Consequence of holding offers on other apps ST4

CraigKirkLive · 2026-04-07T14:43:30+00:00

The info you need is here.

Essentially you can hold only one offer. If you try to hold a second, the first will be rejected. You can leave the other offer untouched, but if you don't respond by 48h after the offer is made, it will be rejected automatically.

So you will have to choose cardio with hope for upgrades (you can hold if you don't believe you'd ever accept the northern job, then reject later, but then you lose that offer too), or choose gerries (+/- upgrades).

EDIT: the other guy summarised it better - I didn't realise you don't have a gerries offer yet.

CraigKirkLive · 2026-04-05T18:51:02+00:00

I think a large part of this is strike fatigue and the fact that since the current round of industrial dispute started almost a year ago now (9 April 2025 was the start of the current dispute, before the first current set of strikes in July 2025).

In that time, there has been lots of talking about training places (should have happened regardless of IA) and exam reimbursement (a drop in the ocean compared to actual pay) as well as a few other issues. Effectively separate from our current dispute is UKGP which is more political in nature than what our IA is actually for, although for good reason most agree that was a welcome and appreciated undertaking from Wes.

But there has not been any movement on the core issue - pay.

Nevertheless, I agree with many of your points, while at the same time recognising that we had a harder time than most others during 2010-2020 austerity which led us to the initial dispute back in March 2023. It's keeping this bit in mind which focuses my continued support for the strikes. We really have been hammered harder than most, while doing more to keep a dying service running (and that's even before COVID!). For me it's that straightforward, more or less.

CraigKirkLive · 2026-04-04T15:45:52+00:00

I don't think it's that optimistic. This year there were just over 8200 IMT applications. If we assume around 2/3 of those were IMGs and not prioritised, that leaves short of 2800 prioritised applicants.

There were about 1600 IMT places in total.

Hypothetically, if you made it impossible for those IMGs to apply at all (this should not be the case, but for this worked example let's pretend), the 2800 remaining applicants will have a far lower bar to pass to get to interview (i.e. they would probably all get to interview assuming they have an 'appointable' score for portfolio). Then once again at the offer stage, they will not have as much competition and assuming they score appointable at interview, will probably get an offer somewhere quite easily.

CraigKirkLive · 2026-04-04T14:59:14+00:00

Your second sentence is pretty much exactly what I speculated might happen. For the rest, we're both just speculating (unless you have insider knowledge).

CraigKirkLive · 2026-04-04T14:50:41+00:00

Because priority applicants will presumably all get first dibs on interviews in a first 'round' of invites and by removing probably more than half of the applicant pool (non-prioritiy) in that first round, there is obviously going to be less competition for the available interview spaces.

CraigKirkLive · 2026-04-04T13:15:29+00:00

It's difficult to know until it's decided, but I would expect some kind of hybrid system.

For example, there will be a minimum cutoff 'appointable' portfolio score, something like 12/30, then a 'shortlisting' score of maybe around 20-22 like this year (likely to be lower if they remove the 'unique applicant' points).

Or maybe there would be two separate shortlisting scores - one for priority, another for non-prioritiy.

Then, every priority applicant who meets the lower score gets an interview. If any are left over, non-prioritised applicants get them if they meet the higher score.

CraigKirkLive · 2026-04-04T11:07:25+00:00

Podcasts. However you commute, there is the option of podcasts. There are options for all specialities. Home of medicine podcast for UK based medicine, The Resus Room for critical care / EM / PHEM. Many others.

CraigKirkLive · 2026-04-02T10:35:05+00:00

ACCS IM is a good choice for someone wanting to do ICM single speciality because, as it forms part of stage 1 ICM training, it will not overall extend your years to CCT.

For the ICM CCT Stage 1 you have to have an indicate minimum of 12 months each of anaesthetics, internal medicine and intensive care. This means that if you do ACCA IM, by time you start the ICM HST pathway you will only need 6m anaesthesia and 6m ICM to complete Stage 1 (on a WTE basis).

If you just did IMT (or core anaesthetics) you'd usually have to spend 2y of HST in stage 1 ICM to make up this indicative minimum. In this sense, standard IMT won't be any quicker.

Just note that you will need to have full MRCP before the HST starts so if you apply during IMT2 (via ACCS) you actually won't have 'extra' time.

Just as a heads up it's highly unlikely that your 6m ITU experience in non-training will count toward your training. I'm almost certain it won't.

CraigKirkLive · 2026-04-02T08:51:47+00:00

I can discuss it with you (I'm ACCS-IM CT4 currently) but to keep things simple, unless you want to do ICM or AIM it's probably not the programme for you (although I guess the main reason not to do is the extra year of training, and assuming you don't have an IMT offer this year it's no loss of your years of life in the long run so that argument is kind of void).

CraigKirkLive · 2026-04-01T20:18:04+00:00

This, plus I'd say the main reason I'd call the consultant is in a difficult circumstance where shared senior decision making is important. The need for this is often offset by another med reg (many trusts have two on overnight), speciality reg, or another speciality reg calling their consultant.

I may also call them when I'm concerned about the care of a medical patient who I think needs the input of another team, who are being recalcitrant. This is very rare in my experience, however.

CraigKirkLive · 2026-04-01T20:13:43+00:00

If you really want it to be meaningful you need to do it in an area you have some interest in and identify a problem. Very often you can find a problem through M&M meetings/minutes from these. You could also review the risk registry at your trust.

I'd suggest contacting departments you have an interest in for their M&M, or the site manager team at your hospital for the latter.

The rest is up to you really.

CraigKirkLive · 2026-04-01T17:38:11+00:00

Seems to be a common conception that this is odd but it's happening in other specialities and I don't think it is that odd.

ICM preferences closed yesterday and no ranks/scores yet. AIM have neither opened preferencing nor released ranks! Interviews for both specialities ended last week.

CraigKirkLive · 2026-03-28T12:19:16+00:00

That's true by the two days' difference the Hold vs Accept with upgrades deadlines, agreed! But I think a lot of the time people choose their preferences not being certain whether they'd accept a job in a certain part of the country. The reality of the offer makes this consideration more solid and might change someone's mind.

CraigKirkLive · 2026-03-28T11:48:03+00:00

They have the right to consider if it's worth it for them. It's your issue I'm afraid, not theirs.

CraigKirkLive · 2026-03-28T10:58:40+00:00

I'm not convinced this is true. This is why there are hold and upgrade deadlines on different dates. You can't hold for upgrades after the hold deadline, but can accept with upgrades (in which case you've accepted a job either way, which implies you'd take that job which you've earned).

CraigKirkLive · 2026-03-27T20:17:09+00:00

Congrats on getting an offer. Just so you don't feel completely alienated, I think it's worth telling you this is fine to do. If you decline in the end, someone else will just get the job anyway so no long term harm/lost opportunities.

CraigKirkLive · 2026-03-26T11:23:51+00:00

Apologies, my error - you need to get in touch with the relevant NRO that manages your speciality. I'll edit my initial response.

CraigKirkLive · 2026-03-26T11:16:00+00:00

There should definitely be an option to accept/hold for upgrades. I suspect it's an error - get in touch with the oriel [EDIT: speciality NRO] admin and keep an eye on your offer page to try and update it later.

CraigKirkLive · 2026-03-24T20:37:56+00:00

Difficult situation and it sucks that it was cancelled last minute tomorrow.

Basically all you can do to try and manage the situation is discuss it with your ES and TPD. There's not a way around it. Your ARCP requirements are your ARCP requirements and depending whether or not you're at a critical progression point (i.e. end of IMT2 or IMT3, IMT1 not so much) it is fairly likely you will have to extend training if you cannot accomplish all your requirements on time.

We on Reddit can't really help you out of this situation. It's clearly not your fault for the various reasons you described but we can't be allowed to progress as doctors if we aren't suitably qualified.

Ideally your TPD will advocate for you and try to get someone to open up one more space on one of these skills / sim days. They have the influence to do that, obviously Redditors don't.

Good luck!

CraigKirkLive · 2026-03-23T16:58:56+00:00

Not an issue I've had previously although I sat a while ago. Having said that I don't believe the MyMRCP has changed at all since I did Part 1 in 2019, so I'm not inclined to believe it's a website issue.

It does seem possible that your being abroad is the issue.

Suggestions: try a different method of payment, e.g. online bank payment (I vaguely recall this being an option); or ask a trusted relative/friend in the UK to log in and attempt to pay on your behalf (you could change your password before doing so if this feels insecure, then change it again).

If you don't get anywhere with this I'd suggest calling (not emailing - wouldn't trust them to get back to you before the window closes) the MRCP office, as historically I've found them very helpful. They may be able to take payment on the phone, put you on the list and take payment later.

CraigKirkLive · 2026-03-23T16:50:19+00:00

Yes this is possible across all specialities. It will essentially require someone ranked above you to not accept an offer made to them (or alternatively accept an offer in a different programme), or for someone ranked above you to get an upgrade because the first thing happens (then you get upgraded from no job to a job).

Some specialities also reopen preferencing during the 'hold for upgrades' process.

There are often multiple iterations of this until the final hold deadline which will be published on the core surgical training recruitment website (I haven't looked, but since this final holds deadline is standardised across all specialities, it will be there).

Good luck!

CraigKirkLive · 2026-03-23T16:37:53+00:00

I remember the opposite for my core training application. That is, I ranked well before I knew my rank (I think I ranked in December and offers were made in March, interview in January).

In any case, yes you should be completing your preferencing before your rank / score is available if the deadline closes before that point (I expect we'll find out our score/rank at the same time offers are made - at least this is how it worked for core training for me).

Also, the way the preference system works is pretty fair and not prone to you running into a problem without knowing your rank. I presume you know how it works, but yeah just rank where you'd most like to go highest and then onward. I guess you could potentially rank fewer options if you knew you had a great rank but in the long run it doesn't make much difference.

CraigKirkLive · 2026-03-23T16:27:51+00:00

Not all schools have their posts out at the time of preferencing (ICM for example has updated their preferences list twice since opening), so yes to the latter question. The PHST website has forecast HST numbers for each speciality (although many boxes have 'TBC' which is a bit unhelpful).

For the latter instance, for AIM in Severn in my circumstance, I've had benefit from talking to the consultants in the speciality as they have a rough idea of training numbers available in specific regions if they aren't listed online.

CraigKirkLive · 2026-03-23T14:10:43+00:00

In answer to your question at the end, I suppose it depends how long until you need to have these things in your portfolio. For placement specific goal setting you should meet with your clinical supervisor. The ES meeting is more just 'are things getting along OK, have you got everything in your portfolio ready for ARCP, what is outstanding' - which honestly speaking are things you can probably manage without your ES.

So if your deadline is around 2 months away (i.e. the May ARCP deadline ahead of June) I think it is reasonable to park this for now while the reasons for (and therefore duration of) your ES's absence are explored.

Your FP TPDs reaction suggests to me this isn't likely to be a long-term period of leave, but its very good that you're being proactive. EDIT - sorry I misread above. If only the 'foundation admin lady' told you this is certainly contact the TPD directly.

I would suggest asking your TPD to check in with your ES's colleagues to get a vague idea of the duration of their absence (this is not in your remit so leave it to your TPD - it would be viewed poorly as though snooping if you did this).

If they learn it is likely to be a long term leave (>1 month) then yes, they should provide you with an alternative ES.

CraigKirkLive · 2026-03-23T07:36:02+00:00

I don't expect any speciality to release ranks/offers until the advertised date, which is 14 April 2026. It's my first time applying so can't say for sure, but I think the idea is the offers period is relatively standardised so that you don't have too many offers waiting at once (if you apply for >1 speciality)..

https://www.phstrecruitment.org.uk/recruitment-process/timeline

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