It is a requirement for all ST3 applicants to have achieved the competences equivalent to that of a trainee who has completed UK core medical training.

These are divided into two categories, in line with the two levels of training in the UK between primary medical training (ie medical school) and higher specialty training (ie ST3):  foundation and core competences.

Foundation competences

For recruitment purposes, it is not necessary to demonstrate your achievement of foundation competences. If you can demonstrate achievement of core competences, it will be taken you have also gained the necessary foundation competences.

Core competences

The way in which this is demonstrated varies depending on the previous training of the candidate. There are five main categories of candidates and a section explaining what this means and how core competence can be demonstrated:
  • Current CT2 - candidates currently on the second year of a UK core medical training or ACCS acute medicine programme, or a JRCPTB internationally level 3 accredited equivalent of core medical training

  • Completed CT2 - candidates who have a completed a UK core medical training or ACCS acute medicine training programme, or a JRCPTB internationally level 3 accredited equivalent of core medical training

  • Non-physicianly training - candidates applying to ST3 from 'non-physicianly' training routes

  • Alternative - candidates who do not fit into one of the above categories

  • Refugee doctors - candidates with exceptional circumstances that prevent them supplying the standard evidence; in most cases this will because they are a refugee but could include other candidates if they have very exceptional circumstances.

Providing evidence

All candidates except those on a pre-ST3 UK medical training programme, or who have exceptional circumstances, will be required to upload evidence of their core competences with their application. The 'Providing evidence' section of this page has guidance on how this is done on the Oriel system .


How do I demonstrate core competence?

You can refer to the flowchart below if you are unsure which competence route applies to you. This will then direct you to the appropriate tab of this section of the website.

How to demonstrate competence flowchart

Candidates who are currently in pre-ST3 UK medical training

Core medical training (CMT)

Candidates currently in the second year of a GMC-approved, two-year UK CMT programme will not need to provide evidence of achievement of core competence at time of application.

You must be able to demonstrate that you are on track to complete the programme and gain all core competences by time of the advertised post commencing from date.

On your application: give details of your current training status.

At interview: provide evidence of achievement of progression through CT1; a satisfactory CT1-level ARCP.

Acute care common stem: acute medicine (ACCS-AM)

If you are in the third year of an ACCS-acute medicine programme, you must show that your training progress to date has been satisfactory; and also that you are on track to gain all core competences by the advertised post commencing from date.

On your application: give details of your current training status.

At interview: provide evidence of your training progress to date; a satisfactory CT2-level ARCP.

Stand-alone posts

Undertaking CMT/ACCS as stand-alone posts - ie appointment directly to a CT2 post without having completed CT1 - does not affect how competences are assessed. Provided that you are in your final year of training and due to complete before the advertised post commencing from date, your application will be able to proceed.

In the event your current training status comes under this heading, the guidance given above applies here also. That is:

On your application: give details of your current training status.

At interview: provide evidence of your training progress to date.

JRCPTB internationally level 3 accredited training

The JRCPTB accredits training outside the UK as meeting the standards set by the Federation of the Royal Colleges of Physicians of the United Kingdown. Where a programme has been given level 3 accreditation as equivalent to core medical training, this will be accepted as a direct alternative to UK training.

If you are training in one of these programmes, you will be eligible to apply provided that you can show that your training progress to date has been satisfactory and that you are on track to gain all core competences by the advertised post commencing from date.

In 2018 recruitment this can only include those training in Iceland.

On your application: as the application form has been designed for UK trainees, you will need to answer no to all the competence questions until a text box asks you to explain why you are unable to supply standard documentation. You can then explain your circumstances so the recruitment team know you are entering via your internationally accredited training; you will not need to supply any documentation until interview.

At interviewprovide evidence of your training progress to date; a satisfactory CT1-level ARCP.

Candidates who have already completed pre-ST3 UK medical training

If by time of application you have already completed a core medical training or ACCS acute medicine programme, you can use this to demonstrate core competence. 

In recent years the 'Alternative Certificate of Core Competence' was required unless this had been completed within a certain time limit, however, this time limit does not apply in 2018 recruitment.

Please note that this only applies to those completing a GMC approved core medical training programme; those completing medical specialty training prior to the advent of core medical training will need to complete the 'Alternative Certificate of Core Competence' (go to the 'Alternative' tab above). 

On your application: give details of the training programme, attach the electronic version of your ARCP confirming completion.

At interview: provide original version of above documentation.

Not yet completed the MRCP(UK)

If you have not yet gained the full MRCP(UK) diploma, but otherwise you have successfully completed CMT or ACC acute medicine you can still apply.

On your applicationwhen asked 'have you already achieved full CMT or ACCS competence...', answer 'Yes'; then complete the remaining fields as relevant, give details of the training programme, and attach the electronic version of evidence of completion of training (ie your ARCP).

Record information on your MRCP(UK) status under the relevant section of the form.

At interviewprovide original version of above documentation.

JRCPTB internationally level 3 accredited training

The JRCPTB accredits training outside the UK as meeting the standards set by the Federation of the Royal Colleges of Physicians of the United Kingdown. Where a programme has been given level 3 accreditation as equivalent to core medical training, this will be accepted as a direct alternative to UK training.

If you have completed training in one of these programmes, you will be eligible to apply and will demonstrate this by attaching your ARCP documentation to your application in exactly the same way as detailed above for UK trainees.

Alternative certificate of core competence

If you have not completed, or will not complete, a pre-ST3 UK training programme which is valid for the specialty to which you are applying, you will need to take alternative steps to demonstrate your achievement of core competence.

Alternative Certificate of Core Competence

The 'Alternative Certificate of Core Competence' provides a list of the core competences you are required to have gained prior to entering ST3 training; the form should be completed and uploaded to Oriel with your application form.

A 2018 version of the form is downloadable from the document library; however, please note that if you applied in previous years, the 2016 and 2017 versions of the form are also acceptable, provided that they meet the required criteria.

The document itself gives some advice on its use and completion, but we have also added some further guidance below:

Completed by supervisor

You must have it completed by either:

  • a consultant in a physicianly specialty (a full list can be found on the JRCPTB website ) or

  • a consultant in an alternative specialty, eg emergency medicine or intensive care medicine, who holds the MRCP(UK) diploma, or is a fellow of one of the three royal colleges of physicians of the United Kingdom

You must have worked with them:

  • in a medical specialty, emergency medicine or intensive care medicine post

  • for a minimum continuous period of three months since 1 Januaray 2015.

Notes about the certificate

Below are some notes answering common questions about the criteria for completing the certificate:

  • The three months is whole-time equivalent and could be spread out over a period much longer than this; for example, if you are doing research but have been undertaking clinics during this time to maintain you clinical skills, the three months may be spread over the three year period.

  • You do not need to have practised all competences within the three year period but whoever is signing the form needs to be satisfied that there is no reason why these competences are in doubt and that they believe you are sufficiently core medical competent to progress to ST3. Examples of how supervisors can satisfy themselves of your competence include:

    • first hand knowledge via supervision of you

    • discussion with previous clinical supervisors
    • (for those maintaining one) viewing your ePortfolio.
  • It is permissible for a supervisor to sign off competences which they have not personally witnessed, provided they have satisfactory assurance that a competence has been gained.

  • Alternatively if one supervisor is unable to sign off all competences, you can ask multiple supervisors to complete multiple forms. Please note that each supervisor giving evidence of your achievement of competence must complete their own separate alternative certificate.

    Please note: If more than one form is required to demonstrate a complete set of core competences, the version of the form must be the same for comparable purposes. 

Candidates previously undertaking CMT/ACCS-AM

If you have previously undertaken a CMT or ACCS-AM programme and did not have one or more competences signed off on your ePortfolio, it is not permissible for this competence to be signed off on your alternative certificate on the basis of being acquired during the programme.

Instead your supervisor will need to be satisfied that any competences which are not recorded as complete in the ePortfolio have been achieved and demonstrated subsequent to leaving the CMT programme.

Submitting the alternative certificate

On your application attach an electronic copy of your certificate(s) to your Oriel account at time of application.

At interview: provide the original, 'hard' copy of the certificate(s)

Palliative medicine alternative certificate

The competences required for entry to ST3 palliative medicine are slightly different to those required of the other specialties, so a modified alternative certificate is available for candidates to this specialty.

This should be completed in exactly the same fashion as the standard alternative certificate, and can be downloaded from the document library.

Please note - there is no requirement for the clinician completing the certificate to be related to the specialty of palliative medicine. The only difference is that some of the competences from the standard form have been removed, reflecting the different requirements of the specialty.

Candidates applying to ST3 from 'non-physicianly' training routes

In addition to applicants whose experience to date has been in 'physicianly' medicine programmes (eg CMT), several specialties participating in the recruitment process also allow applications from trainees of other specialties.

These specialties are: audiovestibular medicine, clinical genetics, clinical neurophysiology, clinical pharmacology and therapeutics, dermatology, haematology, immunology, palliative medicine, rehabilitation medicine and sport & exercise medicine.

For these specialties the competence requirements can vary slightly depending on the training backgrounds they seek. You are advised to review the relevant person specifications as their competence requirements are outlined within.

Demonstrating competence

Regardless of the specialty in which you have trained, unless you are a current UK trainee on track to gain all required competences, you will need to attach evidence to your application form.

Each specialty has differing ways in which you can demonstrate competence. Some still require you to demonstrate core medical competences, whilst others accept competences from a different training programme. Information on demonstrating core medical competence via the alternative certificate of core competence can be found in the 'Alternative' tab above.

If you are applying to a specialty which accepts core competence from another specialty and you have trained outside of a UK training programme in that specialty, the way in which you can demonstrate competence differs depending on the specialty of your training and you should check the relevant person specification.

Level 1 paediatric competence

If you are a trainee from a paediatric background, the specialty has an alternative certificate of competence to demonstrate competence to 'Level 1' of the paediatric curriculum. Information about this and the form can be found on the Royal College of Paediatrics and Child Health website.

In most cases applications made without evidence of core competence, other than those currently in pre-ST3 UK training, will not be eligible and their application will be rejected.

However, it is recognised some doctors have exceptional circumstances, such as refugees, and may not be able to provide an alternative certificate at time of application. 

Applicants in this position will have the opportunity on the application form to explain their circumstances and, subject to approval, may be given more time to submit a certificate. Although candidates with exceptional circumstances can be initially considered without an alternative certificate, this will be required before being able to take up any offer of a programme.

Candidates who think they may have exceptional circumstances should contact their local postgraduate region for further advice - please refer to the region contacts page of this website. Where possible, regions will be able to provide assistance for bona fide refugee doctors in obtaining an alternative certificate of competence.

Unless you are a current pre-ST3 UK trainee, or have exceptional circumstances, you will be required to upload/attach evidence of your achievement of core competences (where applicable) to your application form. 

Deferring post start date

The start of training may only be deferred on statutory grounds (eg maternity leave, ill health). Please see the Gold Guide for further information.

This includes a period of illness or maternity leave taken during core training prior to making an application. Where applicants are unable to achieve competence on time, they may still apply whilst they complete the time/competences missed. Extended training will need to be organised in the current post to cover the time that was missed. 

Under these circumstances you would not need to submit evidence of core competence at time of application.

Upon receiving an offer, you should contact the region managing your application to ensure they are aware of your desire to defer your start date and ensure this will be permissible. The final decision on whether a start date can be deferred is at the discretion of the region.

Evidence must be uploaded where necessary

If you are required to supply evidence but submit your application without it, it is likely that your application will be rejected as ineligible. Therefore, please ensure you have this ready to attach to your application prior to submission.

If your status requires evidence to be supplied at time of application, the application form prompts you into attaching this and will not let you submit without. It is not permissible to claim you have exceptional circumstances and submit without evidence unless your circumstances warrant this.

Uploading/attaching documentation

Where required to provide evidence with your application, an electronic version must be uploaded to your Oriel 'dashboard' before submission. 

To attach a document, log into Oriel, click 'dashboard', and then click on the 'document upload' tab once there. Click the 'Add' icon to upload a new document.

On the next page choose an appropriate category (either 'ARCP/RITA' or 'Alternative Certificate of Core Competence', depending on which category applies to you). Please ensure you select the correct category, only categories which match the options you choose in the form can be attached to your application. 

The maximum size of an upload is 10MB. However, if the document you wish to upload is bigger than 10MB, you can divide and upload this as multiple files.

Once you reach the end of the application you will be prompted to confirm the documents you wish to attach to your application.

In the event you encounter any difficulties with uploading or obtaining a document - please notify the region managing your application as soon as possible to find out your options.