Complete guide to getting into Clinical Radiology

Recruitment into Clinical Radiology ST1 starting in 2027

Like speaking to surgeons on the phone, going home on time and sitting in dark rooms?

Radiology has always been a popular choice, but with competition ratios reaching 11.27 it's never been more important to know the recruitment process inside and out.

In this guide we'll cover everything you need to know, from portfolio scoring to past MSRA scores to what actually happens on interview day, we've got you covered. Let's get started.

The Clinical Radiology recruitment pathway consists of four steps: (1) Longlisting, (2) Shortlisting, (3) Interviews (including a Portfolio review) and (4) Offers.

Applications are all submitted via the online Oriel Platform.

Application Timeline

Estimated, based on patterns observed in previous years

The next recruitment cycle for Clinical Radiology ST1 will be Round 1. This will be recruiting for programmes starting in August 2027.

		Round 1 Programmes Starting Aug 2027
	Applications Open	22nd October 2026
	Applications Close	19th November 2026
	Book MSRA via Pearson Vue	14th December 2026
	MSRA Window	5-15th January 2027
	Results Released	By 16th March 2027

Competition Ratios

Like most specialities, applicants for Clinical Radiology ST1 have grown rapidly over the past 5 years, leading to a sharp rise in competition ratios.

Longlisting

Longlisting is the process of checking if you meet the essential eligibility criteria for Clinical Radiology training.

Candidates who pass longlisting will be invited to sit the Multi-Specialty Recruitment Assessment (MSRA) which is used to decide who gets an interview (shortlisting).

It is important to note that most candidates are assumed to meet the essential criteria and that some of the formal checks are not done until after the shortlisting process has started. As such it is important to make sure you are definitely eligible, otherwise you run the risk of being removed when you are much further into the recruitment process.

18 months

One Clinical Radiology specific essential criteria is that you do not have more than 18 months of experience working in Radiology prior to the expected start date of the training post.

Anyone with more than 18 months will be excluded from applying. This does not include any experience gained during a UKFPO Foundation Programme. It does include experience gained abroad.

For applicants who have not done the formal UKFPO Foundation Programme and are applying with equivalent competencies, you are allowed to exclude 4 months of your Radiology experience as Foundation-level, any subsequent experience will be counted towards the 18 months maximum. Giving you a real maximum experience of 22 months.

Foundation Competencies

If you have not completed the Foundation Programme, or did so more than 3.5 years ago, it's worth checking out the official recruitment guide to see exactly what you will require. Normally this will either be a Certificate of Readiness to Enter Specialty Training (CREST) or a Foundation Programme Certificate of Competence (FPCC).

Shortlisting

Shortlisting is the process of deciding who gets to proceed to interview, this is selected based solely on your Multi-Specialty Recruitment Assessment (MSRA) score.

The MSRA consists of two papers:

1. Clinical Problem Solving

Consisting of 86 clinical questions testing your medical knowledge.

2. Professional Dilemmas

Consisting of 50 situational judgement test questions, where you will be tested on your Empathy & Sensitivity, ability to Work under Pressure and Professional Integrity.

They are sat together in a single sitting, you can learn more about the MSRA in our complete guide.

The top ~850 scoring applicants will be invited to upload their portfolio evidence on Oriel.

The top ~700 scoring applicants will then be offered an interview.

MSRA Score Distributions for Clinical Radiology ST1

Explore past MSRA score distributions for Clinical Radiology applicants

Portfolio

The portfolio is a key component of applying for Clinical Radiology. It makes up 2 out of 7 questions in your interview and 40% of your total selection score.

WARNING - The portfolio component often changes year to year. This section currently represents the portfolio for training places starting in 2026. We endeavour to keep this section in sync with any changes and will update it as soon as 2027 portfolio scoring becomes available.

You can also check the latest on the official recruitment page.

Commitment to Specialty

Descriptor	Category	Score
Multiple¹ significant exposures² to the work of a clinical radiology department	A	4
One significant exposure to the work of a radiology department	B	3
Attended a radiology-based course of at least 1 day in length	C	2
Attended a radiology related conference	D	1
None of the above	E	0

1. Multiple exposures (A) must be meaningfully different i.e. 2 taster weeks in different settings.

2. Significant exposure is defined as a period of 3 whole days (or equivalent) attached to a Clinical Radiology deparment.

Leadership and Management

Descriptor	Category	Score
Hold/have held a national level leadership or managerial role involving radiology For example, within specialist society, royal college, nationally held fellowship position, relevant to radiology	A	4
Hold/have held a national level leadership or managerial role not involving radiology, but relating to healthcare or a local/regional level leadership or managerial role involving radiology For example, within British Medical Association (BMA), royal college Local role, for example, committee member of undergraduate radiology society	B	3
Hold/have held a national level leadership or managerial role outside healthcare or a local/regional leadership or management role not involving radiology but relevant to healthcare National roles outside healthcare may include charity work, sports, creative arts Local role relevant to healthcare but not radiology, for example, Junior Doctors Forum or Mess committee, Foundation programme representative	C	2
Hold/have held a local/regional leadership or management role outside healthcare Same as for C but at a local level	D	1
None of the above	E	0

Any roles being claimed must have been for a minimum period of 6 months.

Teaching and Training

Descriptor	Category	Score
Hold a formal teaching qualification¹ awarded at postgraduate level	A	4
Have made a major contribution² to a national or international³ teaching programme⁴, with evidence	B	3
Evidence of other training in teaching methods after study of at least 2 days (such as Train the Trainers)	C	2
Have evidence of providing regional teaching⁵	D	1
None of the above	E	0

1. Masters, CILT, PGDip, PG Cert

2. A major contribution means a leading or organising role, such as a formal teaching fellowship or personally organising a formal, multi-session teaching course.

3. National or international programmes should be open to all relevant learners in that discipline and would usually form part of a formal qualification, such as Bachelor of Medicine, Bachelor of Surgery (MBBS) degree, specialty diploma etc.

4. A formal teaching programme must have a duration of at least 3 months in total to be included.

5. Local or regional programmes would be organised at the level of, for example, a single hospital Trust, and could include Foundation Programme teaching or similar activities. Formal teaching outside medicine, for example, to school students or in the community can also be included.

Audit and Quality Improvement

Descriptor	Category	Score
I have led¹ 2 or more audits or quality improvement projects relating to radiology² which can be shown to have resulted in changed practice³	A	4
I have led an audit or quality improvement project relating to radiology which can be shown to have resulted in changed practice	B	3
I have led a non-radiology audit or quality improvement project, shown to have resulted in changed practice	C	2
I have contributed to, but not led, an audit or quality improvement project	D	1
None of the above	E	0

1. Leading an audit/Quality Improvement (QI) project would usually include a major role in conception, data collection, analysis, and presentation. If your evidence does not demonstrate this, please select a different descriptor appropriately.

2. Relating to radiology means that diagnostic imaging formed a major part of the project.

3. Demonstration of changed practice could be via a closed-loop second audit cycle showing better compliance to gold standard, or by improvement in a quality metric etc.

Academic Achievements

Descriptor	Category	Score
Postgraduate research degree or research Masters (PhD, MD, MDRes) or At least one peer-reviewed publication relating to radiology as first author	A	4
At least one peer-reviewed publication relating to radiology, not as the first author or At least one peer-reviewed publication not relating to radiology but as a first author or A case report related to radiology, as first author or At least one oral or poster presentation¹ relating to radiology at a national or international level, as first author	B	3
At least one peer-reviewed publication not as first author or A case report not related to radiology, as first author or At least one oral or poster presentation relating to radiology at local/regional level, as first author	C	2
At least one oral or poster presentation not relating to radiology at either local, regional, national or international level or Involvement in a research team as part of an elective, intercalated degree, extended student research and enterprise project, academic foundation programme, academic summer school or other research taster	D	1
None of the above	E	0

1. Presentations should be proffered papers which have been through a process of peer-review

All activity in this section should be scientific relating to radiology means the project should involve diagnostic imaging. This does not preclude papers in other fields such as surgery, oncology and so forth if they have a significant imaging focus. Publications and presentations can relate to audit/QI activity.

Interviews

Interview

The Clinical Radiology ST1 interview is conducted online via a virtual interview system called Qpercom Recruit. You will receive an invite to book an interview slot via Oriel. Slots are on a first-come first-served basis and they go very quickly. There is a short window where you can book a slot, but the sooner you book it the better.

While submitting your initial application you will have signed an Applicant Declaration which states the terms you agree to adhere to as a condition of your interview.

The interview itself consists of two, helpfully named, stations: (1) Station A and (2) Station B. Each station is 15 minutes long.

Interview day

Before your interview you will need to log onto Qpercom Recruit via a web browser at the time you have booked the interview for.

You will first be greeted by an administrator who will brief you on the interview process and confirm your ID. You must have valid photographic ID available for this process.

You will also need to move the camera on your computer/laptop to show the whole room so the administrator is satisfied that there is no one else in the room with you. Following this your interview will begin.

Station A

Before Station A begins the interview one of the interviewers will have spent 10 minutes checking your Portfolio Evidence and given you a score.

They will then start Station A which will consist of 4 main questions:

1. Portfolio Question #1

The panel will ask you two questions in total about your portfolio, so make sure you know it inside and out.

2. Portfolio Question #2

3. Understanding of Radiology

You will be asked a question checking your understanding of Radiology as a specialty. This is not a clinical question.

4. Skills Question

Past question from 2025 interview

What skills have you learnt that will make you an effective radiologist and why?

Station B

Station B consists of three main questions:

1. Clinical Scenario Prioritisation

Past question from 2025 interview

33 Male RTA - GCS 13, pulse 114 BP 80/40 SpO2 90% on 5l O₂

Head: There is a left, extradural haematoma, measuring a maximal depth of 5cm. This overlies, the left frontal temporal, and parietal lobes. There is no midline shift. The cerebellar tonsils above the level of the foramen magnum. The skull vault and base are unremarkable.

Chest: There is no mediastinal haematoma. The great vessels, opacify normally. There are multiple left sided rib fractures with a left-sided tension pneumothorax with a maximal depth of 8cm and 3cm mediastinal shift to the right.

Abdomen and pelvis: There is active extravasation of contrast arising from the left, renal parenchyma. There is a surrounding perinephric haematoma, 10cm left retroperitoneal haematoma and layering of blood within the pelvis. The liver, spleen pancreas, gallbladder, right, kidney, adrenals, and visualised, unprepared, bowel are unremarkable.

Musculoskeletal: No evidence of further bony injury in the axial or appendicular skeleton.

You are the requesting clinician; how do you proceed with the findings in the report?

2. Coping with Pressure and Managing Uncertainty

Past question from 2025 interview

A surgical registrar does not feel your provisional diagnosis during on call reporting is correct - how do you deal with this?

3. Team Involvement

Past question from 2025 interview

Give me an example from your portfolio of team working? What role do you play?

Appointability

Following your interview it will be determined firstly if you are appointable. To clear this hurdle you must score at least 22 marks on both stations and have a combined score of at least 48. You must also not score a 1 on any station and clear at least 6/10 marks on the Clinical Prioritisation question.

Ranking

If you are deemed appointable you will then be ranked against all the other appointable candidates.

Your score will be made up of:

Interview Score

60%

Portfolio Score

40%

Your MSRA score is not used in ranking for offers. It is only used in shortlisting for interview.

The top ~350 ranked candidates will then be offered a training place.

Offers

Once you have been sent an offer, you will have 48 hours to action it. You can do one of three things:

Accept

On accepting an offer you have secured your training place for Clinical Radiology. You will automatically be withdrawn from any other specialty training programme applications you have submitted.

You can also choose to opt-in for upgrades. If you do, you may still be offered jobs that you ranked higher than the one you have accepted.

Hold

When holding you are reserving the job offer, without committing yet to accepting or declining it. This option is intended for people who have applied for multiple specialities as it allows you to wait to see what's happening with your other applications before deciding what to do with your current offer.

You can also choose to opt-in for upgrades. If you do, you may still be offered jobs that you ranked higher than the one you have put on hold.

Decline

On declining an offer you will be completely withdrawn from the process of applying for Clinical Radiology. Your offer will propagate down to the next highest ranked candidate whose own offer is on hold and who ranked the job you were offered above their own. You can proceed with other specialty training programmes.

FAQs

How competitive is Clinical Radiology?

Very. Radiology has long been one of the most sought-after specialties, and competition has risen sharply over the past few years, with competition ratios reaching 11.27 in the most recent cycle. You can see how applicant numbers have grown in the chart above.

What MSRA score do I need to get a Radiology interview?

There's no fixed pass mark, the cut-off shifts every round depending on the number of applicants and interview capacity. As a rough guide, the top ~850 scoring applicants are invited to upload their portfolio, and the top ~700 are then offered an interview. You can explore the full historical score distributions in the chart above.

Does my MSRA score affect my final ranking?

No. Unlike many other specialties, your MSRA score is only used for shortlisting (deciding who gets an interview). Once you reach interview, your final ranking is made up entirely of your interview score (60%) and your portfolio score (40%).

How much does the portfolio count towards my application?

The portfolio makes up 40% of your final selection score, with the interview making up the other 60%. It's also referenced directly in 2 of the 7 interview questions, so it's worth knowing your portfolio inside and out, as you'll be asked to discuss it on the day.

What counts as 'significant exposure' to radiology for my portfolio?

For the Commitment to Specialty domain, a significant exposure is defined as a period of 3 whole days (or equivalent) attached to a Clinical Radiology department, for example a taster week. To score the maximum 4 points you need multiple significant exposures that are meaningfully different, such as two taster weeks in different settings.

I've already worked in radiology, can I still apply?

Possibly. One radiology-specific eligibility rule is that you cannot have more than 18 months of radiology experience prior to the start date of the post. Experience gained during a UKFPO Foundation Programme doesn't count, but experience gained abroad does. If you're applying with equivalent competencies rather than a formal Foundation Programme, you can discount 4 months as Foundation-level, giving an effective maximum of 22 months.

What does the Radiology interview involve?

The interview is conducted online via Qpercom Recruit and consists of two 15-minute stations. Station A covers your portfolio (two questions), your understanding of radiology as a specialty, and a skills-based question. Station B covers a clinical scenario prioritisation question, a question on coping with pressure and uncertainty, and a teamworking question.

What score do I need to be appointable?

To be deemed appointable you must score at least 22 marks on each station, achieve a combined score of at least 48, not score a 1 on any single station, and score at least 6 out of 10 on the Clinical Prioritisation question. Candidates who clear these hurdles are then ranked against one another for offers.

How do I book my interview slot?

You'll receive an invite via Oriel to book a slot, on a first-come, first-served basis. The booking window is short and slots go very quickly, so book as early as you possibly can to avoid being left with limited options.

What's the difference between Accept, Hold and Decline on an offer?

You have 48 hours to action an offer. Accept secures your place and withdraws you from other specialty applications (you can opt in for upgrades). Hold reserves the offer while you wait to hear from other applications, without committing yet. Decline withdraws you from the Clinical Radiology process entirely and passes your offer to the next eligible candidate.

Can I still apply if I finished the Foundation Programme more than 3.5 years ago?

Yes, but you'll likely need to provide additional evidence of your competencies, usually a Certificate of Readiness to Enter Specialty Training (CREST) or a Foundation Programme Certificate of Competence (FPCC). Check the official applicant guide for the exact requirements for your situation.

And that's our complete guide to getting into Clinical Radiology.

Good luck with your applications!

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