Receiving offers

If you are offered an HST post, you will receive an email notifying you of this, along with instructions on how to respond and the deadline to give your decision. You may also receive a text to alert you to the email.

All offers will be shown in the offers tab of your Oriel dashboard. It is from here that you will make your response; responses to offers will not be accepted by any other means.

There are various responses you can make to an offer which are detailed on the other tabs in this section.

Response deadline

Every offer made will have a response deadline of 48 hours from when the offer was made.

You must respond to an offer within this time - be it to accept, reject or hold the offer - otherwise the offer will be withdrawn. Your application will also be considered withdrawn, so you would receive no further offers.

Holding included

If you wish to take up the option to hold a post offer, you must still respond to the offer within 48 hours to state your wish to hold.

Weekends not included

The 48-hour deadline does not include weekends, although it does include bank holidays.

This means if you receive an offer at 1pm on a Thursday, the deadline will be 1pm on the following Monday.

Regardless of when you are made the offer, the offer email will contain the deadline by which you need to respond.

How do I know my response has been confirmed

When confirming your decision on Oriel you will undergo a two-step process to confirm the response to your offer: once to select the option and then again to confirm it; if you do not go through both stages your decision will not have been made. There are three ways you can confirm that a decision has been registered:

  • You will receive an automatic email confirming your decision. Please note that the email may not arrive immediately, in busy times there can be a significant delay in when this email is received.
  • Check your messages in your Oriel account. Any emails sent to you via the application system will be stored in your candidate portal on Oriel (ie your 'account') in the 'My Messages' section of your Dashboard.
  • Check that your application status has been updated from 'Offer made' to the relevant decision. This can be seen in the 'My Applications' area of your Dashboard.

If you are still concerned, contact the offering region as soon as possible so it can be investigated. Offers without a decision come the deadline are considered to be declined and will be offered to someone else where possible.

Further information

Additional guidance and help with offers is available from the following sources:

  • The email notifying you of your offer.
  • The offers FAQs section of this website.
  • Guidance on using the Oriel system can be found in the Oriel Applicant User Guide which can be downloaded from the resource bank of the Oriel website.

There are three responses available to an offer: accept, hold and reject. In addition, when you accept or hold an offer there is the possibility of being considered for upgrades, which is covered on the next tab.


Before accepting an offer, please ensure that this is your preferred option. Once you have accepted the offer you will not receive any others (in this round).

This also applies across all specialties/programmes. For example, if you have applied to dermatology, acute internal medicine and geriatric medicine, then if you accept an offer in one of these programmes, your applications to the other two will be withdrawn automatically.

Please also be aware that accepting an offer you do not intend to take up will prevent an offer being made to a colleague.

GMC Good Medical Practice

You should also consider the GMC's guidance on taking up and ending appointments, as outlined in Good Medical Practice:

'Patient safety may be affected if there is not enough medical cover. So you must take up any post you have formally accepted, and work your contractual notice period before leaving a job, unless the employer has reasonable time to make other arrangements.'


The key consideration is to be certain you do not wish to take up an offered post before you reject the offer.

Once you reject an offer of a post in a particular specialty, you will not be made another (in this round), and your application to this specialty will be regarded as withdrawn.

Rejecting an offer from one specialty/programme will not affect any applications you have made elsewhere.


When offers are made initially, there will be a third option available - that of 'holding' the post offer. Choosing this will allow you to consider the offer beyond the standard 48-hour response deadline.

This option was brought in for the benefit of those candidates who make applications to more than one specialty/programme. It allows you to keep a post offer under consideration longer-term, while awaiting the outcome of any other applications you have made.

Please note - if you hold an offer, you will still need to select to hold within the 48-hour response limit.

Applies across all specialties

The holding option will be available across all specialties participating in the round, including those not part of the nationally-coordinated process. Therefore it will be possible to hold an dermatology offer while awaiting the outcome of a paediatric cardiology application, for instance, or vice versa.

Only one offer can be held

It is only possible to hold one offer at a time.

So in the event you had applied to three specialties, received offers from two, and wanted to wait for the outcome of the third before making a decision, then it would not be possible to hold both beyond the standard 48-hour consideration period.

Holding one offer would automatically reject the other one.

Offer holding deadline

It is not possible for offers to be held in this manner indefinitely, as this would delay the recruitment process as a whole. Therefore, it is only possible to hold offers up until the offer holding deadline; see the timeline of the round for details of when this is.

After this point, you must choose whether to accept or reject any offer you are holding. Any offers still held at the deadline will be automatically rejected.

Any offers made after the holding deadline will only include the options of 'accept' and 'reject'.


In the event you choose to accept or hold an offer you receive, you can also choose to be considered for offer upgrades.

When an offer is made to you, you will be offered the highest of your programme preferences which are available at the time of offer. Should you choose to be considered for an upgrade, if a higher ranked preference becomes available, your offer can be upgraded automatically to your higher preference.

Please note - upgrading is a wholly subjective process; ie it is based purely on your preferences, and nothing else.

How and when are upgrades made?

Upgrades are considered each time the offers algorithm is run. It is not possible to say exactly when this will happen but will usually be every few working days once the first offers commence. 

If an upgrade can be found, this will automatically replace your previous preference and you will receive an email confirming this. You cannot make a decision on whether you prefer an upgraded programme to the one previously offered; by making it a more highly ranked preference and opting into upgrades, you are effectively making a decision in advance.

Changing preferences

You can change your decision to opt-in or out of upgrades at any time until the upgrade deadline. The exception to this is when the offers algorithm is being run and your upgrade opt-in status is locked until the match is completed.

Additionally, those opting in for upgrading have the option to review/revise their programme preferences. This gives you the option to revise the ordering of your preferences and change your mind about any of the available programmes; so if your circumstances change you can still compete for any programme up until the upgrading deadline. For example, you can:

  • decide to include in your preferences programmes that you did not originally want
  • move preferences to the 'not wanted' column (with the exception of the offer you are currently holding/have accepted)
  • move programmes initially ranked more highly than your current offer to a lower rank
  • move programmes initially ranked lower than your current offer to a higher rank. 

Regardless of changes made by candidates to their preferences, a programme which is held or accepted cannot go to another candidate, regardless of how highly they are ranked, unless it is released by them.

One point to note is that there will be periods during offers when you will not be able to revise your preferences as the offers matching algorithm is being run so it is necessary to suspend the feature during these times. If you encounter this we recommend you try again later.

Upgrade deadline

The upgrading function will only be in place until a fixed deadline; see the timeline of the round for details of when this is. Anyone still opting for upgrades at the deadline will be emailed to confirm that the current offer is confirmed.  

Any offers made subsequent to the deadline will not include the option of upgrading.

Offers held with upgrades

If the holding deadline is approaching and you are hoping for an upgrade, you will have to decide by the holding deadline whether to:

  • accept the post - in which case you will have the option to continue being considered for upgrades. If you are not prepared to take up the currently offered programme, you must not accept it; by doing so you will be denying another trainee the chance of an offer.
  • decline the offer - you will not be eligible for any further offers in the round. If you wish to be considered for an offer you will need to contact the region managing your application to find out if your application can be reinstated and considered when offers are next run.

If you make no decision by the holding deadline, it will be automatically rejected by Oriel.