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RCSI
HST Cardiothoracic Surgery
Six-year RCSI higher specialty training programme (ST3-ST8) in cardiothoracic surgery, entered after Core Surgical Training and the MRCS.
6 years (ST3-ST8)
Duration
Competition: 2025 ST3 cycle (Specialty Progression Metrics 2017-2025, AD8706): 3 CST + 1 ESR applicants tracked; 2 CST appointed, 0 ESR. Across all surgical specialties in 2025, 42 of 59 (71%) CST applicants and 9 of 24 (37.5%) ESR applicants were appointed. CST applicant counts are drawn from the 2023 CST intake cohort.
Applications: Annual cycle per RCSI Specialty Training Intake Guide 2026: applications open October-November and close in November; academic paperwork deadline January; OSCE completion and academic scoring February; interviews March (2026 intake: week commencing 13 March 2026); posts allocated March-April for a July start. Applications for the July 2026 intake are closed.
Entry: After Core Surgical Training (ST1-ST2) + MRCS, via direct Pathway progression from CST2 or the Equivalent Standards Route (ESR) for candidates with CST-equivalent training completed in Ireland or abroad.
Exams: MRCS required for ST3 eligibility (completed during CST; results issued in March before interviews). Fellowship (FRCS) exit exam of RCSI required to achieve CCST; RCSI does not name a specialty-specific FRCS variant on its cardiothoracic pages.
Higher specialty training in cardiothoracic surgery in Ireland is a six-year RCSI programme running from ST3 to ST8. Trainees rotate through six approved public cardiothoracic units, with mandatory minimums of three years in adult cardiac surgery, six months in thoracic surgery and six months in paediatric cardiothoracic surgery. Progression is assessed through biannual CAPA reviews, and the RCSI Fellowship (FRCS) exam must be passed to receive the Certificate of Completion of Surgical Training (CCST).
Entry is at ST3 after Core Surgical Training (ST1-ST2) and the MRCS, either by direct progression from CST2 or through the Equivalent Standards Route for equivalent training completed elsewhere. Selection uses a 1,000-mark progression score; cardiothoracic surgery does not apply the pre-interview academic scoring used by other specialties, and its academic interview station is weighted at 80 rather than 40 marks. In the 2025 cycle, two of the four applicants recorded in RCSI's progression metrics were appointed.
How selection is scored
Pre-interview shortlisting - CST scoresmax 600
Cumulative CAPA 1, 2, 3 scores (Trainer Assessment Reports + RCSI eLogbook) plus Operative Surgical Skills and Human Factors in Patient Safety OSCEs500
MRCS Part B score is added under a published weighting formula ((% above the 60% cut-off) x 4; weighting varies by exam sitting) to give the 600-mark CST total. Shortlisting carries a 60% minimum. Cardiothoracic Surgery does not apply the separate 40-mark pre-interview academic scoring (Specialty Training Intake Guide 2026, s3.1).
Specialty interviewmax 400
Station 1 - Quality and safety in surgical healthcare80
Station 2 - Commitment to academic advancement and lifelong learning (worth 80 marks for Cardiothoracic Surgery, vs 40 for other specialties)80
Station 3 - Knowledge of current issues relevant to surgical practice80
Station 4 - Decision making in surgery80
Station 5 - Professionalism and probity in surgical practice80
Each station is scored out of 100 by 2-3 panel members and pro-rated; a minimum of 60% of the interview total is required for appointment. Final progression score is out of 1000.
Equivalent Standards Route (ESR) variantmax 1000
CST or recognised equivalent record (logbook, MRCS, TARs, OSCEs)500
Out-of-programme experience (eLogbook 30 + Trainer Assessment Reports 35)65
Interview (same five stations)360
Applies to ESR candidates instead of the Pathway split; per the generic guide Cardiothoracic Surgery does not apply academic scoring.
Where you train
Six approved public cardiothoracic units: Mater Misericordiae University Hospital, St James's Hospital, St Vincent's University Hospital (thoracic), Cork University Hospital, University Hospital Galway, and Children's Health Ireland at Crumlin (paediatric cardiothoracic only). Mandatory minimums: 3 years adult cardiac, 6 months thoracic, 6 months paediatric cardiothoracic.
Where this leads
CCST confers eligibility for registration with the Irish Medical Council. RCSI states graduates typically take consultant cardiothoracic surgeon posts, with sub-specialisation available in adult cardiac, thoracic, transplantation or congenital cardiothoracic surgery.
Facts last verified 2026-07-27. Scheme details change year to year; always confirm against RCSI's current documentation.