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RCSI
HST Trauma & Orthopaedic Surgery
Six-year RCSI higher specialty training programme (ST3-ST8) in trauma and orthopaedic surgery with 10-12 ST3 posts in 2026, the only Irish surgical specialty publishing its appointable range.
6 years (ST3-ST8)
Duration
Annual intake: 10-12 ST3 posts (2026 appointable range, published in the RCSI Specialty Training Intake Guide 2026 - Trauma & Orthopaedic Surgery Applicant Edition). The only surgical specialty with a published 2026 appointable range.
Competition: 2025 ST3 cycle (Specialty Progression Metrics 2017-2025, AD8706): 15 CST + 3 ESR applicants tracked; 9 CST + 1 ESR appointed. 2024 cycle: 14 CST + 1 ESR applied; 11 CST + 0 ESR appointed. CST applicant counts are drawn from the corresponding CST intake cohort.
Applications: Annual cycle per RCSI Specialty Training Intake Guide 2026 (T&O Applicant Edition): applications open October-November and close in November; academic paperwork deadline January; OSCE completion and academic scoring February; intake interviews week commencing Friday 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); T&O has its own dedicated applicant intake guide and ESR marking scheme.
Exams: MRCS required for ST3 eligibility (completed during CST). Fellowship (FRCS) exit exam of RCSI required to achieve CCST; RCSI's T&O pages do not name the FRCS (Tr & Orth) variant explicitly.
Higher specialty training in trauma and orthopaedic surgery in Ireland is a six-year RCSI programme (ST3-ST8) treating traumatic, developmental and degenerative musculoskeletal conditions and related bone and soft-tissue tumours. Progression is tracked through biannual assessments on the Intercollegiate Surgical Curriculum Programme, and the FRCS exit exam is required for the Certificate of Completion of Surgical Training. For 2026 the published appointable range is 10-12 ST3 posts.
Entry is at ST3 after Core Surgical Training (ST1-ST2) and the MRCS. T&O is the one surgical specialty with its own applicant intake guide: Pathway candidates are scored on a 1,000-mark progression score with a T&O-specific academic matrix, while ESR candidates are scored on a separate 100-point scale combining post-CST registrar posts, trainer reports, logbook and academic record (60 marks pre-interview) with a 40-mark interview. In the 2025 cycle ten of eighteen tracked applicants were appointed.
How selection is scored
Pre-interview shortlisting - CST scores (Pathway)max 600
Cumulative CAPA 1, 2, 3 scores (Trainer Assessment Reports + RCSI eLogbook) plus Operative Surgical Skills and Human Factors in Patient Safety OSCEs500
MRCS 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. Source: T&O Applicant Edition intake guide (T&OGui1 Rev 3).
Academic scoring (Pathway, T&O-specific matrix)max 25
Higher degree by thesis (PhD 15, MD 13, MCh 10, submitted with verification 8)15
Other higher degrees/awards (taught modular MCh or relevant Masters 10, Higher Diploma 7, Diploma 5, Certificate 3)10
Publications (peer-reviewed papers 3-10; invited review 4; book chapters 4 each max 4; case reports 2 each max 4)15
Presentations at scientific/clinical meetings (international/national, 2 each)10
Prizes for research (international 5, national 3)5
RCSI/other approved education5
The guide caps items 1-5 at 20 marks with an additional 5 marks for approved education (scorecard shows a 25-mark research and academic maximum); the guide's high-level Pathway diagram allocates 40 marks to the academic component within the 1,000-mark progression score. Additional academic credit can be given at interview Station 2.
Specialty interviewmax 360
Station 1 - Quality and safety in surgical healthcare80
Station 2 - Commitment to academic advancement and lifelong learning (40 marks Pathway; 80 marks ESR)40
Station 3 - Knowledge of current issues relevant to surgical practice80
Station 4 - Decision making in surgery80
Station 5 - Professionalism and probity in surgical practice80
Interview total is 360 marks for Pathway candidates and 400 marks for ESR candidates (Station 2 doubled). Each station scored out of 100 and pro-rated; 60% interview minimum for appointment.
Equivalent Standards Route (T&O-specific pre-interview matrix)max 100
Core/Basic Surgical Training record (eligibility gate: completed CST or equivalent + MRCS; carries 0 marks)0
Post-CST workplace performance - full-time clinical registrar posts in approved orthopaedic training units (7 x 3)21
Post-CST Trainer Assessment Reports (5 x 3, one per 6-month post, different trainer each)15
Post-CST electronic logbook (3 per 6-month rotation, x 3)9
Academic development and performance (thesis max 20: PhD 15/MD 12/MCh 10; publications max 15; oral presentations max 10; courses 0.5 per day max 7.5; merits/awards max 2.5 - capped at 55)55
T&O ESR scores are recalculated out of 60 pre-interview (minimum 10 in the post-CST section to be shortlisted); the interview is then marked out of 40, giving a final panelling score out of 100.
Facts last verified 2026-07-27. Scheme details change year to year; always confirm against RCSI's current documentation.