General Practice ST1

ST1 Guidance for Applicants 2020-21

To view the guide, please expand the relevant chapters. A PDF copy can be downloaded via the left-hand menu or via the Resource Bank.

The General Practice National Recruitment Office (GPNRO) co-ordinates the nationally agreed and quality assured process for recruitment to General Practice (GP) Specialty Training (ST1) Programmes.

Academic Clinical Fellowships (ACF) and Global Health Fellowships (GHF) routes are also available in GP training however these are independent from the national process and are recruited to locally by individual HEE Local Offices and Deaneries (henceforth referred to as region or regions). Therefore, this guidance deals only with the ST1 Programme.

Recruitment to GP Specialty Training will take place three times a year, twice for August 2020 commencement and once for February 2021 commencement. Round 1 and Round 1 Re-advert cover August 2020 commencement; Round 2 covers February 2021 commencement.

All submitted applications for GP Specialty Training will be assessed using a standard, national and consistent staged process outlined below. This is an established and well-researched selection process using modern methodologies that are fair, robust and fit for purpose. The competency based selection process allows applicants to demonstrate their abilities and suitability for GP training - applications are assessed by the demonstration of competences as outlined in the GP ST1 Person Specification (2020).

Applicants are reminded that entry to GP Specialty Training is highly competitive. Information about competition ratios in previous rounds and the number of available vacancies in each region are available on the GPNRO website.

Applicants will make a single application for all available GP ST1 training posts in participating regions. The assessment and selection processes involve the Multi-Specialty Recruitment Assessment (MSRA) which is a computer-based assessment and a face-to-face assessment at a Selection Centre. Successful applicants will be considered for appointment across the whole of the UK, based on their performance. This method is known as Single Transferable Score (STS) as applicants are not restricted to being considered for appointment in a single specific region. The STS system is designed to maximise opportunities for successful appointment.

There have been some significant changes to the recruitment process in recent years so you are advised to read all the following information before you commence your on-line application form. This will enable you to familiarise yourself with the GP assessment and selection process and the essential entry requirements. You should also refer to both the Oriel Applicant User Guide (for general guidance on how to navigate Oriel and technical help with the on-line application form) and the 2020 Medical Specialty Recruitment Applicant Handbook (for general information about the administration of national recruitment processes).

All applications must be made electronically via the Oriel recruitment portal by the specified deadline. Late applications will NOT be considered. The dates and deadlines relating to 2020/21 recruitment activity are available on the GPNRO website.

The GP application form will only ask for factual information about you and your employment history. Once your application has been submitted you are unable to make any changes, apart from to update your own contact and referee details so please ensure that you do not submit unless it is complete. All sections of the application form must be completed fully according to written guidelines; incomplete applications will not be considered.

Important: Please be aware that Oriel does not support internet browsers that have reached the end of their product support lifecycle.

Communication regarding your GP application will be via direct messaging through Oriel. An email will also be sent by Oriel as a secondary form of communication however, as emails are external to Oriel, delivery cannot be guaranteed and therefore this method of communication should not be relied upon. Therefore, please ensure you check your Oriel account regularly for messages throughout the entirety of the recruitment process.

You should also make sure that you are using an email account that you can access at any time and will not be blocked by your employer’s IT security system. If you are uncertain about this, you should check with your IT department at work.

To ensure messages from the GPNRO are not filtered by your email provider’s junk / spam filters, you are strongly advised to add and to your email whitelist.

Applicants are permitted to submit ONE application, per Round, for a standard GP ST1 training programme. At the time of application, you will be asked to indicate your preferences from all GP Training Programmes available in the UK, in rank order. This means that you can be considered for appointment across the whole of the UK.

Important: please only preference the programmes that you would be prepared to work in, including those listed with zero vacancies as posts may become available at a later date. If you preference a post, it is assumed that you are able to accept this, if offered. It is therefore imperative that applicants consider their preference choices before submitting them. In making those decisions, researching regions carefully is recommended.

GP Training Programmes are available at ST1 entry level only and are for 3 years duration however, Scotland also offer some 4-year programmes. This information will be shown in the preference detail. Applicants are advised to read the regions’ profile pages and access individual region websites for more information about the opportunities available. It is suggested that you research not only the types of programmes offered in each region but also the geography of each region, the main Trusts within the geography, transport links to home and so on.

The ability to record your preferences will be locked at point of application submission however you will be presented with a further window to continue preferencing; this window will span from the date of invitation to the Multi-Specialty Recruitment Assessment until 48 hours before the first offers date; these dates are published on the GPNRO website for all relevant rounds. Applicants who successfully complete the recruitment and selection process will have a further opportunity to amend their preferences once the offers process commences. See section 21.1 Offer Exchanges/Enhanced Preferences for details.

The GP Training Programmes that you preference in your application will be used to make you an offer, subject to the successful completion of the selection process.

4.1 Targeted Enhancement Recruitment Scheme (TERS)

This scheme will offer financial incentives to GP trainees committed to working in selected locations in England, Scotland and Wales that have been hard to recruit to. These areas often have an extremely good track record for education but are initially less popular simply because of their geographical location. However, those trainees that do choose to train there usually stay after training. For more information please visit GPNRO website.

Several formalised processes are available to better assist applicants with training in their desired locations of the country.

5.1 Special Circumstances

A standardised national process is available for all specialty recruitment to ensure that applicants with special circumstances and a requirement to train in a specific region are treated in a fair and consistent way.

Any applicant who falls into one of the following eligibility criteria can apply to have their circumstances taken into consideration, allowing them to be pre allocated into a post, subject to it meeting the requirements of entering GP training:

  • Criterion 1 – the applicant is the primary carer for someone who is disabled, as defined by the Equality Act 2010,
  • Criterion 2 – the applicant has a medical condition or disability for which ongoing follow up for the condition in the specified location is an absolute requirement.

Applicants wishing to be considered for special circumstances should complete the special circumstances application form (available from the Oriel Resource Bank) and forward this, together with the appropriate supporting evidence by email to as soon as their application has been submitted.

It is important that you review the relevant section in the 2020 Medical Specialty Recruitment Applicant Handbook for full details on the eligibility criteria and administrative process.

5.2 Deferred Entry

UK applicants can defer the start of their ST1 programme on statutory grounds such as personal ill health or maternity/paternity/adoption leave in line with the Reference Guide for Postgraduate Specialty Training in the UK (The Gold Guide, 7th Ed.).

Successful applicants appointed to England, Scotland or Wales are eligible to defer entry to GP training on non-statutory grounds for up to 12 months; non-statutory deferment is not permitted in Northern Ireland.

Non-statutory deferment to GP ST1 training has been standardised across England, Scotland and Wales and is now detailed in one Step on Step off (SST) Policy. Applicants will be required to read the policy to understand the processes and timescales for requesting deferred entry and action accordingly.

All applicants applying for non-statutory deferral must indicate they are interested in deferment at time of application by saying “Yes” to the question “Do you wish to apply for a deferred start date?” on the Oriel application form, disregarding the statement that training can only be deferred on statutory grounds. Failure to do so will make the applicant ineligible.

All non-statutory deferment requests are subject to consideration and approval from the local training region, not the GPNRO, and all decisions will be taken by the local training region in alignment with their local policy and workforce demand. It should be noted that as non-statutory deferments are not an entitlement, approval of requests cannot be guaranteed.

All recruiters are aware of the requirements of the Equality Act 2010 and in this regard, recruiters will make reasonable adjustments to accommodate applicants at Assessment and Selection Centres provided these are made known in advance. Applicants who require adjustments (e.g. wheelchair access, extra time, nursing mothers) will be required to submit supporting evidence to substantiate the required adjustment. This evidence will need to be uploaded to Oriel via the Document Upload dashboard as “Supporting evidence” and attached to the application form at the point of application.

Adjustments cannot be guaranteed if evidence is provided late and no adjustments can be made on the day of the assessment.

In some instances, to satisfy requests for adjustments, it may be necessary to schedule an Assessment/Selection Centre place at a specific time or a specific location.

From 6 October 2019, all medical practitioners have been added to the Shortage Occupation List in the UK. This means that all general practitioners are exempt from the Resident Labour Market Test (RLMT) and can apply for GP training in any recruitment round, subject to eligibility; there will be no restriction on their appointment.

It is strongly suggested that you read the 2020 Medical Specialty Recruitment Applicant Handbook to familiarise yourself with the immigration information contained within, esp. the guidance relating to Home Office requirements.

All applicants will need to be able to evidence of their English language skills in line with the acceptable evidence detailed in the GP ST1 Person Specification (2020).

8.1 Evidence of Communication Skills for Medical Performers’ List

Eligibility for entry onto a UK Medical Performers’ List is an essential criterion and therefore, applicants must also ensure their evidence of communication skills complies with the Standard Operating Procedure (SOP) or Guidance issued by the relevant Primary Care Organisations (PCOs) responsible for maintaining a medical performers’ list in each of the four countries.

PCOs are NHS England in England, Health and Social Services Boards in Northern Ireland, Local Health Boards in Wales, and primary care divisions within area health boards in Scotland.

All applicants to ST1 posts are required to provide evidence of having met the UK achievement of Foundation Competences, or equivalent within the 3½ years prior to the intended commencement date for the advertised post(s). Foundation competency can be demonstrated in any of the following ways:

  • Currently on a Foundation Programme - Applicants currently undertaking a recognised foundation programme in the UK which is due to finish by the advertised start date will need to confirm the name of their Foundation School but do not need to submit any other evidence at the point of application. Any offer of a training programme will be conditional upon successful completion of the Foundation Programme and being awarded a Foundation Programme Certificate of Completion (FPCC) before the advertised start date.

  • Already completed a Foundation Programme - Applicants who have already completed a UK Foundation Programme will be asked to confirm that they have been awarded an FACD 5.2 or an FPCC, signed no earlier than 3½ years prior to the advertised start date and will be required to upload their FACD 5.2 or FPCC to their application form, at the time of application submission.

  • Currently on a Specialty Training Programme - Applicants currently in active clinical or clinical and academic practice in a UK educationally approved training post (CT/ST/LAT or equivalent), holding either a National Training Number (NTN) or Deanery Reference Number (DRN) will be considered as having had their foundation competences assessed on entry to their current post and do not need to demonstrate these again, regardless of when foundation competences were signed off.

    Important: Applicants in this category, who relinquish their NTN or DRN between the time of application and commencement of GP training will be required to submit a Certificate of Readiness to Enter Specialty Training for the period out of training.

  • Previously resigned from GP training in the UK - Applicants who have previously resigned voluntarily from a GP training programme will be considered as having had their Foundation competences assessed previously, providing that they can demonstrate evidence of satisfactory progress in the form of ARCP documentation for the duration of the training undertaken.

  • Applicants who have started but who have not satisfactorily completed a 2-year UK Foundation Programme or a standalone UK Foundation Year 2 post are expected to return to the Foundation Programme to complete their training. In exceptional circumstances, where trainees were unable to continue their training in the Foundation Programme at that time, e.g. due to personal illness or family caring responsibility, applicants can provide a letter written and signed by the Postgraduate Dean where the previous training took place. This letter must use the standard proforma available from either the GPNRO or the Oriel Resource Bank and be uploaded to the application form at the point of application. The letter must include the following information:

    • The dates of the previous training
    • Confirmation of the reasons for the resignation, removal or relinquishing of their post in the Foundation Programme
    • Confirmation that the applicant has met the requirements and/or demonstrated the competences of foundation training
    • Confirmation that the applicant has completed a period of remediation, if applicable


  • Currently in a Widening Access to Specialty Training (WAST) Programme - Applicants in WAST post need to obtain a fully completed and signed Certificate of Readiness to Enter Specialty Training (CREST) by the start date of the post to which they are applying. No further evidence needs to be provided at the time of application.

  • Anybody who is not covered by the above - Applicants who do not fall into any of the above categories will be required to submit a Certificate of Readiness to Enter Specialty Training (CREST) signed by a consultant who has supervised them for at least 3 months (whole time equivalent and continuous period) in the 3½ years prior to the advertised start date; CRESTs will be accepted where the assessed post has been wholly undertaken in the 3½ years prior to the advertised start date. Applicants must not submit multiple Certificates, from different posts to show evidence of achievement of all competences; only one certificate should be submitted. Only the 2020 CREST will be accepted; forms from previous recruitment years will not be accepted.

    The signatory for the certificate must not be the applicant’s spouse, partner or family member.

    Where the signatory does not currently have GMC registration, it is the applicant’s responsibility to ensure that adequate evidence of their signatory’s standing with a regulatory authority is provided. This evidence must be scanned and attached to the CREST. Where this evidence is not in English, an official English translation should also be provided. In cases where the signatory has historic but not current GMC registration, it is the current registration that is required; previous GMC registration will not be accepted. Where adequate evidence is not provided, the CREST and the GP training application will be rejected.

    In addition, applicants are also required to have 12 months experience after achieving full registration with the GMC, or equivalent medical regulatory body, by the advertised start date.

It is anticipated that applicants will be able to provide a CREST at time of application. If you are not able to provide a CREST at this time, you will need to ensure you answer ‘no’ to all questions regarding achievement of foundation competences. The application form will then ask you to justify why you feel you are exempt. You will be required to provide information justifying why you believe you will have it by a specific date.

The deadline for submitting CRESTs is detailed in the table below:

Round Deadline
Round 1, August 2020 Friday 24th April 2020
Round 1 Re-advert, August 2020 Friday 24th April 2020
Round 2, February 2021 Friday 25th September 2020

Applicants who are required to submit a CREST and fail to do so by the deadline will have their application withdrawn, irrespective of their final outcome.

Please note:

  • This extended period for the submission of a CREST is applicable to GP applicants only.

9.1 Exceptions

The only exception to providing evidence of Foundation Competences is if you are a refugee. Refugees, as defined by UK Visas and Immigration, are advised to submit a Certificate of Readiness to Enter Specialty Training (CREST), if possible. Where this is not possible, on successful appointment, there may be a requirement by the employer or the responsible officer for you to undergo further assessments to ensure that your competence, professional knowledge and skills up to date in line the GMC Good Medical Practice.

If you answer yes to any of the Fitness to Practise questions on the application form, you will be required to send further information about this declaration to your first preference region by the application closing date. This must be provided on the Fitness to Practise (FtP) Declaration Form and sent to the contact details found in Annex C of the 2020 Medical Specialty Recruitment Applicant Handbook.

Failure to provide this evidence by the application closing date will result in your application not progressing any further in the recruitment round.

Many core competences are common across some, but not all, specialty curricula. When moving from one approved training programme to another, competences gained in Core, Specialty or General Practice training should not have to be repeated if already achieved.

The Academy of Medical Royal Colleges has developed the Accreditation of Transferable Competences Framework (ATCF) to assist trainee doctors in transferring competences achieved in one Core, Specialty or General Practice training programme, where appropriate and valid, to another training programme.

Trainees who decide to change career path could transfer competences achieved in another training programme and reduce the length of their new training programme.

The time to be recognised within the ATCF will need to be reviewed at the trainee’s first Annual Review of Competence Progression (ARCP), if appointed. Where accreditation is not granted, trainees will be expected to complete the full training programme.

To qualify for ATCF, you must be transferring from one of the following approved specialty training programmes:

  • ACCS programmes
  • Anaesthetics
  • Emergency Medicine
  • General Psychiatry (Core Training in Psychiatry programme)
  • Internal Medicine Training programme (previously known as Core Medical Training)
  • Obstetrics and Gynaecology
  • Paediatrics

Applicants wishing to be considered for accreditation of transferable competences should indicate this on their application form.

Further information on the ATCF is available from COGPED website.

Specialty training posts and programmes are not normally available to any doctor who has previously relinquished or been released or removed from that training post/programme. However:

12.1 Support for Reapplication to Specialty

If you have previously resigned or been removed from a GP training programme, you will need to provide full details of the resignation/release/removal. This must be provided on the Support for Reapplication to a Specialty Training Programme form and approved by both the Head of School/Training Programme Director and Postgraduate Dean in the region where training was previously undertaken. This evidence should be emailed to the confidential email address of your first preference region at the point of application.

Any applications from excluded trainees without submitted evidence will not progress any further in the recruitment process.

12.2 Support for Reapplication to Specialty Training in a Different Region

Trainees currently working in General Practice, applying to continue their training in another region, without a break in service, will need to provide information relating to this. You must gain support from your current region by completing the Support for Reapplication of Specialty Training in a Different Region form. This evidence should be emailed to your first preference region at the point of application.

Any applications without submitted evidence will not progress any further in the recruitment process.

As you progress through your application it may become apparent that you will be required to upload some form of documentation to allow GPNRO to assess your eligibility.

If you are required to do this you must:

  • Ensure that the document is uploaded as a single document and not in separate pages
  • Ensure that the document label describes the nature of the document
  • Ensure that the document is uploaded in to the correct document section

GPNRO reserves the right to request re-submission of documentation if the above rules are not followed.

All applications will be assessed against the essential criteria outlined in the national GP ST1 Person Specification (2020).

All eligible applicants (i.e. those who have been assessed as demonstrating evidence of eligibility as outlined in section 14) will be invited to attend the next stage of the recruitment and selection process. The MSRA is a computer-based assessment which forms the short-listing process. The assessment has been fully researched and evaluated and has been shown to have high predictive validity.

GPNRO lead on the delivery of the MSRA and has developed a separate guide which provides GP applicants with information about the whole MSRA process (e.g. registering to sit the test, centre locations, format of the assessment, etc.).

All applicants are expected to read this document in full to develop an understanding of this particular stage of the recruitment process and what is expected of applicants; it is available from the GPNRO website.

All applicants who achieve a combined total score of 550 in the MSRA will qualify for a streamlined route which does not require them to attend a face-to-face assessment at Selection Centre. If you qualify for this route, you will be ranked before those who were deemed appointable via Selection Centre, increasing your chance of receiving an offer of training at a programme in one of your most preferred programmes/locations.

On completion of the Multi-Specialty Recruitment Assessment (MSRA) stage, applicants who have met the minimum required standard will be considered for Selection Centre, except for those that qualify for the Direct Pathway to Offers.

Applicants who are successful at the MSRA will be able to choose where they would like to attend Selection Centre. Applicants will be invited to attend one Selection Centre and will be considered for appointment to programmes in all preferenced regions.

17.1 Booking a Selection Centre

If you are invited to attend a Selection Centre, you will be required to log into your Oriel account and use the self-service functionality to the book an appointment at a centre on a date and time of your choosing, subject to availability. The only exception to this is if you have requested a special accommodation under the Equality Act 2010. In this instance, the GPNRO will pre-book your appointment either at a Selection Centre hosted by your first preference region or at a Selection Centre nearest to the home address declared on the application form.

When booking your Selection Centre, it is strongly recommended that you avoid booking from a mobile device or internet browsers that have reached the end of their product support lifecycle as these are unlikely to be supported.

17.2 Confirmation of booking

Once you have booked your Selection Centre, you will receive an automated confirmation of booking message in Oriel and a secondary automated message will be sent to your registered email address. If you do not receive confirmation, log into your Oriel account to confirm if the booking process was completed in its entirety.

The Selection Centre involves applicants completing several exercises which are observed and assessed by trained assessors. This competency-based selection process has been researched and evaluated. We are confident that it is fair, robust and fit for purpose.

On the day of the Selection Centre, please ensure that you allow yourself plenty of time to get to the Selection Centre venue to allow for applicant registration. Applicants can expect the Selection Centre to last approximately 3 hours, however this can vary.

If you are booked to attend Selection Centre and are unable to attend due to unforeseen circumstances or an emergency, you must contact the organising region directly to ascertain whether alternative arrangements can be made. Alternative arrangements cannot be guaranteed.

All recruiters are aware of the requirements of the Equality Act 2010 as detailed in Section 6. Extra time is only available for the written assessment. If you feel that there are any issues related to a disability need you may have, you MUST discuss these with the region before the assessment as no adjustment can be made for any applicant afterwards.

Applicants should note that children are not permitted at Selection Centre.

Important: On arrival at Selection Centre, if you find you have a conflict of interest with a panel member, for example you are already familiar with them and you are not comfortable in being assessed by them; it is your responsibility to inform a member of the recruitment team at your earliest opportunity so that alternative arrangements can be made, such as being interviewed by a neutral panel member.

18.1 Dress Code

Recruitment and selection will involve non-physical contact with simulated patients who should be treated as if they were patients, for clinical communication and assessment of clinical performance. Conventionally in the UK, formal professional practice between doctors and patients is appropriately marked by a certain formality of dress and you will be expected to adhere to a dress code when you attend Selection Centre. The Royal College of General Practitioners (RCGP) Dress Code is available as guidance to postgraduate doctors. It has been written in conjunction with HEE Local Office/Deanery guidance. Please ensure you are familiar with this before attending Selection Centre.

18.2 Selection Centre Format

There are no interviews and assessors do not have access to your application form, your CV or any other biographical information.

The competences that are assessed at Selection Centre are:

  • Communication Skills
  • Empathy & Sensitivity,
  • Conceptual Thinking & Problem Solving,
  • Professional Integrity.

Please refer to the GP ST1 Person Specification for more information about these.

There will be a briefing session at the start of your Selection Centre session and an opportunity for questions at the end of it; this is NOT a feedback session. Feedback on your performance will be given later and will be after the offers have been made.

18.2.1 Simulation Exercises

These will involve simulators and 3 different situations:

  • A consultation with a patient
  • A consultation with a relative or carer
  • A consultation with a non-medical colleague.

They do not involve a physical examination and clinical expertise is not specifically assessed. The time allowed for each is 10 minutes.

18.2.2 Written Exercise

The written exercise will require some prioritisation or ranking of issues and a justification of your responses. The time allowed for the written exercise is 30 minutes.

All exercises will have specific and individual written instructions, with advice to spend time reading and being familiar with the requirements of the exercise. You can download example Selection Centre scenarios from GPNRO website.

18.3 Preparation Hints
  • Be yourself and be natural. Do NOT “act”
  • Listen to and, carefully read carefully all instructions given on the day about the exercises
  • Be honest
  • Trust the process which has always had excellent applicant evaluation; specifically, the evaluation says the process is fair, even from those who are not successful first time
  • Practice the example scenarios with your colleagues by all means but we do NOT recommend you book commercial courses or purchase advice and guidance books specifically aimed at doctors undertaking the GP Selection Centre. None of the GP assessors take part in or endorse any preparation courses or books

We understand that applicants may wish to revise and prepare for Selection Centre with each other in small groups and would encourage this. However, sharing information about the actual Selection Centre is unacceptable and is viewed as unprofessional behaviour. Assessments at Selection Centre are competency based and there is published evidence demonstrating that prior knowledge of the content and context of assessment does not positively affect performance. We would counsel applicants against altering their behaviour based on the advice of other applicants. We also remind applicants that entry to GP Specialty Training is competitive.

All applicants will be notified of their final results on the published offers date. The offers date can be found on the Recruitment webpage of the GPNRO website.

Applicants’ final national rank will be published in Oriel against the GP ST1 application as interview scores. Detailed guidance on how to locate or view these scores is contained in the Oriel Applicant User Handbook.

19.1 Composition of Final Result

The final mark for all applicants that have undertaken GP selection is calculated by combining results from both the MSRA and Selection Centre. To give an applicant’s final selection score, the Professional Dilemmas (PD) element of the MSRA and Selection Centre scores are weighted at 40% each and the Clinical Problem Solving (CPS) element of the MSRA at 20%.

Assessment Weighting
  • PD Paper
  • CPS Paper
Selection Centre 40%

To achieve an accurately weighted final score, it is important that all results use the same scale. Therefore, the weighted MSRA scores for the PD and CPS must be rescaled to allow them to be combined with Selection Centre scores.

An applicant’s final score is then calculated by combining the weighted PD, CPS and Selection Centre scores in the agreed manner. A cut-off will be set to determine the minimum mark an applicant needs to achieve to be deemed ‘successful at selection’. Applicants who achieve this score or above will be ranked and offers allocated accordingly. An applicant’s final score, their rank, and the agreed cut-off score will be provided as feedback.

19.2 Appealing the Outcome

The outcome is final and cannot be reviewed, re-marked or disputed. There is no appeals process.

If you feel your application has not been managed correctly and have evidence of a failure in the process, there is a national complaints policy and procedure. You should explore this route if you have any concerns about your application. A copy of the policy can be located in the GPRNO Resource Bank.

All offers will be made via Oriel by GPNRO. Offers received in any other way will be deemed invalid. If you are made an offer, you will need to respond to this on Oriel.

Applicants will be ranked in a single national list based on their performance throughout the selection processes. Applicants who qualified for Direct Pathway to Offers will be ranked first, above those who were deemed appointable via the Selection Centre. Offers are made in rank order based on this national ranking.

Initial offers will be released by close of business on the first offer date published for the current round (see the GPNRO website). Please do not contact GPNRO about offers prior to this date, as it could delay the release.

You will be given 48 hours (exclusive of weekends) to respond to an offer and you have the option to accept, decline or hold. Only one offer can be held at any one time, across all specialty applications in a given round. If you fail to respond to an offer within the 48-hour window you will be deemed to have declined the offer.

If you are holding an offer and try to hold another, the original held post will be automatically declined on your behalf by Oriel.

Once you have accepted a post, you will not receive any further offers from any other specialty in this round (i.e. Oriel will automatically withdraw you from all other applications you have in the given recruitment round).

Offers that are declined will be reoffered in rank order to other applicants.

If you choose to hold an offer, you can keep this offer held up until the hold deadline published for the current round (see the GPNRO website). Before this deadline, you will be required to go back into Oriel and make a final decision on the offer. Any offers still held when the deadline is reached will be deemed to have been declined and the system will automatically change your status to show that you have declined the post.

After the hold deadline has passed, any offers made will only have the option of accept or decline.


  • When actioning an offer, it is strongly recommended that applicants avoid using a mobile device or internet browsers that have reached the end of their product support lifecycle as these are unlikely to be supported.
  • Applicants who let their offer expire (and are withdrawn from the recruitment process) can be reinstated if they contact the GPNRO; however, their original offer cannot and will not be guaranteed.
  • Applicants who let their offer expire (and are withdrawn from the recruitment process) can be reinstated if they contact the GPNRO; however, their original offer cannot and will not be guaranteed.

20.1 Confirmation of Actioning an Offer

Once you have actioned your offer, you will receive an automated confirmation message in Oriel and a secondary automated message will be sent to your registered email address. If you do not receive confirmation, log into your Oriel account to confirm if the offer action process was completed in its entirety.

If you rank highly enough to be made an offer, this will be made to the highest ranked Training Programme preference that is available when your final rank is reached. If this Training Programme offer is suitable for you and you do not want to be considered for any other preferences you have ranked higher, you can choose to simply accept it.

However, applicants do have the option of getting one of their higher ranked GP Training programme preferences, should they become available, by opting into upgrading. The upgrading option is available to all offers that have been held or accepted, but not where an offer has been declined. An applicant who has accepted or held an offer can opt in or out of upgrading at any time during the window which runs until the upgrade deadline published for the current round (see the GPNRO website). Please be aware that due to the ranking of your GP Training Programme preferences you may move into a different region if you are upgraded.

If you opt into upgrades and a higher preferenced offer becomes available, the upgrade will be automatic. You will be placed in the higher preferenced post and an automated message will be sent to you Oriel informing you of the upgrade; you will not be given 48 hours to decide whether you wish to accept or decline the upgrade. If an upgrade is made, the previously held or accepted post will be released and will be reoffered to another applicant.

Once you have been upgraded you will be sent an automated message through Oriel to inform you of this. Details of the upgrade made will be available in the relevant section on Oriel.

Please note:Upgrading of offers will not continue beyond the stated upgrade deadline, even if a preferred post becomes available at a later date. After the upgrade deadline, vacant posts will be offered to the next eligible applicant who has preferenced the post and who has yet to receive an offer, not to applicants who have already accepted a post.

21.1 Offer Exchanges/Enhanced Preferences

Applicants can have a change in circumstances for any number of reasons in the time between programme preferences being made and offers being released.

For applicants who have accepted or held a post, there will be an option to select upgrade options which not only include those programmes that were originally ranked higher than the offered post, but also those that were ranked lower.

Please note: Any changes to preferences made between the offer algorithm being run and offers being released will not be considered until the next offers match is run.

Applicants who have not been made an offer may also have a change in circumstances that requires them to make amendments to their expressed preferences. GPNRO will keep their programme preferencing open throughout the recruitment process, however this will be temporarily disabled before each offer algorithm is run, until the offers have been released.

These processes will continue up until the upgrading deadline in each recruitment round (see the GPNRO website).

More detailed guidance on this process is contained in the Oriel Applicant User Handbook.

Referees should be contacted at the earliest opportunity to confirm that they are happy to support the application and provide a reference. You are required to give details of your last three clinical or educational supervisors from your current post, your previous post and the post before that.

All offers made will be on the condition of the offered region receiving three satisfactory references. Obtaining references is an applicant’s responsibility. The offered region will NOT chase your referees.

22.1 Reference Requests

Reference requests are an automated process in Oriel. A request will be triggered and sent electronically to your nominated referees when you accept or, accept with upgrades an offer of GP training. To ensure that the requests are not blocked or filtered by your referees’ email providers you are strongly advised to inform your referees to add to their email whitelist.

22.2 Completing a Reference

Referees are required to submit references electronically, using the online referee portal in Oriel. You will be advised, via your Oriel portal, when your referee has submitted a reference. In rare cases there may be a need for your reference to be provided on paper. We will instruct you if this is necessary. You can download a Structured National Reference Form from the Oriel Resource Bank and you will need to ask the affected referee to return the completed form directly to the offered region or employer, if known.

22.3 Changing Your Nominated Referee

For any references that have not yet been submitted you are able to update the details of or, change your, nominated referees. However, if a referee has already submitted your reference, you will not be able to make any changes to their details.

If you change the email address against a referee, a new reference request will be sent to the newly provided email address, and the original request will be withdrawn.

Once you have accepted an offer of training at a region and the upgrade deadline has passed, you will be asked, by the offered region, to indicate your preferred geography and/or rotational posts from those that are available within the Training Programme that you have accepted.

Information regarding these further preferences will be published on individual region websites.

The GPNRO does not have any involvement in this process. Any queries relating to this should be sent to the region where the training offer was received.

23.1 Allocation of Trainees within Local Training Programmes

Once offered a Training Programme within a region it is expected that further preferences will be based on individual ranking and achievement over the exercises involved in the selection process, i.e. higher performing applicants are offered a higher preference from the pool of local placements/rotations on offer.

There is, however, a risk associated with the lower level of allocations to programme level if done purely by choice. Therefore, each region has developed its own allocation policy to mitigate risk. You should visit the website of the relevant region for further information on this.

Using the Single Transferable Score model in GP recruitment means there will be no option for clearing. Therefore, if you do not receive an offer in this round of recruitment it will be for one of two reasons:

  1. Every one of your GP Training Programme preferences are accepted before your rank is reached (this could happen even if you are considered appointable in the process).
  2. You were unsuccessful at a certain part of the recruitment process (you will be notified if this is the case).

Applicants will be given feedback throughout the recruitment process and will not need to make a formal request to receive it.

Applicants that are rejected at the longlisting stage will be advised of the reason why their application was rejected. Applicants that are rejected following MSRA will be advised of their total scores, and the scores needed to be invited to Selection Centre. Selection Centre feedback will be released within seven days after the initial offer date.

Applicants who wish to request feedback above and beyond the standard feedback that is provided (i.e. their actual score sheets) can do so by making a request to the GPNRO.

GPNRO expect the score sheets to be sent back to applicants within 20 working days however applicants must understand that in busy periods this could take longer to receive.

There is no further feedback that can be provided after score sheets have been requested.

The offer and allocation of a Training Programme referred to above is NOT an offer of employment. An employment contract detailing the terms and conditions of employment will be issued by the responsible employing organisation and is made subject to satisfactory pre-employment checks. Your offer of employment will include the name of your employer, the start date and length of the period of employment, the location, the hours, the minimum rate of remuneration and the notice period applicable.

Information regarding pay, hours, sick pay and annual leave entitlements, notice period, study leave, pension scheme etc. are set out in the national terms and conditions available from NHS Employers. A framework for a written contract of employment for GP specialty registrars is also available from the BMA. Individual region websites may also provide additional local information and links to individual employer websites.

The employing organisation carry out several pre-employment checks before an offer of employment can be confirmed. These will include verification of identity, registration and qualifications, right to work (immigration), employment history and employment reference checks (these are different from the clinical reference checks that the region needs), a Disclosure and Barring Service (DBS) check and an occupational health check. Some of these (verification of identify, registration and qualifications and right to work for example) may also be undertaken by the region during the recruitment process.

Any claims for expenses incurred in travelling to a Selection Centre should be made to the region that interviewed you, not the GPNRO. This should normally be a venue close to your residence or place of work. You will be expected to explain why this is not the case if you appear to have excessive expenses.

Please contact the organising region for further guidance on their expenses policy.

All national recruitment offices use a nationally agreed process for handling complaints about recruitment. If you feel your application has not been managed correctly and have evidence of a failure in the process, you should explore this route. A copy of the national complaints policy and procedure document can be located in the GPRNO Resource Bank.

28.1 Raising Concerns

Applicants wishing to raise concerns about any part of the recruitment process, where this falls outside the scope of the complaints policy should forward these, in confidence to

Concerns raised without detail are difficult to investigate due to the volume of applications received. Applicants are therefore requested to provide details of the specialty and, where applicable, the applicants concerned. Any information provided would be treated in the utmost confidence.