All roads can lead to surgery

Pursuing a career in surgery is a rigorous process that demands commitment and hard work. Surgeons in the United Kingdom must go overcome a myriad of competitive stages prior to becoming a consultant. In the United Kingdom, the most common pathway to become a surgeon is via the 'direct route' which encompasses completing multiple training programs, namely, the Foundation Program, followed by Core Surgical Training, and then onto Higher Speciality Training, with the aim of obtaining the Certificate of Completion of Training (CCT). More recently, certain specialities have introduced the 'Improving Surgical Training' (IST) pathway. IST is a competence-based, run through surgical program that was introduced by the Royal College of Surgeons of England (RCS) and Health Education England (HEE). "The pilot trials improvements in the quality of training, a better balance between service and training for trainees, and professionalisation of the role of the surgical trainers" [1]. However, there are alternative pathways that have been designed for those who prefer a different route to training or have been unsuccessful during the selection stages. These pathways are not well-advertised, but with the competitive rates now higher than before, it is becoming a more attractive pathway for junior doctors, hence the increasing the demand for clearer instructions on potential routes for aspiring surgeons.