ST3 Portfolio Building Essentials: Area 1: Time spent in medicine post-foundation and The Paradox of Overqualification


One crucial area of evaluation for those seeking a surgical training post is the amount of time spent in medicine post-foundation. However, it is important to note that having a significant amount of experience in this area could actually work against the applicant, potentially resulting in a lower score for their portfolio. This may seem counterintuitive, but it’s a way to ensure that training posts go to those who are still in the early stages of their careers and have yet to fully establish themselves.

But how exactly is this assessed? A formula is used to calculate an N number, which serves as a denominator in some of the applicant’s other
portfolio scores. This ultimately discounts or reduces their overall score. At the time of my applications, the lowest possible N number is 1, reserved for those with under 27 months of experience. The highest is 5 for those with over 64 months. These requirements and assessments tend to change from year to year, so remember to check the Health Education England Website for the latest requirements.

I completed my Medical School training in December 2012 & started my medical internship (the equivalent of foundation training in the UK) in April 2013. I applied for my ST3 training in November 2022 and was expected to start my training in August 2023. After deducting 2 years of foundation training, I had 100 months of experience, well over the 64 months. Despite getting the lowest negative score here, I was still able to secure an interview and get a training number in 2 specialities, i.e.. General Surgery and Vascular Surgery. I addition, I got my preferred training regions on both interviews.

Applicants may have an N number higher than 1, but this should not be a cause for discouragement. Instead, focus on improving the scores in other sections of the portfolio to boost your overall score and enhance your chances of ranking highly in the entire application process.

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