Core Surgical Training (CST) Interview: The Complete Guide
The Core Surgical Training (CST) interview is the national selection interview for entry into core surgical training (CT1) in the UK. It is delivered online via Qpercom as two 15-minute stations — a Management & Clinical station and a Portfolio station — marked on a 0–6 scale. It sits alongside the MSRA (the written shortlisting exam) in the overall recruitment process. This guide covers the format, both stations, how the marking works, and how to prepare.
The format at a glance
You sit two 15-minute stations, rotated in any order, each with its own panel of assessors:
| Station | Time | What happens |
|---|---|---|
| Management & Clinical | 15 min | One management (professional dilemma) scenario + two clinical scenarios, ~5 minutes each, given on the day. |
| Portfolio | 15 min | A ~3-minute pre-prepared presentation with questioning, then two portfolio questions (~5 minutes each) on panel-selected domains. |
The two stations carry roughly equal weight, so about half of your interview score comes from each. (The MSRA is scored separately and is not part of the interview itself.)
The two stations, station by station
Management & Clinical station
Management (professional dilemma). You are given a situation that tests judgement rather than clinical knowledge — a colleague who appears impaired, a near miss or never event, a rota or staffing conflict, a probity or confidentiality issue. The guiding principle is patient safety first: make the situation safe, gather information, involve and escalate to seniors, and support those involved. A structure such as SPIES helps, but the panel is marking your reasoning, not your recall of an acronym.
Clinical scenarios (two). You are given an acutely unwell surgical patient — usually a post-operative complication or a surgical emergency — and asked to think on your feet. Assessors want a safe, systematic approach: an A–E assessment, sensible investigations and initial management, clear prioritisation, and — crucially — recognising when something is beyond your level and escalating with a structured SBAR handover. The level is pitched at a core surgical trainee, not a registrar. Cases span the surgical specialties (general surgery, urology, orthopaedics, ENT, vascular, and more).
Portfolio station
Presentation. You give a short pre-prepared presentation — around three minutes — followed by about two minutes of questions. It may be your own topic or a themed one circulated in advance (leadership, teamwork, communication, overcoming a challenge, improving patient care). You are assessed on structure and delivery, the significance of what you present, your personal contribution, and your insight and reflection.
Portfolio questions. The panel then asks two questions drawn from two different portfolio domains — commitment to the specialty, quality improvement and audit, research and publications, teaching, leadership and management, training and courses, or career insight. There is no single right answer: you are marked on the evidence you bring, the depth of your examples, and your reflection. Concrete examples framed with STAR land far better than general statements.
How you are scored
Each dimension of each station is marked on the 0–6 national selection scale:
| Score | Band |
|---|---|
| 0 | No evidence |
| 1 | Very poor |
| 2 | Weak |
| 3 | Satisfactory — the expected standard for CST entry (appointable) |
| 4 | Good |
| 5 | Excellent |
| 6 | Outstanding |
Each station is scored across a few dimensions (for the clinical part, for example: clinical skills and knowledge, judgement and prioritisation, and communication), and these are averaged into the station score. Safety runs through all of it — failing to recognise a deteriorating patient, or to escalate, pulls the mark down sharply however fluent the rest of the answer is.
What examiners are actually looking for
- Safety and escalation. Recognise the sick patient, start A–E, and escalate early with a structured SBAR handover — knowing your limits as a core trainee is a strength, not a weakness.
- Structured clinical reasoning. A systematic approach (assessment → investigations → management → prioritisation), scaffolded with frameworks like CCrISP and ATLS where relevant.
- Professional judgement. In the management scenario: patient safety first, gather information, involve seniors, act with probity. SPIES is a useful skeleton.
- Evidence and reflection. In the portfolio and presentation: real examples, your personal contribution, and honest reflection on what you learned — not a list of achievements.
- Clear communication. Structure and clarity carry a large share of the mark across every station.
What to prepare
- Clinical emergencies across the specialties: post-operative bleeding, anastomotic leak, upper GI bleed, small bowel obstruction, testicular torsion, compartment syndrome, cauda equina, ruptured AAA, acute limb ischaemia.
- Management dilemmas: the impaired colleague, a never event (e.g. retained swab), a struggling or persistently late colleague, being pressured to consent a patient, confidentiality breaches, and rota or staffing conflicts.
- Portfolio domains: commitment to the specialty, quality improvement and audit, research and publications, teaching, leadership and management, and career insight — each backed by real evidence.
- Presentation: a polished three-minute talk on your own achievement or a themed prompt (leadership, teamwork, improving patient care), with reflection built in.
How to prepare well
The biggest gain is rehearsing the real stations out loud, under the clock— not reading model answers silently. The interview rewards thinking on your feet in a spoken conversation, and that only becomes comfortable with reps. Practise escalating, structuring dilemmas, and telling portfolio stories concisely, then get feedback against the marking dimensions and fix the specific gaps.
That is what Reviva is built for: an AI examiner that runs each CST station in the real format, on the real clock, and scores you against the national selection criteria — so you can rehearse the whole interview as often as you need before refining with colleagues. You can try a station for free, or see the full scenario library and mock-exam mode.
Frequently asked questions
- How long is the Core Surgical Training interview?
- The CST interview is delivered online (Qpercom) as two 15-minute stations — a Management & Clinical station and a Portfolio station — rotated in any order, for about 30 minutes in total.
- What stations are in the CST interview?
- Two. The Management & Clinical station is one management (professional dilemma) scenario plus two clinical scenarios, five minutes each, given to you on the day. The Portfolio station is a short pre-prepared presentation (around three minutes) with questioning, followed by two portfolio questions on domains the panel selects.
- How is the CST interview scored?
- Each dimension is marked on a 0–6 scale: 0 No Evidence, 1 Very Poor, 2 Weak, 3 Satisfactory, 4 Good, 5 Excellent, 6 Outstanding. A 3 (Satisfactory) is the standard expected for entry to core surgical training (appointable). The two stations each contribute roughly half of your interview score.
- Is the MSRA part of the CST interview?
- No. The MSRA (Multi-Specialty Recruitment Assessment) is a separate, machine-marked written exam used earlier in the recruitment process, mainly for shortlisting and ranking. The interview is the two stations described here — that is what this guide, and Reviva, focus on.
- What is the management station?
- You are given a professional dilemma — for example a colleague who seems impaired, a near miss or never event, a rota or staffing problem, or a probity issue. It assesses professional judgement rather than clinical knowledge: patient safety first, then gathering information, involving seniors, and escalating appropriately. Frameworks like SPIES help structure the answer but are not required.
- How should I prepare for the CST interview?
- Rehearse the actual stations out loud, under the 5-minute clock: work acute cases systematically (A–E assessment, then escalate with a clear SBAR handover), structure professional dilemmas around patient safety, and prepare portfolio answers with concrete examples (using STAR). Then get feedback against the marking dimensions and fix the specific gaps.
Sources. This guide reflects the CST interview format modelled by Reviva, based on the official HEE national recruitment guidance for core surgical training. It is educational and for interview preparation — always confirm the current format, dates, and marking against the official national recruitment portal for your cycle.