The certificate of readiness to enter higher surgical training (CREHST) route: Proportion of applicants and likelihood of success

Abstract

ObjectiveTo compare the distribution of Higher Surgical Training (HST) applications received through the Certificate of Readiness for Higher Surgical (CREHST) route with the traditional Core Surgical Training (CST) route and to evaluate the likelihood of success in obtaining an HST post for each route across all surgical specialities. MethodsA national, retrospective cohort study was conducted to compare the proportion of applications and likelihood of success in obtaining an HST post between the two routes during the 2021–22 application cycle in the United Kingdom. Univariate statistical analysis was performed for categorical variables using the chi-squared test, or Fisher exact test. Relative risk was calculated for each route and each surgical speciality. ResultsThe study included 1964 HST applicants, of which 46% (n = 904) were via the CREHST route. This proportion varied from 23% for otolaryngology to 66% for vascular surgery. The study found that 20% (n = 98) of the available HST posts were awarded to CREHST applicants, ranging from 0% for cardiothoracic surgery to 39% for vascular surgery. For most specialities, applicants from the CREHST route were significantly less likely to be awarded a training post, with relative risks ranging from 0.07 (95% CI 0.01–0.51, p < 0.0001) for otolaryngology to 0.4 (95% CI 0.25–0.79, p = 0.0032) for urology. ConclusionsThis study provides valuable insight into the proportion and success of HST applications via the CREHST route. The findings demonstrate that the use of the CREHST route is commonplace across all surgical specialties, but the likelihood of a successful application is significantly lower when compared to the traditional CST route for most specialties.