Specialty Training Application Form Part 2

These are the UK Specialty Training application form questions used on Oriel for applications to ST1, CT1, ST3 and ST4 specialty training posts. These are the application form questions used for posts advertised in November 2023 with a start date from August 2024. Dental Specialty posts are usually advertised in January with a start date in September.

The questions are presented here to help you prepare for your future applications. Please be aware application form structures, questions, word counts, etc. can change and there is no guarantee that future application forms will remain the same. 

Training History / Previous training details

1. Training history / Previous training details
Level to which you are applying (drop-down list)
If multiple levels are available to select, please choose the highest to which you can demonstrate eligibility.

This training post/programme is not normally available to any doctor who has previously relinquished or been released/removed from this training programme or the associated core training programme

Have you previously relinquished or been released or removed from a training programme in the specialty or associated core training programme for which you are applying? (Yes/No)

Do you currently hold a National Training Number (NTN) or Deanery Reference Number (DRN) in the specialty to which you are applying and are you applying to continue your training in another area/region? (Yes/No)

The information you enter on this part of the form will be passed direct to the recruiting department at the area/region or national recruiting organisation. It will not be used in assessing and scoring your application. If you are successful the details entered in this part of the application form will then be passed to your prospective employer and/or HR department.

Please note that incomplete application forms will not be considered.

2. Personal details
Do you currently hold a National Training Number (NTN) or Deanery Reference Number (DRN)? (Yes/No)

All trainees in core (with the exception of dental core), higher, specialty or locum appointment for training posts will hold either an NTN or DRN.

Are you a member of the Protecting Vulnerable Groups (PVG) Scheme? (Yes/No)
Please note, this will only apply to applicants who have previously worked in Scotland.

Do you have a disability, learning difficulty or health condition, or are pregnant or breastfeeding and require any specific arrangements / adjustments to enable you to attend a computer based test, interview or assessment, or other selection process? Depending on the circumstance/request, you may be asked to provide medical evidence (Yes/No)

If you have a disability, defined as a physical or mental impairment which has a substantial and long term effect on your ability to carry out normal day to day activities and you meet the minimum criteria as specified in the Person Specification, do you wish to be offered an interview under the Disability Confident Scheme?

Are you considering an application for less than full-time training (LTFT)? (Yes/No)
Please note that selecting ‘Yes’ does not result in an application for LTFT training. This must be submitted directly to the region/area appointed to.

3. Professional registration
Do you have FULL General Medical Council (GMC) registration? (Yes/No)

If applying to OMFS, will you have registration with the General Dental Council (GDC) by the start date of the post to which you are applying? (Yes/No)

4. Support for doctors new to the UK
Are you a UK medical graduate or do you have more than six months experience in the NHS (including Foundation)? (Yes/No)

5. Language Skills
Evidence of English Language Proficiency

As a doctor you are required to demonstrate skills in written and spoken English which allow you to perform your clinical skills safely and to communicate effectively on medical and/or health topics with patients, colleagues and the public.

Was your undergraduate training taught in English? (Yes/No)

6. Special Circumstances
Do you have special circumstances that may require you to remain in a geographical area for specific caring or health reasons? (Yes/No)

7. Programme specific information
Do you wish to apply for a deferred start date? (Yes/No)

8. Academic clinical fellowship / Clinical specialty training
Have you also applied for academic clinical fellowship (ACF) training in this specialty in the 2024 academic recruitment round? (Yes/No)

References

1. References information
Reference reports are not used at eligibility checking or at the selection centre but will be requested and reviewed after offers have been accepted and prior to confirmation of appointment for successful applicants. The reference process is designed to check the accuracy of your previous employment and training history and to provide assurance of your suitability for employment.  
 
You must provide contact details, including e-mail addresses, of three referees who have supervised your clinical training during the last two years of your employment or undergraduate training. One referee must be your current or most recent consultant or educational supervisor familiar with your clinical development. 
 
NHS pre employment checks require your NHS employer to take up references spanning the last three years of your work and education.  You may be required to provide further referee details to your NHS employer, if appointed.
 
If you are applying for an Academic Clinical Fellowship post, one of your referees must be able to provide the academic reference.
 
You should contact your clinical referees in advance to confirm that they are willing to provide a reference and are available and able to do so in the time period required for selection and appointment.
 
Please ensure they provide you with their preferred email address.  This will be the email address that will be used when requesting references. 
Your future employer may need to request an employment reference from your medical/dental school if you graduated less than three years ago. This information will not be requested until after you have been made a conditional offer of employment. 
 
2. Employment or training post 1
Referee 1
This referee must be your present or most recent employer, Consultant or Educational Supervisor.
Post specialty
Post grade 
Start date 
End date
Referee title
Referee forename
Referee surname
Job title of referee
What was their role in relation to you (e.g. Consultant, manager)?
Contact email address
Please ensure you enter a valid email address as your referee may be asked to submit an online reference in support of your application.
Confirm referee e-mail address
GMC/GDC registration no.
Contact phone number
 
3. Employment or training post 2
Referee 2
Post specialty
Post grade 
Start date 
End date
Referee title
Referee forename
Referee surname
Job title of referee
What was their role in relation to you (e.g. Consultant, manager)?
Contact email address
Please ensure you enter a valid email address as your referee may be asked to submit an online reference in support of your application.
Confirm referee e-mail address
GMC/GDC registration no.
Contact phone number
 
4. Employment or training post 3
Referee 3
Post specialty
Post grade 
Start date 
End date
Referee title
Referee forename
Referee surname
Job title of referee
What was their role in relation to you (e.g. Consultant, manager)?
Contact email address
Please ensure you enter a valid email address as your referee may be asked to submit an online reference in support of your application.
Confirm referee e-mail address
GMC/GDC registration no.
Contact phone number

Fitness to practise

1. Data Protection Act 2018
The Data Protection Act 2018 requires us to provide you with certain information and to obtain your consent before processing sensitive data about you. Processing includes: obtaining, recording, holding, disclosing, destruction and retaining information. Sensitive personal data includes any of the following information: criminal offences, criminal convictions, criminal proceedings, disposal or sentence.

The information that you provide in this Declaration Form will be processed in accordance with the Data Protection Act 2018. It will be used for the purpose of determining your application for this position. It will also be used for purposes of enquiries in relation to the prevention and detection of fraud in the interest of patient safety.

This Declaration Form and any information provided relating to a positive declaration will be kept securely and in confidence, and access to it will be restricted to designated persons within the recruiting organisation and other persons who need to see it as part of the selection process and who are authorised to do so. If successfully appointed to a training post, this information may be passed to designated persons in your first or lead employing organisation and any organisations through which you rotate.

2. Fitness to practise
It is vitally important that you read, understand and answer the questions asked in this section by ticking each box. Please read the notes below carefully before completing this part of the form. If you require further information, please contact the recruiting organisation that you are applying to. All enquiries will be treated in strict confidence.

We aim to promote equality of opportunity and are committed to treating all applicants for positions fairly and on merit regardless of race, gender, marital status, religion, disability, sexual orientation or age. We undertake not to discriminate unfairly against applicants on the basis of criminal conviction or other information declared.

The position you have applied for has been identified as a regulated activity within the terms of the Safeguarding Vulnerable Groups Act (2006), as amended by the Protection of Freedoms Act (2012) and is eligible for an enhanced criminal records check (Access NI in Northern Ireland, Protecting Vulnerable Groups Scheme (PVG) in Scotland) under the provisions of the Police Act 1997 (Criminal Records) Regulations (as amended). The enhanced criminal record check will, where appropriate to the role, also include any information which may be held against the barred lists for working with children and / or adults.

Before you can be considered for appointment in a position of trust as a trainee in this position we need to be satisfied about your character and suitability.

The position you have applied for is exempt from the Rehabilitation of Offenders Act 1974. This means that you must declare all criminal convictions, including those that would otherwise be considered ‘spent’, under this Act, unless they are considered protected.

Answering ‘yes’ to any of the questions below will not necessarily bar you from an appointment. This will depend on the nature of the position for which you are applying and the particular circumstances.

Prior to making a final decision concerning your application, we shall discuss with you any information declared by you that we believe may have a bearing on your suitability for the position. If we do not raise this information with you, this is because we do not believe that it should be taken into account. You still remain free, should you wish to discuss the matter with the interviewing panel. As part of assessing your application, we will only take into account relevant criminal record and other information declared.

Please answer the following questions. If you answer “YES” to any of the questions, you will need to complete the FTP declaration form found on the resource bank. Please submit this form via e-mail to the lead recruiter (details can be found on the recruitment leads page) Please mark the email “CONFIDENTIAL”. Emails should be received by no later than the submission deadline for applications.

If you would like to discuss what effect any previous convictions, police investigations or fitness to practise proceedings taken or being taken either in the UK or by an overseas licensing or regulatory body might have on your application, please contact the lead recruiter (details can be found on the recruitment leads page).

1. Are you currently bound over, or do you have any convictions or cautions (including warnings and reprimands) which are not deemed ‘protected’ under the amendment to the Exceptions Order 1975, issued by a Court or Court-Martial in the United Kingdom or in any other country? You do not need to tell us about parking offences, or fixed penalty notices but other driving offences must be declared. (Yes/No)

2. Have you been charged with any offence in the United Kingdom or in any other country that has not yet been disposed of? (Yes/No)
Please note:
You are reminded that you have a continuing responsibility to declare any new criminal convictions, police investigations or fitness to practise proceedings that arise after application submission.
Where recruitment is ongoing, you should inform the recruitment office. After an offer has been made, you should notify the appointing region. Once in a training post or programme, you should inform your employer(s) and the Postgraduate Dean.
You do not need to tell us about parking offences, or, fixed penalty notices but other driving offences must be declared.

3. Are you aware of any current NHS Counter Fraud and Security Management Service (CFSMS) investigation following allegations made against you? (Yes/No)

4. Have you been investigated by the Police, NHS CFSMS or any other Investigatory Body resulting in a current conviction or dismissal from your employment or volunteering position? (Yes/No)
Investigatory bodies include: Local Authorities, Customs and Excise, Immigration, Passport Agency, Inland Revenue, Department of Business, Innovation and Skills, Department of Work and Pensions, Security Agencies, Financial Service Authority, or any successor bodies to the above. Note: This list is not exhaustive and you must declare any investigation conducted by an Investigatory Body.

5. Have you ever been dismissed by reason of misconduct from any employment, volunteering, office or other position previously held by you? (Yes/No)

6. Have you ever been disqualified from the practice of a profession or required to practise subject to specified limitations / conditions / warnings following fitness to practise proceedings by a regulatory or licensing body in the United Kingdom or in any other country? (Yes/No)

7. Are you currently the subject of any investigation or fitness to practise proceeding by any licensing or regulatory body in the United Kingdom or any other country? (Yes/No)

8. Are you subject to any other prohibition, limitation, or restriction that means we are unable to consider you for any position for which you are applying? (Yes/No)

9. Do you know of any other matters in your background which might cause your reliability or suitability for employment to be called into question? (Yes/No)
If you answer “YES” to any of the questions, you will need to complete the FTP declaration form found in the resource bank. Please submit this form via e-mail to the lead recruiter (details can be found on the recruitment leads page). Please mark the email “CONFIDENTIAL”. Emails should be received by no later than the submission deadline for applications.

Where you have a Fitness to Practise declaration as a result of a health issue, please contact the recruitment lead for a confidential discussion to determine the level of detail that you need to provide.

A list of FTP email addresses is available in the Applicant Handbook found in the Resource Bank. They can also be found on the Recruitment Leads page on Oriel for each Recruitment Office.

Competences / Eligibility

1. Entry qualification
Please give details of your primary medical qualification
Qualification
Entry date to medical school
Date of qualification
Medical school / University
Medical school / University address line 1
Address line 2
Address line 3
Postcode
Country of primary medical education
Recommended contact for academic/educational reference
Telephone number
Contact email address for academic/educational reference
Your future employer may need to request an academic/educational reference from your medical school if you graduated less than three years ago. This information will not be requested until after you have been made a conditional offer of employment.

2. Entry qualification – applicants to Oral and Maxillo Facial Surgery only
Please give details of your primary dental qualification
Qualification
Date of qualification
Dental school/university
Address line 1
Address line 2
Address line 3
Post code
Country of primary dental education

3. Accreditation of transferable capabilities
If successful in your application to this specialty, would you be interested in accrediting transferable capabilities? (Yes/No)
See specialty specific guidance for further information. Please note, accreditation of transferable capabilities needs to applied for separately through the area/region where you accept a training programme.

Declarations

1. Confirmation

I have met/or am expecting to meet the essential entry criteria as set out in the person specification for the specialty and entry level to which I am applying, including, where necessary the acquisition of the relevant competences and college memberships. (Tick box)

I confirm that my data may be used anonymously for research and evaluation purposes in particular for the continued development of national application processes and shared with the GMC and Royal Colleges for this purpose. (Tick box)

I confirm that I understand the implications if I do not complete this application form correctly. (Tick box)

I have read the guidance for this specialty/application and understand the specialty entry requirements for the training programme I have chosen. See Applicant Guide. (Tick box)

2. Declarations

Important: The Data Protection Act 2018 requires us to advise you that we will be processing your personal data. Processing includes: holding, obtaining, recording, using, sharing and deleting information. The Data Protection Act 2018 defines ‘sensitive personal data’ as racial or ethnic origin, political opinions, religious or other beliefs, trade union membership, physical or mental health, sexual life, criminal offences, criminal convictions, criminal proceedings, disposal or sentence.

The information that you provide in this Application Form will be processed in accordance with the Data Protection Act 2018. It will be used for the purpose of determining your application for this position. It will also be used for purposes of enquiries in relation to the prevention and detection of fraud.

Once a decision has been made concerning your appointment, the recruiting organisation will not retain this declaration for any longer than is necessary [see further details in ‘Guidance Notes for Applicants’]. This declaration will be kept securely and in confidence. Access to this information will be restricted to designated persons within the trust / employing organisation who are authorised to view it as a necessary part of their work.

Declaration 1: I declare that the information I have given in support of my application, including information supplied on this form and any attached appendices, is, to the best of my knowledge and belief true and complete. I understand that if it is subsequently discovered that any statement is false or misleading, or that I have withheld relevant information, particularly on criminal convictions and/or fitness to practise and/or have breached the Confidentiality: good practice in handling patient information (2017) stipulated by the General Medical Council/General Dental Council/any other licensing or regulatory body of which I am a member, my application may be disqualified.  If I have already been appointed, I understand that I may be dismissed and I may be reported to the General Medical Council/General Dental Council or any other licensing/regulatory body of which I am a member.

Declaration 2: I declare that my answers to the questions on this form, any attached appendices and any other application forms required by Deaneries/NHS England recruitment offices are my own work and are not copied or reproduced from any other sources. I understand that if any of my answers are discovered not to be original, my application may be disqualified.

Declaration 3: Where applying for medical posts, I am aware that Good Medical Practice states that if I formally accept a post I must not withdraw unless the employer has time to make other arrangements. I understand that failure to comply with this requirement may result in a complaint being made against me to the GMC.

Declaration 4: I understand that if I am allocated to a training opportunity, any subsequent contract of employment will be subject to satisfactory pre-employment checks and subject to a condition that the information provided on the application form or any related documents is correct. I also understand that pre-employment checks will be carried out to review and confirm the details of my application. 

Declaration 5: I understand that employment offered in this training programme is subject to satisfactory medical clearance which may include a medical examination and/or blood tests. Where applying for a medical post, I am aware of the GMC guidance on Gateways to the profession explaining how health and disability issues should be handled by education and training providers. 

Declaration 6: I understand that if recommended for training I will be subject to a Disclosure and Barring Service (DBS) check (previously known as CRB), Access NI in Northern Ireland the Protecting Vulnerable Groups Scheme (PVG) in Scotland. I am aware that I must inform the National Recruitment Office/Deanery/NHS England recruitment office of any new criminal convictions, police investigations or fitness to practise proceedings that arise after the completion of this application form. 

Declaration 7: I have read and understand the Privacy Notice and understand that my Personal and Sensitive Personal Data will be processed in the manner set out in this Notice.

Declaration 8: I confirm that if there is a change in my training status once I have submitted my application (i.e. removal of training number, interdeanery transfer etc), which would significantly affect the content of my application form, I will inform the Lead Recruiter for the training programme. Failure to disclose such changes could lead to the withdrawal of any training offer.

Declaration 9: I have read in full and confirm the acceptance of the 2024 Medical recruitment applicant declaration.

I agree to the above declarations (tick box)