CST Portfolio 2027: the Five Domains, A to E Grades and the Evidence Index

The Core Surgical Training (CST) portfolio is graded A to E across five domains: operative experience, surgical experience, quality improvement or audit, presentations and publications, and teaching, according to NHS England's portfolio guidance for candidates for 2025/26. The grades are declared on an uploaded index sheet, verified from uploaded evidence, and questioned at the portfolio station, which is worth 45% of the selection score. There is no Oriel self-assessment any more, and a portfolio submitted without the index sheet scores zero.

Reviewed and updated 10 September 2026. The domain descriptors below are the 2025/26 guidance, which NHS England last reviewed on 23 October 2025 and which is still the current published position; the 2027 guidance is not yet out.

Key takeaways

• The CST portfolio has five domains graded A to E in the 2025/26 guidance, and the portfolio station carries 45 of the 100 selection points.
• The index sheet is mandatory: NHS England says candidates who omit it "will score 0 for their portfolio evidence".
• Only one item of evidence per box per domain is scored; if you upload more, assessors read the first item only.
• A supervisor letter without the supervisor's GMC number "will not be accepted by the interview panel and will score zero points".
• Grade A for operative experience is involvement in 40 or more cases; grade A for QI is leading all aspects of a surgically themed project that demonstrated change.
• NHS England says it is "likely that from 2027" the domains will be realigned to Good Medical Practice: knowledge and skills, safety and culture, and communication.

What are the five CST portfolio domains for 2027?

The five CST portfolio domains in the current guidance are commitment to specialty through operative experience, surgical experience, quality improvement or clinical audit, presentations and publications, and teaching experience. Each is declared as a letter from A to E on the index sheet, and the panel checks the uploaded evidence against the letter you chose.

The evidence index is the single-page sheet, uploaded with your evidence, on which you record the grade you are claiming in each domain and the item that proves it. It replaced the Oriel self-assessment for the 2026 round.

Two of the five domains reward something you can still do between now and the evidence upload: a five-day taster week, and a closed audit loop. The other three are the accumulated record, and that is why the index has to be planned from FY1.

What earns an A in each CST portfolio domain?

An A is earned by the top descriptor in each domain, and the descriptors are specific enough to plan against. The lines below are NHS England's wording, shortened where the original runs to a paragraph.

How is operative experience graded?

Operative experience is graded by case count: A for 40 or more cases, B for 30 to 39, C for 20 to 29, D for 11 to 19 and E for 10 or fewer or no evidence. The count is of cases you were involved in, evidenced from your logbook, so a validated eLogbook summary is the item to upload.

How is quality improvement graded?

Quality improvement is graded on your role and on whether change was demonstrated: A for leading all aspects of a surgically themed audit or QI project with demonstrated change, such as a closed loop; B for the same in a non-surgical project; C for contributing to a project with demonstrated change; D for involvement in any project; E for none. A second set of options grades whether you presented both cycles, one cycle, or neither.

How are presentations and publications graded?

Presentations and publications grade A for a top oral-presentation prize at a national or international meeting, or a first-author PubMed-cited paper that is not a case report or letter. B covers a selected national oral presentation, a prize-winning first-author poster, a first-author case report, or a published book chapter. C is a named co-authorship on one PubMed-cited paper; D is a first-author national poster, a regional oral presentation, or a cited collaborative authorship.

How is teaching graded?

Teaching grades A for designing and organising a face-to-face programme of four or more sessions with local educators and delivering at least four of them. B is the same in an online format, C is designing the programme but delivering fewer than four sessions, D is regular teaching of four or more sessions a year or some training in how to teach, and E is no teaching.

Why does the CST evidence index sheet matter so much?

The index sheet matters because it is the only route to any portfolio marks: NHS England's guidance states "This is mandatory and candidates who fail to include the index sheet will score 0 for their portfolio evidence". Forty-five points out of 100 rest on one page.

In practice the sheet does two jobs. It tells the assessors which letter you are claiming per domain, and it points them to the one item that proves it, so they can verify five claims in the short review window before you join.

The coresurgeryinterview portfolio scenarios (43 questions across seven scenarios in the £97 bank) are written around this sheet, because the questions you face are the questions the sheet invites.

What are the CST portfolio evidence rules for 2027?

The evidence rules are the 2025/26 rules until NHS England republishes them: one item per box per domain, supervisor GMC numbers where asked, no patient-identifiable data, and nothing from before your first degree. Each rule carries a zero for the domain or the whole portfolio if broken.

However, the rule candidates most often misread is the one-item rule. If you have three audits, you upload the one that earns the highest letter, and nothing else. A second upload does not add marks; it displaces the first.

When is the CST evidence upload window for 2027?

The 2027 CST evidence upload window is not yet published. In 2026 the portfolio evidence portal opened on Monday 16 February and closed on Thursday 26 February, after interview invitations on Friday 13 February and before interviews from 2 to 11 March.

That said, the 2027 national interview window opens on 11 January and offers are on 6 April, so an upload window in the second half of February 2027 would fit the same shape. Have the evidence PDFs named and ready by the end of January.

How is the CST portfolio station assessed at interview?

The CST portfolio station is a 15-minute online station on Qpercom in which a panel of three or four reviews your uploaded evidence before you join, then hears a three-minute pre-prepared presentation, asks two minutes of questions on it, and asks two five-minute questions on domains the assessors choose. That is the 2026 format from NHS England's interviews page, last reviewed 15 October 2025.

Two official pages give different review lengths, 10 and 15 minutes, so both are shown. Either way the evidence is read without you in the room, and the questions test whether you can talk about two of your own achievements with the depth the letter implies. Each item is scored on a 0 to 6 scale from "no evidence" to "outstanding".

Is there still a CST self-assessment in 2027?

No. The Oriel self-assessment for CST was removed for the 2026 round, and NHS England's applying page says plainly: "You will no longer be asked to complete self-assessment on Oriel. Instead, you will be asked to upload an index page with appropriate entries".

The change moved the verification from an administrator before interview to the panel at interview. Old advice about "self-assessment points" and lever-arch folders describes a process that no longer exists, and any resource still built on it is out of date.

What is likely to change in the CST portfolio from 2027?

NHS England says it is likely that from 2027 the evidence domains will be realigned to Good Medical Practice, so that candidates demonstrate "knowledge and skills, safety and culture, and communication", with the communication evidence combined into one domain. The wording is "It is likely that from 2027", which is stated intent rather than settled policy.

In practice the raw material does not change. Operative cases, a closed audit loop, a first-author paper and a delivered teaching programme will sit under whichever headings the 2027 guidance uses. Build the evidence now and re-map it to the domains when the guidance publishes, which for the 2026 round happened on 23 October 2025.

The coresurgeryinterview guide pages will be updated the week the 2027 portfolio guidance is released, and the free sample scenarios let you rehearse a five-minute portfolio answer out loud before then.