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.

Update (14 April 2021): There was an administrative issue with a small number of the Paediatric training offers that were released on 13 April, 2021. We worked closely with HEE to conduct a thorough investigation and can confirm that the issue has been resolved and the ranking and scores on Oriel have been updated. We can confirm no applicants have been disadvantaged and no offers will be withdrawn. We are writing to the applicants who have been affected today (14 April) to confirm their offers and we apologise for any inconvenience or distress this may have caused.

Update (13 April 2021): In the last 24 hours we became aware of an administrative issue which may have affected the ranking process for ST1 candidates. Alongside HEE, we are investigating this issue - to assess the degree of any potential impact and what, if any, action may be required. We will post a further update on Wednesday 14 April.

Last modified
14 April 2021

Update - 08 April 2021 Following a significant increase in applications to medical training programmes in Round 1 (R1), Health Education England (HEE) have announced that the Round 1 Re-advert (R1R) has been cancelled across all specialties for 2021. Full details can be found on the HEE Specialty Training website.

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 have been interview-based for National Round 1, taking place at six regional centres. However a general rule was put in place for this year that no face-to-face interviews would take place for any specialties, so an adapted process was been put together, that allowed 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 therefore went ahead using the plan A set out by each specialty.

Decisions were made on a specialty by specialty basis as to whether there would be a need to move to plan B during the recruitment process. This could 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.

Paediatric recruitment - Plan A

Plan A will came into effect immediately, and included 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 are weighted to get an overall recruitment score out of 100%, as follows, with a final appointability score of 55% or more:

  • 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 consisted 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 weighted to get an overall recruitment score out of 100%, as follows a final appointability score of 55% or more::

  • 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 are 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
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 provided general information on the impact of COVID-19 on national recruitment.

You can also see the full guide:

Interview days for 2021

Interviews have taken place virtually, managed by the local teams, as follows:

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