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Surgery Career Paths

As your career progresses from medical school student through to surgeon, you will go through a number of stages that all have a level of competitive entry. Below we outline the ways in which you can enter and follow a surgical career, specifically:

  • The training pathway
  • Fixed term specialty training appointments
  • Career grades

Training pathway

The training pathway is the most direct route through surgical training. Following each training stage, particularly in the early years, you will need to be selected into the next stage. 

If you are unsuccessful at these selections or decide that an alternative route would suit you better, there are other options you can take up. It is important that you make contingency plans throughout your career so that you are prepared for the unexpected.

These are the stages you will pass through during your training. Click on each stage to see more information.

Foundation Training

Duration 2 years.
Content A paid training job in a clinical setting. Foundation trainees will rotate around a number of different medical specialties.
Application method Applicants apply via the UK Foundation Programme. Medical students are “matched“ to places based on their application form.
Normal entry requirements Successful completion of approved medical degree.

Core Surgical Training

Duration 2 years.
Content A paid training job in a hospital setting with rotations covering a range of surgical specialties. These may be themed towards one particular specialty or sub-specialty.
Application method Applications are made via Oriel
Normal entry requirements Completion of required Foundation competencies and full GMC registration. Applicants should read the person specifications to ensure they meet all of the requirements.

In some specialties, surgical trainees can begin specialty training at ST1. This is the equivalent of Core Surgical Training. Health Education England provide more information on this. The RCS launched the Improving Surgical Training pilot in 2017, which has introduced run-through training in a number of surgical specialties to trial improvements in surgical training.

Trainees wishing to continue their surgical training at specialty level must complete their Membership of the Royal College of Surgeons exam (MRCS) by the end of their CT2 year. This exam is a prerequisite for Specialty Training. The MRCS covers all areas of surgical practice and both Part A and Part B of the exam may be sat during Foundation Training and/or Core Surgical Training. 

Specialty Training

Duration ~ 6 years
Content A paid training job in a hospital setting in one of 10 surgical specialties.
Application method Applications via HEE, via form and interview/assessment etc.
Normal entry requirements Completion of core training competencies, MRCS Part A&B passed, and mandatory courses. Varies by specialty.

Senior medical appointment

Once you have completed your surgical training, you will be eligible to take the Fellowship of the Royal College of Surgeons (FRCS) exam. This exam is a mandatory requirement for the award of a Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration (CESR). The examinations are regulated by the Joint Committee on Intercollegiate Examinations (JCIE) for UK residents. The Joint Surgical Colleges’ Fellowship Examination (JSCFE) provide the exam for the international surgical community. The FRCS exam must be sat with the royal college of your choice.

Once a surgeon has attained CCT or CESR, they will be added to the GMC's specialist register and will be eligible to apply for a consultant post or a fellowship for further, more specialised training.

Training pathway alternatives 

SAS grades (specialty doctor and staff grade positions)

The group of career grade posts comprises staff grades, associate specialists, clinical assistants, hospital practitioners and other non-standard, non-training Trust grades. These surgeons work in key service roles within the NHS and carry out a wide range of surgical care on the ward, in the outpatient clinic and in the operating theatre.

You can enter these posts at almost any point in your career when you decide to leave the training pathway. (Obviously, this will be subject to successfully navigating the application process.) 

However, it will be easier to pursue a fulfilling career that includes training and progression if you complete some of your training before leaving the training pathway. For more information on the wide range of roles and opportunities available in the Career Grades, visit our section on SAS Grades.

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