-year-old female who was admitted with right iliac fossa pain 2 days ago. Her observations were stable on admission, and her pain improved with analgesia. She is currently awaiting further investigations after an abdominal ultrasound showed moderate hydronephrosis in her right kidney.
Her current observations are as follows:
NEWS=4
Respiration rate 18
SpO2 96%, Temp 38.4°C
BP 98/67
HR 103.
Please explain how you would approach this scenario”.
In the above scenario, you have been called to an acutely unwell patient who is under the care of the urology team. You must now talk through how you would approach information gathering, patient assessment, initial treatment, and escalation.
Information gathering is the first step – you need to be able to prioritise your workload and determine the urgency of the situation. You can ask more about the patient’s background, previous observations, and anything you think that the person on the other end of the phone will be able to tell you.
Next, you need to decide how urgently the patient needs to be seen. Consider:
Is the situation so urgent that a 2222 cardiac arrest call should be placed?
Is there anything the nurse can do while you are on your way to the patient (e.g. bloods, obs, emergency fluids, arranging for urgent blood, cultures)?
Is this the most urgent task on your to-do list?
Always keep in mind a structure for assessing an acutely unwell patient – an ABCDE approach will work for any emergency situation. Your interviewers will give you prompts and information, and will ask you further questions as you work your way through the scenario. Questions might include:
How would you approach clinical assessment?
What is your working diagnosis?
What conditions do you need to rule out?
What immediate interventions do you want to make?
Who would you like to contact?
Ash's Tips - Clinical Section
Prepare for the common topics and prepare them well. ATLS, post-operative and Emergency department scenarios.
As useful as question banks are, formulate your own answers through reliable sources (BMJ best practice, ATLS manual, CCRISP manual, MRCS resources).
If an assessor believes that you have demonstrated unsafe clinical practice, you may be deemed unappointable. If there is a question you truly don’t know the answer to, use your initiative to demonstrate that you will not work outside of your current level of competency and will escalate to a senior rather than make up a potentially unsafe treatment plan.
Your interviewers will score three areas out of 6:
Your clinical skills and knowledge
Your judgement and ability to prioritise under pressure
Your communications skills
Performing at Your Best on the day
Even if you have the self-confidence of a candidate on The Apprentice, the pre-interview jitters can get to you on the day. There are some simple steps to take to put your best foot forward for the interview.
Take Some Leave
I’m sure you’ll have heard stories of docs who didn’t realise until too late that their set of nights clashed with their interview dates.
Don’t be that doc.
Take some time off before the interview to make sure that you have time to prepare and, most importantly, relax. Rota coordinators are notoriously inflexible – give them plenty of notice and take the time you deserve to prepare for one of the more important days of your life.
Sort Out Your Sleeping Pattern
The life of an SHO is often incompatible with a decent sleeping pattern but try to get into a good rhythm a couple of weeks before your interview.
Without a regular bedtime and morning alarm, you may find yourself answering questions on a couple of hours of sleep – a bad idea.
Make Sure Your Tech Works
How embarrassing would it be to turn up to your interview, adrenaline surging through your body, only to find out that your microphone isn’t working properly?
Take the time the day before your interview to make sure that your webcam and microphone work properly on Qpercom video platform.
Relax…
Interviews are stressful. Always. You’ll be highly strung on the day no matter how zen your day-to-day life is, but if you’re already at your breaking point before the interview day you’re at risk of a full-on breakdown.
Take at least a few hours to chill out on the day before, and ideally the morning of, the interview. Whether you unwind best with a spa day, meditation, or furiously logging appendicectomies, take a break. It’ll do you far more good than cramming in an extra couple of hours of preparation.
Ash's Tips - Conclusion
Verbal practice. Read, speak, record, repeat.
Prepare for all 2 stations in equal amounts, not just clinical stations.
Every answer should have a structure and you should have blueprints in your head. The more you practice this, the better you will be at replicating this in the interview.
Work on your leadership presentation every day. Keep it efficient and surgical.
Mock interview circuits with high-scoring current trainees are the highest yield preparation you can do. Attend The London Core Surgical Training Interview Coursefor this and everything you need to succeed in the interview.
Spot something that needs updating? We do our best to keep things accurate, but medicine changes fast. Let us know and we'll sort it.
