UK CT1/ST1 Specialty Training Application Guide 2026
Understanding the Official Statistics
These are the headline statistics released from NHS England regarding applications for CT1/ST1 training jobs in 2025. Over the past 3 years, there has been an almost exponential increase in speciality training applications, means that it is becoming much harder for UK resident doctors to progress their career and job security is a real concern. This article helps break down these statistics so you can position your application strategically.
Where Does the Data Come From?
There has been a lot made of the increasing competition ratios in the media, so it is important that you know where the data is coming from. The figures in this article are based on official NHS England data, published either on their website or in response to Freedom of Information (FOI) requests.
We’ve focused specifically on CT1/ST1 entry-level posts — excluding higher-level registrar applications.
Historical Data: A Narrowing Bottleneck
Each year, NHS England releases information on the competition ratios for training roles. For the 2025 intake, these statistics are alarming, with a ratio of 8.4:1 Applications: Posts. The graph below shows that the number of applications is increasing at an almost exponential rate, while the growth of training roles, from 9,235 in 2022 to 9,479 in 2025, cannot be fully appreciated on the scale.
Why the headline statistics can be misleading
The headline figure of 8.4:1 doesn’t tell the full story. Over recent years, there has also been a trend of applicants applying to multiple different specialties on Oriel, since the system makes it easy to submit several applications with no upper limit in previous years. In 2025, NHS England released that applicants submitted an average of 2.37 applications each. When we adjust for that, the true competition ratio — unique applicants to posts — can look quit different. The graph below shows how the true measure of competition has been changing over the last 5 years.
However, even after adjusting for this we can see a worrying trend in competition for placed. In 2025, the ratio unique applications to places was 3.57:1. This means that 72% or 24,000 of applicants were rejected in 2025.
Future outlook
With the 24,000 applicant rejected last year likely to apply again and new eligible doctors joining the bottleneck each year the future outlook suggests that competition will only intensify. This issue has gained national attention and there are changes coming into force for the 2025/26 application round.
Changes to the 2026 Application
On the 6th of September NHS England published two significant changes to the application process for 2026:
- Maximum number of applications per person capped at 5.
- Applicants now need to be fully registered with the General Medical Council (GMC) at point of application rather than the start date.
What do these changes mean?
1. Capping the maximum number of applications per person will have an effect on the total number of applications submitted this year. Using information from a Freedom of Information Request, we estimate that this change will mean that there will be 10,000 fewer applications submitted. However, this change will not make any difference to the true measure of competition which is the unique applications to posts ratio.
2. The change in policy to require full GMC registration at the point of application will only effect International Medical Graduates (IMGs). It is hard to estimate the exact impact that this will have. However, given that this is a last-minute change, it will make some IMGs ineligible for this year’s application and may reduce the number of unique applications. Nevertheless, the impact of this change is unlikely to reverse the swelling pool of eligable applicants that were rejected from the 2025 application.
Our prediction is that the headline statistics may look slightly better for the 2026 application round but real-term competition will still increase. Therefore, expect stiff competition and further changes to the application process in years to come.
Should I submit multiple applications?
In short, it depends on your personal situation and whether you are set on a particular career path.
How to Achieve a Competitive Score
With the bar getting higher each year you need to be more strategic in how you prepare your application.
Here are 5 key steps to achieving a competitive application:
1. Know your the scoring criteria for your chosen speciality back to front.
The first step is to make sure that you understand the scoring criteria for your chosen speciality in detail. This can be subject to change so make sure you check up to date guidelines on the specialities National Recruitment Offices website.
2. Identify Portfolio Easy Wins
If your chosen speciality uses a portfolio, focus on easy wins to boost your points. If you are involved in an audit, why not try to publish your findings in a journal, present that same piece of work at a conference or even run a teaching session about your findings. That way, one piece of work can score you points in 4 different domains!
3. Start MSRA Prep Early
Balancing preparation with a full-time rota is tough. Begin early to spread the workload and reduce burnout closer to the exam window.
4. Use Evidence-Based Learning
Avoid low-yield revision tactics like making and reviewing note. Instead, use proven, evidence-based strategies such as spaced repetition, active recall, and question-based learning.
5. Find your MSRA competitive advantage on the Professional Dilemmas Paper
Because it is difficult to know how to prepare for the Professional Dilemmas Paper (SJT) candidates often prioritise the clinical problem solving paper. Preparing for the Professional Dilemmas Paper effectively can be a massive point of difference in your application and the biggest return on time investment that you can make.
How can MedicRecall Help?
At MedicRecall, we help you master the Professional Dilemmas paper — the most under-prepared yet highest-yield section of the MSRA.
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Based on official NHS England and GMC resources and Delivered using evidence-based learning techniques.
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