The National Training Number (NTN) training pathway for cardiothoracic surgery, involves two years of core surgical training which are speciality training years one and two (ST1-2) and five years of speciality training (ST3-7). The entry point as of 2023 is at ST1. A new ST4 entry into thoracic surgery was introduced in the 2022 application cycle. The recruitment process in cardiothoracic surgery operates through national recruitment, conducted by Health Education England South East (Wessex).

This national recruitment covers all cardiothoracic surgery posts in England, Northern Ireland, Scotland and Wales. The Health Education England website link below has detailed information on entry requirements, including the person specifications for ST1 Cardiothoracic Surgery and ST4 training in Thoracic surgery.

The core surgical training component involves rotating between different surgical specialities - including six months in cardiothoracic surgery – acquiring basic surgical skills. At the end of these two years, a trainee is expected to pass Membership of the Royal College of Surgeons’ exam (MRCS). Trainees in ST3-7 years have to choose their major subspeciality, choosing from thoracic surgery or cardiac surgery, the period of training in that speciality is five years. All trainees have to do one year in the minor speciality. In some deaneries 6 months of congenital surgery is mandatory. In the latter years of training, trainees are expected to pass the fellowship of the Royal College of Surgeons exam in Cardiothoracic surgery (FRCS-CTh). 

Trainee surgeons who wish to pursue a career in Congenital cardiac surgery will need to spend at least two years of their final training within a dedicated Congenital Programme. Trainees must hold an NTN in Cardiothoracic Surgery. They must then apply for one of the UK training programmes for Sub-Specialty Training. All consist of two paired centres with the trainee spending one year in each. The posts are interviewed for at the same time as national recruitment, once a year. 

Upon finishing training, trainees are awarded Certificate of Completion of Training (CCT). CCT confirms that a doctor has completed an approved training programme in the UK and is eligible for entry onto the specialist register. Many trainees proceed to a senior fellowship position or locum consultant position, to get senior experience before taking on a substantive consultant position.