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Will IST trainees need to complete a benchmarking process to progress to ST3?

No. IST trainees' progression will be managed through the ARCP process.

How can I apply for a training post in the IST pilot?

Applications for both traditional core surgical training (CST) and the IST posts are made through Oriel. IST run through and uncoupled posts are listed alongside uncoupled CST posts, and applicants must rank those posts they would accept if offered. IST posts are clearly indicated, allowing applicants to rank only IST posts, only non-IST posts, or a combination. Offers are made on the basis of ranked preferences and scores achieved at interview.

For more information on Oriel and the application process, go to

Which specialties are participating in the pilot?

The IST pilot began with its first cohorts in general surgery and core surgery in 2018, with cohorts in urology and vascular surgery joining in 2019. These were joined by the trauma trauma and orthopaedic surgery cohort in 2020.

How many pilot training posts are available?

In 2020, a total of 175 posts were available: 111 in England, 53 posts in Scotland, and 11 posts in Wales. Posts available in subsequent years are confirmed via Oriel.

Will the IST pilot lead to a reduction in the number of uncoupled specialty posts?

Unless additional ST3 posts are created, the allocation of NTNs at ST1 level in the pilot may lead to a reduction in the number of NTNs available for uncoupled training from ST3.

Can I transfer to another specialty after joining the pilot?

IST supports flexibility for trainees that wish to change specialties after beginning their training. For trainees who join the pilot but subsequently wish to train in a different specialty, prevailing arrangements for flexibility in training will ensure that competencies gained are transferable between the specialties.

Where will the IST pilot take place?

Details of pilot post numbers and locations can be found here. Please note, these are subject to change and the posts listed on Oriel are final.

How does training in the IST pilot differ from uncoupled non-pilot training?

Run through training in the IST pilot follows the same curricula as uncoupled core/higher specialty surgical training outside the pilot. The end point of training (CCT) is therefore the same, but the experience of training is enhanced in the pilot, and the duration of training may be shortened if competencies are achieved at a higher rate. However, many IST training enhancements are expected to also benefit non-pilot trainees in IST pilot sites. 

In Scotland, all core surgical training posts are included in the pilot.


Is less than full time (LTFT) training available as part of the IST pilot?

LTFT arrangements in IST are the same as for all training posts governed by the Gold Guide.

Are out of programme training, research, experience or career breaks (OOPT / OOPR / OOPE / OOPC) available as part of the IST pilot?

Out of programme arrangements are the same as for all training posts governed by the Gold Guide.

How is the delivery of IST training quality assured in pilot sites?

Quality assurance/monitoring of posts is managed locally by each pilot site’s LETB/deanery.

Is it possible to move between deaneries in the pilot?

National arrangements for interdeanery transfers will continue to apply to trainees in the pilot and outside it. As a vacant post is required to accommodate each successful transfer applicant, it cannot be guaranteed that an IST post in another location will be available for any trainee transferring out of an existing IST pilot post.

What does the future look like for the project – will there be a national roll-out?

An independent evaluation will report on IST in England and Wales in December 2021. Any roll-out will be informed by this evaluation.

A separate independent evaluation will report on IST in Scotland.

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