The CREHST form (Certificate of Readiness to Enter Higher Surgical Training), now formally known as the slightly less catchy ACEEHST (Alternative Certificate of Eligibility to Enter Higher Surgical Training), is a certificate of equivalence for Core Surgical Training (CST). It can be used by individuals who have gained core surgical experience outside a UK CST post but can demonstrate that they have achieved the same outcomes as a trainee completing CST with a satisfactory ARCP.

The Multi-Specialty Recruitment Assessment (MSRA) has become a decisive factor in CST shortlisting. In this bulletin, I will attempt to explain how the exam has evolved over recent years and how to best revise for it. With the proposed changes to ST1 recruitment, MSRA may ultimately be of less relevance. However, it is still important to acquaint ourselves with the exam while it is being used for CST applications.

OMFS is still a relatively young specialty, and its development has differed across the world. What started as basic dentoalveolar surgery has grown into everything from microvascular reconstruction to major head & neck oncology, however,  not every country has taken the same route to get there. Some demand dual degrees, others focus on dental-only training, and some have created hybrid models that offer flexible training pathways.

For those of us planning to pursue (or are currently training) OMFS in the UK, understanding these differences may help us appreciate why the UK pathway is structured the way it is, and what opportunities (or challenges) await if you're considering working abroad. Whether you stick with the UK grind or explore international options, being aware of the landscape helps you make informed choices about your career.