ST3 T&O initial offers for 2027 are due by 5pm on Tuesday 13 April 2027 under NHS England's national Round 2 timetable, with 48 hours to respond, a hold deadline of 1pm on Wednesday 21 April and an upgrade deadline of 4pm on Thursday 22 April.
Offers go out in rank order of your 234-mark interview score against your Oriel preferences. In 2026 you needed 146 out of 232 to be appointable, and the 2027 threshold is not yet published.
Reviewed and updated 10 September 2026. The T&O-specific 2027 handbook has not been published by NHS England North East and Yorkshire, so every T&O-specific date below carries the year it belongs to.
Key takeaways
- NHS England's 2027 Round 2 (ST3/ST4) timetable, reviewed 24 February 2026, sets initial offers by 5pm on Tuesday 13 April 2027, a hold deadline of 1pm on Wednesday 21 April and an upgrade deadline of 4pm on Thursday 22 April.
- In 2026, ST3 T&O initial offers were released by 5pm on Tuesday 14 April 2026, with hold and upgrade deadlines on 22 and 23 April.
- Your rank is your interview score out of 234: 34 from the validated self-assessment and 50 from each of four stations. The 2026 appointability threshold was 146 out of 232, or 63%.
- You have 48 hours, excluding weekends but including bank holidays, to accept, hold or decline an offer. Silence counts as a decline.
- NHS England's applicant guide says you are better on the reserve list than holding an offer you do not want.
- In 2025 there were 684 applications for 150 ST3 T&O posts, a ratio of 4.56 to one, so about 22% of applicants were appointed.
When are ST3 T&O offers released in 2027?
ST3 T&O offers are released by 5pm on Tuesday 13 April 2027 if T&O follows NHS England's national Round 2 timetable, which it did in 2026. The table gives both years.
| Stage | 2026 (T&O actual) | 2027 (national Round 2, ST3/ST4) |
|---|---|---|
| Applications open | 10am, Thu 20 November 2025 | 10am, Thu 19 November 2026 |
| Applications close | 4pm, Tue 16 December 2025 (T&O handbook; national close Thu 11 December) | 4pm, Thu 10 December 2026 (national); T&O date not yet published |
| Interviews | Tue 24 to Fri 27 March 2026 | Window Mon 11 January to Fri 9 April 2027; T&O days not yet published |
| Initial offers released by | 5pm, Tue 14 April 2026 | 5pm, Tue 13 April 2027 |
| Hold deadline | 1pm, Wed 22 April 2026 | 1pm, Wed 21 April 2027 |
| Upgrade deadline | 4pm, Thu 23 April 2026 | 4pm, Thu 22 April 2027 |
| Hierarchical upgrade deadline | 5pm, Thu 23 April 2026 | 5pm, Thu 22 April 2027 |
NHS England's specialty recruitment timelines page, reviewed 24 February 2026, states that Round 2 is "predominantly for recruitment to ST3/ST4 for posts commencing between August and December 2027".
In 2026 the T&O handbook named its own application deadline and interview days inside the national window, so expect the 2027 handbook to do the same.
How are ST3 T&O applicants ranked for offers?
ST3 T&O applicants are ranked on their overall interview score out of 234, with individual station scores used alongside it, according to the 2026 applicant handbook's scoring section.
| Component (2027 scoring matrix) | Marks | Share |
|---|---|---|
| Validated self-assessment (13 questions) | 34 | 15% |
| Commitment to Specialty station | 50 | 21% |
| Clinical station | 50 | 21% |
| Prioritisation station | 50 | 21% |
| Communication station | 50 | 21% |
| Total | 234 | 100% |
NHS England's applicant guide states that appointments "will be offered in rank order, based on selection scores", and that interview panels never see your preferences.
Ortho Interview (orthointerview.com) marks spoken answers against those station domains, because the rank that decides your offer is built from what two interviewers hear in four 10-minute stations.
How does the Medical Training (Prioritisation) Act change ranking in 2027?
The Act does not change your rank. NHS England states that ranks "are based on performance in the selection process only", and that there is one ranked list covering priority and non-priority applicants.
What changes is the order of offers: applicants in the priority group are considered in rank order before those outside it, at every offers matching run.
For posts starting from 2027, NHS England states that prioritisation applies at shortlisting as well as offer, and that the 2026 immigration-status proxy "will not apply automatically"; the 2027 criteria are set through regulations.
What score do you need to be appointable for ST3 T&O in 2027?
The 2027 ST3 T&O appointability threshold is not yet published. In 2026 it was a minimum overall score of 146 out of 232, or 63%, and the 2027 handbook will confirm the figure against the 234 total.
Appointable is the status of reaching the minimum score; it is not an offer. NHS England reports 684 applications for 150 posts in 2025, so rank, preferences and post numbers decide who is actually offered.
How do Oriel preferences decide which post you are offered?
Oriel offers you the highest-ranked programme on your preference list that is still available when your rank is reached, and nothing on the list changes when that happens.
According to NHS England's preferencing guide, every programme starts in a "not wanted" list; anything you would accept must be moved into "preferences" and ranked. If you preference nothing, you cannot receive an offer.
Ranking an unpopular post first does not bring an offer sooner. Include programmes showing zero places, in the order you would want them, because places are sometimes added later.
Preferences usually open around the time of interview for at least a week, and the drag-and-drop screen does not work well on phones, so use a laptop. That week overlaps the final rehearsals most candidates run on orthointerview.com's voice mock interview.
What happens in the 48 hours after an ST3 T&O offer arrives?
An ST3 T&O offer arrives in your Oriel account and you have 48 hours, excluding weekends but including bank holidays, to accept, hold or decline it. An unanswered offer expires and goes to the next applicant.
| Response | What NHS England says it means |
|---|---|
| Accept | No further offers from this or any other specialty in the round, except a hierarchical upgrade. Pre-employment checks begin. |
| Accept with upgrades | Automatically moved to a higher-ranked preference if one becomes available before the upgrade deadline, with no contact beforehand and no way back. |
| Hold without upgrades | The offer is reserved until the hold deadline; no upgrades; offers from other specialties can still arrive. |
| Hold with upgrades | Reserved until the hold deadline and automatically upgraded if a preferred post becomes available. |
| Decline | The offer is removed and no further offers come from this specialty in the round. |
Recruitment offices reinstate an expired offer only where a genuine mistake is reported at once, and even then the original post may already have been re-offered.
What is the difference between holding and upgrading an ST3 T&O offer?
Holding keeps an offer open until the hold deadline; upgrading swaps an accepted or held offer for a better-ranked preference until the upgrade deadline. The two run to different clocks.
A held offer is one offer reserved until the hold deadline, 1pm on Wednesday 21 April 2027. Only one offer can be held at a time, and holding a second rejects the first.
An upgrade is an automatic move to a preference you have opted into, processed once all other offers in the specialty have been answered, never at weekends, and closed at 4pm on Thursday 22 April 2027.
A hierarchical upgrade is the only route by which an offer from another specialty can still reach you after acceptance, and it closes at 5pm on Thursday 22 April 2027.
Upgrade options are configurable: you choose which programmes count, including ones originally ranked below the offered post. Opt in even to programmes showing no vacancies, or you cannot be upgraded into them.
Should you hold an ST3 T&O offer or stay on the reserve list?
Stay on the reserve list rather than hold an offer you would not accept. NHS England's guide states you are "better to be on the reserve list than holding an offer you do not want".
The reasoning is the hold deadline: a held offer must become accept, accept with upgrades or decline by 1pm on 21 April 2027, and declining removes you from the specialty. An applicant without an offer stays in contention as declined offers recycle.
After the upgrade deadline, vacant posts go to the next eligible applicant who preferenced them and has no offer, never to someone who has already accepted. That said, holding a post you would genuinely take is the safer position.
What feedback do you get, and what if you are not offered a post in 2027?
You get your score per station, your total, the maximum, the appointability minimum and, if appointable, your rank, no later than seven days after the national offer deadline, according to NHS England's guide.
If you are not offered a post, you remain on the reserve list while declined and expired offers are recycled, and clearing may re-preference remaining posts in specialties where applicants were not in contention nationally.
Round 3 for posts starting January to March 2028 opens on Tuesday 13 July 2027, but NHS England reserves the right not to advertise where enough appointable applicants exist from Rounds 1 and 2.
Ortho Interview's terms grant a candidate who does not secure an ST3 T&O post free access to its 782-question bank and voice mock interview for the following interview year, on emailing their score and station feedback.
What should you check when the 2027 ST3 T&O handbook publishes?
Check four things the week the 2027 handbook publishes, because each of them moved between the national timetable and the T&O dates in 2026.
- The T&O application deadline, which in 2026 was 16 December against a national Round 2 close of 11 December.
- The T&O interview days inside the national window of 11 January to 9 April 2027; in 2026 they were 24 to 27 March.
- The appointability threshold against 234, which was 146 out of 232 in 2026.
- The preference window and the offer date, which the national timetable sets at 5pm on 13 April 2027.
The application overview carries the process as it stands, the interview overview carries the 234-mark matrix, and orthointerview.com will update this article the week the handbook lands.