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.
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.
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!
IMGs often have questions about the best ways to prepare for the MRCPsych Paper B exam, particularly with a new exam format and so many online materials geared towards UK trainees and applicants.
So, what study materials, courses and support are available for international psychiatrists? Here we have compiled some of the best guidance and resources to help in your preparation for the Paper B exam. We will also address some of the changes in 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 B?
How do I get started with my preparation?
What other resources are available?
How has the exam been affected by COVID-19?
#IMG Tips
Passed? What’s next?
If you know what you’re looking for, skip ahead to the relevant section.
If you’d like an overview of the entire examination series, take a look at the article published in our IMG Resources library here.
MRCPsych Paper B
Let’s begin with a quick recap of the second exam in the MRCPsych examination suite.
MRCPsych Paper B is a three-hour written exam which asses critical review and the clinical topics in psychiatry.
The 150-mark paper comprises It is made up of around two-thirds multiple-choice questions (MCQ) and one-third extended matching item questions (EMI). One third of the paper covers critical review, with the other two thirds covering clinical topics.
The breakdown of the sections is as follows:
For full guidance on the structure of the exam, visit the examination page of the Royal College website or see our detailed blog on the MRCPsych Paper B exam here.
Preparation
It can be tough to know the best place to start, and after talking with some psychiatry consultants (both IMGs and UK trainees), the consensus was that the Royal College website is the best place to begin. There are some great resources on their website to help applicants to prepare for the exam. See 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 find this here.
Current critical review syllabus: For Paper B, candidates will need to ensure that they make optimal use of the MRCPsych Paper B critical review - evidence-based practice syllabic content, available here.
Sample Papers: These will help you polish your exam techniques and are a good way to regularly benchmark your knowledge against the syllabus. Additionally, they will help you work quickly on the day as you will already know what to expect. The samples can be found here.
Marking schemes: Candidates pass or fail the written papers based on their performance. As such, it is a good idea to understand how the exam is marked so you can maximise your exam skills, giving you the best chance of a pass. These can be accessed 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.
Other resources
IMG Connect has a library of written resources geared towards preparation for the Paper B exam. If you’re interested in any of these, please get in touch here and we would be delighted to share these with you.
Other online resources available for the exam include a mixture of paid and free resources. These include:
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 Video Lectures: A course covering the most important questions pertaining to clinical and critical appraisal topics. This is delivered through 19 hours of viewing - 10.5 hours of clinical topics and 8.5 hours of critical appraisal. Also provided is a PDF of Q-Bank to print and practice. These are available for 3 months from the date of purchase for the price of £199 and can be found here.
Brainscape Flashcards: Sets of web and mobile flashcards with hundreds of questions across all of the syllabus covered in the MRCPsych Paper B exam. This free resource can be used as either revision or practice material and is available here.
Superego Café Question Bank: This question bank provides over 500 multiple choice questions to help you prepare for your examination. The question bank includes constantly updated revision questions and is available as a mixed variety to reflect the MRCPsych Paper B examination. This can be accessed here.
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.
Get Through MRCPsych Paper B: Written by authors with recent exam success, the book provides candidates with realistic and up to date MCQ and EMIs, closely matched to themes appearing most often in the Paper B exam. This can be found here.
TrickCyclists Exam Notes: A series of psychiatry notes specifically tailored to the MRCPsych Paper B 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.
Courses
The SPMM and MRCPsychMentor resources are the most highly recommended by IMG psychiatrists we have spoken to and are available in different formats depending on your revision needs.
MRCPsych Mentor Mock Exam
A three-hour long exam which simulates exam conditions with a mock exam paper comprising new questions not available in the question bank. It includes a revision mode, timed tests, extensive performance analysis and powerful question review functions.
Duration
6 weeks
Cost
£15
Next start date
On demand
Website
www.mrcpsychmentor.com/mocka/index.php
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
IMG Psychiatrists MRCPsych Paper B 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 B Study Course by joining the Facebook group here.
How the exam has been affected by COVID-19
As a result of the pandemic, all MRCPsych exams have moved online. Applicants from Singapore and Hong Kong who intended to sit exams in local centres are also invited to apply for the online sitting of the exam. You can learn more about the online exams for MRCPsych in the blog we've written 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.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Build on your existing knowledge and experience – you’re being tested on things which you’ll likely be familiar; take your experiences and use that to bolster any new information you learn through your revision.
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; take what’s available online and maximise their impact on your preparation.
Maintain a work-life balance – whilst you should dedicate time to study for the exam, it’s important to avoid burnout by setting aside time away from work and revision to reset and clear your mind.
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.
For regular news and updates on the Royal College and all things histopathology, follow IMG Connect on social media using the links below:
Passed? What next?
Great stuff, this is a massive achievement and you deserve to put your feet up for a while! After a well-earned break, you can apply to sit the CASC exam, which you are eligible for once you’ve passed the MRCPsych Paper A and Paper B exams. For more information, take a look at our blog we will explore MRCPsych CASC and everything that you need to know about how to sit the exam, including syllabus, dates, results, fees and preparation.
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.
GMC Registration can be a long and complex process. With a few options available for demonstration evidence of skills and knowledge, it can be difficult for IMGs to decide the best route to take to register with the GMC.
For international doctors planning their route to the UK, there are essentially two main pathways to consider – postgraduate qualifications (for psychiatrists, this is MRCPsych) or PLAB.
Whilst these are the most common routes to GMC registration, this is not an exhaustive list. There are other options such as Royal College sponsorship and GMC-approved qualifications or licensing exams, and you can read more about these here.
Here we provide a summary of both of the main pathways and briefly consider their benefits.
PLAB for GMC Registration
MRCPsych for GMC Registration
Which is better for me as an overseas psychiatrist, PLAB or MRCPsych?
#IMG Tips
How do I get started?
Professional & Linguistics Assessment Board (PLAB)
The first and most common route we’ll be discussing, which tends to be popular among junior doctors, is PLAB.
PLAB is a two-part exam (one written and one practical element), which assesses whether a candidate is at least as capable as a doctor starting the second year of their Foundation Programme Training and can therefore work safely as an SHO in the NHS.
The GMC has a useful video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.
MRCPsych - UK Postgraduate Qualification for Psychiatrists
The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience.
Within psychiatry, this can be done by attaining Membership of the Royal College of Psychiatrists. The Royal College of Psychiatrists is the professional body that regulates the specialism of psychiatry in the UK, and Membership of the College of the Royal College of Psychiatrists (MRCPsych) is the full qualification attained through these examinations. Take a look at our IMG Resources library for complete guides on MRCPsych to learn more.
PLAB vs MRCPsych
Both MRCPsych and PLAB are legitimate routes that demonstrate skills and knowledge and will allow you to register with the GMC and work in the UK. To decide which route is best for you, you’ll need to consider the benefits of each and how they align with your needs and priorities in moving to the UK.
Seniority of Positions in the NHS
It would be difficult for an overseas psychiatrist to obtain a more senior post in the NHS without either MRCPsych, a GMC-approved training programme, or extensive experience from a similar, English speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Specialty Training
To practice as a consultant in the UK, you must have gone through specialty training and will need a GMC-recognised postgraduate qualification to do so, whether a qualification from the country in which you completed your specialty training, or MRCPsych.
Only one type of evidence is required to demonstrate skills and knowledge, so once you pass MRCPsych, you would not need to additionally sit the PLAB exams. However, due to the more specialised nature of MRCPsych, psychiatrists may want to sit the MRCPsych exams at a later date, to allow them access to more senior roles and competitive salaries.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
MRCPsych has three stages, the last of which must be taken after at least 36 months of postgraduate experience in psychiatry and can take anywhere between 24-36 months to prepare from start to finish.
Cost
MRCPsych costs just under £2,000 for the three exams. All MRCPsych exams can now be sat online, so there is no longer the added expense of international travel. You can read about the changes to the exam format here.
PLAB costs £1,189, and both exams are sat in person. PLAB 1 can be taken in the UK or several overseas centres, which you can find here. PLAB 2 must be taken in the UK.
So, for PLAB 2, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.
It’s important to note that these costs can rise if re-sits of the exams are necessary.
Summary
PLAB, as an exam which examines a doctor’s ability to work safely as a Senior House Officer (SHO), does not assess ability in psychiatry specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine, I.e., psychiatry.
PLAB allows doctors to enter the UK system much faster than other routes and for this reason alone, it is favoured by international doctors when considering their path to the UK.
MRCPsych involves three more difficult examinations and takes more time to prepare for. However, for overseas doctors, attaining MRCPsych will allow you to jumpstart your career in the UK, as you don't need PLAB or Core Training.
Additionally, MRCPsych will facilitate the application for more senior roles in UK psychiatry than PLAB.
#IMG Tips
Determine your priorities – your goals and timeline for relocating to the UK are important in deciding which route is best for, and this is different for everyone.
Plan well ahead – depending on the route you choose, you may be embarking on a long journey through these exams, so plan how you will fit them into your life and how best to prepare to maintain a good work-life balance at the same time.
Find a support network – once you know which exams you will sit, find a support network of others who are also preparing for the exam. A great way to do this is to join the IMG Psychiatrists Facebook group, an online psychiatry community of UK and NHS psychiatry aspirants and dedicated psychiatry recruiters. You’ll find advice, guidance and news and updates about all things psychiatry for IMGs. Join the conversation here.
Getting started
Once you’ve decided which exams are best for you, it’s time to delve deeper into the exams and what they entail. For more useful blogs and articles on PLAB or MRCPsych exams, registrations and qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.
Or if you have any questions on PLAB or postgraduate qualifications, please get in touch with our psychiatry recruiters here. They will be more than happy to help you.
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.
Are you an overseas psychiatrist preparing to take the MRCPsych CASC exam?
International doctors often have questions about how to prepare for the CASC exam, particularly when there are so many materials and information online which can be overwhelming or mostly geared towards UK applicants and trainees.
What study materials, courses and support are available for IMGs? Here we have compiled some of the best advice and resources available to help in your preparation for the exam.
The topics we’ll cover are as follows - skip to one of these sections if you know what you're looking for:
What is MRCPsych CASC?
How do I get started with my preparation?
What other resources are available?
#IMG Tips
How have the exams been affected by COVID-19?
What’s next for me?
If you’d like an overview of the entire examination series, take a look at the article published in our IMG Library here.
What is MRCPsych CASC?
Let’s begin with a quick recap of the CASC exam. The Clinical Assessment of Skills and Competencies or CASC is a practical exam which takes the format of an OSCE and tests your clinical skills in a range of competencies.
It is made up of two circuits of individual stations made up of:
Five stations on history taking, including risk assessment
Five stations on examination, including physical and mental state
Six stations on patient management
For full guidance on the structure of the exam, visit the examination page of the Royal College website or see our detailed blog on the MRCPsych CASC exam here.
Getting started with preparation
It can be tough to know the best place to start, and after talking with some psychiatry consultants (both IMGs and UK trainees), the general consensus was that the Royal College website is the best place to begin. There are some great resources on their website to help applicants to prepare for the exam.
Royal College Materials
Syllabus: this is the best place to start - you should always plan your study and preparation around the topics within the curriculum to start you off on the best path to success. You can find this here.
CASC candidate guide: this handy guide contains information on domain-based marking, candidate instructions, pass mark, exam criteria and grade descriptors, which you can access here.
Blueprint: the CASC blueprint is a more detailed breakdown of the skills being assessed within the exam and the categories and stations candidates should expect to find. This is available here.
Marksheets: copies of the marksheets which are used in the exam are available online for history, management and examination and allow candidates to familiarise themselves with the marksheets in advance, found here.
Sample stations videos: you can watch videos of sample stations from a face-to-face examination – this will be similar to what you can expect on the day as the principles will remain the same for online exams. You can access these here.
What other resources are available?
IMG Connect have a library of written resources geared towards preparation for the CASC exam. If you’re interested in any of these, please get in touch here and we would be delighted to share these with you.
Other online resources available for the exam include a mixture of paid and free resources. These include:
Books
These are the most highly rated books for MRCPsych CASC on Amazon:
Pass the CASC for MRCPsych – Seshni Moodliar (£34.70)
Get Through MRCPsych CASC – Melvyn W. B. Zhang (£45)*
How to Pass the MRCPsych CASC – Andrew Iles (£33.99)
* Get Through MRCPsych CASC is particularly highly regarded by recent CASC candidates who have passed the exam.
Other resources
Passing the MRCPsych Exams – an insider’s guide: a useful guide to the MRCPsych CASC exam written by former trainees and members of the Psychiatric Trainees’ Committee (PTC). This can be found here.
MRCPsych CASC flashcards: flashcards created by a former candidate who has passed the exam. 136 flashcards which cover different aspects of the exam. These are available for free here on Brainscape.
CASC Cluster Cards – Oxfordpsych revision cards written by a consultant psychiatrist in the UK. This is a set of 100 CASC scenarios with instructions and guidance to remember. These can be found here at a cost of £169.
CASC Videos – SPMM: 86 exam stations performed by consultants and role players under exam conditions, featuring advice and tips from examiners for each task. 6 months access is priced at £180 and is available on demand. These are available here.
Oxfordpsych – access to the Oxfordpsych online video bank featuring short and long instruction CASC stations, covering the range of stations and tasks listed in the CASC blueprint. 6 months access costs £169 and £99 for 3 months and can be found here.
Online courses
CASC Prepare mock exam
This exam consists of 16 stations which have all featured in previous RCPsych CASC exams. The mock will be conducted in the format of the actual exam and detailed written feedback on RCPsych marking sheets will be provided after the exam. Other aspects of the exam such ass time management, and communication strategies will also be discussed.
Duration
4 hours
Cost
£310
Next start date
Ongoing
Website
https://www.cascprepare.com/mock-exam
Oxfordpsych CASC mock exam
These online exams are based on the RCPsych CASC blueprint. Candidates take the 16 stations under exam conditions and interview with professional actors with CASC experience. Candidates will receive written feedback for each station.
Duration
4 hours
Cost
£475
Next start date
Autumn 2022
Website
http://www.oxfordpsychcourse.co.uk/index.php/online-registration
CASC Master mock exam
This mock exam is carried out over skype or zoom and has 8 continuous stations with one 20-minute break, followed by the final 8 stations. It is set according to the CASC blueprint and is available with or without an actor.
Duration
4 hours
Cost
£325
Next start date
TBC
Website
https://www.cascmaster.com/skypemockcasc
IMG Psychiatrists MRCPsych CASC Crash Course
This is a tailored MRCPsych CASC course for overseas psychiatrists sitting the CASC exam. This course offers weekly sessions covering the entire exam and its various domains, including marking and station requirements. This is accompanied by small group role play sessions to allow IMGs to practice stations across various scenarios with feedback on each station, 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 CASC Study Course by joining the Facebook group here.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Find the right materials for you – whether its online courses, books or flashcards, try to figure out what the best materials are to jumpstart your preparation
Speak to your peers and colleagues – your senior colleagues may have been through this process themselves and may have helpful tips and guidance to share. Or maybe you’ll find a like-minded peer with whom you can be study buddies! Take advantage of those around you to support you on this journey.
Practise, practise, practise - Our IMGs have shared that it’s crucial that you practice your clinical examinations as often as possible, preferably under the supervision of a senior colleague which will allow you to receive feedback.
Join our online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation.
I've passed, what’s next?
Once you’ve passed MRCPsych CASC, you’ve completed the Royal College of Psychiatrists examination suite. Great stuff, this is a massive achievement! Armed with this and your English language test, you are ready to apply for full GMC registration with license to practice.
You may want to start looking for NHS jobs and with the click of a button, you can receive them directly to your inbox. To receive jobs postings which you can tailor to your desired grade, specialty and sub-specialism, sign up here.
If you have any questions about any element of CASC, the Royal College exams as a whole or any other queries related to the processes involved in IMGs coming to the UK to work in the NHS, please get in touch and our psychiatry specialist will be more than happy to assist you.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
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.
In this blog we will explore MRCPsych Clinical Assessment of Skills and Competencies (CASC) including dates, exam locations, fees and eligibility.
In our exploration of CASC, we will take a broad look at the following topics:
What is the format of the CASC exam?
How is the CASC marked?
Am I eligible?
Assessment Portfolio for Overseas Candidates
Sponsorship requirements
How do I apply?
How much will it cost me?
Where can I sit the CASC exam?
How do I prepare for the CASC exam?
Passed? What next?
For a more general overview of the MRCPsych examinations, click here.
MRCPsych CASC is a practical exam taking the format of an OSCE and tests your clinical skills in a range of competencies.
What is the format of the CASC exam?
The CASC format is like an OSCE (Objective Structured Clinical Examination).
The exam is made up of two circuits of individual stations which will test your clinical skills:
The morning circuit will have 4 minutes to read the instructions and 7 minutes to complete the task
The afternoon circuit will have 90 seconds to read the instructions and 7 minutes to complete the task.
The sixteen CASC station exam is made up of:
five stations focused on History Taking, including risk assessment
five stations focused on Examination - both physical and mental state, including capacity assessment.
six stations focused on patient Management
Each circuit follows the topics below:
Circuit 1:
6 stations focused on Management
1 x station focused on Examination
1 x station focused on History Taking
4 minutes reading
7 minute task
Circuit 2:
4 x stations focused on Examination
4 x stations focused on History Taking
90 seconds reading
7 minute task
How is the CASC marked?
You can find details on how the test is marked here. See also marksheets for your information.
History Marksheet
Management Marksheet
Examination Marksheet
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
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.
Am I eligible for the CASC exam?
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC.
AND
You have a pass in both Paper A and B
AND
You can demonstrate the following:
AND
You have sponsorship in place – sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.
Overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Assessment Portfolio for Overseas Candidates:
As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC.
In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans:
observation in interviewing patients in ward rounds for specified reasons
observation in interviewing patients in out-patient or community settings or other contexts for specified reasons
assessment via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
formal assessment in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy.
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
Sponsorship requirements:
International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC examination.
Your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
You will be required to provide the sponsor’s title, full name and email.
Acceptable sponsors are:
College Tutor
Training Programme Director
Educational Supervisor
Head of School
Director of Medical Education (or equivalent)
Head of Department of Psychiatry
Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
How do I apply?
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.
You will need to provide the following:
Personal details
Primary Medical Qualifications & Registration
Training
Written paper selection
Sponsor evidence for Assessment Portfolio for Overseas Candidates
How much will it cost me?
At the end of your application you will be directed to an online payment system where you can pay be 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.
The fees for MRCPsych CASC for 2023 are as follows:
PMPT Trainees and Affiliates - £1,054
Non-PMPT Trainees and Affiliates - £1,171
Where can I sit the CASC exam?
The final diet of the CASC exam which will involve online delivery will be in May 2023. From September 2023, the exam will be back in-person, being delivered in the UK with international test centres to be confirmed from 2024.
Examination dates can be found here and results from the CASC examinations will be released around 1 month later.
How do I prepare for the CASC examination?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and 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. See 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.
Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry
Marking scheme (CASC): A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
CASC examination guide: The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos: Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint: This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggests taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
IMG Psychiatrists MRCPsych CASC Study Course
This is a tailored MRCPscyh CASC course for overseas psychiatrists sitting the CASC exam. This course offers weekly sessions beginning with an overview and in-depth breakdown of the exam and its various domains, including marking and station requirements. This is followed by small group role play sessions to allow IMGs preparing for the exam to practice stations across various scenarios with feedback on each station, 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 CASC Study Course by joining the Facebook group here.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Find the right materials for you – whether its online courses, books or flashcards, try to figure out what the best materials are to jumpstart your preparation
Speak to your peers and colleagues – your senior colleagues may have been through this process themselves and may have helpful tips and guidance to share. Or maybe you’ll find a like-minded peer with whom you can be study buddies! Take advantage of those around you to support you on this journey.
Practise, practise, practise - Our IMGs have shared that it’s crucial that you practice your clinical examinations as often as possible, preferably under the supervision of a senior colleague which will allow you to receive feedback.
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.
I've passed, what’s next?
Once you’ve passed MRCPsych CASC, you’ve completed the Royal College of Psychiatrists examination suite. Great stuff, this is a massive achievement! Armed with this and your English language test, you are ready to apply for full GMC registration with license to practice.
You may want to start looking for NHS jobs and with the click of a button, you can receive them directly to your inbox. To receive jobs postings which you can tailor to your desired grade, specialty and sub-specialism, sign up here.
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 practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.
Getting started
If you have any questions about any element of CASC, the Royal College exams as a whole or any other queries related to the processes involved in IMGs coming to the UK to work in the NHS, please get in touch and one of our psychiatry specialists will be more than happy to assist you.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
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.
Training in the NHS offers an extensive training scheme and career development for psychiatrists, with the quality and depth of this programme being recognised as a gold standard throughout the international medical community.
In line with developments and progression in psychiatry across the field and around the world, training provided to UK psychiatry trainees is regularly reviewed and updated. This should make the training programme attractive to UK graduates, as well as IMG psychiatrists seeking the best training programmes for their field and career development.
In this article, we will explore the training pathway for psychiatrists in the UK, with a broad look at 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 psychiatry?
What happens after completing the psychiatry training programme?
Can I enter specialty training in the UK as an IMG?
The NHS Training Pathway
The NHS training pathway refers to the complete programme for UK trainees, from foundation training to the completion of specialist or higher training, where candidates may be eligible for a CCT within their chosen specialism, such as General psychiatry or any of its sub-specialties.
It is important for IMGs to understand this process, as it clarifies what stage they can most likely enter the system if they are interested in training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors will 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, such as psychiatry – for psychiatry, this first stage is known as Core Psychiatry Training (CT).
Specialty Training in Psychiatry
The UK Specialty Training programme in Psychiatry is 6 years long, and whilst doctors may pass through training quicker depending on how quickly they achieve their competencies, this is rarely the case and psychiatrists will usually take the indicated time, or slightly longer to complete the Specialty Training programme.
Successful applicants entering year one of core psychiatry training (CT1), will follow the Royal College of Psychiatrists’ 2017 Specialist Training in Psychiatry Curriculum.
The Psychiatry training programme
The psychiatry specialty training scheme operates both as a run-through and uncoupled programme, though it is more often un-coupled.
Depending on where your application is successful, you may complete your period of core training, as well as the Royal College exams before making a further application for the next stage of training (requiring two applications). Alternatively, you may be able to apply for run-through training, which guarantees you complete both Core and Higher training in one region, as you are recruited for the full duration of Specialty Training.
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.
Selection
Here, trainees will either choose whether to enter GP (General Practitioner) training, internal medicine training (IMT) or core training in psychiatry (CT).
Core Psychiatry Training (CT1 – CT3)
This part of training takes place from year 1 to 3, where trainees will work and train in several different sub-specialties within psychiatry. They will gain a broad understanding of psychiatry by rotating between 6-month posts in the following sub-specialties:
General and Community Psychiatry - including Assertive Outreach, Crisis Home Treatment, Outreach for Homeless People, Early Intervention for Psychosis, Rehabilitation and Liaison Psychiatry.
Old Age Psychiatry - including Memory Clinics, Community Teams, Domiciliary Clinics, Young Onset Dementia, Day Hospital and Liaison Psychiatry.
Child and Adolescent Psychiatry - including Specialist Adolescent and Academic Psychiatry.
Substance Misuse
Learning Disability Psychiatry - including Specialist Asperger Services.
Forensic Psychiatry - including all levels of security.
By the end of CT3, trainees will need to have completed the MRCPsych exams.
Please note, trainees must pass the MRCPsych Paper A, Paper B and CASC exams in order to progress to higher psychiatry training.
For more information of the Royal College of Psychiatrists examination suite, take a look at our IMG Resources library here.
There are two opportunities per year to apply to core psychiatry training. Information about how to apply, including the person specifications, is available via the North West Deanery, who manage the recruitment process.
Selection
Here, trainees who are not currently training in a run-through programme will make applications to a deanery for higher psychiatry training in their chosen specialty. Selection is open by national competition.
Higher Psychiatry Training (ST4 – ST6)
This training takes place from years 4 – 6, where trainees will complete 3 years of yearly rotations in their chosen speciality, building on their core training and develop increasing levels of competence in clinical psychiatry.
There will also be opportunities to work in other sub-specialties including: addictions, eating disorders, neuro-psychiatry, perinatal and social & rehabilitation psychiatry.
Trainees will usually be allocated a certain number of PAs (programmed activities) weekly for special interest or research purposes. As well as sub-specialty opportunities, these can also be used towards educational opportunities such as local training days/conferences in relevant domains, from clinical leadership to humanities.
Completion of the Psychiatry Specialty Training Programme
Upon completion of the training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in General Adult Psychiatry of one of its sub-specialisms. This will be based on criteria set out in the curriculum by the Royal College. You can find the 2021 curriculum here.
At this point, the psychiatrists are entered 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 psychiatry training outside of 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 Psychiatry Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Psychiatry 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 start begin ST1
Although UK trainees are not given priority for specialty training places, it can be very difficult to join the Psychiatry Specialty Training programme without NHS experience.
So here you have it, a broad overview of the NHS Psychiatry Specialty Training pathway for UK trainees. This training scheme is the core of psychiatry training in the UK, and for IMGs looking to join the training programme, understanding of the pathway allows you to better align your overseas training with the relevant stage you wound enter into Specialty Training in the UK.
Getting started
If you have any further questions about the UK training pathway or your route to the UK as an overseas psychiatrist, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
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.
Are you an overseas psychiatrist taking the postgraduate route to GMC registration? Are you just beginning your journey through the MRCPsych exams?
Today, we’re back with Dr Kevin Li, who will be sharing some top tips on the MRCPsych Paper A and Paper B for overseas MRCPsych A & B aspirants. Kevin is a brilliant psychiatry specialty doctor who relocated to the UK from Hong Kong, having passed the MRCPsych and received full GMC registration with license to practice.
1. Start with the Royal College website
This is the best place to begin as it has key information including the syllabus - on which the exam is based, helping to guide the course of your preparation and revision.
2. Don’t use resources that are more than 3 years old – 5 years maximum
The curriculum and syllabus for Specialty Training in Psychiatry are updated regularly, so it’s best to find and use resources that are as up-to-date as possible.
3. Don’t combine study for Paper A and Paper B
Focus on each paper as an individual element – they each have different requirements, including what sections of the syllabus they are targeting and how much experience you must have before sitting the exam.
4. Divide your time according to the marks weighting of the sections
For example, general adult and critical review have the most marks in the exam, with 20% and 33.5% respectively, so you should prioritise these in your revision, then try to spend a proportionate amount of time on each section based on the marks it holds.
5. Perfect what you know
If there are any areas you are experienced or confident in, try to perfect these in order to gain the most marks possible in what you find to be the least challenging areas. These areas may also be easier to revise if they are better aligned with your training and practice to date.
6. Which exam should you sit first? It depends
If you want to pass the exams as quickly as possible, it makes sense to apply for the nearest upcoming diet of whichever exam comes first.
Knowledge wise Paper B has more sections and requires a lot more time and practice, particularly for critical review calculations. This combined with the Royal College’s advice of having 12 months’ experience in psychiatry before sitting the exam means that for most people, sitting Paper A first is the best choice.
7. Use diagrams for more challenging topics
Find or better still, create diagrams to better illustrate and explain the mor difficult to understand topics. Especially where you have little experience of a topic, it can be helpful to represent it visually.
8. Keep difficult topics fresh in your mind
If you need longer than 3 months to prepare for either exam, either leave the more difficult topics to the end of your revision or begin with them and be sure to revisit them at the end. You may not retain this information long-term, so it’s important to have it as fresh in your mind as possible when coming up to the exam.
9. Take time off before the exam for intense study
If you can, try to put some time aside in the week(s) coming up to the exam to for a final push of intense study before the exam.
10. Practice is key
Books are great resources for increasing your overall psychiatry knowledge, however they are not necessarily the best resources for the Paper A and Paper B exams. Question banks and past papers such as SPMM are very useful in preparing for the MRCPsych Paper A & B.
Getting started
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
For 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.
The postgraduate route to GMC registration, whilst not the fastest, can be the most rewarding in the long run. The MRCPsych exams are the central components of psychiatry training in the UK, and as an international psychiatrist, this is the route that allows you to most closely align your qualifications with the requirements of more senior jobs in the NHS.
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 psychiatry for overseas consultant psychiatrists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) in more detail, including the application process, 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 psychiatrist?
Do I have to complete CESR before I can work in the UK?
Do I need MRCPsych for Specialist Registration?
What is the CESR equivalence process?
What evidence do I need to submit for a CESR in psychiatry?
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 psychiatrists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to apply for Specialist Registration.
For psychiatrists, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.
Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a psychiatrist in the UK.
Routes to Specialist Registration
There are three types of certificates issued by the GMC for specialist registration, and the type of certificate you receive depends on which training route you followed.
For overseas doctors 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, 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. You can read more about this in the Specialist Registration section under your country on the GMC website here.
Psychiatry 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 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 psychiatry curriculum.
These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.
MRCPsych for Specialist Registration
Whilst it is always beneficial to complete MRCPsych, 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 is the MRCPsych exam, so passing these exams confirms the attainment of the competencies of the Core Curriculum.
MRCPsych 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 psychiatrists who have passed the MRCPsych 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 the evidence presented.
CESR Equivalence Process
Equivalence describes 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
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 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 800-1200 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.
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 is the application process for CESR in Psychiatry?
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 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.
#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).
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 to 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
Many psychiatry 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 psychiatry 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 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.
Are you a psychiatrist finalising your revision for the MRCPsych CASC exam? Here are the tips you can't live without!
As you've likely got months of dedicated study behind you already, in the final push to the exam, we’re sharing some of the essential tips from Dr Kevin Li (MRCPsych) for your final days of preparation for CASC.
Mental state, history taking and risk assessment (8 stations)
It is important to demonstrate your clinical skills in assessing symptoms such as delusions and hallucinations.
Prepare for a cognitive examination station!
Management and counselling (8 stations)
Address any concerns or expectations early on in the station
Provide factual knowledge and information - some last minute reading up on topics such as ECT, psychiatric emergencies and ECG is very important!
For stations where you encounter angry patients or relatives, demonstrating good communication skills is more important than delivering lots of factual knowledge
Prepare stock phrases and questions
Empathetic statements
I can appreciate this must be very difficult for you
I understand that this must be quite concerning
Soft questions to elicit sensitive information
How are you coping with...?
Are you doing anything to manage the stress of the situation?
Phrases to manage angry situations
I appreciate your concerns and why you feel let down
We are all trying our best to help
Reflect on your manner and style of speaking
It is important to try and demonstrate genuine empathy!
Do not sound paternalistic or patronising
Take an MDT approach where necessary - the clinical team is good backup where you don't know what to do e.g. next steps like admissions
Always be courteous and do not show any anger or frustration
Always look at and address the actor
Time management
Get yourself an analogue countdown timer to allow you to properly manage your time during the stations
Look the part
Dress professionally, as if you were speaking to a real patient (pick your outfit at least the night before)
Finally...
As much as it is important to practice a lot near the exam, it is equally important to relax the day before and morning of the exam. At that stage, try not to think about what you have not practiced or not read! You will have sufficient knowledge, it’s just about communicating it and executing it confidently.
We hope you find these tips helpful and wish you the best of luck in your exam. Don't forget to share your successes with us on social media using the hashtag #imgstories
Join the IMG Psychiatrists Facebook group to become part of a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters.
In the group you will find tailored resources for Psychiatry IMGs including our MRCPsych Crash Course.
This course offers weekly sessions covering the entire exam and its various domains, including marking and station requirements. This is accompanied by small group role play sessions to allow IMGs to practice stations across various scenarios with feedback on each station, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
You can access our IMG Psychiatrists CASC Study Course by joining the Facebook group here.
Get in touch
Passed the MRCPsych CASC exam? Get in touch with one of our dedicated psychiatry recruitment specialists here to discuss your next steps towards GMC registration, finding work in the NHS and relocating to the UK.
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.