Specialty training at Level 1 - application guidance

Most doctors enter paediatric training at Level 1, predominantly starting their posts at ST1 (in August or September). This is known as 'National Round 1'.

Applications closed as of 16:00, 1 December 2020. For reference, you can find information on recruitment below, including the 2021 applicant guide and person specification.
Last modified
21 January 2021

Update - 11 January 2021 Following our meeting with Health Education England on 8 January, we intend to continue with 'Plan A' (described on this page) as the preferred option for recruitment, which includes virtual interviewing. We will continue to keep this under review working closely with our colleagues at HEE and keeping the four Statutory Educational Bodies appraised. Our Officer for Recruitment and Trainee Representative for Recruitment explain more in this letter.

National recruitment processes for 2021

The format of recruitment for all specialties for 2021 was discussed and agreed by the Medical & Dental Recruitment and Selection Group (MDRS). Under normal circumstances, recruitment would be interview-based for National Round 1, taking place at six regional centres. However there is a general rule in place for this year that no face-to-face interviews will be taking place for any specialties, so an adapted process has been put together, that will allow us to focus on the areas that we feel are most important for recruiting into paediatrics.

A set of general principles were introduced by MDRS that all medical specialties will be adhering to for the upcoming rounds of recruitment:

  • No face-to-face interviews
  • Single panel virtual interviews only
  • Clear Plan A and Plan B for every specialty laid out to applicants in advance of applications
  • Plan B is the ‘no interview’ scenario, in case of circumstances that mean it is not even possible to run interviews virtually
  • A need for specialties to explore the use of more alternative assessment methods where appropriate (eg MSRA, self-assessment) in order to ensure robust delivery and assessment

Recruitment will therefore go ahead using the plan A set out by each specialty.

A decision will be made on a specialty by specialty basis as to whether there is a need to move to plan B during the recruitment process. This might be due to a lack of available consultants to undertake interviews as a result of service pressures instigated by COVID-19, depletion of operational staff, etc. If the decision is made to move to plan B, it will be communicated to applicants as soon as possible. Accordingly, plan B has been designed to have minimal impact on applicants and still allow for a process that allows applicants to demonstrate as wide a range of relevant attributes and skills as possible.

Paediatric recruitment - Plan A

Plan A will come into effect immediately, and has three elements:

  1. Multi Specialty Recruitment Assessment (MSRA): to cover Governance, Clinical reasoning, Communications
  2. Application form (white-space questions): to cover Past achievements, Clinical experience, Career motivation, Transferable Skills, Reflection
  3. 25-minute virtual interview with two assessors: to cover Communications, Career motivation, Reflective practice

The overall scores for each part will be weighted to get an overall recruitment score out of 100%, as follows:

  • MSRA – 20%
  • Application form – 30%
  • Interview – 50%

The MSRA is a computer-based assessment, currently used by a number of specialties for entry into postgraduate medical training: General Practice, Psychiatry, Radiology, Ophthalmology, Obstetrics and Gynaecology, Community and Sexual Reproductive Health and Neurosurgery. Each specialty contributes to the development of new content annually; therefore, content is varied across and does include some paediatric-based questions.

The MSRA is in two parts: a Professional Dilemmas (PD) paper, and a Clinical Problem Solving (CPS) paper. Both parts are blueprinted to a foundation level of competence, and is therefore relevant for doctors applying to any medical specialty, at CT1/ST1

As this will be the first time that the MSRA has been used for paediatric recruitment, please refer to the following links for further information:

You can also access:

Paediatric recruitment - Plan B

Plan B will consist of two elements:

  1. Multi Specialty Recruitment Assessment (MSRA): to cover Governance, Clinical reasoning, Communications
  2. Application form (white-space questions): to cover Past achievements, Clinical experience, Career motivation, Transferable Skills, Reflection

The overall scores for each part will be weighted to get an overall recruitment score out of 100%, as follows:

  • MSRA – 40%
  • Application form – 60%

The full paediatric timelines for National Round 1 are laid out below and should remain the same for each element of the process, regardless of which plan is being followed. Any changes will be communicated to applicants as soon as possible.

For further details of each part of the recruitment process, see

National round 1 paediatric recruitment timelines for 2021

Timelines for Paediatric National Recruitment for level 1 entry posts, starting in August/September 2021 can now be confirmed as follows.

Advert appears Monday 2 November 2020
Application window opens Thursday 5 November 2020, 10:00
Application window closes Tuesday 1 December 2020, 16:00
Application scoring window opens (shortlisting) Thursday 17 December 2020
MSRA invitations sent out Tuesday 5 January 2021
Applicant preferencing window opens Monday 11 January 2021
Application scoring window closes (shortlisting) Thursday 14 January 2021
MSRA window opens Thursday 28 January 2021
Invites to interview & applicant declarations sent Monday 1 February 2021
Deadline for interview booking and applicant declaration return Thursday 4 February, 16:00
MSRA window closes Friday 12 February 2021
Interview window opens Monday 15 February 2021
MSRA results From Friday 26 February 2021
Interview window closes Wednesday 31 March 2021
Applicant preferencing window closes Sunday 11 April 2021
Initial offers released Monday 12 April 2021
Hold deadline Wednesday 28 April, 13:00
Upgrade deadline Friday 30 April, 16:00

Due to the COVID-19 pandemic, there were considerable delays in confirming recruitment processes for all specialties. The HEE website also has general information on the impact of COVID-19 on national recruitment.

You can also see the full guide:

Interview days for 2021

Interviews will take place virtually. They will be managed by the local teams who will send details of how to book and attend your interview.

Lead centre Interview days
Thames Valley 22, 23, 24, 25 March
West Midlands 22, 23, 24, 25 February
North East 3, 4 March
Scotland 8, 9, 10, 11 March
Northern Ireland 22, 23 March

About recruitment

We at RCPCH have an ongoing commitment to continue to improve the national recruitment process for paediatrics and ensure applicants have as much flexibility as possible.

One vacancy for Level 1 entry

All trainees now enter UK training programmes at ST1. There is no longer a separate vacancy for ST2 entry. ST2 entry was previously limited to only a few regions and limited to applicants with more paediatric experience.

No requirement for prior paediatric experience

Due to the very varied opportunity for gaining paediatric experience at Medical and Foundation School, there is no requirement for applicants to have any direct paediatric experience before applying to ST1.

The main thing we are looking for at interview is clear evidence of understanding of paediatrics and the aptitude and motivation for a career in our specialty.

Fast track options

Equally, those who have been able to spend a bit longer working in paediatrics, outside the UK Foundation programme (or equivalent), are able to evidence this at application and have the opportunity to be fast-tracked through Level 1 training. As there is no separate ST2 entry, applicants can provide evidence of at least 12 months experience in paediatric posts, outside the UK Foundation programme (or equivalent) and have the opportunity to declare this on their application form.

Employing deaneries will be informed of all new trainees who have evidenced 12 months minimum prior experience on their application and potential fast track progression will be discussed your educational supervisor when you start your post. 

To be eligible for early fast tracking to ST2 level for posts in Scotland, applicants should be able to evidence a minimum of six months first on experience in General Paediatrics with an additional six months experience at first on level in a level 3 neonatal unit following appointment. This should be evidenced in the same way and will be confirmed by your employing deanery, following the national offers process.

Vacancy and applications process

Applications for ST1 entry are closed as of 16:00, Tuesday 1 December.

Applicants were required to apply on the Oriel recruitment system

You can read information on using Oriel and the national recruitment process on the HEE Specialty Training website. This operational aspects of the paediatric national recruitment process are managed by the Paediatrics National Recruitment Office

Watch our webinars

We have run a webinar on two dates, each of which outlined the processes for 2021 and gave prospective applicants the opportunity to ask a host of questions.

Here's the webinar from 22 October:

You can also watch this webinar and all our careers webinars/workshops on our Careers in paediatrics playlist on YouTube.

You can download the responses to queries from both webinars:

Person specification

There is a single person specification that covers entry at Level 1. 

Applicants need to be registered with and licensed by the General Medical Council (GMC) by the intended start date of the post you are applying for. (You don't need to be registered with or licensed by the GMC at the time of application but we would recommend that you start looking into this as early as possible). For paediatric training posts, the start date is typically August or September, depending on the UK region. All start dates will be clearly displayed when you make your preferences on the Oriel system, once the vacancy is 'live'. If you need any further clarification, please contact the relevant region/HEE office.

Post numbers for 2021 recruitment

Post numbers for all UK regions will be posted here as soon as they are confirmed by the local recruitment offices and collated by PaedsNRO.

Please note that there was a separate preferencing window for applicants to rank their choices this year and preferencing did not take place during the application window. The preferencing window will run from Monday 11 January 2021 to Sunday 11 April 2021.

Past application numbers and competition ratio

In 2020, 712 applications were made for 461 posts overall across the UK. 645 applicants were invited to interview. The competition ratio for paediatric posts was therefore 1:40, equivalent to a little under 1.5 applicants for each post advertised.

Some regions do prove more popular than others. However, applicants can preference any or all of the preferences for any or all regions, so it is not possible to give an accurate competition ratio by region.

Both overall application numbers, and consequently also competition ratios, saw a considerable increase for the 2020 national recruitment round 1. Remaining unfilled posts were still re-advertised in the national round 1 re-advert. 


For any queries, please contact PaedsNRO@hee.nhs.uk