CST Interview Guide 2024

Published February 17, 2023 | Updated June 11, 2024

Ash Ahluwalia

By Ash Ahluwalia

Orthopaedic Registrar in London, surgical director of MedCourse, and founder of The London Course – interview courses for core and higher speciality training programmes.

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 jumped from ~3:1 to around 4:1. This has been consistent since then, so you’re expecting some competition.

In this article, we will go through the CST interview, including the process, format, and marking scheme.

Updated 30th October for final 2023/24 application guidance.

Hints and Tips by Mr Ash Ahluwalia

I’m Ash, an ST5 Trauma and Orthopaedics Registrar on the UCLH rotation.

Dr Nikhil Ahluwalia

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.

Following a successful ST3 Trauma and Orthopaedics application, I have set up The London ST3 Trauma and Orthopaedics Interview Course to help applicants on their path into surgery.

Our CST Recruitment Series
CST Application Process Guide
CST Self-Assessment guide
CST Interview Guide

Key Documents

CST Recruitment Timeline

Applications openThursday 26th October 2023 at 10am
Applications closeThursday 23rd November 2023 at 4pm
Invitation to MSRABy Tuesday 19th December 2023 latest
MSRA WindowThursday 4th January – Tuesday 16th January 2024
Evidence Upload WindowThursday 8th February – Wednesday 14th February 2024
MSRA Results Date &
Invitation to Interview
Thursday 8th February 2024
Interview windowMonday 19th February – Wednesday 28th February 2024
Preferencing WindowBy 5pm Tuesday 13th February – Tuesday 5th March 2024
Initial Offers outTuesday 26th March 2024 by 5pm
Hold deadlineThurs 4th April 2024 at 1pm
Upgrade DeadlineTuesday 9th April 2023 at 4pm
Post start dateWednesday 7th August 2024
From HEE

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, and in 2024 is being held 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. Around 1100 candidates with the highest MSRA score (of ~2300 total applicants) will be invited to the interview.

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 Microsoft Teams, 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.

YouTube video
Courses, Events & ResourcesFor Your SpecialityMonthly course updates, direct to your inbox.

How Competitive is the CST Interview?

From the 1100 candidates interviewed, around 620 will be offered a post, so if you’ve made it this far you have roughly a 56% chance of being offered a job if you get to this stage.

CST Interview Statistics

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 3 stations and make sure you’re constantly saying your answers, not just reading!

Search Interview Courses

All Course Events
On-Demand Events

The CST Interview Format – Online

The CST Interview for the 2023/2024 application will take place online on Microsoft Teams. 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.

The CST interview online format consists of a 20-minute interview split into two 10-minute sections – the management section and the clinical section. While previous interviews have also included a portfolio station, this will not be part of the 2023 interview, with the portfolio self-assessment score making up 30% of your final application score.

You will be interviewed by two panel members who will be present for both sections of the interview.

You will not be given any advanced notice of the questions in either section, though there are general themes that come up frequently in both sections. For the management section, you will be asked to prepare a 3-minute presentation beforehand.

Following your interview, your score will be adjusted to make up your overall CST application score, which is weighted as follows:

CST Overall Score pie chart

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.

Section 1 – Management Section

Management Presentation – 5 minutes

The first part of the management section of the CST interview is an opportunity to show off your leadership and management experience with a 3-minute pre-prepared presentation.

The topic for this section will be emailed to you 2 weeks in advance of your interview date. This 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.

Management Question – 5 minutes

Following your presentation, 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.

For more information, please attend The London Core Surgical Training Interview Course.

Section 2 – Clinical Section

Clinical Scenario – 5 mins x 2

In the clinical station you will be given two scenarios, one you can read before the station and one which the interviewers will ask during the station. Each scenario is marked separately and will last 5 minutes each.

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).

Be safe. Always, be safe.

For more information, please attend The London Core Surgical Training Interview Course.

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 Microsoft Teams.


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 Course for this and everything you need to succeed in the interview.

Share Your Wisdom

  • £50-100 per blog post!
  • Portfolio Certificate
  • Bragging Rights

Latest Posts