At some point after short-listing, the region at which your interview will be held will contact you to seek your programme preferences. The timing can vary but as a guide this usually starts around the time of interview.

Once available, you will receive an email from the region inviting you to log in to your account on the Oriel application system and make your preferences.

Upon doing so, you will be able to see all of the region's CT1 programmes for both ACCS-AM and CMT, and two sections into which you can divide these posts: preferences and not wanted.

Please note that the level of detail supplied at this stage can vary between regions. Some are able to break programmes down to rotational level with details of the location and specialty of each rotation. Others are able to give less information at this stage, eg they may know the location but not the rotations.


You should move all posts for which you wish to be considered into the preferences section. All posts you move into this section must be put into rank order; ie the post you want most at the top as #1, next-most at #2, etc.

Should you come to be made an offer, you will be considered only for posts you have included in this section, and you will be offered your highest-ranked post which remains available.

Not wanted

The not wanted section is where you should move any posts for which you do not wish to be considered.

All posts are included in this not wanted section to begin with. So please note - if you do not give any preferences, you cannot receive a post offer.


If you receive an offer of a post and choose to accept or hold the offer, you will be given the option to be considered for offer 'upgrades'.

If you accept/hold a post with upgrades, and at a later date one of your higher-ranked preferences becomes available, your offer will be upgraded automatically to the higher preference.

See the responding to offers page of this section for more information.

Both ACCS-AM and CMT programmes available in the region in question will be considered alongside each other within the preferences.

This means that you are welcome to give just ACCS-AM posts within your preferences and disregard all CMT posts, or vice versa; or to rank any mixture of the two you see fit.

Please note that not all regions have ACCS-AM programmes available; for details of the number of programmes for each specialty in each region, see the dates & posts page of this website.

Further information - please read!

In each recruitment round, we receive a large number of queries from candidates regarding preferences and offers, often after offers have been made and it is too late to make any changes.

Therefore, please read the guidance given below to make sure you are fully-informed on the process before giving preferences:

Be sure of your choices

Please do make sure you divide posts between the preferences/not wanted sections accurately, in line with your wishes.

If you receive an offer of one of your preferences, but decide you no longer want it and reject the offer, your application for this round will be withdrawn as a result. You will not receive any further offer in this round.

Similarly, after the point where preferences close, you will not be offered any of the posts in your not wanted section - so please make sure your not wanted posts are genuinely those you do not want.

Will my choice of preferences affect whether I will receive an offer?

The more programmes you include in your preferences, the more likely it is you can be made an offer but the order in which you rank them will not. Whether or not you will be made an offer will be determined solely by your total score, relative to competing candidates within your region, the number of programmes available and your preferences of these.

When offers are made, candidates are considered in rank order and assigned their highest available preference. Once your rank is reached, your preferences will be considered to see which can be offered to you. If all your preferences are offered by the time it comes to your rank, you will not be offered and go on a reserve list.

However, you should only preference programmes you would genuinely consider accepting if offered; if you are made an offer and reject it you will no longer be considered in that round.

Don't try gaming the offers process

If you believe a certain post will be unpopular, then ranking this as your #1 preference will not mean you are more likely to receive an offer, nor at an earlier stage, than would be the case if it were your #50 preference.

As noted above, your preferences only come into play once it is 'your turn' to be made an offer. That particular post is more likely to be offered to you if it were ranked as #1 than if it were #50; but will not affect whether or not the region makes you an offer.

Give honest preferences

Our overall advice is to consider all posts available to you, and organise them in an order which genuinely reflects your preference of the posts available.

The offers process is designed in such a way that, provided you give honest and accurate choices, then where possible you will be offered your highest-available post preference.