Training and development (neurosurgery)

This page provides useful information on the training and development for this specialty and also has tips for people at all stages of their career including medical school.

Specialty neurosurgery training

Training to become a neurosurgeon comprises specialty training (ST1-8) and takes eight years (although this can vary according to individual circumstances). Training for neurosurgery is a run-through training, so once you are accepted (at any level) you won’t have to apply again.

Most trainees who have completed a UK foundation programme start their specialty training for neurosurgery at ST1.

ST1-3 comprises the first year of core knowledge in the clinical neurosciences. This includes a six month attachment in neurosurgery and a six month attachment in acute neurology. ST2-3 includes one or more placements in complementary surgical disciplines to develop surgical skills and knowledge.

You must pass the MRCS exams before progressing to ST3.

By the end of ST3 trainees have completed a minimum of 12 months full-time training in neurosurgery. You also need to have passed the MRCS exams before progressing to ST3.

ST4-5 takes two years and comprises full-time training in general neurosurgery.

ST6-7 - advanced neurosurgical training - takes a further two years

ST8 – this last year of training includes special interest training in a neurosurgical subspecialty

Joining the training at different stages, from ST1-4

Applicants to:

  • ST1 training need 18 months’ or less experience in neurological specialties
  • ST2 will need at least 12 months’ experience in neurosurgical specialties, as well as experience of participation in national and international meetings relevant to neurosurgery
  • ST3 will need at least 24 months’ experience in neurosurgical related training and other relevant experience as above
  • ST4 will need at least 36 months’ experience in neurological training and other relevant experience as above.

The Oriel website has detailed information on entry requirements, including the person specifications for ST1-4 in neurosurgery.

During your ST1-8 training you will be employed as a specialty registrar. At the end of this training you can then apply for consultant posts. However, before you can do this you must pass the Intercollegiate Specialty Examination (FRCS (SN)). You also need a portfolio of experience which includes formal teaching, leadership, management, research and audit. Once you have passed this you will receive a Certificate of Completion of Training (CCT) and you will be eligible to be on the GMC Specialist Register.

Completion of other training courses such as Advanced Trauma Life Support (ATLS), Basic Surgical Skills and Care of the Critically Ill Surgical Patient (CCrISP) will also greatly enhance your application for specialist training.

Selection panels also look for evidence of academic and research achievements, such as degrees, prizes, awards, distinctions, publications and presentations. An understanding of research, audit and teaching is also important.  Entry is highly competitive so you will need achievements that are relevant to neurosurgery. Completion of an elective in neurosurgery will demonstrate your commitment to the selection panel.

The GMC provides information on the curriculum for neurosurgery training.

Academic neurosurgical training

If you are interested in research the academic pathway may be for you. Academic clinical fellows start at ST1-3 level and spend 25% of their time on research. During this time you can do some initial research with a view to taking time out of the programme to work towards a higher degree such as a PhD.

After completion of the higher degree you are qualified to apply for clinical lecturer posts where your time will be equally split between clinical and research work. If you continue your postdoctoral research you can apply for academic consultant posts.

The scheme in England is different to that in Scotland and Wales.

This information is correct at the time of writing. Full and accurate details of training pathways are available from medical royal colleges, local education and training boards (LETBs) or the GMC.

Getting in tips

It is important to develop your practical skills and interest in surgery as early as you can. This will also give you valuable experience to add to your CV.

The Oriel website has detailed information on entry requirements, including the person specifications for ST1-4 in neurosurgery.

BMJ Careers have given us kind permission to link to their article ‘A career in neurosurgery: selection, training and beyond’

    • make contact with neurosurgeons in your hospital - offer to help with research projects or audit
    • attend courses such as those offered by the Royal College of Surgeons and the Royal College of Surgeons of Edinburgh – topics include surgical skills, interview skills for core surgical training and career-planning
    • ensure your e-portfolio has plenty of surgery evidence and that this is kept properly up-to-date
    • try to gain teaching and management experience
    • continue to develop your practical and academic expertise
    • undertake a research project
    • Try to get some of your work published and present at national and international meetings
    • join or start a Journal Club (a group who meet to critically evaluate academic research)
    • join the British Neurosurgical Trainees’ Association
    • teach junior colleagues
    • take on any management opportunities you are offered
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