How to Maximise Points in the 2022 Core Surgical Training Interview Portfolio

Core Surgical Training (CST) interviews are usually held between January and March. Whether you are a foundation year doctor, medical student or taking a year out of training, if you are serious about applying for surgical training, it is important to review the portfolio points early to put yourself in the strongest position, within your time scale.

We will break down the Oriel Portfolio Scoring from the 2022 Scoring.

You can also check-out our Core Surgical Training Interview Question Bank to help you prepare. We will be adding updates to the question bank based on applicant feedback and new scenarios, including scenario’s concerning COVID-19 for clinical and management sections.

2022 Interview

The 2022 interviews will take place from the 7th to the 18th February 2022 with invitation for interview sent on the 25th January. They will be conducted via Microsoft Team as per the 2021 interview with 1,100 candidates due to be invited for interview.

Interviews consist of one 20-minute interview divided into 2x 10-minute stations, comprising a 10-minute management station and a 10-minute clinical station. These stations are back to back and conducted by the same interview panel.

Candidates shortlisted has remained based on portfolio evidence. Therefore, maximising portfolio points is more important than previously.

Guaranteed points

The portfolio station is worth 33% of the overall score and is the only aspect which provides guaranteed points

With only a few points between candidates, an extra point can make a significant difference to the outcome of your applications.

The remaining 66% of interview points come from the management and clinical stations for which performance also relies on good preparation. All these points are determined on the day – please see our core surgery interview question bank for preparation in these areas.

Commitment to surgery

This is a broad section with points in various categories.

MRCS Part A

You must pass this exam to get maximum points here. This year the points have been updated to reflect no points being awarded for sitting the exam alone.

Option  Score  Notes 
MRCS Part A Examination: choose one of the following options 
I have sat and passed the MRCS part A Examination  4 Examples include: Email or PDF showing a pass in MRCS part A 
I have sat and failed the MRCS part A Examination 0 Examples include: Email confirmation showing exam 
I have already booked to sit the exam in the future  0
I have not sat and have not booked an MRCS part A exam 

Surgical Courses 

There is a wide range of courses available with examples given in the handbook. These should be relatively easy points as you can book many courses within a short time scale. In addition to gaining you vital points, these courses which will benefit your clinical skills and knowledge for your surgical career.

BSS and ATLS are the courses most commonly undertaken, and many trainees find them very useful. Your study budget may also be useful to cover some course fees. But there are many other surgical introductory courses from ASIT, the BMA or Royal Surgical Colleges also accepted which often have lower course fees. It is useful to identify courses which interest you and book early as courses often fill up.

Option  Score  Notes 
Attendance at surgical courses: choose one of the following options 
I have attended 2 or more surgical courses  Proof of attendance must be provided 
I have attended 1 surgical course  Proof of attendance must be provided 
I have not attended any surgical courses 

Surgical Conferences

This is a new category in 2022 and should be easy points. If you present posters or presentations, you will likely have these already. Study budget is available. Conferences can be a good way to learn about your chosen specialty and meet like-minded people.

Option  Score  Notes 
Attendance at surgical conferences: choose one of the following options
I have attended 3 surgical conferences  3 Proof of attendance must be provided 
I have attended 2 surgical conferences  2
I have attended 1 surgical conference  1
I have not attended any surgical conferences 0

Operative Experience

Having at least 30 surgical cases assisting, or supervisor trainer scrubbed is needed for full points here. The increase in cases needed in 2022 reflects the competition. Keeping an eLogbook of surgical cases should begin at medical school and is useful to monitor your progress through training. The summary sheet is required to be signed by a consultant.

Option  Score  Notes 
Surgical experience: choose one of the following options 
Involvement in 30-39 cases or more  6
Involvement in 20–29 cases  4
Involvement in 11-19 cases  2
No evidence / involved in 10 cases or less 0

Surgical Experience

Doing a surgical placement (with redeployment included) OR a surgical elective will get full points here. 

If you are a student, it is recommended you complete a surgical elective, if you have done one ensure you reflect on it for evidence. Although usually undertaken at medical school, you can also do short electives in your FY3 if applying then. Some bursaries are available from surgical societies if undertaken later with potentially more opportunity for hands-on surgical experience.

If you have not had the opportunity to do a surgical placement a 5 day taster week will get you 2 points. Use this as an opportunity to try out a subspecialty of interest to help you with preferencing your surgical jobs in CST. You can also use it to increase your operating logbook, network with surgeons and sign up to research or audits.

Surgical experience: choose one of the following options 
I have undertaken an elective in a surgical specialty (minimum 4 weeks) Or

OR

I have undertaken a surgical placement (see additional notes below) during my foundation training or equivalent (minimum 12 weeks) 

Proof of completion required
I have attended a surgical taster week (minimum 5 days, can be non-consecutive days) (see additional notes below))  1 Proof of completion required
I have not attended a surgical taster/ elective

Degrees

This section covers additional degrees. There are no easy ways to maximize the points in this section in a short time scale. If you are an applicant for 2022, you either have them or you don’t.

If still at medical school or in a position where you would like to take an additional degree the shortest option to max out points in this section would be an MSc or intercalated BSc (with 1st class honors). However, gaining points in this area is certainly the most expensive and time-consuming, and you may be better of focusing on other areas of your portfolio.

Option Score  Notes 
PhD or MD by additional research (level 8 qualifications). This can include non-medical qualifications.  You undertook full-time research involving original work, usually of at least three years’ duration, and ideally resulting in one or more peer-reviewed publication 
Bachelor degree (level 6 qualification) in addition to primary medical qualification; 1st class honors or equivalent. This can include non-medical degrees or BDS  3
Degree obtained during medical course (e.g. intercalation, BSc, BA, etc.) – 1st class honors or equivalent  This must be a specific course that usually lasts for three university terms (or equivalent) and is eight months’ or more duration (full time equivalent); 
Research masters degrees MD (UK only)  You undertook full-time research involving original work, usually of at least two years’ duration, and ideally resulting in one or more peer-reviewed publication 
Single-year postgraduate course (e.g. MSc, MA, MRes, etc)  This must be a specific course that usually lasts for three university terms (or equivalent) and is eight months’ or more duration (full time equivalent); it must not be claimed for upgrading a bachelor’s degree without further study as is offered in some universities 
MPhil Master of Philosophy 
Degree obtained during medical course (eg intercalation, BSC, BA, etc.) – 2.1 or equivalent 
Degree obtained prior to starting medicine – 2.1 or equivalent (can include non-medical related degrees or BDS) 
Any other degrees or qualifications in addition to PMQ not covered in the above categories  For example: certificates or diplomas that do not fall into the above categories, partial higher degrees, intercalated degrees achieving 2.2 or lower. 
Primary medical qualification only 

Prizes

These can be challenging to achieve in a short space of time if you do not have them already. Potential areas include:

  • Essay competitions from medical or surgical societies (e.g. BMA, Royal Colleges, ASIT). These often have poor submission figures with less competition than you may think.
  • Conference poster or presentation prizes – try to submit to as many as you can but consider small conferences or regional meetings may be less competitive to win prizes. While larger meeting e.g. RSM may offer a range of prizes.
  • Prizes related to Quality improvement projects/ audits (can score points in multiple categories with one project!).
    Option  Score  Notes
    Awarded a prize from a recognised surgical institution or national conference/national meeting 

    OR 

    Distinction at Final Year undergraduate level 

    6 This means that the prize is open to medical undergraduates and / or postgraduates in the country of training
    More than 1 prize awarded at a local institution 2 The prize should be open to all medical undergraduates and/or medical postgraduates in a specific locality/organisation (e.g., NHS trust, hospital, primary care network) 
    1 prize awarded at a local institution  The prize should be open to all medical undergraduates and/or medical postgraduates in a specific locality/organisation
    None/other 

Quality Improvement (Clinical Audit)

Full marks in this section requires you to have “lead in ALL aspects of a surgically themed clinical audit or QI project that has demonstrated change” (ie second cycle/ closed audit loop). This should be achievable if you choose a project early (ideally FY1 year) and identify regional/ national conferences/ meeting that allow submissions. This can be presented at national, regional or local level (not nationally only for full points as previously).

Notes:

Benefits of a large, high-quality surgical audit or quality improvement with significant changes to clinical practice:

  • Impress assessors who may give you the benefit of the doubt with some other marks
  • Present the results in conferences – poster or oral – extra points
  • Win a prize locally or in a meeting – extra points
  • If very good project it may be publishable – extra points

These large projects can often take 6-12 months and some many cases they are not be completed due to changing trainees or problems implementing change.

If time-limited there are several straightforward, important (but maybe less interesting) audit subjects which trainees can complete in short spaces of time. For examples:

  • Low molecular weight heparin e.g. VTE checklist, prescription in GI malignancy post-discharge, correct dose for weight
  • Surgical documentation: based on Royal College guidelines
  • Antimicrobial prescription
  • Consent forms
  • Theatre booking forms
  • Hydration – IV and oral fluids
  • Oxygen prescription

Remember to register the audit with the audit department and keep evidence of presentation at the local/ regional/ national audit meeting.

Beware of consultants asking you to do an ‘audit’ which involves reviewing a significant number of cases (I’ve heard of >500 patients) which may just be a means of reviewing their operative figures. Frequently these are not audits, with no standards or way to implement change. This may be a poor use of your time and you may wish to find a way to tactfully decline such a request if you do not think it will be worthwhile. If it is not an audit it will not count in this section.

Option  Score  Notes
I was involved as Lead in ALL aspects of a surgically themed clinical audit or QI project that has demonstrated change (i.e., second cycle/closed audit loop) AND I presented this at a minimum of a regional/local meeting  8 You participated in all stages of the audit/QI project (planning, data collection, data analysis, implementing change and involvement in at least two cycles) and you presented this at a national or regional or local organisation meeting (e.g., deanery NHS trust, hospital, primary care network). The project must be surgically themed.
I played a leading role in the design and implementation of a sustainable change (I.e. more than one completed cycle) using QI methodology or clinical audit AND 

I have presented the complete results at a local meeting 

6 I was involved as Lead in ALL aspects of a clinical audit or QI project that has demonstrated change (i.e., second cycle/ closed audit loop) AND I presented this at a minimum of a regional/ local meeting 
I was involved as a contributor in a clinical audit or QI project that has demonstrated change (i.e., second cycle/ closed audit loop) AND This was presented at a minimum of a regional/ local meeting  4 You participated actively through multiple cycles but did not take a leading role in the project. You may not have personally presented this audit. 
I was involved in a clinical audit or QI project AND This was presented at a minimum of a regional/ local meeting  2 For example, you assisted with data collection for the project in at least one cycle. You did not take a leading role or present the findings. 
None/other 

Teaching Experience

1 or 2 points – Teaching medical students or other healthcare professionals occasionally. All applicants should have done this. It can be done as volunteering to do a departmental teaching session or a teaching session for medical students. Many hospitals also offer twilight teaching sessions for students, which you can get involved with (this may now be virtual).

Formal feedback to get you 2 points involves either senior observation/ feedback or independent collection and analysis (which can be arranged through the course organiser e.g. Medical Education department or course lead).

4 points – Teaching medical students or other healthcare professionals regularly > 4 sessions As above – this is a very achievable goal.

6 points – Worked with local tutors to design and organise a teaching programme (a series of sessions) to enhance locally organised teaching & provided teaching for 4 or more sessions months (with formal feedback). Requires you to be very proactive and consider the hospital which you work in, looking for areas where medical student teaching is lacking. Ask the students if you are unsure. 
10 points –As per 6 but at a regional level. This involves going beyond your trust to involve other hospitals in your region.

Examples of teaching programmes include:

  • Virtual surgical webinar series (during COVID-19)
  • Virtual group tutorials 
  • Structured bedside teaching
  • Clinical skills in early years
  • OSCE preparation +/- examination
  • Surgical teaching delivery e.g. set up a ‘Surgical Series’ of core subjects taught by Junior Doctors
  • Communication skills

How to set up a program

  • Start as early as possible e.g. in induction week
  • Briefly plan a program e.g. session titles, audience, setting, teaching style, teachers e.g. others colleagues/ junior doctors.
  • Discuss the plan with your education supervisor during the first meeting as they may be able to assist.
  • Discuss with the medical education department and arrange meetings with the head of medical education to discuss your proposal.
  • If approved you will need to plan the program in more detail
  • Following this the medical education department will usually email junior doctors asking for volunteers to prepare and deliver teaching based on your topics, offering certificates and formal feedback.
  • This may be more challenging during COVID-19 but there has been a proliferation of virtual teaching and webinar series in surgery which offers an opportunity for teaching programmes. This may be the most straightforward way to set up a program which is accessible at a regional and even national level.
Option  Score  Notes 
I have worked with local educators to design and organise a teaching programme (a series of sessions defined as 4 or more) to enhance organised teaching for healthcare professionals or medical students at a regional level (please see appendix for definition of regional) 

AND 

I have contributed regularly to teaching for healthcare professionals or medical students within the last year (4 or more sessions/year) 

AND 

I have evidence of formal feedback (defined in additional notes)

10 You have shown the ability to identify a gap in the teaching provided and have worked with local educators to design, organise and deliver a regional teaching programme. As part of this process, you will have had input into the programme objectives and outline of sessions delivered. 
I have worked with local educators to design and organise a teaching programme (a series of sessions defined as 4 or more) to enhance organised teaching for healthcare professionals or medical students at a local level (please see appendix for definition of local) 

AND 

I have contributed regularly to teaching for healthcare professionals or medical students over the last year (4 or more sessions/year) 

AND 

I have evidence of formal feedback 

You have shown the ability to identify a gap in the teaching provided and have worked with local educators to design, organise and deliver a local teaching programme. As part of this process, you will have had input into the programme objectives and outline of sessions delivered. 
I have provided regular teaching for healthcare professionals or medical students over the last year (4 or more sessions/year) 

AND 

I have evidence of formal feedback 

Examples of teaching include but not restricted to regular bedside or classroom teaching, acting as a mentor to a student, acting as a tutor or delivering teaching in a virtual learning environment. 
I have taught healthcare professionals or medical students occasionally (occasional is defined as less than 4 sessions/year) 

AND 

I have evidence of formal feedback

I have taught medical students or other healthcare professionals occasionally, but I have no formal feedback  If you have no formal feedback then you must upload a 200-250 word reflection on your teaching experience to the evidence verification portal 
None/other 

Training in Teaching

Whilst it may not be feasible to achieve higher qualifications in teaching before the interviews (maximum), it is definitely achievable to score 1-2 points for some training in teaching. There are also plenty of online courses available, from institutions such as the Open University for 1 point. Many of these courses are free, so don’t feel you have to spend lots of money just for a few extra points!

Another tip is to look at what was covered in medical school. Some Undergraduate MBBS courses provide dedicated training in teaching modules – which can get you 1-2 points in this section, with no extra work. Try and find your certificates/ proof of attendance.

Option  Score  Notes 
I have a masters level or higher qualification in teaching e.g. MA or MSc  This could be full time over one academic year or part-time over multiple years 
Teaching specific postgraduate qualification e.g., PG Cert or PG Diploma  3
I have had substantial training in teaching methods lasting at least five days; this could include a completed module which forms part of a postgraduate teaching qualification  2 This should be additional to any training received as part of your primary medical qualification. 
I have had training in teaching methods lasting no more than two days

 

1 This should be additional to any training received as part of your primary medical qualification. This could be delivered locally. This can be delivered virtually
I have had no training in teaching methods 

Presentations

These include regional, national and international conferences where you may present posters or oral presentations. Many applicants are unaware of the low rejection rates for posters in many conferences particularly as virtual posters during COVID has increased the number of accepted posters. It can be much easier to get accepted than most people think!

Review forthcoming conference deadlines with colleagues including smaller meetings in surgery (and areas such as radiology, pathology and anatomy).

Write abstracts appropriate for the meetings. They do not need to involve ground-breaking research and can include audits, case reports, reviews and even the history of a procedure.

Please note as of 2022 you may not gain points for the same audit as gained you points in the Audit/ QI section.

Options  Score  Notes 
I have given an oral presentation at a national or international medical meeting after being invited/selected to do so  Personal delivery of presentation required
First author for 2 or more posters presented at an international or national meeting convened by an accredited institution (virtual or face-to-face) after being invited/selected to do so 
I have given an oral presentation at a regional medical meeting after being invited/selected to do so  3
I have contributed to a national or international oral presentation but did not give the presentation myself 2
I have presented one or more posters as first author at a regional medical meeting(s) after being invited/selected to do so 1
I have contributed to a poster presented nationally or internationally but was not first author (please see appendix for definition)  1
None/other 

Publications

A first author of a PubMed-cited publication is required for full points. The top points require a good degree of planning and work and cannot be obtained last minute. Medical school intercalated degrees or academic foundation programs provide the opportunity to undertake original research. While anyone can take initiative and register their interest with consultants and registrars in specialties of interest to get involved in projects (co-author) or lead your own (first author). Original research projects are definitely achievable, however, give plenty of time for finding a supervisor, collecting data, writing up, waiting for peer review etc (usually >1year). 

Case reports and letters are usually the fastest turn around for ‘quick points’ 4 points per publication. During placement keep a lookout for interesting cases for case reports and consider short projects which may be used as letters to journals. QIPs may be publishable as a short article or letter to a journal.

Options  Score  Notes 
I am first author (please see appendix for definition) of one or more PubMed-cited publications (or in press) not including a case report or editorial letter  For this option, you need to be first or joint-first author in all the publications to which you refer 
I am first author of one or more PubMed-cited publications of a case report or editorial letter (or in press)  4 For this option, you need to be first or joint-first author in all the publications to which you refer
I have written a book chapter related to medicine (this does not include self-published books)  4
I am a named co-author (please see appendix for definition) of one PubMed-cited publication (or in press)  3
I am a Cited Collaborative author (please see appendix for definition) as part of a research collaborative publication in 3 or more PubMed cited publications  2 Cited as part of research collaborative. Does not require named authorship alongside publication title. 
I am a Cited Collaborative author as part of a research collaborative publication in 2 or more PubMed cited publications  1 Cited as part of research collaborative. Does not require named authorship alongside publication title. 
None/other 

Leadership and Management

This can be quite a difficult section to score highly at short notice. Regional/ national leadership positions require application and preparation well in advance, so think about this in FY1 year and before. Points are provided for medical and non-medical based leadership and management. Non-medical involvement includes sporting, charity, innovation or creative arts. Consider areas which may be interesting and relevant for you and apply/ show interest.

It is very achievable to take up a local role, as there will be several positions available at your local hospital (or even regionally). Examples include

  • Trainee rep or FY1/FY2/FY3 representative: This is potentially an easy 4 points. Consider applying for this position if it is available at your trust during induction. If not available, suggest this as a new position.
  • Role in the doctors’ mess: Probably the easiest point in the portfolio and something to apply for during induction.
  • Rota Coordinator for foundation trainees in your department
  • Monthly mortality and morbidity meeting organiser
  • Organising a journal club in your department
Option  Score  Notes 
I hold/have held a national leadership or managerial role for 6 or more months and can demonstrate a positive impact  Examples include: BMA national executive, trainee representative of a specialist society or college or a nationally held leadership and management fellowship. 
I hold/have held a regional leadership or managerial role for 6 or more months and can demonstrate a positive impact  5
I hold/have held a local leadership or managerial role related for 6 or more months and can demonstrate a positive impact  3
None/other 

Evidence

Ensure you look at what evidence is required (e.g. letters, audit presentation etc.) early enough in the process, to give yourself time to gather it.

Further Reading

https://medibuddy.co.uk/core-surgical/core-surgical-training-interview-preparation-and-essential-reading/

You can access our other interview resources in the Core Surgical Interview section of the website

Personal background

I am a registrar who previously worked in a top ranked rotation in London, which includes plastic surgery (my chosen specialty). I was not top ranked at medical school; in fact I was in the 8th decile academically on my foundation application. I was definitely daunted when I first reviewed the points required for CST and did not think I would be able to achieve enough points to obtain a job which included my chosen specialty, let alone in my chosen region. Please do not be put off by the points sheet and note that medical school academic performance is worth a minority of points on the interview application. The majority coming from other work in areas such as audits, teaching, clinical performance and projects work (presentations and publications).

I would suggest you read carefully the previous interview points specifications and set your own objectives on how you can achieve them. I would also recommend that you work with others, find mentors, form groups and share the workload involved in teaching, doing audits and research projects. There is a lot of work (and unfortunately expense) involved in scoring highly on the application and collaborating with peers makes this much more manageable. Please feel free to get in touch if you have any specific questions regarding the portfolio.

Mr Peter Macneal MBChB BSc PGDip (Clin Ed) MRCS (Eng)

Further reading

More tips on smashing your Core Surgical interview.

Core Surgical

Core Surgical Training Interview 2022: Complete Guide

Doing well in the core surgical training interview is very achievable, provided you put in sufficient preparation and practice. Starting earlier gives more opportunity to get the points on the portfolio station, leaving plenty of time to practice clinical and leadership scenarios. The template below is a basic outline of targets to set yourself when […]

By Medibuddy — 05 March 2022

Online interview

Core Surgical

Core Surgical Interview Tips 2022

The 2022 interviews will take place from the 7th to the 18th February and will be conducted via Microsoft Team. Interview technique Interview technique and how you present yourself to interviewers is fundamental to success in the interview. While knowledge and content of answers will give you marks, if you present yourself professionally and confidently, you […]

By Medibuddy — 18 January 2022