ICM Recruitment: The ST3 Perspective

Dr Luke Buswell
ST3 ICM Specialty Registrar

My name is Luke Buswell, I recently joined the North-West ICM training programme and am currently working in Emergency Medicine en route to completing Stage 1 ICM. My route of entry to ICM has been via core training in anaesthetics, starting ST4 anaesthetics in February 2023 then applying for and fortunately gaining a number to start ST3 ICM in August 2023. I applied for ICM hot on the heels of an (eventually) successful application to higher anaesthetics training.

The challenges in anaesthetic registrar recruitment have been well publicised and as such, before applying to ICM I’d had more experience of registrar recruitment processes than I’d have initially hoped for. Although I appreciate applicants will also be applying with previous experiences of both medical and emergency medicine application processes, which may have some differences, I hope I can share some insights that will be useful regardless of route of entry

The process

ICM application is a three stage process consisting of an application form, portfolio upload, and then subsequent interview. Applications open in November for a start in the following August with an approximately 3-week window to submit an online application via Oriel. Following application submission, applicants are then invited to upload their portfolio documents via an online portal in mid-January. Portfolio documents are assessed online as to whether they justify the submitted self-assessment score and applicants then shortlisted for interview based on this.

Shortlisted applicants will undergo an online interview in the March/ April preceding their anticipated start date, with offers released a few weeks thereafter.

Application submission

The initial application form through Oriel was straightforward to complete after locating the online job advert on Oriel. Although the portfolio upload and interview were still weeks and months away, respectively, the application form did require some careful thought as it involves the submission of your self-assessment score.

Although the window to submit the application is open for a few weeks, I found it really helpful to have already looked through the information provided on the ICM national recruitment office website regarding portfolio self-assessment.

Of particular help was to read both the scoring matrix and the separate document with the ‘self-assessment applicant guidance’. There are aspects of the scoring matrix where I had evidence that I could have mistakenly scored in two domains, the guidance document makes clear what can and can not be used twice.

If you gain evidence to score more highly for your portfolio in between submitting the application and the portfolio upload window then reviewers can upgrade your score. Speculatively scoring yourself more highly without being certain you can produce the evidence in time for the upload window runs the risk of your score being downgraded.

Portfolio upload

A short break from applications over Christmas led quickly into the window for uploading my portfolio via the portal provided.

Other than some differences in scoring, the portfolio upload portal will be familiar to many who have applied to anaesthetics higher training or indeed a range of core training programmes since the start of the pandemic.

Compared to the process of printing, categorising then carrying a lever arch file full of evidence to a distant city for interview, the move to an online upload certainly has its merits. On the other hand, there is no capacity to point an interviewer to evidence in your portfolio so the structure of your evidence uploads really needs to be crystal clear to avoid being marked down and to maximise your global score.

Dr Luke Buswell
ICM ST3 Specialty Registrar

By the time it comes round to applications, you have probably ran out of time to fit in a quick PhD to increase your score and it might feel as if you can’t do much to change this.

Speaking to colleagues at the time of my own application, it was clear that most people have scores that are fairly closely bunched together so a few points gained on the global score (8/44 available points) can make a big difference to your ranking. There’s no one set of prescriptive advice for this but selecting evidence that demonstrates commitment to specialty will likely help your global score and a clear, well-structured portfolio with no superfluous content will only support your application.

Some deaneries run teaching sessions aided by previously successful applicants with tips on how to structure your portfolio. Attending such a session locally for the anaesthetic application process changed much of how I was structuring my evidence when it came to the ICM application and I’m certain I’d have received a poorer global score without it.

Interview process

Those scoring highly enough with their portfolio were invited to online interview. The date for invitations to interview was publicised beforehand and interview slots at more convenient dates and times went quickly. Keeping an eye on emails (and the spam folder) on the day was worthwhile to avoid having to interview in the middle of a set of nights.

Communications from the recruitment office about the software used for the online interview were fairly detailed and I didn’t have any technical issues either testing the interview software or using it on the day.

Interviews are divided into three stations: a clinical scenario, task prioritisation and commitment to specialty. An email from the recruitment office beforehand with some example questions helped me to think about how I would approach scenarios on the day and were representative of the questions I eventually had.

The clinical scenario and task prioritisation both involved situations that might commonly be encountered on-call for critical care but actually didn’t necessarily require specific critical care knowledge or experience. Scenarios felt as if they would have been fairly balanced for applicants from anaesthetics, emergency medicine or internal medicine.

Trying to take a calm and structured approach to the clinical scenario with a systematic A-E assessment seemed to help with answering the interviewers. Although clearly that is easier said than done in an interview setting, the scenario felt as if it was more about doing the basics well which we use in every day clinical practice rather than anything designed to trip up an applicant.

Likewise, the task prioritisation scenario certainly wouldn’t be anything unfamiliar to an applicant from any acute specialty and felt as if it gave opportunities to demonstrate critical thinking, creativity and team working within the wider hospital.


The commitment to specialty section of the interview gave the opportunity to talk about reasons for applying to ICM and to demonstrate both commitment to specialty and reflective practice. Reading through the person specification published online beforehand helped with directing my answers and highlight any achievements or situations where I’d used reflection to change my practice.

I’m certainly glad to not have any further registrar applications to go through but as they go, the ICM recruitment process felt both easy to follow and well structured.


The above is taken from Dr Buswell's article in FICM's Critical Eye, Winter 2024.

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