Core Surgical Training can be rewarding, intense and occasionally chaotic. You are trying to become more technically confident while still handling ward jobs, referrals, on calls, clinics, teaching and portfolio evidence. The trainees who thrive are not always the ones who arrive knowing the most. They are usually the ones who organise themselves early and stay deliberate about how they use the two years.
What CST is trying to do
Core Surgical Training usually has an indicative duration of 24 months and is designed to give broad early surgical training before progression to higher specialty training for most pathways. That means the goal is not just surviving service provision. The goal is to build a strong general surgical foundation while steadily moving towards the specialty you may eventually want.
Arrive with a plan, not just ambition
A common early mistake is assuming training opportunities will automatically appear. Some do. Many do not. Surgical training rewards trainees who are proactive in a professional way.
During your first few weeks, work out:
- who your clinical and educational supervisors are
- what the local rota really looks like
- how clinic attendance is protected
- how to log operative cases
- how workplace based assessments are actually done in the department
- what regular teaching exists
- which consultants are keen teachers
- where your likely portfolio gaps will be
You do not need to solve your whole training future in week one, but you do need a working map.
Theatre matters, but service still matters
Most CSTs want more theatre time. That makes sense. It is a surgical training programme. But consultants and registrars are much more willing to teach trainees who are reliable in the ordinary parts of the job.
That means:
- know your patients
- keep ward work organised
- follow up plans
- hand over properly
- answer pages promptly
- be someone the team can trust
Being dependable on the ward often creates the goodwill that leads to better teaching opportunities in theatre.
How to get more from theatre
Theatre time is only truly useful if you prepare for it.
A much better way to approach a case is:
- know the patient
- know the indication
- read the operation steps the night before
- revise the anatomy
- know what instrument or exposure issues commonly arise
- decide what you want to practise in that case
Even if you only get a small technical opportunity, that preparation changes how much you learn.
After the case, log it promptly while the details are fresh. If feedback is available, capture it early rather than telling yourself you will do it later.
Use your logbook and portfolio continuously
Do not leave case logging and assessments until the end of a rotation. That is how good experiences get lost and weak evidence accumulates.
A sustainable rhythm is:
- log cases weekly
- request assessments close to the event
- review your portfolio every two to four weeks
- identify gaps before they become stressful
ISCP and surgical training evidence become much easier to manage when they are part of your routine rather than a rescue operation before ARCP.
Learn to ask for training opportunities well
Asking for opportunities is part of CST, but the way you ask matters.
Better: "I've read up on this case and I'd like to practise the incision and closure if appropriate."
Less helpful: "Can I do more today?"
Specific, prepared requests are easier to support than vague ones.
Clinics matter more than some trainees realise
It is easy to treat clinic as secondary to theatre. That is a mistake. Clinic teaches:
- surgical decision making
- risk discussion
- consent conversations
- follow up planning
- management of uncertainty
- how to decide who does and does not need an operation
Those are core surgical skills. Attend clinics properly, not just physically.
Examinations and courses: pace yourself
If MRCS is on your horizon, do not wait until the last moment to look at the syllabus. Even if your main focus is settling into the job, a low intensity early start helps a lot.
That might mean:
- regular anatomy revision
- question practice a few times a week
- building a reading habit around common surgical principles
- practising communication and examination for the clinical part later on
A steady approach is usually more sustainable than trying to revise during a particularly brutal run of on calls.
Build a reputation for being teachable
Being teachable is not the same as being passive. It means:
- taking feedback without defensiveness
- coming prepared
- trying again after correction
- reflecting honestly on what went badly
- showing that feedback changes your practice
Surgery often involves direct, immediate feedback. The more constructively you handle it, the more people invest in you.
Protect your time where you can
CST can become fragmented very quickly. If you do not protect any time for training, revision and recovery, the service work expands to fill everything.
Try to keep some regular structure for:
- weekly admin and portfolio review
- MRCS revision
- exercise or recovery
- meal prep or life admin
- a small amount of rest that is actually restful
It sounds basic, but it makes a big difference.
Things worth doing early
Helpful early habits include:
- learning common post-op issues well
- becoming confident with ward referrals and escalation
- understanding perioperative basics
- keeping short notes on operations you see repeatedly
- building an anatomy revision system
- asking registrars what they wish they had started sooner
Final thoughts
Core Surgical Training is not just about collecting cases. It is about learning how surgeons think, communicate, prioritise and operate. The trainees who make the most of CST tend to be organised, prepared and easy to teach. They show up, read before cases, keep their portfolio live and take feedback seriously.
If you do those things consistently, you give yourself the best chance of leaving CST with more than just a long rota history. You leave with genuine progress.
Study with Medinova
For CST doctors, Medinova works well as a structured study companion around the job. The Notebook is useful for quickly revising anatomy, surgical topics and perioperative principles around cases you have seen. The Question bank and Flashcards help keep MRCS style revision moving even during busy rota periods.
The Virtual study buddy is especially useful if you want timed practice in structured explanations, examination flow, interpretation tasks and CST interview style reasoning. Used consistently, Medinova can help you keep training momentum going even when service pressures are high.