Last reviewed: October 2026.
UK surgical training is full of abbreviations that make a relatively simple idea look much more complicated than it is: CST, CT1, CT2, MRCS, ISCP, ARCP, ST3, NTN.
At its core, Core Surgical Training is the early structured period in which trainees build broad surgical competence before moving into higher specialty training. The details matter, because progression depends on much more than simply completing two years.
How long is Core Surgical Training?
The Joint Committee on Surgical Training currently describes CST as having an indicative duration of 24 months for most trainees. These are usually referred to as CT1 and CT2.
Training may be themed toward particular specialties or arranged across several surgical areas. The purpose is to build the common competencies needed before entry into higher surgical training.
How do you enter CST?
Formal Core Surgical Training posts are recruited through a national selection process. The current person specification sets the eligibility criteria for CT1 recruitment, including medical qualification, GMC registration requirements, right-to-work requirements, and evidence expected at selection.
Recruitment criteria can change between cycles, so applicants should use the current Medical Hub person specification rather than relying on an old portfolio-scoring blog post.
What is ISCP?
The Intercollegiate Surgical Curriculum Programme—ISCP—is the training platform used to record progress against the surgical curriculum. It is not simply a storage folder for certificates.
Workplace-based assessments, learning agreements, evidence of progress, operative experience, supervisor reports, and other training information feed into the record that supports progression.
JCST guidance is blunt about the practical consequence: if important training evidence is not recorded, it may not be considered at the Annual Review of Competence Progression.
What is ARCP?
The ARCP is the formal review of whether a trainee is progressing appropriately through the curriculum. It looks at the evidence accumulated during training rather than one isolated exam or one supervisor’s opinion.
For residents coming from systems where time served is the main organizing principle, this can feel different. UK training is heavily portfolio-based: if an activity matters, documentation matters too.
Where does MRCS fit?
JCST currently states that the Membership of the Royal Colleges of Surgeons examination—MRCS—is an exit requirement for formal CST and must be achieved before completing CST and taking up an ST3 post.
This means exam preparation runs in parallel with clinical training. Leaving it too late can create a progression problem even if the clinical side of training is going well.
What happens after CT2?
For many surgical specialties, trainees apply through national selection for higher specialty training at ST3. Entry depends on meeting the relevant specialty person specification and demonstrating the required competencies.
Some specialties have run-through or differently structured pathways, so the exact route depends on the discipline. JCST advises CST trainees to understand the future ST3 person specification early enough to shape their training toward it.
What do trainees actually need to think about during CST?
- Getting broad clinical and operative exposure rather than chasing numbers without context.
- Keeping ISCP evidence current instead of reconstructing it months later.
- Preparing for MRCS early enough to avoid a last-minute bottleneck.
- Understanding the entry requirements of the specialty you may pursue at ST3.
- Using each rotation to develop evidence of progression, not merely attendance.
- Getting meaningful supervisor feedback rather than collecting signatures.
What does CST feel like from the resident side?
The tension is familiar across countries: you are trying to become clinically useful while also building a formal record that proves you are progressing. A busy rotation can be educational and still leave a weak portfolio if assessments and evidence are ignored. A perfect portfolio can also become meaningless if it is disconnected from real clinical development.
The goal is to keep the paperwork attached to the learning rather than treating them as two separate jobs.
International doctors should also read Surgical Training in the UK for International Doctors, which covers the IMG-specific route rather than CST structure alone.
Sources and further reading
- JCST: Core Surgical Training
- Medical Hub: Core Surgical Training CT1 2026 person specification
- Intercollegiate Surgical Curriculum Programme
- GMC: General Surgery Curriculum
The alphabet soup becomes manageable once you see the sequence: get into CST, build competence and evidence through ISCP, progress through ARCP, complete MRCS, and meet the requirements for the next specialty selection point.
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