In this article, we’ll be taking a closer look at the specific guidance on NHS applications for entry onto the Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for psychiatrists.
We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:
What is CESR and who is it for?
Do overseas psychiatrists need MRCPsych for CESR?
What is the CESR equivalence process?
What evidence is required for a CESR in psychiatry?
Where will I find this evidence?
Submitting a CESR Application
How much does CESR cost?
How long does it take to receive a decision?
How long does it take to complete?
Do I have to complete CESR before I can work in the UK?
#IMG Tips
How do I get started?
Skip ahead to the relevant section if you know what you’re looking for.
An Introduction to CESR
The CESR, or Certificate of Eligibility for Specialist Registration, is the route to specialist registration for psychiatrists who have not completed a GMC-approved training programme but who are able to demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of CCT in the UK.
CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a psychiatrist, attaining specialist registration will mean you are qualified to practice independently as a psychiatry consultant in the NHS.
Psychiatrists must satisfy the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question. Doctors who have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist medical experience or knowledge as a psychiatrist within a non-training post, and are currently practicing, may apply to the GMC for assessment of their competencies.
Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced psychiatrists will secure a post in the UK, and work towards CESR whilst in post. Typically, CESR is a preferred route towards specialist registration for overseas trained psychiatrists.
An overseas psychiatrists training may not have covered all the ground of the CCT curriculum, but they may be able to show competence in the missing area through experience in a fixed term Specialty Doctor, Specialty Grade, Associate Specialist, or Acting Consultant post in the NHS. In this case, overseas psychiatrists will likely complete the MRCPsych exams to gain GMC registration and start working in the NHS, before completing CESR.
MRCPsych for Specialist Registration
Overseas doctors looking to join the Specialist Register are not required to have completed the Royal College postgraduate exams. In this case, MRCPsych is only a requirement for doctors looking to attain Specialist Registration via the CCT route.
The standard test of knowledge in the CCT curriculum is the MRCPsych exam, so passing these exams confirms the attainment of the competencies of the core Curriculum.
However, if CESR applicants have not successfully completed MRCPsych, they must provide alternative evidence that demonstrates equivalent knowledge to psychiatrists who have passed the exams.
Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside of the evidence presented.
This is not to be confused with the requirements for registering for a full licence to practice with the GMC – many overseas applicants choose to complete MRCPsych.
Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a psychiatrist in the UK.
You can read more about the full MRCPsych examination suite in our IMG Resources library.
The CESR Equivalence Process
Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current psychiatry training programme requirements, in order to be awarded CESR.
The equivalence process involves submitting a written body of evidence to the GMC, consisting of:
training and/or competence; AND
skills and knowledge
The Royal College of Psychiatrists will assess each application against the relevant Curriculum before providing a recommendation to the GMC, who will then make a decision.
Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.
Evidence Requirements for CESR in Psychiatry
Skills & Experience: The evidence provided for a CESR application in psychiatry must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the General Psychiatry Curriculum, and the Advanced Module in the sub-specialty you are applying in. If evidence is missing from any area of the curriculum, the application will fail.
Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.
Audit & Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle
Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.
As a general guide, the GMC usually expects to see about 800 - 1200 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:
Domain 1 – Knowledge, skills and performance
Domain 2 – Safety and quality
Domain 3 – Communication, partnership and teamwork
Domain 4 – Maintaining trust
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
The full list of evidence required for each domain can be found on the GMC website here.
Gathering Evidence for a CESR Application
Domain 1 – Knowledge, skills and performance
Qualifications
Primary Medical Qualification (PMQ)
Specialist medical qualification(s)
Curriculum or syllabus (if undertaken outside the UK)
Specialist registration outside the UK
Honours and prizes
Other relevant qualifications
Assessments and appraisals
Appraisals and assessments
RITAs, ARCPs and training assessments
360˚ and multi-source feedback
Awards and discretionary points letters
Personal development plans (PDP)
Logbooks, records of daily clinical practice and portfolios
Logbooks
Consolidation, cumulative data sheets, summary lists and annual caseload statistics
Medical reports
Case histories
Referral letters discussing patient handling
Patient lists
Departmental (or trust) workload statistics and annual caseload statistics
Rotas, timetables and job plans
Portfolios (electronic or revalidation)
Details of posts and duties (including both training and experience posts)
Employment letters and contracts of employment
Job descriptions
Job plans
Research, publications and presentations
Research papers, grants, patent designs
Publications within specialty field
Presentations, poster presentations
CPD and CME
CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences
CPD registration points from UK Medical Royal College (or equivalent body overseas)
Membership of professional bodies and organisations
Teaching timetables
Lectures
Feedback or evaluation forms from those taught
Letters from colleagues
Attendance at teaching or appraisal courses
Participation in assessment or appraisal and appointments processes
Domain 2 – Safety and quality
Participation in audit, service improvement
Audits undertaken by applicant
Reflective diaries
Service Improvement and clinical governance meetings
Safety
Health and safety
Domain 3 - Communication, partnership and teamwork
Communication
Colleagues
Patients
Partnership and teamwork
Working in multidisciplinary teams
Management and leadership experience
Chairing meetings and leading projects
Domain 4 – Maintaining trust
Acting with honesty and integrity
Honest and integrity
Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)
Data protection
Relationships with patients
Testimonials and letters from colleagues
Thank you letters, cards from colleagues and patients
Complaints and responses to complaints
Additional areas of evidence
Topics Covered in the MRCPsych Exams
Paper A:
Behavioural science and sociocultural psychiatry
Basic psychology
Social psychology
Social science and sociocultural psychiatry
Human development
Basic neurosciences
Neuroanatomy
Neurophysiology
Neurochemistry
Molecular genetics
Neuropathology
Clinical psychopharmacology
General principles
Pharmacokinetics
Pharmacodynamics
Adverse drug reactions
Classification and assessment in psychiatry
Paper B:
Organisation and delivery of psychiatric services
General adult psychiatry
Prevalence/incidence, aetiology, presentation, treatment and outcome of psychiatric disorder in adulthood
Disorders related to pregnancy and childbirth
General hospital psychiatry
Emergency psychiatry
Eating disorders
Psychosexual disorders
Old age psychiatry
Psychotherapy
Dynamic psychotherapy
Family therapy
Cognitive-behavioural therapies
Other therapeutic models
Effectiveness of psychotherapy
Group therapy
Child and adolescent psychiatry
Substance misuse/addictions
Forensic psychiatry
Relationship between crime and mental disorder
Psychiatry and the criminal justice system
Practicing psychiatry in a secure setting
Human rights legislation as it affects patients and psychiatric practice
Learning disability
Services
Epidemiology/Aetiology
Clinical
Research methods, statistics, critical review and evidence-based practice
Translation of clinical uncertainty into an answerable question
Systematic retrieval of the best available evidence
Critical appraisal of the evidence
Application of the results in practice
Evaluation of performance
All these topics covered in the MRCPsych exams can be found in the Core Training in Psychiatry curriculum.
For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for psychiatry.
Validating the evidence
Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.
All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.
Submitting a CESR Application
All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.
Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.
Your electronic evidence can be in any of the following formats:
.doc
.pdf
.ppt
.xls
Formats outside of these are unlikely to be accepted.
The Online Application
You will be required to complete the following sections once you begin your application:
Specialty details
Qualification details and professional experience
Details of your referees
Registration and licensing history
Evidence summary
Details of your verifiers
Final declaration and payment
Additional Evidence
Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:
What evidence they’ve accepted
What evidence they’re unable to accept (including the reasons for this)
Advice and guidance on how your application could be strengthened
You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).
For further information about the online application process, see the GMC’s User Guide.
The Cost of CESR Applications
All psychiatrists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.
How long does it take to receive a decision?
The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.
How long does it take to complete?
As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.
It is worth noting that more senior psychiatrists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.
The indicative period of training for a CCT in psychiatry is six years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior psychiatrists.
NHS Positions in the NHS without CESR
It is important to note that you can apply for more senior psychiatry roles such as a specialty doctor (SAS), specialist grade or acting consultant without being on the Specialist Register.
Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS.
When compared to a trainee post, you will likely receive better pay and responsibilities that are more appropriate to your level of experience. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK psychiatry curriculum.
Across the UK there are several NHS Trusts with well-established CESR programmes of support for psychiatrists who have taken up a fixed term post with the view to completing CESR.
These positions also facilitate a faster route to working in UK and attaining Specialist Registration when compared to making an application for CESR from overseas, which can take an additional amount of time.
#IMG Tips
Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.
Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.
Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.
Ensure that the evidence you collect demonstrates your competence across the whole of the psychiatry curriculum, not just your sub-specialty.
Remember to refer to the most up-to-date Psychiatry CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress.
Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
Choose your referees carefully - they will need to be able to comment on direct observation of your clinical competences. At least six (from the last 5 years) are required but it would be preferable to give provide eight to ten (based on previous experience).
Reconstruct your CV from scratch so that it matches the application form - if you submit a CV that doesn’t contain the required information or you have not submitted all evidence as mentioned on the CV, this will delay your application.
Request a CV consultation with one of our experts
Ask an IMG Connect recruitment specialist about NHS psychiatry posts with CESR support. These are not always advertised by a Trust, but we can help you find a role which aligns well with your career goals in the NHS.
Join the IMG Psychiatrists community – as well as support on Royal College exams, our online community of international psychiatrists and dedicated psychiatry recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Getting started
Attaining Specialist Registration through the CESR pathway can be a long but very rewarding process. Look at our introduction to CESR for psychiatrists for a full overview.
If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
There are several routes a haematologist can take to register with the GMC and practice in the NHS.
Haematologists looking to secure a job in the NHS must satisfy certain criteria before fully registering with the GMC (General Medical Council) to receive a license to practice. For haematology, these criteria depend on where you received your training, and the qualifications you hold. In this blog, we’ll be giving you a snapshot of the steps you need to take to begin your journey to the UK as an overseas haematologist.
We’ll be covering the following:
Will my training be recognised in the UK?
How do I demonstrate my knowledge and skills as an EEA haematologist?
How do I demonstrate my knowledge and skills as a non-EEA haematologist?
How can I demonstrate my English language skills?
What is a certificate of good standing and how do I get one?
What do I need to register with the GMC?
Will I need a visa to work in the UK?
Skip ahead to the relevant section if you know what you’re looking for.
Recognition of training
For haematologists who trained in an EEA country (all countries inside the EU, also Lichtenstein, Iceland, Switzerland & Norway), there are several options potentially available to you.
Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either GMC registration; check the relevant GMC page here.
Knowledge and Skills for EEA Haematologists
Basic Medical Training: If you meet the requirements for basic medical training, you will not need to demonstrate your medical knowledge and skills to work as a doctor in the UK, and would therefore not need to complete a Royal College postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, without Specialist Registration.
Specialist Training / Residency: If you meet the criteria for entry onto the Specialist Register, then once you have completed the GMC application process, you would be granted Specialist Registration in haematology and can be appointed as a substantive or permanent consultant in the NHS. So as a haematologist, if you hold a Relevant European Specialist qualification, you would be put on the specialist register for haematology and can be appointed as a substantive haematologist in the NHS.
As an EEA haematologist, the main hurdle you will face will be demonstrating that your English skills are of a high enough standard to practice safely as a doctor in the NHS.
Therefore, for European haematologists, this is most likely the easiest route to becoming GMC-registered and being able to practice haematology in the UK.
If you do not meet the GMC requirements for your training to be approved for general or specialist registration, other routes you may consider to GMC registration include PLAB, or (via the postgraduate route) the Royal College exams for haematology (FRCPath). You can find out more about these alternative routes here.
Knowledge and Skills for non-EEA Haematologists
If you qualified as a haematologist outside the EEA, then you will have to demonstrate that both your medical knowledge and skills AND English Language capabilities meet the level required to practice safely in the UK.
Haematologists who have trained from outside the UK and EEA must demonstrate to the GMC they have sufficient knowledge & skills to practice safely in the UK. This can be done through three main routes:
Professional & Linguistics Assessment Board (PLAB): The PLAB exam is a two-part exam that assesses a doctor’s ability to work safely as an SHO in the NHS, as such it does not demonstrate ability in haematology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries. If taking this option, haematologists can then take up training or a more senior post once they have established themselves in the NHS. Take a look through our comprehensive guides on PLAB.
Royal College of Pathologists: The Royal College of Pathologists is the professional body that regulates the specialism of haematologists in the UK, and Fellowship of the Royal College of Pathologists (FRCPath) is the full qualification attainable by examination. For overseas doctors, attaining FRCPath will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior roles in UK pathology. Take a look at IMG Resources library for a complete guide to FRCPath to learn more.
Please note that only UK trainee haematologists are required to also complete the MRCP (UK) examinations. You can read more about this here.
GMC-recognised or equivalent qualifications: Some overseas qualifications and licensing exams are recognised by the GMC and accepted for registration purposes. This is to say these qualifications or licensing exams are considered as meeting the same standards as the Royal College qualifications.
To find out if your qualification is accepted by the GMC, take a look at our blog: Overseas accepted postgraduate qualifications
English Language Testing
Both EEA and non-EEA haematologists, regardless of experience and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below:
IELTS – a guide for overseas doctors
OET – a guide for overseas doctors
Experience in English-speaking countries
For doctors who have at least two years of their most recent experience in an English-speaking country, you can use a reference from your current employer or employers over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.
Certificate of Good Standing
All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.
The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. You can find out which medical regulatory authority to contact via the GMC website here.
If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.
Please note that each certificate is only valid for three months from the date it's signed and must be valid when we approve your application.
GMC Registration
Once you’ve completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:
English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).
AND
Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.
AND
(EEA haematologists) Sufficient skill and knowledge – as an EEA haematologist, this would either be your recognised EEA qualification.
(Non-EEA haematologist) Sufficient skill and knowledge – as a non-EEA haematologist, this would either be PLAB, MRCP or a GMC-approved qualification.
To understand the registration process more fully, read our article on GMC registration for overseas doctors here.
Visas
If you or your family are from the EU, Switzerland, Norway, Iceland or Liechtenstein and started living in the UK by 31 December 2020, you may be able to apply to the free EU Settlement Scheme. Otherwise, you will need to apply for a visa from the Home Office.
A Tier 2 visa is the document given to a skilled worker by the UK Home Office following a job offer from a UK employer with a valid Tier 2 Sponsorship License. The list of valid Tier 2 Sponsors can be found here.
Understand Tier 2 visas and Certificates of Sponsorship in depth by taking a look at our article: Tier 2 Visa application process & documents needed.
Wondering whether you can relocate with your family? Take a look at our blog on the Tier 2 dependent visa below: Tier 2 Dependent visa - Can I bring my family with me to the UK?
So there you have it! Hopefully this clarifies any questions or doubts you may have on your route to the UK as a haematologist planning a career in the NHS. If you have any questions, or wish to know more about the haematology job market then get in touch with our team.
For regular news and updates on all things pathology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Overseas doctors often have questions about the best ways to prepare for MRCPsych Paper A, particularly with the changes to the exam format and so many online materials geared towards UK applicants and trainees.
So, what study preparation, materials, courses and support are available for international psychiatrists? We have compiled some of the best guidance and resources to help you in your preparation for the Paper A exam. We will also address some changes to the availability of test centres and exam delivery as a result of the COVID-19 pandemic.
The topics we’ll cover are as follows:
What is MRCPsych Paper A?
How do I get started with my preparation?
What other resources are available?
How has the exam been affected by COVID-19?
#IMGTips
Passed? What’s next?
If you know what you’re looking for, skip ahead to the relevant section.
For an overview of the entire examination series, have a look at our article in the IMG Resources library here.
What is MRCPsych Paper A?
Let’s begin with a quick recap of the first exam in the MRCPsych examination suite.
MRCPsych Paper A is a three-hour written exam which covers the scientific and theoretical basis of psychiatry
The paper comprises 150 questions and is worth 150 marks, with two thirds being multiple choice questions (MCQ) and the other third, extended matching item questions (EMI).
The breakdown of the sections is as follows:
For full guidance on the structure of the exam, see our detailed blog on the MRCPsych Paper A exam here.
Preparation
It can be tough to know the best place to start, so we’ve spoken to some IMG psychiatrists and the consensus was that the Royal College website is the best place to begin. There are some great resources on their website to help candidates in their preparation for the exam. These include:
Syllabus: We always recommend this as the best place to start – plan your study around the curriculum topics for a road map to your success in the exam. You can find this here.
Sample papers: These will help you perfect your exam techniques and are an effective way to benchmark your knowledge against the syllabus. They will also help you work quickly on the day as you will already know what to expect. The sample papers can be found here.
Marking schemes: It’s always a good idea to understand how exams are marked so you can structure your revision accordingly, giving you the best chance of a pass. These are available here.
Sample exam: Samples of the exam are also helpful in fully understanding the format and to familiarise yourself with the online exam environment, particularly as this is a more recent change to the exam. This is available here.
Online exam guidance: This guidance has been written specifically to help candidates to prepare for sitting an online exam, including technology checks and timings that will be in place on the day. This will be more useful closer to the exam date. The guidance can be accessed here.
Passing the MRCPsych - an insider’s guide: the Royal College suggest having a look through this guide, which is a helpful resource to help you to get over the first steps, available here.
What other resources are available?
IMG Connect has a library of written resources geared towards preparation for the Paper A exam. If you’re interested in any of these, please get in touch here and we would be delighted to share these with you.
The most highly recommended resources are the SPMM and MRCPsychMentor resources. They are available in different formats depending on your revision needs:
SPMM Starter Study Materials: A range of comprehensive study materials and subject-based question banks with evidence-based answers and explanations (SPMM HiYield and SmartRevise). These are available for 6 months from the date of purchase for the price of £299 and can be found here.
SPMM Booster Mock Exams
These practice tests are simulations of the real exam prepared to the exam blueprint, allowing you to identify your weakest areas before the actual exam. This package includes access to 6 individual practice papers, comprising reconstructed questions from the most recent exams. Subscriptions can be purchased only 10 weeks before the College exam date.
Duration
N/A
Cost
£249
Next start date
On demand
Website
spmmcourse.com/local/coursepackages.php
MRCPsychMentor Revision Course: unlimited access to a bank of over 2000 questions, including some from previous exams. These are delivered in the same format as will be in the exam (MCQs and EMIs), with practice timed tests you can complete as many times as you like. You can access the course here.
MRCPsychMentor Mock Exam
There are two three-hour long exams available here which simulates exam conditions with mock exam papers of questions not available in the question bank. They include a revision mode, timed tests, extensive performance analysis and powerful question review functions.
Duration
6 weeks
Cost
£15 each
Next start date
On demand
Website
www.mrcpsychmentor.com/mocka/index.php
IMG Psychiatrists MRCPsych Paper A Crash Course
This is a tailored MRCPsych Paper A course for overseas psychiatrists. This course offers weekly sessions covering the exam and its various domains. This is accompanied by practice MCQs and EMQs for exam-style practice, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
The course is supplemented by additional advice and guidance on MRCPsych as a whole, GMC registration support, as well as guidance and webinars on other topics such as finding work in the NHS, relocation support and specialist registration.
You can access our IMG Psychiatrists Paper A Study Course by joining the Facebook group here.
Other online resources available for the exam include a mixture of paid and free resources:
BMJ Revision Questions: The BMJ has created an app-based revision resource with over 270 core questions, including the SBA and EMQ formats that will be seen in the exam. They are available at several price points dependent on the duration of access, from £29.99 for one month to £129.99 for 12 months. These are available here.
TrickCyclists Exam Notes: A series of psychiatry notes specifically tailored to the MRCPsych Paper A exam, including the nine topics covered by the exam and more. They are available in word and PDF format and are free to be used, distributed and modified. They are available here.
How have the exams been affected by COVID-19?
As a result of the pandemic, all MRCPsych exams have moved online. You can learn more about the online exams for MRCPsych here.
The application process for the exam takes 15 – 20 minutes where candidates will need a valid debit/ credit card, as well as the email address and full details of your sponsor. Further details on the application process can be found here.
#IMGTips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Divide your study time according to the marks percentage for each section – dividing your time in this way will ensure you’re putting most of your time towards what will gain you the most marks.
Think about your personal learning style and use this to plan effective revision - consider the ways you study best and use them to your advantage.
Try to take some time off work before the exam – you’ll likely be preparing for the exam alongside full-time work, so, if possible, take around 5-7 days somewhere in the run-up to the exam for some intense revision.
Join the online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation here.
Passed? What next?
Great stuff, this is a fantastic achievement and you should take a well-deserved break!
Once you’re ready, you can apply to sit the Paper B exam (or CASC if you started with Paper B). For more information, take a look at our blog, where we explore MRCPsych Paper B and everything you need to know about sitting the exam, including dates, results, fees and structure.
For more useful blogs & articles on exams, registrations & qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Overseas doctors taking the postgraduate route to GMC registration must attain MRCEM.
International Medical Graduates (IMGs) from any country in the world can sit the Royal College of Emergency Medicine examinations (MRCEM), provided certain eligibility criteria are met. FRCEM however can only be sat once practicing in the UK, so is not a suitable route for international doctors who have not yet practiced in the NHS. To help doctors understand the FRCEM and MRCEM exams the following guide will provide you with key information covering the exams, dates, fess, eligibility, preparation and application.
These are summarised below along with a broad look at the following topics:
What is FRCEM and what is MRCEM?
FRCEM Route
MRCEM Route
Eligibility for MRCEM
Eligibility for FRCEM
Where can I take the exam & how much will it cost me?
How do I apply?
How to prepare and what resources are available
Should I take an MRCEM course?
Passed? What next?
What is the Royal College of Emergency Medicine?
The Royal College of Emergency Medicine is the professional body responsible for the specialty of Emergency Medicine throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession in the UK.
What is FRCEM and what is MRCEM?
Membership or Fellowship of the Royal College is awarded to candidates who pass three examination components.
There have been a few changes to the MRCEM and FRCEM examination structure over the last few years, as such there are currently two routes to an accreditation in Emergency Medicine, both leading to RCEM Membership.
These two routes are:
Membership of the Royal College of Emergency Medicine (MRCEM)
Fellowship of the Royal College of Emergency Medicine (FRCEM)
MRCEM & FRCEM are one several routes an overseas emergency medicine doctor can take full GMC registration. Read our blogs on acceptable postgraduate qualifications and PLAB if you are unsure what route to take.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCEM or FRCEM would be the best route to take.
MRCEM Examination Route
The alternative route, Membership by Examination (MRCEM), is offered to candidates who have passed all the following components:
FRCEM Primary or (MRCEM Part A)
One written paper, three-hours total
FRCEM Intermediate SAQ (replaces MRCEM Part B)
Short Answer Question paper - 3 hour paper comprised of 60, 3-mark questions
MRCEM OSCE
Practical examination setting with 18, seven-minute stations
FRCEM Examination Route
The Fellowship Examinations consists of the following components:
FRCEM Primary Examination
one, three-hour written paper
FRCEM Intermediate Certificate
Short Answer Question Paper (SAQ)
Situations Judgement Paper (SJP)
FRCEM Final Examination
Critical Appraisal (Short Answer Question Paper)
Quality Improvement Project (QIP)
Clinical Short Answer Question Paper
Objective Structured Clinical Examination (OSCE)
Membership or Fellowship of the Royal College is awarded to candidates who pass three examination components, using either route above.
Eligibility for MRCEM Examinations
Eligibility for FRCEM Primary:
To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
Eligibility for FRCEM Intermediate:
To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme and have passed FRCEM Primary Examination after 1st August 2016.
You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012.
Eligibility for MRCEM OSCE:
To be eligible to enter the MRCEM OSCE (Part C) you must meet the following requirements:
Hold a medical qualification approved by the GMC and
Have completed the UK Foundation Programme of equivalent (electronic evidence required at point of application) and
Have passed the FRCEM Primary examination after 1st August 2016 or
Have passed the MRCEM Part A examination after 1st August 2012 and prior to 31st July 2016 and
Have passed the FRCEM Intermediate SAQ after 1st August 2016 or
Have passed the MRCEM Part B examination after 1st August 2012 and prior to 31 July 2016 and
Have 36 months experience including 6 months experience in Emergency Medicine at a level above Foundation Year 1 (post full registration)
Eligibility for FRCEM Examinations
Eligibility for FRCEM Primary:
To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
Eligibility for FRCEM Intermediate:
To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme and have passed FRCEM Primary Examination after 1st August 2016.
You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012.
Eligibility for FRCEM Final Examination:
To be eligible you must have FRCEM Primary and FRCEM Intermediate Certificate, attained after 1st August 2016.
Where can I take the exams & how much will they cost me?
Examination and application dates are regularly updated by the Royal College and can be found here.
Please remember, applications made outside the application period will not be accepted.
Examination
Location
Fees
FRCEM Primary
Short Answer Question Paper
UK
£310
Iceland, Malaysia, Oman, India
£390
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
FRCEM Intermediate Cert.
(SJP)
UK
£200
Kuala Lumpur
£200
MRCEM
OSCE
UK
£450
India
£450
FRCEM Final
Clinical SAQ
UK
£300
FRCEM Final
Critical Appraisal SAQ
UK
£240
FRCEM Final
QIP
N/A
£150
FRCEM Final
OSCE
London
£420
How can I apply?
All applications are made online and links to all application forms and windows are available here. It is worth noting, the application can take some time to complete, so it is always advisable to apply well in advance of the deadlines.
Please remember, applications submitted after the application period will not be accepted.
How do I prepare for each exam and what resources are available?
With lots of resources available online, such as FRCEM Success, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
Curriculum:
Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.
We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Information Packs:
These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day:
FRCEM Primary
FRCEM Intermediate
FRCEM Final Examination
MRCEM OSCE
SAQ Blueprint:
The blueprint for the new Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
SJP Blueprint:
A blueprint of the new Intermediate SJP exam can be found on page 11 FRCEM Intermediate examination pack, downloaded from the RCEM website here.
Sample questions:
Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below:
Primary – sample questions
Intermediate Certificate – sample SJP questions
Final – successful QIP
Reducing referral rates of paediatric patients to plastic surgery
Management of fractured neck of femurs in the ED
Final – unsuccessful QIP
Critical Appraisal Questions – Advice to Candidates
Critical Appraisal – Most Frequently Offered Answers
Glossary of Terms:
The royal college uses many terms that may cause confusion, so take plenty time to understand the terms and definitions used in this guide. Candidates are expected to be rigorous in their use of these terms.
Glossary of terms used in RCEM exams.
Examination Report:
The Royal College recently began to publish reports on the performance of those sitting FRCEM examinations. Below is the first report published and helps to break down results for those in training and those out of training.
2018 Examination report.
Online resources:
There are lots of resources online, such as videos on YouTube, FRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.
For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connects Top Tips for exam preparation.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Should I take a course to prepare for the OSCE?
Whilst it is not essential to take a course when preparing for the MRCEM or FRCEM OSCEs - there is no doubt it will help your preparations both technically and mentally, and should be considered an investment towards your future career plans. Have a read of our blog on recommended MRCEM courses for Emergency Medicine doctors.
You can find a full range of articles covering MRCEM and FRCEM examinatins to help you to make a success of your preparations here.
Passed? What next?
First of all, congratulations! After you have passed all parts of FRCEM or MRCEM you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.
IMG Jobs
Search and find live emergency medicine NHS doctor jobs in the UK
IMG Resources
In our IMG Resources library you can read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding, CESR, a typical doctor salary in the UK and the most suitable NHS job & hospital locations for you.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
The Medical Oncology SCE is a postgraduate qualification delivered by the Royal College of Physicians as a higher specialist qualification for medical oncologists. It is one of 11 SCEs offered by the Royal College and offers physicians a postgraduate qualification which demonstrates achievement of a high standard (equivalent to UK specialist trainees) to prospective employers.
Here we take a closer look at the MRCP (UK) Medical Oncology Specialty Certificate Examination for doctors who have chosen to specialise in medical oncology. We cover the exam content, fees and eligibility, summarised below along with a broad look at the following topics:
What is the medical oncology SCE?
Where does the SCE fit into my oncology training?
What is the structure of the SCE?
How do I apply for the exams and what do they cost?
Where can I sit the exams as an overseas medical oncologist?
How should I prepare for the exams as an IMG?
I’ve passed? What’s next?
Skip ahead to the relevant section if you know what you're looking for.
MRCP (UK) Medical Oncology SCE
The Royal College of Physicians is the professional body responsible for the specialty of medicine throughout the UK.
The medical oncology specialty certificate exams are administered as a compulsory component of assessment for Certificate of Completion of Training (CCT) in medical oncology for all UK trainees.
The purpose of an SCE is to:
ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants
complement workplace-based assessments
provide a rigorous national assessment to establish public confidence
offer a challenge similar to sub-specialty certification examination in North America
For in-depth information on each of the MRCP exams, see our IMG Resources library here.
Medical Oncology SCE as Part of Training in Oncology
As the MRCP exams are taken during the Internal Medicine Training years (CT1-CT3), an SCE allows medical oncologists to demonstrate that they are able to practice independently.
The SCE has no official entry requirements (both for UK and overseas candidates), however, UK trainees would normally take the SCE in their penultimate year of higher specialty training (ST5).
To find out more about the medical oncology training pathway in the UK, see our blog on this topic here.
Exam Structure
The SCE assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum:
Topic
Number of questions
Breast cancer
14
Colorectal and anal cancer
14
Lung and thoracic cancer
14
Carcinoma of unknown origin
7
Ovarian cancer
7
Germ cell tumours
7
Oesophagogastric cancer
6
Lymphoma
3
Uterine cancer
3
Hepatobiliary cancer
5
Skin cancer
5
Sarcoma
5
Leukaemia
1
Prostate cancer
3
Urothelial cancer
3
Cervical cancer
3
Head and neck cancer
2
CNS cancer
2
Renal cell cancer
3
Endocrine cancer
2
Scientific basis of malignancy
18
Professional skills
14
Acute oncology
20
Clinical research, ethics and economics
8
Systemic anticancer therapy
18
Supportive therapies and palliative care
10
Standard operating procedures
3
Total
200
All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.
Medical Oncology SCE Applications
SCEs are held once a year and applications are made online through My MRCP(UK) account, within the Upcoming Exams section of the Royal College website.
The application process is as follows:
Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)
Request a preferred test country and city
Pay applicable examination fee
Application is confirmed via an automatically generated email
Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.
The Royal College has created a helpful video guide on SCE applications which you can watch here.
Cost
The cost of the MRCP exams are as follows:
UK centres: £665
International centres: £833
Exam Centres
UK Centres
Candidates choosing to sit the exam in the UK must contact Pearson VUE to book their test. There are up to 137 test centres throughout the UK for each SCE, and the Royal College advise that candidates should book their exam as early as possible to secure their preferred test centre, as bookings operate on a first come, first served basis.
International Centres
Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. MRCP (UK) will pass this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the date of the examination. If the exam is not available in a requested location, candidates will be offered a choice of the nearest available test centres.
Please note, international candidates should not book their own test centre with Pearson VUE, and attempting to do so may delay a candidate's application.
The full list of international SCE test centres can be found here.
Preparation and resources for the Medical Oncology SCE
With lots of resources available online, it can be difficult for IMGs to know where to start with their preparation and revision. This list should provide a good starting point for any international medical oncologists preparing to sit the SCE:
Curriculum - Applicants are tested on a range of common and important disorders in Medical Oncology as set out in the Joint Royal Colleges Specialty Training Curriculum for Core Medical Training. We recommend getting to know the curriculum as early as possible and using it as a roadmap for your study.
Guidelines - These resources are helpful for supplementing your knowledge:
British Journal of Cancer 2009 March 100 (5) 684–692 Jones et al. – guidelines for Herceptin modification
British Thoracic Society (BTS) - pleural disease guidelines
International Prognostic Index score for non-Hodgkin's lymphoma
National Comprehensive Cancer Network (NCCN) - guidelines for follicular lymphoma
NHS Cancer Screening – guidelines for bowel and other cancers
Books
Candidates can find information on genetics and some basic science in the Oxford Desk Reference of Oncology 2011.
Sample questions
It is a good idea to regularly benchmark your knowledge by testing your knowledge and progress throughout your preparation using example questions from the current exam syllabus. You can find these here.
For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connect's Top Tips for exam preparation.
IMG Oncologists
Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded oncology SCE aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
I’ve passed? What’s next?
First, congratulations - this is a fantastic achievement! Armed with your MRCP and medical oncology SCE qualifications, you can apply for a full GMC registration with a license to practice. Once the GMC has approved your application, you can work as a doctor in the UK. Nice one!
Don’t hesitate to get in touch with an IMG oncology recruitment specialist to discuss GMC registration, oncology positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.
To receive the latest news and updates on all things oncology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.
Here we explore specialist registration in histopathology for overseas consultant pathologists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) specifically, including the application, costs, and eligibility criteria, along with some other topics, summarised in the headings below:
What is Specialist Registration?
What route to Specialist Registration is best for me as an overseas pathologist?
Do I have to complete CESR before I can work in the UK?
Do I need FRCPath for Specialist Registration?
What is the CESR equivalence process?
What evidence do I need to submit for a CESR in histopathology?
How much does CESR cost?
How long is the CESR application process?
#IMG Tips
How do I get started?
Skip ahead to the relevant section if you know what you’re looking for.
Specialist Registration
Specialist registration in any specialty means that you can be appointed to a substantive (permanent) consultant position in the NHS. All physicians who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to gain Specialist Registration.
Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a histopathologist in the UK.
Routes to Specialist Registration
There are three types of certificates issued by the GMC for specialist registration across all specialties, and the type of certificate you receive depends on which training route you followed.
For pathologists who have completed their full training outside a GMC-approved training programme, CESR is the route they will usually take towards attaining specialist registration. This route does not require further training, but rather the submission of an application.
Doctors who have trained outside the UK or Switzerland, but within an EEA country, will be awarded CCT (Certificate of Completion of Training) after a successful specialist registration application. Specialist Certifications from across the EU are deemed as equivalent by the GMC, and therefore a straightforward application can be made.
Pathology Positions in the NHS without CESR
It is important to note that you attain more senior histopathology roles in the NHS, such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register.
Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS.
In these NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK histopathology curriculum.
These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.
FRCPath for Specialist Registration
Whilst it is always beneficial pathologists to complete FRCPath, overseas doctors looking to join the Specialist Register do not necessarily need to have completed the Royal College postgraduate exams.
The standard test of knowledge in the CCT curriculum are the FRCPath exams, so passing these exams confirms the attainment of the competencies of the Histopathology Curriculum.
FRCPath is only a requirement for doctors looking to attain Specialist Registration via the CCT route.
However, if CESR applicants have not successfully completed these exams, they must provide alternative evidence that demonstrates equivalent knowledge to histopathologists who have passed the FRCPath exams.
Even if the competencies covered by the exams require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.
CESR Equivalence Process
Equivalence describes the process of assessing an overseas applicant’s training and experience against the current histopathology training programme requirements, in order to be awarded CESR.
The equivalence process involves submitting a written body of evidence to the GMC, consisting of:
training and/or competence
skills and knowledge
The Royal College of Pathologists will assess each application against the relevant Curriculum before providing a recommendation to the GMC, who will then make a decision.
Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.
Evidence Requirements for CESR in Histopathology
Skills & Experience: The evidence provided for a CESR application in histopathology must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the Curriculum for Specialty Training in Histopathology. If evidence is missing from any area of the curriculum, the application may be unsuccessful.
Capabilities in Practice: The Royal College of Pathologists has divided the Training Curriculum into 11 different Capabilities in Practice (CiPs) – each comes along with its own descriptor and guidance on where such CiPs would be evidenced.
Applicants are required to gather evidence by area of competence and attach this under the relevant section of the online application.
Generic CiPs
Able to function effectively within healthcare and other organisational and management systems to deliver consistent high-quality patient care.
Able to work within ethical and legal frameworks across all aspects of clinical practice.
Communicates effectively and is able to share decisionmaking, while maintaining appropriate situational awareness, professional behaviour and professional judgement.
Maintains patient safety at the forefront of clinical working. Can utilise quality improvement activity realistically within the constraints of the role.
Able to contribute to and support research.
Behaves as an educator in the context of the role and promotes educational culture.
Able to self-appraise, learn and adapt.
Histopathology-specific CiPs
Able to demonstrate leadership and management within the laboratory setting for the benefit of patient care.
Able to use laboratory and other services effectively in the investigation, diagnosis, and management of patients, relatives, and the deceased.
Able to manage and contribute to a multidisciplinary team effectively.
Able to take, manage and interpret pathological specimens accurately and safely, mindful of risks to self and others.
Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle.
Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.
As a general guide, the GMC usually expects to see about 800-1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:
Domain 1 - Knowledge, skills, and performance
Domain 2 – Safety and quality
Domain 3 – Communication, partnership, and teamwork
Domain 4 – Maintaining trust
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
The full list of evidence required for each domain can be found on the GMC website here.
The Cost of CESR Applications
All histopathology applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.
How long does it take to complete a CESR in Histopathology application?
The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.
As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.
It is worth noting that more senior histopathologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.
The indicative period of training for a CCT in histopathology is five years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior pathologists.
#IMG Tips
Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.
Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.
Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.
Ensure that the evidence you collect demonstrates your competence across the whole of the histopathology curriculum, not just your sub-specialty.
Remember to refer to the most up-to-date Histopathology Specialty Training Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
Create a CESR ‘to-do list’ with sections under the 11 CiPs headings – organise your evidence directly into these sections to manage your progress.
Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
Ask an IMG Connect recruitment specialist about NHS histopathology posts with CESR support. These are not always advertised by the Trusts, but we can help you find a role which aligns well with your career goals in the NHS.
Join the IMG Histopathologists community – as well as support on Royal College exams, our online community of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Getting started
Many pathology IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route. Take a look at our guide to CESR Applications for Histopathology for more information on how to apply and what to expect.
If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS histopathology posts which offer CESR support, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Overseas histopathologists wanting to secure a job in the UK via the postgraduate qualification route will need to attain Fellowship of the Royal College of Pathologists in Histopathology or FRCPath in Histopathology, a sub-specialty exam of FRCPath. FRCPath is the UK qualification and a GMC-recognised postgraduate route.
International Medical Graduates (IMGs) from any country in the world can sit the sub-specialty FRCPath in Histopathology examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is FRCPath in Histopathology?
Eligibility for overseas doctors
FRCPath in Histopathology structure and format
FRCPath in Histopathology: Part 1 - MCQ/EMQ
FRCPath in Histopathology: Part 2 - Practical Examination
As an overseas candidate where can I take the exams and how much will it cost me?
How do I apply?
How to prepare and what resources are available?
Passed? What next?
What is FRCPath in Histopathology?
Set against the Curriculum for Specialty Training in Histopathology, the examinations are designed to recognise histopathologists close to the end of their training who can demonstrate sufficient knowledge and technique for independent practice. In other words, completion of the full set of exams (Part 1 & 2) demonstrates your ability to work at consultant level.
Eligibility for overseas doctors:
Below we outline the eligibility for overseas doctors looking to sit both FRCPath Histopathology exams. For international candidates, the eligibility criteria for FRCPath specialty examinations can be a little confusing when looking online so IMG Connect spoke to the Royal College directly in an effort to clarify this.
Time spent in histopathology training is stated as a requirement of eligibility and the Royal College do consider equivalents to NHS training programmes though there is no list of countries with accepted or unaccepted training programmes. The royal college advises you should speak to your Educational Supervisor or Sponsor (if you have one) who can advise you if you are ready or eligible to sit the Examinations if you are unsure. Remember, there are many overseas doctors applying for all parts of the FRCPath exams so don’t be put off applying!
Top Tip: If you have the required months training in a recognised programme in your country for Histopathology specifically, the chances are you will be eligible.
Eligibility for Part 1:You are required to have trained in a recognised training programme in Histopathology for a period of no less than 12 months.
Did you know? Candidates who have passed the FRCPath Part 1 examination in Histopathology who, after appropriate training, can attempt the Part 2 examination in one of the following: Forensic Pathology, Neuropathology or Paediatric Pathology.
Eligibility for Part 2: The Royal College expects you to have at least three years of specialty training specific to Histopathology in your own country. Furthermore, the Royal College strongly advises candidates to attempt Part 2 at least 12 months after passing Part 1.
FRCPath in Histopathology structure and format:
The FRCPath examinations consist of two parts:
Part 1 – One paper comprised of 125 multiple choice questions (SBAs and EMQs)
Part 2 – six-part practical examination held over two consecutive days.
Part 1 examination:
FRCPath Histopathology Part 1 One comprises of 125 multiple choice questions in both single-best-answer (SBAs) and extended-matching-questions (EMQs).
The exam is orientated towards assessing your overall knowledge and understanding of:
histopathology/ cytopathology
basic science underpinning pathology (inc. molecular biology)
full range of autopsy practices undertaken in an NHS District General Hospital
Part 2 Practical Examinations:
The exams consists of six components taken over two days, summarised below:
Part 2 Practical examinations
Surgical history
20 cases in 20-minute slots
Cytopathology
8 cases in 20-minute slots
Macroscopic pathology
4 cases with 20-minute reviews followed by 20-minute discussions
OSPEs
2 20-minute stations
Long cases
4 20-minute stations
Frozen sections
6 cases in 2, 20-minute stations.
One meeting with examiners in separate 20-minute station.
Surgical history: 20 cases are provided in 10 pairs of haematoxylin and eosin (H&E) stained slides in 20-minute slots over 3-hours 20 minutes of the second morning. The cases will represent a range of difficulties, with some proving complex cases requiring detailed description, differential diagnosis and special techniques or cases not diagnosable on a single H&E.
Cytopathology: Held on the first morning of the exam. Eight non-gynaecological cytology cases will be provided in pairs in 20-minute slots.
Macroscopic Pathology: This part is designed to allow candidates to demonstrate their capabilities in discussing gross pathology and familiarity with block selection in the context of the RCPath Minimum Datasets. Four cases provided in the form of photographs of gross pathology specimens. Two 20-minute slots will be provided for 2 cases, followed by 20-minute discussions with 2 examiners.
OSPEs: 2 x 20-minute stations. One of which is conducted face-to-face with 2 examiners while the other is a written exercise only. Possible topics can include management/clinical governance type and MDT type cases.
Long Cases: 4 x 20-minutes stations provided on the first afternoon including cases which cannot conventionally be covered in a single H&E stained section.
Frozen Sections: 6 cases viewed in 2 x 20-minutes stations (3 cases per station) before meeting with a pair of examiners in a 20-minute station. You need to take notes and be able to provide the examiners with a bottom-line diagnosis only, to form basis for discussion in face to face meetings.
Where can I take the exams and how much will they cost me?
The COVID-19 pandemic has caused disruption to Royal College exams across all specialties, and unfortunately the RCPath exams have been affected also. For the most up-to-date news on the RCPath examinations please refer to their website here.
FRCPath Part 1 (current COVID-19 arrangements): In 2022, the Part 1 examination will be offered using online delivery to candidates. This means you can take the exam remotely and will not need to travel overseas to sit the exam, or attend an examination centre. The College will deliver the written components of these examinations through a company called TestReach, the Oral components (including oral OSPE stations) will be delivered using a video-conferencing platform such as Zoom or Microsoft Teams and for the written examinations, candidates will be given the opportunity to trial the TestReach system to familiarise themselves with it ahead of the examination. You can read more about the new, remote examination process further here on our website.
Previously, the Part 1 examination was sat in multiple overseas centres and once the pandemic is under better control globally, it is highly anticipated the Royal College will return to previous set-ups.
The FRCPath Part 1 exam costs £622. You can see how the Royal College breaks down the cost here on their website.
FRCPath Part 2 (current COVID-19 arrangements): Part 2 exams will be held in person in the UK in 2022. There will be no online delivery for the exam.
Keep an eye on the RCPath website for the most up-to-date news on the exams.
The FRCPath Part 2 exam costs £1,308. You can see how the Royal College breaks down the cost here on their website.
How do I apply?
Applications must be made via the Royal College of Pathologists website, with applications only available once an application window is opened by the Royal College. This is usually twice a year, in SPrin and in Autumn.
How do I prepare for RCPath exams and what study resources are available?
With lots of resources available online, we have discussed with consultants the best place to start looking for materials relating to the exams. Most recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
Curriculum: Questions are set against the Curriculum for Specialist Training in Histopathology We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Regulations and Guidelines: Before applying for FRCPath examinations, the Royal College recommends you read both the General & Specialty Specific regulations and guidelines:
General Regulations and Guidelines
Royal College - Histopathology Regulations & Guidelines
Sample Questions:Testing yourself against previous exam questions is always a recommended way to prepare. Histopathology Part 1 sample questions
Cancer Datasets and Tissue Pathways: The College’s datasets for Histopathological Reporting on cancers have been written to help pathologists work towards a consistent approach for the reporting of the more common cancers and to define acceptable practices in handling pathology specimens. Whilst these are not specific to FRCPath examinations they are certainly relevant to the wider practice in histopathology.
IMG Connect advice:
Part 2 – food and drink:With multiple exams taking place for Part 2 in one day bring supplies! It will be a long day and there may not be access to food.
Hiring a microscope: For Part 2 you will be required to sit examinations in the UK and will require a microscope. The examination centres will not provide equipment for any applicants so you will need to hire a microscope in advance. There are a few companies easily accessible through a web search, find a microscope and book well in advance of the exam. You can arrange for the company to drop off and pick up the microscope from the exam centre, don’t worry!
I passed the FRCPath exams! What next?
First of all, congratulations! After you have passed both parts of FRCPath in Histopathology you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a histopathologist in the UK.
Don’t hesitate to get in touch with an IMG Consultant to discuss UK job options in Histopathology, including discussions regarding a typical doctor salary in the UK and the most suitable locations for you.
The Royal College makes it clear that individuals who reach the standard required to pass the FRCPath examination in their chosen specialty are deemed to have the necessary professional competence to practice unsupervised. FRCPath also greatly contributes to the Certificate Confirming Eligibility for Specialist Registration (CESR), the alternative route to the Specialist Register for doctors who do not complete their training in an approved UK training programme.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Are you an overseas psychiatrist taking the postgraduate route to GMC registration through the MRCPsych exams? Are you interested in sitting the exams in the future?
As part of IMG Stories, we're introducing Dr Bilal Zafar, a psychiatrist who has recently sat and passed the MRCPsych Paper A exam. Bilal will be sharing his experiences of the first of the Royal College of Psychiatrists exams, taking you through his preparation, experience of sitting the exam and sharing some hot tips for international MRCPsych aspirants.
1. Tell us about yourself... what should the IMG Community know about Bilal Zafar?
My name is Dr. Bilal Zafar and I'm from Karachi, Pakistan. I graduated from Dow University of Health Sciences (DUHS) in 2018 and cleared my FCPS residency entrance exam from College of Physicians & Surgeons, Pakistan. Currently, I'm working as a psychiatry resident at Liaquat National Hospital in Pakistan. I am also Editor in-chief at MEDizzy UK, Global Executive Member at Oli Health Magazine Turkey, and an i-act manager for mental health certified by the Royal College of Psychiatrists, UK. I served as an ambassador for Banja Luka International Medical Congress (BLIMC) 2019, the 25th Scientific Congress of Hellenic Medical Students and the 13th International Forum for Medical Students and Junior Doctors from Pakistan.
More recently in 2022, I excelled in the MRCPsych Paper A examination by Royal College of Psychiatrists.
2. What motivated you to sit the MRCPsych exams?
When I started my residency, I was originally convinced to aim for PLAB, however during my practice, I watched one of my supervisors clear all the Royal College exams. This inspired me to switch to my focus to MRCPsych.
3. At what point in your career and training did you sit the MRCPsych Paper A exam?
I took the MRCPsych Paper A exam in December 2021. For me, the timing was appropriate as I was in the second year of my residency, therefore more aware of the fundamentals. By this point, I had built enough thorough clinical experience to tackle Paper A.
4. How far in advance did you start preparing for the MRCPsych Paper A and how much time did you spend on revision?
I started studying for MRCPsych Paper A soon after clearing my FCPS entrance exam. I had initially allocated 2 hours of studying daily, but as I was at the beginning of my residency so my dedicated study time fluctuated. However, I did my best to adhere to my study plan. When I was around 6 months away from the MRCPsych Paper A exam date, I started aggressive preparation. This is what I recommend to everyone; you will never feel ready for the exam. Book a place, start your preparation and take the exam!
5. Did you benefit from speaking to senior colleagues or peers about the exam? Did you study with other candidates?
I was grateful to find very professional, concerned and co-operative senior colleagues. Their thorough guidance and support provided me with the strategy and study materials for this exam. Around 6 weeks before the exam, I joined a study group of IMGs (which I found through IMG Connect) where I found an amazing study partner. She had more than 5 years' experience in clinical psychiatry, and together we solved MCQs and discussed concepts - her experience benefited me a lot!
6. You are one of the creators of the fantastic MEDizzy UK Journal. How has this impacted your study and practice as a psychiatrist?
MEDizzy is the world's fastest growing medical learning communities. I joined the community 4 years ago. Back then, I was doing my internship and preparing for the residency entrance exam. For me, MEDizzy is a door to non-stop medical exposure, and I've learned a lot from the app and journal. MEDizzy journal was launched in 2020 and since then I've served as Editor-in-Chief. We serve the global medical community with the latest news, medical cases, medical technology, inspirational interviews and much more. I must say, sometimes it becomes difficult to maintain a work and study balance and there's no perfect formula for this. I would say my studies have made me what I am today and MEDizzy polished me.
7. How did you manage to juggle other commitments whilst studying for the exam (without panicking)?
Sometimes I don't know, myself! After booking my exam, I created a study plan. At the same time, I had to juggle my residency, medical writing on Fiverr, MEDizzy projects and, most importantly, my wedding. It was scheduled for the day after my MRCPsych Paper A exam. I was tangled in multiple commitments and you can only imagine the difficulty. Fortunately, I could manage my personal life, residency and exam and passed the exam on my first attempt, despite the odds. The key is to remain calm and believe that nothing in this world is impossible.
8. What resources did you use to prepare and practice for the MRCPsych Paper A exam?
I relied on SPMM notes, SPMM high yield MCQs and mock exams. For my MRCPsych Paper A, I used a retro approach to studying. In this technique, I first solved the MCQs of any topic and studied the same topic later from the SPMM notes. I practiced mock exam questions 6 times. Always remember - revision is the key. You may cover a long list of topics but if you don’t revise what you studied earlier you won’t retain this information. While practicing questions, read them carefully and memorise the explanations. Lastly, I also used the Shorter Oxford Textbook of Psychiatry and Kaplan Neuroanatomy.
9. What is the single best resource you would recommend for IMGs to use when preparing for the MRCPsych Paper A and why?
SPMM and SPMM only. The mock exams and practice questions are similar to real exam questions. Take the mock exams 6 weeks prior to the actual exam and solve them in the provided time. This will give you real insight about your time management and retention and recall power.
10. Let's face it, exams are not everyone's favourite day out... so on the day of the exam, what did you do to relax?
Nobody should study on the day of exam. This makes you more anxious. For me, I was getting married the very next day and I had so much going around at home and in my mind. My exam was at 12pm, so I woke up at 7am, took a shower, got dressed, and left for the examination centre at 10:00 am.
11. What was your experience like on the day?
My experience was overwhelmingly amazing! It was an online exam at a local examination centre. In the exam there were 3 sections of 50 questions each. We had an option to take a break after completing each section, but I didn’t take any breaks as I thought it might disturb my continuity. Most of the questions were doable for me as I had practiced mock questions. However, there were some entirely new questions as well. In every section, I gave a reasonable amount of time to at least 5 questions. The rest of them didn’t take much time. Therefore, I completed the exam in 2 hours.
12. What was the most challenging part of the exam?
The most challenging part of the exam was the EMIs. They took a fair amount of time and I had to recall my basic concepts and put them together to solve these questions.
13. In hindsight, would you have done anything differently?
After the exam, I was confident about my performance. I thought I'd taken a good approach to the exam and ws confident in the results.
14. What nuggets of advice would you give to any MRCPsych Paper A aspirants?
I would recommend that you not wait for the ‘right time' or a time when you're ‘fully prepared'. There is neither a right time nor any point when you're completely prepared. Book the test, make full use of the question banks, take mock exams, start studying and sit your exam.
15. What did you do to celebrate passing the exam?
On the day the exam results were to be released, I was at home, and my wife and I were anxiously waiting for the email from the Royal College. The moment we saw “PASS” in the email, my wife literally shouted “You did it, Bilal!”. It was a priceless moment. Later that night, we arranged a gathering of close friends and family to celebrate my achievement.
16. What are your plans going forward?
So far, I am a candidate for FCPS (Psych) and MRCPsych. My plan is to take the intermediate module of FCPS in August 2022 and then take MRCPsych Paper B in September 2022. I aim to complete MRCPsych by next year. As far as MEDizzy is concerned, we aim to expand the community by initiating new projects such as the ambassador program and advancing MEDizzy Inspire where we interview the most deserving personalities from the world of medicine who can become inspiration for young healthcare professionals.
Join the IMG Psychiatrists Facebook group for access to a community of like-minded overseas MRCPsych aspirants.
For news and updates on all things psychiatry, follow us on social media and join the conversation.
For many overseas psychiatrists, as well as UK based trainees, the MRCPsych exams can be overwhelming. Where do you turn for study materials? How do you prepare for the exams? What are the exams dates and fees? Where can I sit the exam? How can I find support online?
To help a little, in this blog we will explore MRCPsych Paper A and everything that you need to know about how to sit the exam, taking a detailed look at the following topics:
An overview of MRCPsych
What is MRCPsych Paper A?
How is the exam structured and marked?
Am I eligible to sit this exam?
As an international psychiatrist, when and where can I sit the exam?
Where and how do I apply?
How much will the exam cost?
What is the best way to prepare for MRCPsych A?
#IMG Tips
Passed? What next?
If you know what you're looking for, skip ahead to the relevant section!
An overview of MRCPsych
The MRCPsych exams are the central components of psychiatry training in the UK. The examination series is designed to test the candidate’s knowledge of basic medical sciences as well as the clinical skills needed for diagnosis and management within psychiatry.
Full MRCPsych satisfies the postgraduate requirements for full GMC registration for international psychiatrists taking this route towards working in the UK.
The exams within the series are as follows:
MRCPsych Paper A
MRCPsych Paper B
MRCPsych CASC
For a more general overview of the MRCPsych examinations via our IMG Resources, please click here.
MRCPsych Paper A
Paper A is a three-hour written exam covering the scientific and theoretical basis of psychiatry.
The exam, comprised of 150 questions, is worth 150 marks:
two-thirds multiple choice questions (MCQ), and
one-third extended matching item questions (EMI)
Exam structure and marking
Paper A covers the following sections of the current syllabus:
The percentage split and marks allocation on the 150-mark exam is broken down as follows:
Section
Percentage
Marks
Behavioural Science and Socio-cultural Psychiatry
16.67%
25 marks
Human Development
16.67%
25 marks
Basic Neurosciences
25%
37 - 38 marks
Clinical Psychopharmacology
25%
37 - 38 marks
Classification and Assessment in Psychiatry
16.67%
25 marks
Eligibility
Trainee psychiatrists from any country in the world can sit the MRCPsych examinations providing that they meet the eligibility requirements.
You are eligible to sit Paper A if you are a fully registered medical practitioner.
Exam locations and dates
We have good news – in response to the COVID-19 pandemic, the Royal College of Psychiatrists has made the decision to move all MRCPsych exams online! This means you can sit the MRCPsych exams from your home country with submission and preparation details available on the Royal College website.
This change makes it immensely easier for international doctors to complete their Royal College exams and work towards GMC registration within a normal timeframe and with reduced disruptions.
Examination dates (at the time of writing) are as follows:
Examination Date
Application Period
Results Publication Date
1 December 2022
26 September - 7 October 2022
15 February 2023
Exams are usually held twice a year – and we will regularly check the Royal College website for updates and changes.
Applications
To apply, you’ll need to complete the Royal College online application form. This form is only available during the published application dates and must be submitted prior to the closing date. If you miss the cut off, your application will not be considered.
For new overseas candidates, you will need to register for a Royal College login first.
You will need to provide the following:
Personal details
Primary Medical Qualifications & Registration
Training
Written paper selection
Fees
At the end of your application, you will be directed to an online payment system where you can pay by credit or debit card, so make sure you have your details ready.
Once your application is complete you will receive two confirmation emails, one to confirm receipt of the application and one to confirm the payment has been received.
See below for MRCPsych Paper A fees for 2021:
PMPT Trainees and Affiliates (UK & Ireland Centres) - £486
Non-PMPT Trainees and Affiliates (UK & Ireland Centres) - £539
Preparation
With lots of resources available online, we have discussed with our IMG Psychiatry Community the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. We’ve collated these below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams. You can access this here.
Sample Papers: These will help you prepare and polish your exam techniques and are a good idea to regularly benchmark your knowledge against the syllabus. In addition, sample questions will help you work quickly on the day, you will already know what to expect. The sample papers can be found here.
Marking schemes: Candidates pass or fail the written papers based on their performance, and not how well you perform against other candidates. As such, it is a good idea to understand how the exam is marked, so you can maximise your exam skills and give yourself the best chance of a pass. Marking schemes can be found here.
Sample exam: These can help you understand the exact format of the exam and to familiarise yourself with the online exam environment. This is available here.
Online exam guidance: Detailed guidance written specifically to guide candidates in preparing for an sitting an online exam, including technology checks and timings. The guidance can be accessed here.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful resource to help you to get over the first steps. This is available here.
#IMG Tips
Start early – preparation is key and the best way to avoid last-minutes stress and cramming.
Use the Royal College website – this should be your best friend...or at least one of them. There are so many useful resources on these – what better place to start your revision?
Join our online support community - for all things psychiatry, including access to a community of likeminded psychiatrists and MRCPsych aspirants, follow IMG Connect on social media and join the conversation.
Passed? What next?
If you are completing the papers in order, the next step will be to apply for Paper B. For more information take a look at our blog where we explore MRCPsych Paper B and everything you need to know about how to sit the exam, including syllabus, dates, results, fees and preparation.
For more useful blogs & articles on the MRCPsych exams, registrations & qualifications to help you find your dream job in the NHS - take a look at our IMG library.
Good luck in your MRCPsych Paper A exam!
In response to the high number of inquiries we've had from overseas pathologists about the arrangements for the Autumn sitting of the FRCPath Histopathology Part 2 exam, we've been in contact with the Royal College of Pathologists and have summarised these updates under the headings below.
When will the FRCPath Histopathology Part 2 exam be held?
The publicised dates for the exam are Tuesday 11 and Wednesday 12 October 2022, although these are subject to change due to the ongoing COVID-19 pandemic.
The withdrawal deadline for the exams is Friday 15 July 2022.
Can I sit the FRCPath Histopathology Part 2 exam in Autumn 2022?
The RCPath guidance which asks candidates to wait to sit the Part 2 exam the year after passing the Part 1 exam was in place to avoid overwhelming the limited capacity of the exam centres. Those who were successful in the Spring 2021 Part 1 exam are able to sit the Part 2 exam in Spring 2022. If the College needs to prioritise bookings, it will be done in the same way as previously. Therefore, if there is a requirement for candidates who have passed in Spring 2022 to wait until Spring 2023 to apply, a notice will be put on the News section of the examinations page around the end of May/ beginning of June.
It is therefore important to check regularly for updates to the examinations page, which you can do here.
Where can I sit the FRCPath Histopathology Part 2 exam in Autumn 2022?
Details on the Autumn 2022 sitting of FRCPath Part 2 have yet to be finalised, however, unlike Spring 2022, it may be possible to arrange to sit the exam in Irbid (Jordan), Dubai (UAE) or Cairo (Egypt) if there are sufficient applicants. The availability of FRCPath Part 2 examination centres outside the UK will be indicated on the Royal College website (when the application window opens for Autumn 2022 at the end of May) and candidates should contact the Examinations Department to express their interest in taking the exam in the available centre when they make their application.
We therefore advise that you keep an eye on the RCPath application page here.
Will the College have any microscopes available for me to use for the exam?
The College's overall policy is that the College and centres have no obligation to provide microscopes. Candidates can bring their own as this is equipment they are familiar with, or can hire a microscope. Some overseas centres may be more able to provide microscopes and if that is the case it would be stated on the letter sent to candidates with their centre confirmation.
If you would like to borrow a microscope for your FRCPath Histopathology Part 2 exam, we advise that you check well in advance what the options are for your chosen centre, or are available to you online.
If you have any further questions about the FRCPath exams, your route to the UK as an overseas histopathologist, or any other aspect of GMC Registration, the NHS or relocating to the UK, please get in touch with us here.
We'd also like to invite you to join the IMG Histopathologists online community - as well as support on Royal College exams, our Facebook group of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
The Dermatology SCE is the higher postgraduate qualification provided by the Royal College of Physicians as a specialist qualification for dermatologists. It is one of 11 SCEs offered by the College and offers physicians a higher postgraduate qualification than MRCP which can be used to demonstrate to prospective employers the achievement of a standard equivalent to UK specialist doctors.
Here we take a closer look at the MRCP (UK) Dermatology Specialty Certificate Examination for doctors who have chosen to specialise in dermatology. We cover the content of the exam, as well as fees and the eligibility criteria, which we’ve summarised below with a broad look at the following topics:
What is the SCE in Dermatology?
Where does the SCE fit into my training?
What is the structure of the Dermatology SCE?
How do I apply for the exams and what do they cost?
Where can I sit the exams as an overseas dermatologist?
How should I prepare for the exams as an IMG?
I’ve passed? What’s next?
Skip ahead to the relevant section if you know what you're looking for.
MRCP (UK) SCE in Dermatology
The dermatology specialty certificate exam is administered as a compulsory element of assessment towards the Certificate of Completion of Training (CCT) in dermatology for all UK trainees.
The purpose of an SCE is to:
ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants
complement workplace-based assessments
provide a rigorous national assessment to establish public confidence
offer a challenge similar to sub-specialty certification examinations in North America
The SCE as Part of Training in Dermatology
Since the MRCP(UK) exams are taken during the Internal Medicine Training years (ST1-ST3), the dermatology SCE allows physicians to demonstrate that they are able to practice independently at a consultant level.
The SCE has no fixed entry requirements (both for UK and overseas candidates); however, UK trainees would normally sit the SCE in their penultimate year of higher specialty training (ST6). UK trainees should have made at least one attempt at the dermatology SCE by the time of their penultimate year assessment.
For an in-depth guide to the MRCP exams, see our IMG Resources library here.
Exam Structure
The SCE comprises 200 questions which assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum. This should be taken as an indication of the likely number of questions for each section – the actual number may vary:
Topic
Number of questions
Cutaneous allergy
10
Dermatopathology
10
Dressings & wound care
10
Formulation & systemic therapy
10
General dermatology & dermatology in primary health care
50
Genito-urinary disorders and oral medicine
10
Infectious disease
10
Paediatrics & genetics
30
Photodermatology
10
Psychodermatology
5
Skin biology & research
15
Skin oncology
20
Skin surgery and cosmetic dermatology
10
Total
200
There are two three-hour papers, with the questions in each category distributed across both papers.
All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.
Dermatology SCE Applications
The SCEs are held once a year and all applications are made online through the My MRCP(UK) account, found in the Upcoming Exams section of the Royal College website.
The application process is as follows:
Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)
Request a preferred test country and city
Pay applicable examination fee
Application is confirmed via an automatically generated email
Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.
The Royal College of Physicians has created a helpful video guide on SCE applications which you can watch here.
Cost
The cost of the SCE exams are as follows:
UK centres: £665
International centres: £833
Exam Centres
UK Centres
Candidates who choose to sit the dermatology SCE in the UK must contact Pearson VUE to book their test. There are around 137 test centres throughout the UK for each SCE, and the Royal College of Physicians advise that candidates should book their exam as early as possible to secure their preferred test centre, since bookings operate on a first come first served basis.
International Centres
Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. The Royal College of Physicians passes this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the examination date. If the exam is not available in the requested location, candidates will be offered a choice of the nearest available test centres.
Please note, international candidates should not book their own test directly with Pearson VUE - attempting to do so may delay a candidate's application.
The full list of international test centres for the SCE can be found here.
Preparation and Resources for the Dermatology SCE
It can be difficult for IMGs to know where to start with their preparation and revision, particularly as the exam requires a wide breadth of knowledge around the curriculum and should involve reading textbooks, journals and guidelines.
This list should provide a good starting point for any international dermatologists preparing to sit the SCE:
Curriculum - Applicants are tested on a range of common and important disorders in Dermatology as set out in the Joint Royal Colleges of Physicians Training Board’s Specialty Training Curriculum for Dermatology. We recommend getting to know the curriculum as early as possible and using it as a blueprint for your study.
Below are some other good reading materials and sources:
Textbooks
Rook's Textbook of Dermatology - Eds DA Burns, SM Breathnach, N Cox, CE Griffiths
Textbook of Pediatric Dermatology - Eds AD Irvine, PH Hoeger, AC Yan
Dermatology - Eds JL Bolognia, JL Jorizzo, RP Rapini
McKee’s Pathology of the Skin - JE Calonje, T Brenn, A Lazar, P McKee
Journals
British Journal of Dermatology (BJD)
Clinical and Experimental Dermatology (CED)
Journal of the American Academy of Dermatology (JAAD)
Journal of Investigative Dermatology
The Journal of the American Medical Association (JAMA)
Websites
British Association of Dermatologists (BAD)
British Society for Investigative Dermatology (BSID)
British Society for Cutaneous Allergy
British Society for Medical Dermatology
British Society for Dermatological Surgery (BSDS)
DermIS (dermatology image resource)
eMedicine online reference
DermNet NZ (New Zealand dermatology society)
Dermatology e-learning resource
Sample questions: It is a good idea to regularly assess your knowledge and progress using example questions from the current exam syllabus. You can find these here.
For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, check out at our blog: IMG Connects Top Tips for exam preparation.
I’ve passed? What’s next?
Congratulations – what an achievement! With your higher postgraduate qualification, you will be able to apply for NHS roles above ST3 which are likely more suited to your seniority and experience – nice one.
Don’t hesitate to get in touch with an IMG medicine recruitment specialist to discuss GMC registration, dermatology positions in the NHS, salaries, suitable UK locations and hospitals for you, and relocation.
To receive the latest news and updates, including the Royal Colleges, GMC registration and the NHS, follow us on social media and join the conversation.
The NHS offers an extensive training scheme and career development for medical oncologists, and the quality of this programme is recognised as a gold standard across the medical community.
The training provided to UK medical oncology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of oncology around the world and throughout the profession.
In this article, we will explore the training pathway for medical oncologists in the UK, covering the following topics:
What is the NHS Training Pathway?
How do you enter the training pathway?
What does the specialty training programme look like for medical oncology?
What happens after completing the medical oncology training programme?
Can I enter specialty training in the UK as an IMG?
Skip ahead to the relevant section if you know what you’re looking for.
The NHS Medical Oncology Training Pathway
The NHS training pathway is the name given to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training within i.e. within medical oncology.
It is important for IMGs to understand this as it helps to provide an understanding of at what stage they can most likely enter the system if they are interested in postgraduate training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors with receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).
Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area I.e. medicine – this is known as Internal Medicine Training (IMT), formerly known as Core Training (CT).
Specialty Training in Medical Oncology
The Specialty Training programme in Medical Oncology runs over a 6-year period, and doctors will usually take the indicated time, or slightly longer to complete the Specialty Training programme.
Successful applicants entering into year one of specialty training (ST1), will follow the Joint Royal Colleges of Physicians Training Board 2021 Medical Oncology Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.
Medical oncology training as an uncoupled programme
As medical oncology is a medicine specialty, aspiring oncology trainees will complete a period of core/ internal medicine training that lasts a period of two years.
This is followed by an open competition to enter a higher specialty training post. It is important to note that the application following core training is competitive and does not guarantee a specialty training post.
Medical oncology higher specialty training will be in total (including OCS) an indicative four-year clinical training programme leading to single accreditation in the specialty. There are no critical progression points during higher specialty medical oncology training, though trainees will be subject to an annual review of progress via the ARCP process and will have to complete all curriculum requirements including passing the medical oncology Specialty Certificate Examination (SCE) prior to obtaining CCT.
Foundation Training (FY1 – FY2)
The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills and forms the bridge between medical school and speciality training.
Selection
Here, trainees will either choose to enter into either Internal Medicine Training or into training to become a general practitioner.
Specialty Training (ST1 – ST6+)
Internal Medicine Stage 1 Training (ST1 – ST2)
In this first stage of the Internal Medicine training programme, trainees develop a solid foundation of professional and generic clinical capabilities, preparing them for participation in acute medicine at a senior level and to manage patients with acute and chronic medical problems in outpatient and inpatient settings. You can find the Curriculum for Internal Medicine Stage 1 Training here.
This will culminate in trainees sitting the MRCP (UK) exams. For more information on the Royal College of Physicians examination suite, take a look at our IMG Resources library here.
Please note, trainees must pass the MRCP examinations prior to beginning Specialty Training in Medical Oncology.
Selection
Here, trainees will either choose to continue with Internal Medicine Training for a further year, to continue with training in a specialty that supports acute hospital care, or to provide primarily out-patient based services in e.g. oncology.
Medical oncology recruitment into ST4 posts usually occurs after 2 years of Internal Medicine Stage 1 training. However, trainees who complete the full three-year IMT programme are also eligible and there is no preferential selection for trainees who have completed either two or three years of training.
Oncology Common Stem (ST3)
The Oncology Common Stem (OCS) has a duration of one year and usually takes place in year 3 of specialty training. Here, the focus is on a trainee’s development of the common oncology capabilities relating to the key areas of overlap between the two specialties (medical and clinical oncology), as well as continuing to develop the generic capabilities expected of all doctors.
Clinical Oncology and Medical Oncology are the two main medical specialities that manage patients with non-haematological malignancy. They often work in partnership with each other, and both offer systemic therapy to patients, but only clinical oncologists administer radiotherapy and there are other differences in work-pattern, approach and focus.
Medical oncologists will have the scientific understanding which underpins radiation-based cancer treatments. During the OCS training year, trainees will gain knowledge of radiotherapy planning and delivery. This will enable them to coordinate the care of cancer patients with the wider multidisciplinary team (MDT), managing patients throughout a treatment pathway.
The curricula for medical and clinical oncology have been aligned to reflect this relationship and include aspects of common training that constitute the Oncology Common Stem (OCS), improving transferability and flexibility for trainees who wish to move between the two specialties.
Please note that medical oncology trainees will not be expected to independently plan or deliver radiation-based cancer treatments.
Medical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST6)
Following successful completion of OCS, medical oncology trainees will complete a subsequent higher specialty-specific programme, this takes place from year 4 – 6. The focus here for trainees is on acquiring medical oncology-specific capabilities, alongside consolidation and further development of the common oncology and generic capabilities.
Trainees will then sit the Medical Oncology Specialty Certificate Examination, usually in the penultimate year of higher specialty training. The globally-recognised exam offers medical oncologists a postgraduate qualification which demonstrates achievement of a standard required of UK specialist trainees.
Please note, the medical oncology SCE is a compulsory component of assessment for the achievement of Certificate of Completion of Training (CCT).
To learn more about the medical oncology SCE, read our detailed blog here.
Completion of the Medical Oncology Specialty Training Programme
Upon completion of the medical oncology training programme, the choice is made whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Medical Oncology. This will be based on high-level learning outcomes – capabilities in practice (CiPs) set out in the curriculum by the Royal College. You can find the 2021 curriculum here.
At this point, medical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their medical oncology training outside the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.
Joining the Medical Oncology Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Medical Oncology in the UK, however it is very competitive.
IMGs interested in UK specialty training must have:
Full GMC registration
Completion of a minimum 12-month (FY1 equivalent) internship
English language test
PLAB
AND
12 months post-internship experience by the time you begin ST1
Please note, whilst UK trainees are not given priority for specialty training spaces, it can be extremely difficult to join the Specialty Training programme without prior NHS experience.
So here you have it, the NHS Specialty Training pathway for medical oncology trainees in a nutshell. The training programme forms the basis of medical oncology training in the UK, and for overseas oncologists interested in joining the training programme, good knowledge of the pathway allows you to better understand the alignment of your overseas training with the relevant stage of Specialty Training for medical oncology in the UK.
Join the IMG Oncologists Facebook group for access to a community of like-minded oncologists and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
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