Anaesthetics ST4 — 2026 Application Guide
Complete guide to applying for Anaesthetics ST4 in the 2026 recruitment cycle. This page covers eligibility requirements, self-assessment scoring criteria, portfolio sections, key dates, required forms, and evidence guidance — building on Specialty Training.
Oriel route name: Anaesthetics ST4 · Route family: specialty-training
Interview preparation guide for Anaesthetics ST4 →Medically reviewed by MedNext Clinical Team. Last reviewed 27 April 2026. See our editorial policy and correction policy.
About Anaesthetics ST4
Anaesthetics ST4 is a anaesthetics programme entering at higher specialty training at ST4 level, following Internal Medicine Training. Selection uses portfolio-scored selection. The full training pathway typically takes 9-11 years total.
Entry Level
ST4
Training Duration
9-11 years total (2yr foundation + 3yr IMT + 3-5yr higher specialty)
Selection Method
Portfolio Scored
Training Pathway
Official Source Documents
The scoring criteria, eligibility requirements, and self-assessment guidance on this page are derived from the following official documents. Always refer to the latest published version before your application.
Published by: NHS England Medical Hub
View original documentPublished by: Specialty Applications
View original documentPublished by: Specialty Applications
View original documentKey Dates & Deadlines
Important dates for the Anaesthetics ST4 2026 recruitment cycle. Check the official recruitment timeline for the most up-to-date information, as dates may change.
Eligibility Requirements
You must meet all essential eligibility criteria to be considered for Anaesthetics ST4. These are assessed at the application stage. Failure to meet any essential requirement will result in your application being rejected.
You must hold a Bachelor of Medicine, Bachelor of Surgery (BMBS, MBBS) degree or other equivalent medical qualification.
You must: Be eligible to work in the UK. Hold full registration with the General Medical Council (GMC) at the time of application, **and** hold a current licence to practise on the date your post commences.
Evidence hint: GMC registration details or licence evidence.
You must be able to provide complete details of your employment history, including any gaps.
You must complete all sections of the application form fully and truthfully, in accordance with written guidelines. You must disclose in your application if you are subject to any ongoing fitness to practise proceedings or are subject to any fitness to practise conditions.
You must have evidence of achievement of Stage 1 Domains of Learning from a UK core training programme or equivalent, via one of the following methods: Employment in a UK Core Anaesthetics / ACCS Anaesthetics Training Programme **at the time of application** which leads to achievement of all required Stage 1 Domains of Learning **by the advertised posts start date for the vacancy** evidenced by a Stage 1 Certificate / Stage 1 Equivalence Certificate**, or** Completion of a UK Anaesthetics/ACCS Anaesthetics Core Training Programme **at the time of application**, evidenced by Stage 1 Certificate / Stage 1 Equivalence Certificate; **or**
Evidence hint: Upload the named certificate or supporting form.
You must have: current employment in a UK Anaesthetics or ACCS Anaesthetics Core Training Programme; **or** 48 months’ experience after full GMC registration or equivalent
Evidence hint: GMC registration details or licence evidence.
You must have successfully passed Primary Fellowship of the Royal College of Anaesthetists (FRCA) by the ‘initial offers released by’ date for the round.
Entry Criteria — Person Specification
The following entry criteria are extracted from the official 2026 person specification for Anaesthetics ST4. You must meet all essential criteria at the point specified. Failure to meet any essential criterion will result in your application being rejected.
Qualifications
- You must hold a Bachelor of Medicine, Bachelor of Surgery (BMBS, MBBS) degree or other equivalent medical qualification.
Registration & right to work
- You must:
- Be eligible to work in the UK.
- Hold full registration with the General Medical Council (GMC) at the time of application, and hold a current licence to practise on the date your post commences.
- Meet the standards set out in Good Medical Practice, and not be subject to fitness to practise conditions which would prevent you taking up the post or performing fully within it.
- You must not
- Hold, nor be eligible to hold, a Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration (CESR) for this specialty, nor
- Already be eligible for the specialist register for this specialty.
Career history
- You must be able to provide complete details of your employment history, including any gaps.
Disclosure
- You must complete all sections of the application form fully and truthfully, in accordance with written guidelines.
- You must disclose in your application if you are subject to any ongoing fitness to practise proceedings or are subject to any fitness to practise conditions.
- If you are currently in specialty training and are applying to continue training in the same specialty in another region, you must obtain a Support for Application to another region form signed by the Training Programme Director/Head of School of your current Specialty Training Programme. This must confirm satisfactory progress and be submitted with your application.
- If you have previously resigned, or been removed from, a training programme in any specialty, you must obtain a Support for Reapplication to Specialty Training form signed by the Training Programme Director/Head of School and Postgraduate Dean from the region you previously undertook training in. This must be submitted with your application.
Capability/Competences for ST4 entry
- You must have evidence of achievement of Stage 1 Domains of Learning from a UK core training programme or equivalent, via one of the following methods:
- Employment in a UK Core Anaesthetics / ACCS Anaesthetics Training Programme at the time of application which leads to achievement of all required Stage 1 Domains of Learning by the advertised posts start date for the vacancy evidenced by a Stage 1 Certificate / Stage 1 Equivalence Certificate, or
- Completion of a UK Anaesthetics/ACCS Anaesthetics Core Training Programme at the time of application, evidenced by Stage 1 Certificate / Stage 1 Equivalence Certificate; or
- Current employment in a UK anaesthetics post (a non-training grade post) at the time of application and achievement of all required Stage 1 Domains of Learning evidenced by a Stage 1 Certificate / Stage 1 Equivalence Certificate by the ‘initial offers released by’ date for the round; or
- The Confirmation of Stage 1 Equivalence Certificate is to be used if you have not completed a UK core training programme but have all the required competencies by the ‘initial offers released by’ date for the round.
- You must have:
- current employment in a UK Anaesthetics or ACCS Anaesthetics Core Training Programme; or
- 48 months’ experience after full GMC registration or equivalent
- If you wish to be considered for Locum Appointment for Training posts (where available): you must have no more than 24 months experience in LAT posts in this specialty by the advertised post start date for the vacancy.
PROFESSIONAL EXAMInATIONS
- You must have successfully passed Primary Fellowship of the Royal College of Anaesthetists (FRCA) by the ‘initial offers released by’ date for the round.
Selection Criteria — Person Specification
Shortlisted candidates are assessed against these selection criteria. Essential criteria are requirements; desirable criteria can strengthen your application. Understanding both columns helps you target your evidence and interview preparation.
Eligibility
- You meet all criteria specified in the Eligibility to Apply section above.
Clinical knowledge
- Interest in, and understanding of, the training programme.
Workplace skills
- Ability to work in multi-professional teams and supervise colleagues.
- Ability to lead, make decisions, organise and motivate other team members.
- Ability to manage/prioritise own and others’ time effectively.
- Ability to work safely under pressure and deliver good clinical care in the face of uncertainty.
- Ability to monitor developing situations and anticipate issues.
- Good basic IT skills, including Microsoft Office, email, and ability to learn new systems.
Academic knowledge
- Understanding of research, including awareness of ethical issues.
- Understanding of the basic principles of audit, clinical risk management, evidence-based practice, patient safety, and clinical quality improvement initiatives.
- Knowledge of evidence-informed practice.
Personal skills
- Commitment to personal and professional development.
- Ability to work on own initiative, demonstrating curiosity.
- Strong attention to detail, preparation and planning.
- Ability to communicate messages effectively to a range of audiences.
- Ability to negotiate and build positive professional relationships.
- Strong problem-solving skills, with a scientific approach to problem solving
Values
- Understands, respects, and demonstrates the values of the NHS
Knowledge and experience
- Understanding of NHS management and resources.
- Experience of management.
- Experience of research.
- Experience of audit and quality improvement.
- Experience of teaching.
Specialty: Clinical skills – clinical knowledge and expertise
Essential
- Ability to apply sound clinical knowledge and judgement and prioritise clinical need.
- Clinical experience, ability to undertake indirectly supervised lists and emergency care of ASA 1 and 2 patients for minor and intermediate surgical procedures.
- Understand and demonstrate the non-technical skills required for anaesthesia.
- Demonstrates vigilance and situational awareness.
Desirable
- Has undertaken CPD relevant to training grade to support the stage 1 curriculum including simulation.
Specialty: Research, Audit and Quality Improvement
Essential
- Demonstrates understanding of research, including awareness of ethical issues.
- Demonstrates understanding of the basic principles of quality improvement including audit.
- Demonstrates quality improvement activity with evidence related to anaesthesia and ICM.
Desirable
- Evidence of academic and research achievements, e.g., degrees, prizes, awards, distinctions, publications, presentations, other achievements.
- Participation in a local or national research project as lead or co lead.
- Be lead organiser or part of a faculty on a local, regional, or national training event or course which includes E Learning and Online events.
Specialty: Teaching
- Evidence of feedback for teaching
Specialty: Communication skills
- Demonstrates clarity in written and spoken communication.
- Able to build rapport, listen, persuade, and negotiate.
- Evidence of effective multi-disciplinary team working and leadership.
Specialty: Empathy and sensitivity
- Demonstrate empathy, sensitivity, and respect.
Specialty: Organisation and planning
- Capacity to prioritise time, information, and workload.
- Evidence of thoroughness (being well-prepared, shows self-discipline/commitment, is punctual and meets deadlines.)
Specialty: Working under pressure and managing uncertainty
- Capacity to operate under pressure and have insight into their own behaviour.
- Demonstrates initiative and resilience.
- Is able to deliver good clinical care in the face of uncertainty.
Specialty: Commitment to specialty – learning and personal development
Essential
- Shows initiative/drive/enthusiasm.
- Demonstrable interest in, and understanding of, the specialty and its training curriculum.
- Commitment to personal and professional development.
- Evidence of reflective practice.
- Evidence of extracurricular activities that promote a good work life balance and general wellbeing.
Desirable
- Affiliation to professional societies relevant to anaesthetics, ICM and pain management.
- Commitment to own progress in the specialty.
- Active involvement with RCoA or equivalent.
- Demonstrates commitment to pursuing specialty training in anaesthetics and an understanding of the NHS.
Specialty: Qualifications
Essential
Desirable
- BSc, BA, BMedSci or equivalent (not including intercalated BSc or ‘Honorary’ MA).
- Higher degrees including MSc, PhD, or MD (where research thesis is not part of first medical degree).
- Postgraduate qualifications achieved in other specialties.
Specialty: Career progression
Essential
Desirable
- Additional training/experience in any secondary care specialty or General Practice at CT/ST.
Specialty: Management and leadership skills
Essential
Desirable
- Evidence of involvement in management commensurate with experience.
- Evidence of effective leadership in and outside medicine.
Specialty: Other
Essential
Desirable
- Evidence of achievement outside medicine.
- Evidence of altruistic behaviour, e.g., voluntary work.
- Evidence of organisational skills – not necessarily in medicine, e.g., grant or bursary applications, organisation of a university club, sports section, etc.
Self-Assessment & Scoring
Anaesthetics ST4 uses a portfolio-scored selection process. Applicants complete a self-assessment based on official scoring criteria, then upload supporting evidence. Each question has its own point scale — some worth up to 6 points. Understanding the full marking scheme is essential to maximising your score.
Scoring Sections
The self-assessment is structured across 3 sections with 10 scored questions. Each question has variable points — refer to the official self-assessment guidance for exact marking tiers.
Specialty Training Post Adverts
4 extracted questions map to this section.
Supporting i
1 extracted question map to this section.
Self-Assessment
5 extracted questions map to this section.
Self-Assessment Questions
The Anaesthetics ST4 self-assessment consists of 10 scored questions. Each question has its own multi-tier marking scale (e.g., 0/2/4/6 points depending on your level of achievement). You must provide evidence for each question as a single PDF.
Point scales vary by question — see the official self-assessment guidance document above for exact marking tiers and evidence requirements.
GENERAL
4 questionsSUPPORTING_I
1 questionSelf-Assessment
5 questionsInterview Format
Shortlisted candidates will be invited to interview. Below is the expected interview structure for Anaesthetics ST4. Prepare for each station by reviewing the relevant areas of your portfolio and clinical experience.
Interview
Format: Selection process
Track the route interview flow and supporting evidence.
Required or Recommended Courses
Certain courses may be required or strongly recommended for Anaesthetics ST4 applicants. Check the validity period — expired certificates may not be accepted.
Evidence Packaging & Export
Understanding how to package and present your evidence is just as important as having the evidence itself. Poorly organised submissions can result in lost marks even when the underlying evidence is strong.
Export Mode
question pdf
Each scored question PDF requires its own file
File Size Limit
10 MB per file
Compress images and merge PDFs to stay under the limit
Title Page
Not required
Index Page
Not required
Ordering guidance: One PDF per scored question with title page, page index, and evidence in the strongest-first order.
Evidence Validation Checklist
Before submitting your application, check your evidence against these validation rules. Items marked as errors will block your submission; warnings indicate areas that may cost marks.
Map evidence to a route target
Evidence should be assigned to a section or question before export so the pack builder can assemble the right output.
Build one pack per scored question
This route has question-based scoring, so exports should be prepared at question level rather than one generic specialty bundle.
Check route-specific forms
The route requires supporting forms or certificates in addition to the core evidence uploads.
Evidence Guidelines
General guidance for evidence preparation and organisation for your Anaesthetics ST4 application.
- Keep uploads mapped to the route targets shown on this dashboard rather than storing undifferentiated files.
- This route appears to use a 10-question or question-banded evidence model in the captured 2026 guidance.
Frequently Asked Questions
What qualifications do I need for Anaesthetics ST4?
How competitive is Anaesthetics ST4?
What is the training pathway for Anaesthetics ST4?
When does Anaesthetics ST4 2026 recruitment open?
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