ST3 T&O Self-Assessment 2027: Every Question and Score Explained

The 2027 ST3 Trauma & Orthopaedics self-assessment asks 13 questions, one of which is unscored, and feeds 34 of the 234 points on the interview scoring matrix — about 14.5% of your total. It is not a tick-box exercise: every score you claim is checked against uploaded evidence by assessors before you interview, and the score the evidence supports is the score you keep. This guide walks through each question with its exact marks, the traps in the evidence rules, and where the "sweet spots" sit. The full official tables are on our 2027 self-assessment page.

How much is the self-assessment worth in 2027?

The scoring matrix totals 234 points: the self-assessment contributes 34, and each of the four 10-minute interview stations contributes 50.

Within the matrix, the self-assessment's 34 points split across three domains: 16 to Career Motivation, Learning & Development, 16 to Academic, and 2 to Organisation & Planning. Note that the raw question marks below add up to a maximum of 37 — they are weighted down into the 34 matrix points, so think in terms of relative gains, not raw totals. In 2026 the minimum appointable score was 146/232; the 2027 threshold is not yet confirmed.

What does Question 1 (employment summary) require?

Unscored, but read first. A single page summarising your career to end July 2027: graduation date, foundation training, every post-foundation job with title, specialty and dates, LTFT details, and any periods out of employment (sick leave, parental leave and so on). Do not upload employment contracts here — one summary page only. It frames how the assessor reads everything else, so make it clean.

How is T&O experience scored — and why is more not better?

Question 2 is the single biggest scorer, counting total months (FTE) in primarily T&O posts in any post-foundation job, in any country, by end of July 2027 (or completion of Core Training if later):

The penalty for long experience is deliberate: 37–59 months halves your score to 4, and 60+ months drops you to 1 — the same as a 4-month job. Two evidence rules catch people out. A month counts as 30 days, and any unaccounted period up to end July 2027 is assumed to be T&O employment — so if your summary page has gaps, they count against you. Prospective statements of intent ("I will resign in June") are not considered.

What counts as complementary specialty experience?

Question 3 rewards at least 4 months post-foundation in a listed specialty: Plastics, Neurosurgery, Vascular, ENT, Cardiothoracics, EM, ITU, Urology, OMFS, Paediatric Surgery or General Surgery. One qualifying block scores 1 point; blocks in two or more listed specialties score 2. Evidence is your training post documentation or the contract front page with dates.

How are neck of femur fracture operations and PBAs scored?

Questions 4 and 5 are the operative pair, and both hinge on wholly completed NOF fracture operations performed supervised-trainer-scrubbed (STS) or supervised-trainer-unscrubbed (STU), counted at the time of application:

Evidence must be consultant-validated logbook consolidation sheets — name, signature and GMC number on every sheet. Question 5 adds 1 point for 6 or more ISCP consultant-validated PBAs at level 2 or above for wholly completed NOF operations. Upload exactly six — more is not needed — and note that registrar trainers without a CCT are not accepted as validators.

Which publications actually count?

Question 6 takes your best 2 first-author PubMed-indexed papers since starting medical school: 2 points each, maximum 4. No abstracts, case reports, book chapters, letters or technical tips. Collaborative group names do not count as first authorship, and journals not indexed in both PubMed and Web of Science — Cureus is the named example — are discounted. Only the first two papers you evidence are considered, so choose them.

Question 7 takes your best 2 other publications in any author position (excluding your Q6 papers) at 1 point each. An Associate PI role on an NIHR study counts as one "other author" publication, evidenced by a validated confirmation letter (one only). Collaborative papers need evidence of a significant role — design, analysis or writing.

How do presentations score?

Question 8 scores your best 2 national or international conference presentations. Group 1 — a podium presentation delivered by you — is worth 2 points; Group 2 — delivered by a co-author, poster walk, JAM session or poster — is worth 1. The maximum is 4 points for two Group 1 podiums. Each project counts once, however many meetings it toured. You need the certificate of delivery or acceptance-and-display plus an attendance certificate.

What do audits, QIPs and higher degrees earn?

Question 9 gives 1 point per project (maximum 2) for closed-loop audits against a published standard, QIPs using recognised methodology such as PDSA, or a published collaborative project (data collection counts as one closed-loop audit). You must show active involvement in both cycles, with outcomes on a single slide — not the full deck — and a validated certificate or letter from the audit lead, not the meeting agenda.

Question 10 scores completed stand-alone UK higher degrees (or equivalents) examined by thesis or dissertation: a Masters or PGCert scores 1, a PhD or MD scores 2. Intercalated BScs do not count, and it must be completed at the time of application. Overseas degrees need an equivalence letter plus transcript.

How are leadership and teaching scored?

Question 11 (maximum 3): a local role such as rota co-ordinator or journal club organiser scores 1; a significant local or regional role held 6+ months scores 2; a national or international formal role, elected or competitively appointed and held 6+ months — think BOTA or ASiT — scores 3. National roles need a signed letter from the recognised body; everything else needs consultant-signed documentation with a GMC number.

Question 12 (maximum 3): regular formal teaching over the last 2 years (4+ sessions/year) scores 1; a significant role — a recurring fortnightly-or-more programme, course delivery, or teaching written into your contract — scores 2; a formal substantive solely-teaching post scores 3. The role must be within the last 5 years and held 6+ months. ATLS Instructor and Training-the-Trainer attendance does not count.

What is Question 13, and why is it free marks?

The assessor scores how well your upload is organised: a summary page first in each domain, legible, correctly orientated documents. Well organised evidence scores 2 points; poorly organised scores 0. This is the only question that cannot be appealed — and it maps directly onto the 2 Organisation & Planning points in the matrix. There is no excuse for dropping them.

How is the self-assessment verified?

You upload evidence to Qpercom after applications close, and assessors validate every claimed score against it on dedicated validation days before interviews. Working from the 2026 cycle (the 2027 applicant handbook is not yet published), the shape of the timeline was:

The practical consequence: your score is only as good as your paperwork. Consultant signatures with GMC numbers, dated contract front pages, PMIDs, both audit cycles — collect them now, not the week of the upload window.

What should you do with this before interview?

Bank the certain marks first: organise your evidence properly (2 points), get your NOF logbook consolidated and signed (up to 5 points across Q4 and Q5), and check whether you sit inside the 10–36 month experience window. Then remember the arithmetic: the self-assessment is 34 points, but the four stations are worth 200. The Clinical station favours bread-and-butter trauma — cauda equina syndrome, compartment syndrome, open fractures — and structured practice under time pressure is what moves those 200 points. That is exactly what the orthointerview.com question bank drills. Start with the full 2027 self-assessment tables, score yourself honestly, and spend the rest of your time where the marks actually are.