Offers

Following interview, you will receive a unique ranking and will be deemed successful or unsuccessful and will be informed of this via Oriel.

Applicants who have preferenced England and Wales will be ranked in a single national list based on their performance throughout the selection processes. Applicants who have preferenced Northern Ireland or Scotland will be ranked against other applicants who preference Northern Ireland or Scotland.

Offers are made in rank order based on the national ranking.

Tied ranks occur when applicants achieve the same total interview score. The applicants' unique rank will be achieved in the following order:

1. Overall score
2. Interview score
3. Global rating
4. Commitment to specialty
5. Clinical judgement and decision making
6. Working under pressure
7. Team working
8. Professional behaviours and communication
9. Reflective practice
10. MSRA

The first wave of offers will be sent out by ANRO no later than 5pm, Tuesday 6 April 2027. We ask that applicants do not contact ANRO about offers prior to this date, as it could delay the release.

Applicants will be given 48 hours (exclusive of weekends) to respond to an offer. Applicants have the option to accept, decline or hold an offer. 

If an applicant fails to respond to an offer within the 48 hour window, the offer will expire, and the applicant will be deemed to have declined the offer.

Please note, if applicants find themselves in this position, ANRO are only able to reinstate the application status back to 'interview complete', so the applicant can be included in the upcoming offer recycles. ANRO are unable to reinstate the original offer.

Once an applicant accepts an Anaesthetics post they will be withdrawn from any other specialties within the same recruitment round and will not receive any further offers from them. 

Offers that are declined will be recycled and offered in rank order to other eligible applicants.

Only one offer can be held at any one time, across all specialty applications in the same recruitment round. If applicants are already holding an offer, and try to hold another offer, the original held post will be automatically declined by the system. If they choose to hold an offer, they can hold this up until 9am (UK BST) on Friday 9 April 2027. Please be aware that ANRO are unable to reverse this.

Before this deadline, applicants must go back into Oriel and make a final decision on the offer. Any offers still held when the deadline is reached will be deemed to have been declined and the system will automatically change the status to 'offer declined'. 

After the hold deadline has passed, any offers made will only have the option of being accepted or declined. 

For further information, please refer to the Medical Specialty Recruitment website page on Offers.

Upgrading of offers

Up to the offers stage, applicants will have the ability to rank preferences for training programmes and geographies within their allocated cluster. If an applicant ranks highly enough to be made an offer, this will be made to the highest ranked preference that is available when their rank is reached. If they are happy with this offer, they can choose to simply accept it.

However, if an applicant would prefer the option of a higher ranked preference, should they become available, they can opt into upgrading. The upgrading option is available to all applicants who have held or accepted their offer, but not where an offer has been declined. An applicant who has accepted or held an offer can opt in or out of upgrading at any time during the window which runs until 4pm (UK GMT) on Wednesday 14 April 2027.

If an applicant opts into upgrading and a higher preference post becomes available, subject to their ranking, the upgrade will be automatic. They will be placed in the higher preference post without ANRO making any further contact with them and they will not be given 48 hours to decide whether they wish to accept or decline the new post. If an upgrade is made, the previously held or accepted post will be released and will be reoffered to another applicant. This automatic upgrade cannot be reversed. Applicants must opt out of upgrading if they do not wish to be considered for a higher preferenced post than the one they have. 

Once applicants have been upgraded, they will be contacted via an automated email message to inform them of this. Details of the upgrade will be made available on the Oriel System.

Once the upgrading deadline has passed, no further upgrades will be offered, even if a higher preference becomes available at a later date. Upgrading of offers will not continue beyond the stated upgrade deadline, even if a preferred post becomes available later. Vacant posts will be offered to the next eligible applicant who has preferenced the post and is yet to receive an offer, not to applicants who have already accepted a post. This can include new or additional posts submitted to ANRO after the upgrade deadline.

Offer exchanges/enhanced preferencing

There is increased applicant flexibility for upgrading of offers as described in upgrading of offers.

Any applicant that has accepted or held an offer, and opted into upgrades, can amend their preference options as many times as they like up until the upgrade deadline.

Applicants will be able to re-rank their preference options so that they can move lower ranked preferences, or preferences originally not wanted, into a higher ranked preference than their current offer. This will then mean that these newly ranked preferences are considered for an upgrade in subsequent offer iterations. 

Please note: Any changes to preferences made between the offers' algorithm being run and offers being released will not be considered until the next offers match is run.

The above process will continue up until the upgrade deadline at 4pm (UK GMT) on Wednesday 14 April 2027.

Applicants will not be able to make changes to their preferences once the upgrade deadline has passed. 

Clearing

Clearing will be available to applicants who were deemed appointable in England and Wales and Northern Ireland who have not been made an offer in their chosen region. It will not include applicants who have been made an offer that they chose to decline.

Clearing will only be run if there are available posts left in the England and Wales and Northern Ireland clusters. 

Clearing will not be available to applicants who were deemed appointable in Scotland.

If any applicants are eligible for clearing, they will be contacted through Oriel, by ANRO, and will be asked to preference the available clearing posts.

Applicants will only be able to accept, or decline offers made in clearing. They cannot be held, and they will not be upgraded (as the deadlines will have passed), even if a higher ranked clearing post becomes available at a later date.

Applicants will receive a maximum of one offer in clearing. If this offer is declined, they will not receive any further offers.

References

Referees should be contacted at the earliest opportunity to confirm that they are happy to support the application and provide a reference. Applicants are required to give details of three referees who have supervised their clinical training in the last 2 years. Obtaining references is the applicant's responsibility. 

The deadline for submitting references on Oriel is at 4pm on Wednesday 28 April 2027.

It is not the responsibility of ANRO or the region where an applicant’s post is based to chase up outstanding references that may be requested once the Oriel deadline has passed. This responsibility lies solely with the applicant.

Once the deadline for submission of references on Oriel passes, the responsibility then moves to the employing organisation; any outstanding references will be requested from the referee by the employing organisation when they complete all pre-employment checks.

Reference requests

Reference requests are an automated process in Oriel. A request will be triggered and sent electronically to an applicant's nominated referees when they accept or, accept with upgrades an offer of Anaesthetics training.

To ensure that the requests are not blocked or filtered by their referees’ email providers, applicants are strongly advised to inform their referees to add [email protected] to their email whitelist. 

Referees are required to submit references electronically, using the online referee portal in Oriel. Applicants will be advised, via their Oriel portal, when their referee has submitted a reference.

Should a referee have any issues accessing the request, please contact ANRO via the Freshdesk portal.         

Changing nominated referee

For any references that have not yet been submitted applicants are able to update the details of, or change, their nominated referees. However, if a referee has already submitted the reference, applicants will not be able to make any changes to their details.

If changes to the email address for a referee is made, a new reference request will be sent to the newly provided email address, and the original request will be withdrawn.

Feedback

Applicants will be given feedback throughout the recruitment process and will not need to make a formal request to receive it. 

Applicants who are rejected at the longlisting stage will be advised of the reason their application was rejected.

MSRA scores will be published in an applicant's Oriel account against their Anaesthetics/ACCS Anaesthetics CT1 application summary. They will be visible under the 'shortlist' tab by clicking the 'view station scores' button and will be available before invitations to interview are sent. Where capacity enables all applicants to be interviewed, MSRA scores will be disclosed along with overall scores.

Overall scores will be published in an applicant's Oriel account against their Anaesthetics/ACCS Anaesthetics CT1 application up to 5 working days after the initial offer date. This will be found under the 'interview' tab and includes Interview Score, MSRA Scaled Score and the Combined Overall Score (which is the Interview Score and MSRA Scaled Score, this will be labelled 'Combined Total Interview and MSRA Scaled Score'). These can be found by clicking the 'view station scores' button in this tab.

Detailed guidance on how to locate or view these scores is contained in the Oriel Applicant User Handbook.

All applicants will receive their interview feedback scoresheets within 7 working days of initial offers.

We advise applicants to add [email protected] to their safe senders list to prevent scoresheets being sent to the email junk/spam folder.

We ask for consideration to be given to ANRO staff by applicants in busy periods as their scoresheets could take longer to receive.

If applicants do not receive their scoresheet, they will need to contact ANRO to request them, please contact ANRO via the Freshdesk portal.

There is no further feedback that can be provided after scoresheets have been received.

Offers of employment and pre-employment checks

The offer and allocation of a Training Programme referred to above is not an offer of employment. An employment contract detailing the terms and conditions of employment will be issued by the responsible employing organisation and is made subject to satisfactory preemployment checks.

An applicant's offer of employment will include the name of their employer, the start date and length of the period of employment, the location, the hours, the minimum rate of remuneration and the notice period applicable.

Information regarding pay, hours, sick pay, and annual leave entitlements, notice period, study leave, pension scheme etc. are set out in the national terms and conditions available from NHS Employers.

A framework for a written contract of employment for Anaesthetic specialty registrars is also available from the BMA.

Individual NHS England Local Office, PSD Scotland, NIMDTA or HEIW websites may also provide additional local information and links to individual employer websites.

The employing organisations carry out a number of pre-employment checks before an offer of employment can be confirmed.

These will include verification of identity, registration, and qualifications, right to work (immigration), employment history and employment reference checks (these are different from the clinical reference checks that the NHS England Local Office, PSD Scotland, NIMDTA or HEIW needs), a Disclosure and Barring Service (DBS) check and an occupational health check.

Some of these (verification of identify, registration and qualifications and right to work for example) may also be undertaken by the NHS England Local Office, PSD Scotland, NIMDTA or HEIW during the recruitment process.

Complaints procedure

All National Recruitment Offices use a nationally agreed process for handling complaints about recruitment.

If an applicant feels their application has not been managed correctly and have evidence of a failure in the process, they should explore this route.

Complaints should be made in line with the MDRS Complaints Policy and Procedures. A Complaints Policy Submission form is also available on this page.

Raising concerns

Applicants wishing to raise concerns about any part of the recruitment process, where this falls outside the scope of the complaints policy should forward these, in confidence to MDRS.

Concerns raised without detail are difficult to investigate due to the volume of applications received. Applicants are therefore requested to provide details of the specialty and, where applicable, the applicants concerned.

Any information provided would be treated in the utmost confidence.