Thoracic Surgery ST4 — 2026 Application Guide
Complete guide to applying for Thoracic Surgery 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 Core Surgical Training.
Oriel route name: Thoracic Surgery ST4 · Route family: surgery
Interview preparation guide for Thoracic Surgery ST4 →Medically reviewed by MedNext Clinical Team. Last reviewed 27 April 2026. See our editorial policy and correction policy.
About Thoracic Surgery ST4
Thoracic Surgery ST4 is a surgery 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: Wessex Deanery
View original documentPublished by: Specialty Applications
View original documentPublished by: Specialty Applications
View original documentPublished by: Specialty Applications
View original documentKey Dates & Deadlines
Important dates for the Thoracic Surgery 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 Thoracic Surgery 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 core surgical competences, including the relevant competencies in Cardiothoracic Surgery as described in the Core Surgical Training curriculum, at the time of application via one of the following methods: Successful completion of a UK Core Surgical Training programme, evidenced by a satisfactory ARCP outcome. This must be submitted with your application; **or** A completed Alternative Certificate of Eligibility to Enter Higher Surgical Training*.* This must be submitted with your application.
Evidence hint: Upload the named certificate or supporting form.
You must have completed the following by the time of application: At least 12 months’ experience (whole time equivalent) in general thoracic surgery of which a minimum of 6 months must have been spent at ST3 level. 12 months experience (whole time equivalent) in cardiac surgery of which a minimum of 6 months must have been spent at ST3 level.
You must have successful completion of Membership of the Royal College of Surgeons (MRCS) at the time of application.
Evidence hint: Membership exam pass evidence or certificate.
Entry Criteria — Person Specification
The following entry criteria are extracted from the official 2026 person specification for Thoracic Surgery 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 AND EXPERIENCE FOR ST4 entry
- You must have evidence of achievement of core surgical competences, including the relevant competencies in Cardiothoracic Surgery as described in the Core Surgical Training curriculum, at the time of application via one of the following methods:
- Successful completion of a UK Core Surgical Training programme, evidenced by a satisfactory ARCP outcome. This must be submitted with your application; or
- A completed Alternative Certificate of Eligibility to Enter Higher Surgical Training. This must be submitted with your application.
- You must have completed the ST3 level (Completion of Phase 1) competencies in cardiothoracic surgery with a minimum of 12 months on an ST3+ on-call rota by the advertised post start date for the vacancy.
- You must have completed the following by the time of application:
- At least 12 months’ experience (whole time equivalent) in general thoracic surgery of which a minimum of 6 months must have been spent at ST3 level.
- 12 months experience (whole time equivalent) in cardiac surgery of which a minimum of 6 months must have been spent at ST3 level.
- 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 successful completion of Membership of the Royal College of Surgeons (MRCS) at the time of application.
- You must not have been accepted to sit, or have sat the Part III (exit) exam in Cardiothoracic Surgery.
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
- Ability to apply sound clinical knowledge and judgement to problems.
- Ability to prioritise clinical need.
- Demonstrates appropriate technical and clinical competence and evidence of the development of diagnostic skills and clinical judgement.
- Validated logbook documentation particularly relevant to thoracic surgical exposure to date.
Specialty: Research, Audit and Quality Improvement
- Understanding of basic research principles, methodology and ethics, with a potential to contribute to research.
Specialty: Communication skills
- Able to discuss treatment options with patients in a way they can understand.
Specialty: Organisation and planning
- Understands importance and impact of information systems.
Specialty: Coping with pressure and managing uncertainty
- Awareness of own limitations and when to ask for help.
Specialty: Commitment to Specialty – Learning & Personal Development
- Demonstrated interest in thoracic surgery as evidenced by logbook, audit, research and electives.
- Career progression in Cardiothoracic Surgery should be appropriate to the time spent in the specialty.
- Shows realistic insight into Cardiothoracic Surgery and the personal demands of a commitment to surgery.
- Demonstrates knowledge of training programme and commitment to own development,
- Shows critical and enquiring approach to knowledge acquisition, commitment to self- directed learning and a reflective/analytical approach to practice
Specialty: Qualifications
Essential
Desirable
- Other undergraduate degree: i.e. BA, B Eng, LIB, BMedSci (not including intercalated BSc or ‘Honorary’ MA).
- Masters degree: i.e. MSc., MPhil.
- Higher research degree: i.e. MD (UK), MS or MCh. (UK).
- PhD, D.Phil.
Specialty: Clinical skills – clinical knowledge and expertise
Essential
Desirable
- Exposure to cardiothoracic transplant, paediatric cardiothoracic surgery, intensive care, respiratory medicine and oncology, (interventional) radiology.
Specialty: Research, audit and quality improvement skills
Essential
Desirable
- Evidence of relevant academic and research achievements, e.g. degrees, prizes, awards, distinctions, publications, presentations, other achievements in thoracic surgery.
- Evidence of participation in risk management and/or clinical/laboratory research in thoracic surgery.
- Evidence of thoracic surgical audits, quality improvement programs or research.
Specialty: Commitment to specialty – learning and personal development
Essential
Desirable
- Achievements relevant to thoracic surgery, including elective or other experience.
- Attendance at relevant thoracic surgical courses.
- Attendance at, or participation in, national, international, departmental, regional and online meetings relevant to Cardiothoracic Surgery with special emphasis on thoracic themed presentations (Poster/Oral).
Self-Assessment & Scoring
Thoracic Surgery 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.
Official scoring document with exact point scales, marking criteria, and evidence requirements for each question.
Scoring Sections
The self-assessment is structured across 2 sections with 5 scored questions. Each question has variable points — refer to the official self-assessment guidance for exact marking tiers.
Interview
2 extracted questions map to this section.
Consultants / specialists can only sign this form if you have worked
3 extracted questions map to this section.
Self-Assessment Questions
The Thoracic Surgery ST4 self-assessment consists of 5 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.
INTERVIEW
2 questionsGENERAL
3 questionsInterview Format
Shortlisted candidates will be invited to interview. Below is the expected interview structure for Thoracic Surgery ST4. Prepare for each station by reviewing the relevant areas of your portfolio and clinical experience.
Panel interview
Format: Selection panel
Portfolio, commitment, and clinical readiness discussion.
Required or Recommended Courses
Certain courses may be required or strongly recommended for Thoracic Surgery 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 Thoracic Surgery ST4 application.
- Keep uploads mapped to the route targets shown on this dashboard rather than storing undifferentiated files.
- This route appears to use a 5-question or question-banded evidence model in the captured 2026 guidance.
- referenced by verified 2026 ST4 criteria
- carry-over form
Frequently Asked Questions
What qualifications do I need for Thoracic Surgery ST4?
How competitive is Thoracic Surgery ST4?
What is the training pathway for Thoracic Surgery ST4?
When does Thoracic Surgery ST4 2026 recruitment open?
Related Specialties
Compare adjacent specialties that share a recruitment family, training pathway, or portfolio structure.
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