Complete guide to getting into Core Psychiatry

Recruitment into Core Psychiatry Training CT1 starting in 2027

Core Psychiatry CT1, Child and Adolescent Psychiatry ST1 and Psychiatry of Learning Disability ST1 all share a single common recruitment pathway, and it's a fairly simple one.

There's no interview and no portfolio, selection is based entirely on your performance on the Multi-Specialty Recruitment Assessment (MSRA).

Over the past 5 years the number of applicants have grown exponentially, resulting in an eye watering competition ratio of 21.83 in 2025. Higher than Ophthalmology, Anaesthetics and almost the same as Neurosurgery.

With this in mind, it's never been more important to know the recruitment process inside and out, to give yourself the best possible chance of getting in.

In this guide we'll cover everything you need to know, from the programmes themselves, longlisting criteria, past MSRA scores, we've got you covered. Let's get started.

Application Timeline

Estimated, based on patterns observed in previous years

The next recruitment cycle for Core Psychiatry Training CT1 is expected to be Round 3. This will be recruiting for programmes starting in February 2027.

Will there be a Round 3 for Core Psychiatry Training in 2026-27?

There has been some speculation about whether there will be a Round 3 recruitment cycle this year. At least for ACCS/Core Anaesthetics CT1, another programme that traditionally recruits in round 3, it has been confirmed that there will be.

Following this a new recruitment year will begin, starting with Round 1, for programmes starting in August 2027.

IMPORTANT - Dates for both of these rounds have not yet been formally released. We have estimated the dates below from patterns observed in previous recruitment years. This will be updated once dates are officially released.

	Round 3 Programmes Starting Feb 2027	Round 1 Programmes Starting Aug 2027
Applications Open	28th July 2026	22nd October 2026
Applications Close	14th August 2026	19th November 2026
Book MSRA via Pearson Vue	21st August 2026	14th December 2026
MSRA Window	3-10th September 2026	5-15th January 2027
Results Released	By 8th October 2026	By 16th March 2027

Get notified when official dates are released

The dates above are our estimates. Leave your email and we'll let you know the moment the official Round 3 and Round 1 dates are confirmed.

One email when dates are confirmed. No spam, unsubscribe any time.

Overview

Core Psychiatry Training

Core Psychiatry Training is a 3 year programme. Following successful completion you will be eligible to apply for Advanced Psychiatry Training

Child and Adolescent Psychiatry ST1

Child and Adolescent Psychiatry is a 6 year run through programme. There are typically only a handful of posts available for the whole country, and many regions will often have 0 posts any given year.

The first 3 years are typically spent rotating alongside Core Psychiatry Training, with an effort made to provide a 6-month Child & Adolescent Psychiatry placement and a 6-month Paediatric linked post (e.g. Paediatric Liaison or Ambulatory Paediatrics) in ST2.

Psychiatry of Learning Disability ST1

Psychiatry of Learning Disability is a 6 year run through programme. As per Child and Adolescent Psychiatry, there are typically only handful of posts available for the whole country, and many regions will often have 0 posts any given year.

The first 3 years are typically spent rotating alongside Core Psychiatry Training, with an effort made to provide one 6-month Learning Disability post in this time.

Accreditation of Transferable Competences Framework (ATCF)

If you've already gained overlapping competences in another GMC-approved training programme you may not have to repeat them. The Accreditation of Transferable Competences Framework (ATCF) lets valid competences carry across to your new programme, and is aimed at the early years of training.

If you want to be considered for this, flag it on your application form and then raise it with your Training Programme Director or Head of School within the first three months of starting. The exact time recognised gets reviewed at your first ARCP if you're appointed.

Competition Ratios

Like most specialities, applicants for Core Psychiatry CT1 have grown rapidly, sextupling (x6), over the past 5 years. Meanwhile the number of available posts has remained static, leading to a sharp rise in competition ratios.

Longlisting

Longlisting is the process of checking if you meet the essential eligibility criteria for Core Psychiatry training.

Candidates who pass longlisting will be invited to sit the Multi-Specialty Recruitment Assessment (MSRA) which is used to decide who is offered a training place (direct selection).

This process is straight forward for most applicants, as long as you have completed the Foundation Programme within 3.5 years of the post's start date, have GMC registration and a right to work in the U.K. If you have not completed the Foundation Programme within 3.5 years, or ever, then you will need to prove that you have equivalent Foundation Competencies.

Foundation Competencies

If you have not completed the Foundation Programme within 3.5 years of the expected start date for the Core Psychiatry post, then you will need to show that you have equivalent competencies. There are generally four routes where this applies:

Currently on a Widening Access to Specialty Training (WAST) programme

If you are in a WAST programme, you'll need a fully completed and signed Certificate of Readiness to Enter Specialty Training (CREST) by the start date of the post. Nothing further is needed at the application stage.

Currently on a Specialty Training programme

If you're in an approved training post (CT/ST/LAT or equivalent) holding a National Training Number (NTN) or Deanery Reference Number (DRN), your Foundation competences are taken as having been assessed when you entered that post. You don't need to evidence them again, no matter when they were signed off, and you don't upload an FPCC or CREST. Just enter your NTN or DRN where asked.

Previously resigned from Psychiatry training in the U.K.

If you held an NTN or DRN but voluntarily resigned before completing, you can instead provide Annual Review of Competency Progression (ARCP) documentation showing satisfactory progress before you left. This only works if you're reapplying to the same specialty you were training in. You'll also need to submit a 'Support for Reapplication to a Specialty Training Programme' form, downloadable from the supporting documents page.

None of the above

If none of these fit you, you'll need to submit a CREST signed by a consultant who has supervised you for at least 3 continuous months (whole time equivalent) within the 3.5 years before the start date, uploaded as a single scanned document. CREST applicants are also expected to have at least 24 months of experience in appropriate posts (U.K. or overseas) since their primary medical qualification, roughly a 12-month pre-registration/internship/FY1 post plus 12 months in approved posts. You won't have to evidence this at application, but you may be asked for it later.

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.

Direct Selection

Direct Selection is the process of deciding who gets a training place, this is selected based solely on your 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, including practice papers and our top revision tips.

The top ~500 scoring applicants, on the MSRA, will be offered a training place.

MSRA Score Distributions for Core Psychiatry Training CT1

Explore past MSRA score distributions for Core Psychiatry Training applicants

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 Core Psychiatry Training. 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 Core Psychiatry Training. 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 Core Psychiatry?

Very. Psychiatry has seen one of the steepest rises in competition of any specialty, with applicant numbers sextupling (x6) over the past 5 years while the number of posts has stayed flat. This pushed the competition ratio to 21.83 in the most recent cycle, higher than Ophthalmology and Anaesthetics, and almost level with Neurosurgery. You can see how applicant numbers have grown in the chart above.

Is there an interview or portfolio for Core Psychiatry?

No. This is one of the things that sets psychiatry apart, there's no interview and no portfolio to submit. Selection is based entirely on your performance in the Multi-Specialty Recruitment Assessment (MSRA), which makes preparing for it by far the most important thing you can do.

What MSRA score do I need to get into Core Psychiatry?

There's no fixed pass mark, the cut-off shifts every round depending on the number of applicants and the number of posts available. As a rough guide, the top ~500 scoring applicants are offered a training place. You can explore the full historical score distributions in the chart above.

What does the MSRA involve?

It's made up of two papers, sat together in a single sitting. The first, Clinical Problem Solving, has 86 questions testing your clinical knowledge. The second, Professional Dilemmas, has 50 situational judgement questions assessing your empathy and sensitivity, your ability to work under pressure, and your professional integrity. We cover it in full, along with practice papers and our top revision tips, in our complete MSRA guide.

Can I apply for Child and Adolescent or Learning Disability Psychiatry through the same process?

Yes. Core Psychiatry CT1, Child and Adolescent Psychiatry ST1 and Psychiatry of Learning Disability ST1 all share a single recruitment pathway, so the application route is identical. Bear in mind that the two run-through programmes only have a handful of posts across the whole country each year, and many regions will have none at all in any given year.

What's the difference between Core Psychiatry and the run-through programmes?

Core Psychiatry is a 3-year programme, after which you apply separately for Advanced Psychiatry Training. Child and Adolescent Psychiatry and Psychiatry of Learning Disability are both 6-year run-through programmes, meaning you don't reapply partway through. In practice the first 3 years of all three look broadly similar, with the run-through programmes building in a relevant subspecialty placement along the way (for example a 6-month Child & Adolescent or Learning Disability post).

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

Yes, but you'll need to show you have equivalent Foundation competencies. For most people this means a Certificate of Readiness to Enter Specialty Training (CREST), signed by a consultant who has supervised you for at least 3 continuous months (whole time equivalent) within the 3.5 years before the post starts. There are also specific routes if you're on a WAST programme, currently in a training post with an NTN or DRN, or reapplying after resigning from psychiatry training. Check the official applicant guide for the exact requirements for your situation.

What is the ATCF?

The Accreditation of Transferable Competences Framework (ATCF) lets competences you've already gained in another GMC-approved training programme carry across, so you may not have to repeat them. It's aimed at the early years of training. If you want to be considered, flag it on your application form and then raise it with your Training Programme Director or Head of School within the first three months of starting, the exact time recognised gets confirmed at your first ARCP.

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 automatically withdraws you from your other specialty applications (you can opt in for upgrades). Hold reserves the offer while you wait to hear back from other applications, without committing yet. Decline withdraws you from the Core Psychiatry process entirely and passes your offer down to the next eligible candidate.

Will there be a Round 3 for Core Psychiatry in 2026-27?

It's expected, though not yet officially confirmed. Round 3 has traditionally been the cycle Core Psychiatry recruits into for February start dates, and Round 3 has already been confirmed for ACCS/Core Anaesthetics, another programme that recruits at the same time. The official dates haven't been released yet, so the timeline above is our best estimate based on patterns from previous years.

And that's our complete guide to getting into Core Psychiatry.

Good luck with your applications!

Get a head start on SJT prep

Join our free MSRA SJT question bank, includes 289 official practice questions

and secure access to the first fully validated MSRA SJT question bank, coming soon, places limited