This section of the website gives guidance on the selection of preferences for IMT posts. There are four main areas; please click on the relevant tab for more information on each.

  • Choosing preferences - if your interview was successful you will be invited to select your preferences before offers are made. This section covers how to preference offers on the Oriel system.
  • Preferences guidance - the selection of your preferences is an important stage in the recruitment process as it directly impacts what offers you will be made. This section provides guidance on some of the commonly queried steps in the process.
  • ACCS-AM vs IMT - the recruitment for both ACCS-AM and IMT takes place through the same application and interview process. Preferences for both programmes will be visible to all applicants that progress to this stage.

In addition to this, there is information in the document library about the relative competitiveness of each region using data from previous recruitment rounds. 

Towards the end of the interview period you will be contacted and invited to make your programme preferences. This will be done by logging in to your account on the Oriel application system.

This is a complex and time-consuming area of the process; the applicant survey in 2019 showed 75% of candidates reported that completing the programme preference process took over 3 hours, with 33% reporting that it took more than 10 hours. Reading the guidance below about how to choose preferences on Oriel, as well as some general guidance on the 'Preferences guidance' tab, will help you navigate this part of the process.

You will be able to see all of the programmes for both ACCS-AM and IMT for the whole of the UK, and two sections into which you can divide these posts: preferences and not wanted.


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 is available.

Unfortunately the drag and drop method for making your preferences on Oriel is not usually compatible with phones and tablets so please use a laptop or desktop computer for this part of the process.

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, you will be able to revise the order of your programme preferences and, should one of your higher-ranked preferences become available, your offer will be upgraded automatically to the higher preference.

The responding to offers page of this section has more information about upgrading.

Timing for selecting programme preferences

The timing for each round is included in the timeline section of the website. This will usually be an initial period of about 7-10 days in which you will need to select your preferences if you are to be considered for offers.

However, if you have not been made an offer, there will be short periods during the offering period where you will be able to reconsider your preferences. This will include reordering your list and changing whether a programme is included in your 'preferences' or 'not wanted' lists. You will be emailed at the time when preferences are available to revise.

All programmes in the UK included

As noted above, programmes from all regions in the UK will be available; in round 1 of 2018 recruitment there were 1426 options from which to choose.

Whilst this is great in terms of maximising the choices available to you, it does mean that it could be a big task to select your preferences. Consequently some guidance and notes about how to manage this have been added below:

  • On the screen where you select programme preferences, you can download a spreadsheet containing all the programme options. This is a better format for deciding on your preferences due to the presentation and sorting options this format allows. It is recommended to rank them first in this format, before ordering them on the system. You can also search for particular specialties if that is something which is particularly important to you.
  • Ordering of preferences - programmes will be ordered in a logical way based on geography. For example, all West Midlands' programmes will be grouped together and within this they will be ordered into the regions' distinct sectors.
  • Filtering - the preference system enables you to filter by the information given for each choice. Therefore, if you only want to look at one region you can filter all others out.
  • Bulk preferencing - the preference system works by dragging and dropping individual options into the preferred column. However, you can bulk drag options by using the 'Select All' feature or holding the control button and highlighting all the ones you wish to move. A way you could use this is:
    • You select your most preferred programmes in order of preference.
    • After this you would consider another region as a back up but do not wish to spend the time sorting all these programmes into order.
    • You filter programmes for that region.
    • 'Select All' and drag them over to the bottom of your preferenced programmes.
  • If you are not interested in a particular region you can just ignore it as it will start in the not wanted section. Whilst there will be over a thousand options, there is no requirement to be considered for this many unless you wish to be.
  • As noted in the 'timing' section above, if you are not offered a post initially, there will be opportunity to review your preferences after offers start so you could then look at other regions at that stage if you want to change your mind.

In addition to these notes it is recommended to review the 'preferences guidance' tab in this section of the website. This has further notes to take into account when deciding upon your programme preferences.

Preferences guidance

In each recruitment round, we receive a large number of queries from candidates regarding preferences and offers. The guidance in this section covers the most common areas where issues arise.

Only include preferences you would accept if offered

There is no benefit to including programmes which you would definitely not accept and this could even reduce your chances of being offered a programme you do want as, once an offer is declined, you can no longer be in contention for the specialty.  

If you can't be made an offer initially you will go on the reserve list and considered when declined offers are recycled. You are better to be on the reserve list than holding an offer you do not want and hoping for an upgrade. By the holding deadline you will need to decline the offer and be out of the running, whereas if you had not yet been made an offer you would remain in contention.

Meet deadlines

As all programmes default as 'not wanted', if you do not select your initial preferences by the deadline, you cannot be made an offer. Although there will be opportunity to select or revise preferences later, it may be too late to get one of your most preferred programmes.

Ensure your selection is accurate

Orie makes offers on the basis of your rank and programme preferences, if anything is not in accordance with your wishes, you may miss out on something you did want, or be offered something you do not.

Although there will be opportunities to revise your choices during the offers process, getting them right first time will maximise your chances of being offered what you most want.

You can revise your options as much as you wish before the preference deadline and it is advisable to log back in after selecting them to check you are happy with your selection.

Programmes with zero places

If an option has zero places when you come to preference, you should include it in the order which you would wish to be offered it if there were places. Sometimes places cannot be declared at the point preferences are chosen but they may be added later on, if you have not included it in your preferences you cannot be considered for it.

There is no penalty to including a programme with zero places, all the offers matching algorithm will do is skip this choice and move onto your next one.

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, and resulting ranking, 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.

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.

Your preferences only come into play once it is 'your turn' to be made an offer. Therefore you will be considered for all your preferences before any candidates ranked below you. This means that you will be considered for your #50 preference before a candidate who is lower-ranked but has your #50 preference as their first.

Give honest preferences

Our overall advice is to:

  • Only preference programmes you would genuinely consider accepting if offered.
  • Do not preference programmes you would definitely not accept.
  • Rank them in the order which genuinely reflects your preference of the posts available.

The offers process is designed in such a way that to give you the best chance possible of being offered your highest-available preference without the need to second guess the process.

Both ACCS-AM and IMT programmes 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 IMT 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.