Are you an overseas histopathologist looking to sit the FRCPath exams?
Today we’re bringing you a guide on how to prepare for the FRCPath Histopathology Part 1 exam from Dr Maria, clinical fellow in cellular pathology in London. Maria passed the FRCPath Part 1 exam in March 2021 and is sharing her top tips for FRCPath aspirants, including study planning, revision materials and what you should know about the Part 1 exam.
1. Create a plan and schedule for your study (this is most important!)
I started studying around 3 months before the exam, spending 2-3 hours per day on weekdays and around 5-7 hours on study at the weekend.
REMINDER: This all depends on how much you know already. You cannot focus constantly for hours, so you should schedule your studying time around the way that you know you work best.
Leading up to the exam
Try to keep at least 2 weeks free prior to the exam to re-revise problematic topics and genetics.
The day before exam
Be kind to yourself. Have a good meal, try to relax if you can and avoid stressing too much. Go to bed early and have a good, long sleep.
2. Revision materials
I had been revising using my old notes, where I studied from these books (the best for trainees in my opinion):
Foundation in Diagnostic Pathology series
Dermatopathology
Pulmonary Pathology
Hematopathology
Head and Neck Pathology
Gynecologic Pathology
Bone and Soft Tissue Pathology
Cell and Tissue Based Molecular Pathology
Pulmonary Pathology
Fine Needle Aspiration Cytology
Genitourinary Pathology
Breast Pathology
Neuropathology
Gastrointestinal and Liver Pathology
Diagnostic Pathology series
Diagnostic Pathology: Head and Neck
Diagnostic Pathology: Genitourinary
Diagnostic Pathology: Spleen
Diagnostic Pathology: Thoracic
Diagnostic Pathology: Neuropathology
Diagnostic Pathology: Hepatobiliary and Pancreas
Diagnostic Pathology: Nonneoplastic Dermatopathology
Diagnostic Pathology: Neoplastic Dermatopathology
Diagnostic Pathology: Bone
Diagnostic Pathology: Breast
Diagnostic Pathology: Familial Cancer Syndromes
Diagnostic Pathology: Molecular Oncology
Diagnostic Pathology: Infectious Diseases
Diagnostic Pathology: Gastrointestinal
Diagnostic Pathology: Kidney Diseases
Diagnostic Pathology: Placenta
Diagnostic Pathology: Gynaecological
Diagnostic Pathology: Transplant Pathology
Diagnostic Pathology: Cardiovascular
Diagnostic Pathology: Intraoperative Consultation
Diagnostic Pathology: Cytopathology
Diagnostic Pathology: Paediatric Neoplasms
Diagnostic Pathology: Endocrine
Diagnostic Pathology: Normal Histology
Diagnostic Pathology: Lymph Nodes and Extra-nodal Lymphomas
Diagnostic Pathology: Blood and Bone Marrow
Diagnostic Pathology: Vascular
Diagnostic Pathology: Hospital Autopsy
There are so many books, and it would be too expensive to purchase them all, so stick to what you've got in your department or can borrow from friends or colleagues.
The Pathology Outlines website is also excellent for quick review and genetics! There are also MCQs.
Some trainees study from the Robbins Pathology books, however, in my opinion, this book alone is not enough for the Part 1 exam.
For the MCQs, I used the following resources:
Practical Applications in Histopathology, Cytopathology and Autopsy: an MCQ/ EMQ Resource – Limci Gupta, Jayson Wang, Val Thomas
Anatomic Pathology Board Review – Jay H. Lefkowitch
Robbins Review of Pathology - Edward Klatt, Vinay Kumar
Sternberg's Diagnostic Surgical Pathology Review – Pier Luigi Di Patre, Darryl Carter
Various past papers I found within my network
If you have access to old presentations from FRCPath Part 1 courses, I’d suggest having a look at them. It’s a good idea to use them to review and revise a topic, followed by some MCQs on that topic.
TOPIC
START DATE
DURATION
Breast
27 October 2020
6 days
GIT
2 November
8 days
Liver, GB, Pancreas
10 November
8 days
Skin
18 November
6 days
Endocrine System
24 November
7 days
CNS
1 December
7 days
Renal & Urinary
8 December
9 days
Bone
17 December
5 days
Soft Tissue
22 December
9 days
CVS
31 December
5 days
Thoracic Pathology (Lung & Mediastinum)
5 January 2021
7 days
Lymph Node
12 January
7 days
MGT
19 January
7 days
FGT & Placenta
26 January
8 days
Oral & Nasal
3 February
7 days
Autopsy & Forensic
10 February
7 days
General
17 February
7 days
Cytopathology
24 February
5 days
Clinical Governance
1 March
5 days
Syndromes & Paediatric
6 March
5 days
General Revision
11 March onwards
-
This is a guide to the revision schedule I used for my FRCPath preparation. I actually started studying in December, so I had less time to fit this all in, but I was able to revise faster to cover everything.
3. FRCPath Part 1 Exam
The questions in the FRCPath Part 1 exam are usually quite straightforward, so you either know the answer or you don't, nothing misleading or tricky.
Some key topics you’ll need to know for the exam:
Genetics and the mutation of tumours (and yes...you'll need to learn each tumour that has any typical mutation and its name)
Immunohistochemistry of lesions
Microscopic pictures (all the micro images I had in the test depicted typical morphology)
Genetic syndromes, the mutations behind them and what lesions are most common
Datasets - they are quite wordy, so focus only on pTN, and the stage of each organ system
Audit
Parts of a microscope
There were some questions from general pathology (necrosis, inflammation, etc.), but I’d say most of the questions were from GI, breast, gynae, skin, soft tissue and kidney.
However, you'll have at least a few questions from each of the other organ systems, so it's better to study everything rather than focus on the most common ones only.
#IMG Tips
Prepare early – try to start your preparation early to give yourself enough time to cover all the relevant sections on the Royal College curriculum.
Find the right materials to support your study – it's good to use a combination of resources for your study to reinforce existing knowledge and benchmark your progress. Try to find the right materials for you as early as possible to hit the ground running with your revision.
Familiarise yourself with the Royal College curriculum – we cannot stress this enough! All countries have different training programmes, so being well versed in what the RCPath will be looking for is key.
Join the IMG Histopathologists community – as well as support on Royal College exams, our online community of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Getting started
Attaining FRCPath Histopathology is a great first step for histopathologists wanting to find senior roles in the NHS. It can be difficult for overseas trainees to prepare for the first exam in the Royal College examination suite, but this quick guide from a successful FRCPath pathologist is a great start for pathologists pursuing the postgraduate route to GMC registration and finding work in the UK.
For more information on the FRCPath exams, take a look at our IMG Resources library.
If you have any further questions about FRCPath, your route to the UK as an overseas histopathologist, or any other aspect of GMC Registration, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
GMC Registration can be a long and complex process, and with a few routes for medical oncologists to provide evidence of their skills and knowledge, it can be difficult for IMGs to decide the best route to take to register with the GMC.
For international doctors considering their route to the UK, there are two main pathways to consider: PLAB or the postgraduate route - in this case, MRCP (UK).
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 the two main pathways and briefly consider their benefits, summarised in the headings below:
PLAB for GMC Registration
MRCP (UK) for GMC Registration
Which is better for me as an overseas pathologist, PLAB or MRCP (UK)?
#IMG Tips
How do I get started?
Professional & Linguistics Assessment Board (PLAB)
The most common route which tends to be popular among junior doctors is PLAB.
PLAB is a two-part exam with one written and one practical element, that assesses whether candidates are at least as capable as doctors 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.
MRCP (UK) - Postgraduate Qualification for Internal Medicine
The internal medicine postgraduate qualification is a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience. Within medical oncology, this can be done by attaining Membership of the Royal College of Physicians. The Royal College of Physicians is the professional body that regulates internal medicine within the UK, including the specialty of medical oncology.
Membership of the Royal College of Physicians (MRCP) is the full qualification attained through the postgraduate exams for physicians. The exams assess a candidate’s knowledge of basic medical sciences, as well as clinical skills required for the diagnosis and management of disease. MRCP (UK) has three components, with two written and one practical element.
For complete guides on MRCP (UK), take a look at our IMG Resources library.
It is important to note that the MRCP (UK) exams are for medical oncologist, and you would not need to sit the FRCR (Oncology) exams, as these apply to clinical or radiation oncologists only.
PLAB vs MRCP (UK)
Both PLAB and MRCP (UK) 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 may be difficult for an overseas medical oncologist to obtain a more senior post without MRCP (UK), GMC-approved training, or extensive experience from a similar, English-speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
MRCP has three stages, and the Royal College strongly advises that candidates only sit the final exam after 24 months of practical experience.
These exams can take anywhere from 24-36 months to prepare from start to finish.
Cost
MRCP costs just under £2,500 for the three exams. The final exam, PACES, is an in-person exam, so travel to the UK must be factored into the overall cost.
PLAB costs £1,189, and 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.
For both MRCP (UK) PACES and 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 the total cost of each exam can rise if re-sits 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 oncology or internal medicine 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., medical oncology.
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.
MRCP (UK) involves three more difficult examinations and takes more time to prepare for. However, for overseas doctors, attaining MRCP (UK) will allow you to jumpstart your career in the UK, as you don't need PLAB or Core Training.
The Royal College of Physicians’ exams will facilitate the application for more senior roles in medical oncology in the UK 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.
Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded MRCP aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
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, MRCP (UK), GMC registration and finding your dream job in the NHS - take a look at our IMG Resources library.
If you have any further questions on PLAB, MRCP (UK) or your route to the UK as an overseas oncologist, don't hesitate to get in touch with our oncology specialists here. We’d be more than happy to help you.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
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.
CESR acts as a route to applying for substantive (permanent) consultant jobs for doctors who have not followed a specialty training programme in the United Kingdom.
In a nutshell it is the option available to doctors practicing as consultants from overseas who wish to gain specialist registration in the UK. Some doctors choose to apply from overseas, others work with IMG Connect to secure a job in the NHS geared at helping them gain entry to the specialist register once in the UK.
If you are working as a consultant in your home country and are eligible for specialist registration in the UK, then as an overseas doctor (IMG) you have a couple of options. Here we focus on applying for CESR from abroad as well as the alternative route, applying for a Specialty Doctor or Fixed Term Consultant job in the UK before applying for CESR with support of your NHS employer.
Both routes lead to gaining CESR and entry to the Specialist Registration, meaning that you can work as a substantive consultant in the NHS. Both take hard work, preparation, evidence gathering, time and dedication. Both options have the same end goal, specialist registration.
It is important to say that no matter how you choose to apply, the CESR process involves submitting a large volume of evidence to demonstrate that you have the equivalent experience, skills and competencies as a doctor who has taken the specialty training route in the UK. Whether applying from overseas or not, some doctors are asked to complete additional experiences to meet this strict standard. Because of this, the process can be lengthy.
Applying for CESR from overseas
This is a great option for Consultants who are not constrained by time and have an understanding department that will support the additional gathering of evidence.
The GMC reckons that it takes between 6 – 9 months between submitting your application and receiving a decision. At IMG Connect our experience tells us that is takes a similar amount of time to gather the evidence prior to submitting. In addition, you must have completed the evidence in the first place in real workplace and clinical scenarios. This can take twice as much time as preparing and submitting. Put simply, the process can be time-consuming and laborious.
Add to this the issue of completing and gathering evidence against the CESR application from overseas. It can prove challenging to ensure that you have completed the full complement of competencies for CESR applications. This can result in the GMC asking for further evidence, adding more time to the process. You may have to identify gaps in your learning and then resolve them. It is not all bad though, this is good practice and will benefit you in the long run.
Applying for a specialty doctor job and/or fixed term consultant post before applying for CESR
For doctors who are keen to secure entry to the Specialist register quickly, and work in the UK as soon as possible, then taking up a Specialty Doctor role with CESR programme, or a Fixed Term Consultant post with CESR programme/support is a good option.
Many NHS hospitals or trusts in the UK will offer access to support, clinical experience and study or preparation time for CESR. This is often built into the weekly job plan, but in some circumstances, this may be arranged informally. Either way, this is a good way for overseas consultants to quickly gather the right evidence for their application with the support of their peers, senior colleagues and NHS employer. This can shorten the time spent on the application overall.
If this sounds like the best option for you, it is wise to start gathering and signing off evidence in your current consultant post. That way you will already have some or most of the required evidence for CESR in place, allowing you to quickly focus on any elements that are missing once in the UK and working in the NHS
Secure a job in the NHS with CESR
Securing a job as a Specialty Doctor with CESR programme, or a job as a Fixed Term Consultant with CESR programme/ support, gives you instant exposure to the UK system, NHS experience and a great start to your career in the NHS.
To discuss whether applying for CESR from overseas or securing a job as a Specialty Doctor or Fixed term consultant with CESR programme is the right route for you towards specialist registration, speak with an IMG Connect consultant, register or send your CV.
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For IMGs passing an English Language test is an essential part of the GMC Registration process.
As an overseas doctor looking to work in the UK, there are different scenarios in which you’ll need to provide a pass in an English Language Test. This article should hopefully help you decide which one would suit you best and includes the following topics:
Who needs an English Language Test?
What are your options?
What are IELTS & OET?
Which should you choose?
Which test is accepted by who?
Which is easier?
Where and when can I sit the English Language Tests?
How can I prepare for the English Language Tests?
What resources are available?
How else can I study at home?
Summary
Who needs an English Language Test?
If you are an overseas doctor wanting to work in the UK, you must prove your English Language capabilities to enable you to register with the GMC (General Medical Council). To prove your capabilities you must successfully pass an English Language test.
We advise all overseas doctors intending to relocate to the UK, whether via PLAB or postgraduate routes, to start their English Language Test preparations as early as possibl, you may not be able to pass at first attempt.
What are your options?
In short, you have two options:
IELTS (International English Language Testing System)
OET (Occupational English Test)
Both are used to test the English language levels of healthcare professionals in different parts of the world.
Importantly, both are used to demonstrate the correct levels of English have been attained for registration to work in the UK healthcare system.
What are IELTS & OET?
These English Language Tests are chosen by different regulatory bodies to ensure that doctors and other healthcare professionals have the correct level of English to communicate at a high level with patients and colleagues, so as to provide safe and effective care.
For IMGs relocating to the UK, it is important to start by saying that both the IELTS and OET are accepted by the General Medical Council (GMC).
However, it is also important to note that OET is not accepted for Tier 2 Visa applications, which we will explore later.
IELTS:
IELTS is designed for people wanting to work or study in the UK. IELTS has a non-academic version, but be careful, for overseas doctors it is the Academic IELTS UKVI version that you want.
IELTS consists of 4 sections, Reading, Writing, Speaking and Listening.
To pass an average score of 7.5 or above is required, with all areas scoring above 7.0.
OET:
OET is language assessment designed for healthcare professionals. It has many versions, so be careful to select the relevant course for an IMG, the medical version.
OET is fast becoming a popular choice and is equally recognised by the GMC as an accurate test of English for doctors.
OET consists of 4 sections, Reading, Writing, Speaking and Listening. To pass a grade of B (or above) is required in all areas.
Which should you choose?
IELTS gives a broader test of the English language, not just workplace specific. IMGs who took this option have told us that their preparation has had a positive impact on their life in the UK, outside of the workplace.
However, it is also true that OET focuses more on the language that is relevant to healthcare professionals. Many overseas doctors tell us that they like this option as it tested their ability within the context of the medical profession.
Both are accepted by the GMC, so for the purposes of GMC registration only, one is not better than the other.
Both are now accepted for your Tier 2 Visa sponsorship with the Home Office.
For EEA doctors, you do not require a visa and only need to satisfy the GMC’s English language criteria.
If you have qualified outside of the EEA, your English Language Tests will need to satisfy both the GMC and the UK Home Office.
We have created the table below to help you check if you are taking the right test:
YES (7.5 overall, no less than 7.0 in all sections)
GMC registration
Tier 2 Visa (CoS)
Academic IELTS
YES (7.5 overall, no less than 7.0 in all sections)
NO
Academic IELTS UKVI
YES (7.5 overall, no less than 7.0 in all sections)
YES (4.0 in all sections)
OET
YES (Score of B+ in all areas)
YES
Which is easier?
This really falls down to a matter of preference.
Both are difficult and require hard work and exam study. Why not take a look at our tips for preparing for English Language Exams at home.
Some will find the OET works well for them as it covers healthcare specific language, meaning that you can make good use of your existing healthcare knowledge and vocabulary.
IELTS is not specific to the healthcare profession, it is taken by professionals from all industries. So, the topics covered are more general.
If your English level is good enough, neither OET or IELTS will hold you back.
There is no evidence to suggest that one test is easier than the other.
Here is a comparison chart to help:
IELTS Academic UKVI
OET
Test time
2 hrs 45 mins
Approx. 3 hrs
Listening
30 mins
You will be asked to listen to 4 recordings and answer questions based on what you’ve heard. The recordings will be two lectures or monologues and have two spoken conversations. The questions will ask you to ‘fill in the blanks’ or ‘match the following’, as well as ask you to label, complete sentences and more.
50 mins
This section is broken into two, part A and B.
Part A will ask you to take notes on a consultation, and part B will ask you to fill in the blanks and answer multiple choice questions after listening to a healthcare lecture.
Reading
1 hr
You will be given three passages of text taken from journals and newspapers etc. You will then be asked to answer questions and complete tasks based on the reading material provided. Some of the questions may be multiple choice, true or false, note completion, identification etc.
1 hr
This is split into two parts, part A and B. Part A is made up of 4 short texts – you fill in the blanks and complete a summary of the topic being discussed. Part B requires you to read two longer texts and answer multiple choice questions about each.
Writing
1 hr
This includes two tasks. The first is 20 minutes, you will need to study and write about some data or graphs provided.
The second task will ask you to write an essay based on a broad subject.
45 mins
This test will require you to read some case notes and write a discharge, follow up or referral letter based on the notes.
Speaking
15 mins
This is split into three parts. Each part is a general discussion. Firstly, this will be a discussion on topics such as family, hobbies and interests. This is followed by task card topics, which you will be given with a topic to speak about.
20 mins
This task starts with a short warm up discussion with the examiner. The main test then comprises of two role plays, in which you will play a doctor, and the examiner will play a patient. The interaction will be based on a selected topic card.
Accepted for GMC registration
YES if you take the Academic IELTS UKVI option (7.5 overall, no less than 7.0 in all sections)
YES if you take the medicine version (Score of B+ in all areas)
Accepted for Tier 2 Visa
YES if you take the Academic IELTS UKVI option (4.0 in all sections)
YES
Cost (£)
£200
£349
Where and when can I sit the English Language Tests?
IELTS is available in over 140 countries, with tests held up to 4 times per month. Check if there is a venue near where you live.
OET is available 14 times per year in 40 countries, with the number of cities and venues increasing each year. Check if is there is a venue near where you live.
How can I prepare for the English Language Tests?
IELTS and OET can be challenging, so make sure you are as prepared as possible before sitting the exam.
Preparing for any English Language Test, whether you have chosen IELTS or OET, requires learning a huge amount of vocabulary, learning how to write specific reports or essays, using a high level of grammar and structure and learning how to engage with a range of scenarios and acquire a set of key exam techniques.
You should take time to research each area of the test in detail, but don’t worry, help is at hand, and we will explore some of the best resources online.
Your preparation for each test will need to be different.
This doesn’t mean that one will require more or less preparation, just that you will need to study varied pathways and prepare different topics and vocabulary.
IELTS involves learning a much wider amount of vocabulary on a range of academic subjects so that you will be prepared to read academic texts quickly and effectively, understand lectures, talks and questions, giving opinion in detail.
You will have to prepare how to write reports on a variety of data and essay types.
Written texts are to be of a high standard, including complex structures and grammar.
OET involves learning a wide range of healthcare related and profession specific language. The test will require you to follow clinical scenarios, understand medical texts and talks. You will need to write a healthcare letter, such as a referral. To get the right score, this must be at an advanced level.
Successful IMGs who have passed, told us that learning key exam techniques helps you to work quickly and effectively during the test day.
What resources are available?
For IELTS, the British Council provide free online preparation on their website.
The British Council also offer the IELTS word power app. It's a great way to prepare for your test no matter where you are. Download the app here.
The IELTS publication Information for Candidates has valuable information about the way the test is run and what to expect on the day.
For OET practice, you can buy helpful OET guidance packs online.
The OET also offer a preparation portal full of material to help you study for the test, including free practice materials.
How else can I study at home?
Successful IMGs have told us that one of the most effective ways to improve their general level of English and help them on their journey to improving their English Language scores in both IELTS and OET, is to study at home.
Whilst exam papers are an essential weekly part of your overall study plan, too many exam papers can lead to boredom or frustration.
Most find the following helpful (and enjoyable):
Listen to podcasts
Speak to native English speakers (you can always give us a call!)
Watch relevant YouTube videos for your chosen exam
Watch movies
Listen to radio
Read articles relevant to your exam
In summary:
Neither exam is easier than the other. Both Academic IELTS UKVI and OET Medicine show you have an advanced level in English. It really is up to you!
You may find OET simpler to understand as it is healthcare related and tests the language you use in daily practice.
The same can be said about IELTS, you may find the general nature of the topics more suited to you.
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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.
GMC Registration is a complex process. For histopathologists who’ve qualified outside the EEA region there are two main pathways to consider – FRCPath and PLAB.
Whilst these are the most common routes to GMC registration, this is not an exahaustive 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 will give a summary of both of the main routes and briefly consider their benefits.
PLAB for GMC Registration
FRCPath for GMC Registration
Which is better for me as an overseas pathologist, PLAB or FRCPath?
#IMG Tips
How do I get started?
Professional & Linguistics Assessment Board (PLAB)
The first and most popular route with most junior doctors is PLAB.
PLAB is a two-part exam (one written one practical), and which assesses whether you are 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 have created a video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.
FRCPath - UK Postgraduate Qualification
The UK postgraduate qualification for histopathology – FRCPath Histopathology - is the most popular and recommended route for overseas doctors who have completed a training or residency programme, and will be looking for senior pathology positions in the NHS.
By completing both parts of the FRCPath you are awarded Fellowship of the Royal College of Pathologists. The Royal College of Pathologists is the professional body that regulates the pathology specialties in the UK. Take a look at our IMG Resources library for complete guides on FRCPath for histopathology to learn more.
PLAB vs FRCPath
Both are legitimate routes 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 priorities and needs in moving to the UK.
Seniority of Positions in the NHS
Histopathology is a consultant led specialty in the UK, and it would be difficult for an overseas pathologist to obtain a more senior post without FRCPath, or extensive experience from a similar, English speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
FRCPath has two stages and can take anywhere between 18-30 months to prepare from start to finish.
Cost
FRCPath costs just under £1,930 and whilst the Part 2 exam is an in-person exam, the Part 1 exam can be taken online. You can read about the changes to the FRCPath 1 delivery 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.
For both FRCPath Part 2 and 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 assesses a doctor’s ability to work safely in the UK, does not demonstrate ability in histopathology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine.
Additionally, PLAB can facilitate GMC registration much faster than other routes – so if you feel you can attain an offer of employment in the UK with your overseas experience only – but GMC registration is the one thing standing in your way – PLAB may be a good option for you.
FRCPath involves two more difficult examinations and takes more time to prepare for. Attaining FRCPath in Histopathology will allow you to jumpstart your career in the UK, you’ll most likely be able to take a consultant role. You would not need PLAB or Core Training in addition to FRCPath.
Additionally, histopathology in the UK is also a consultant-led specialism, and FRCPath demonstrates competency to practice unsupervised as a consultant.
#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 IMG Histopathologists, an online pathology community of UK and NHS histopathology aspirants and dedicated histopathology recruiters. You’ll find advice, guidance and news and updates about all things histopathology 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 FRCPath 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, feel free to get in touch with our histopathology consultants here.
For regular news and updates, follow IMG Connect on social media using the links below.
There are several routes a medical oncologist can take to register with the GMC and practice oncology in the NHS.
Medical oncologists looking to secure a job in the NHS must satisfy certain criteria before they can be fully registered with the GMC (General Medical Council) and receive a license to practice in the NHS. For oncology, these criteria depend on where you received your training, and the qualifications you hold.
In this blog, we’re giving you a snapshot of the steps you need to take to start your journey to the UK, as an overseas oncologist. We’ll be covering the following:
How do I demonstrate my knowledge and skills as an EEA oncologist?
How do I demonstrate my knowledge and skills as a non-EEA oncologist?
How can I demonstrate my English language skills?
What is a certificate of good standing and how do I get one?
What do I need to register with the GMC?
Will I need a visa to work in the UK?
Skip ahead to the relevant section if you know what you're looking for.
Evidence of knowledge and skills for EEA medical oncologists
For oncologists who trained in an EEA country (all countries inside the EU, also Lichtenstein, Iceland, Switzerland & Norway), there are several options potentially available to you.
Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either GMC registration, check the relevant GMC page here.
Basic Medical Training
If you have met the requirements for basic medical training, you would not need to demonstrate your medical knowledge and skills to work as a doctor in the UK, and would therefore not need to complete a Royal College postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, but not Specialist Registration.
Specialist Training / Residency
Not all European Specialist qualifications are accepted by the GMC. If you have met the GMC’s criteria pertaining to your county, then you should be eligible for Specialist Registration in oncology. So as a medical oncologist, if you hold a Relevant European Specialist qualification, you would be put on the specialist register for medical oncology and can be appointed as a substantive oncologist in the NHS.
Please note, the criteria that is outlined on your country’s GMC registration page must be met. If your training was undertaken prior to the dates mentioned by the GMC – your qualifications will not be accepted.
For EEA oncologists, the main hurdle that you will face will be demonstrating that your English skills are of a high enough standard to practice safely as a doctor in the NHS.
As a European oncologist, this is most likely the easiest route to becoming GMC-registered and being able to practice oncology in the UK.
If you do not meet the GMC requirements for your training to be approved for general or specialist registration, other routes you may consider to GMC registration include PLAB, or (via the postgraduate route) the Royal College exams for medical oncology (MRCP). You can find out more about these alternative routes here.
Evidence of knowledge and skills for non-EEA oncologists
If you qualified as a medical oncologist outside the EEA, then you will have to demonstrate that both your medical knowledge and skills AND English Language capabilities meet the level required to practice safely in the UK.
Oncologists who've trained from outside the UK and EEA and must demonstrate to the GMC they have sufficient knowledge & skills to practice safely in the UK. For medical oncologists this can be done through one of three main routes:
Professional & Linguistics Assessment Board (PLAB)
The PLAB exam is a two-part exam that assesses a doctor’s ability to work safely as an SHO in the NHS, as such it does not demonstrate ability in oncology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries. If taking this option, medical oncologists can then take up training or a more senior post once they have established themselves in the NHS. Take a look through our comprehensive guides on PLAB.
Royal College of Physicians
Attaining a Royal College qualification is a preferred path for doctors who have already chosen their field of specialism i.e. medical oncology. Oncologists taking this route will gain access to more senior, well-paid jobs in the NHS. The Royal College of Physicians is the professional body that regulates the specialism of medical oncology in the UK, and Membership of the Royal College of Physicians (MRCP) is the full qualification attainable by examination. For overseas doctors, attaining MRCP will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior roles in UK oncology. Take a look at IMG Resources library for complete guides on MRCP to learn more.
GMC-recognised or equivalent qualifications
Some overseas qualifications and licensing exams are recognised by the GMC and accepted for registration purposes. This is to say these qualifications or licensing exams are considered as meeting the same standards as the Royal College qualifications.
To find out if your qualification is accepted by the GMC, take a look at our blog: Overseas accepted postgraduate qualifications
English Language Testing
Both EEA and non-EEA oncologists, regardless of experience, and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below:
IELTS – a guide for overseas doctors
OET – a guide for overseas doctors
Experience in English-speaking countries
For doctors who have at least two years of their most recent experience in an English-speaking country, you can use a reference from your current employer or employers over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.
Certificate of Good Standing
All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.
The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. You can find out which medical regulatory authority to contact via the GMC website here.
If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.
Please note that each certificate is only valid for three months from the date it's signed and must be valid when we approve your application.
GMC Registration
Once you’ve completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:
English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).
AND
Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.
AND
(EEA oncologists) Sufficient skill and knowledge – as an EEA oncologist, this would either be your recognised EEA qualification.
(Non-EEA oncologists) Sufficient skill and knowledge – as a non-EEA oncologist, this would either be PLAB, MRCP or a GMC-approved qualification.
To understand the registration process more fully, read our article on GMC registration for overseas doctors here.
Visas
If you or your family are from the EU, Switzerland, Norway, Iceland or Liechtenstein and started living in the UK by 31 December 2020, you may be able to apply to the free EU Settlement Scheme. Otherwise, you will need to apply for a visa from the Home Office.
A Health & Care visa (Tier 2 visa) is the document given to a skilled worker by the UK Home Office following a job offer from a UK employer with a valid Tier 2 Sponsorship License. The list of valid Tier 2 Sponsors can be found here.
Understand Tier 2 visas and Certificates of Sponsorship in depth by taking a look at our article: Tier 2 Visa application process & documents needed.
Wondering whether you can relocate with your family? Take a look at our blog on the Tier 2 dependent visa below: Tier 2 Dependent visa - Can I bring my family with me to the UK?
IMG Oncologists
Join the IMG Oncologists Facebook group for access to a community of like-minded FRCR (Oncology) aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
So, there you have it! Hopefully this helps to clarify any worries or doubts you may have on your route to the UK as a medical oncologist planning a career in the NHS. If you have any questions or would like to know more about the medical oncology job market, then get in touch with our team.
For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below:
Here we take a closer look at the routes available to overseas consultants & experienced doctors who wish to join the GMC’s Specialist Register.
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.
To shed some light on the routes to Specialist Registration, we've put together a short article to explain further, including the following topics:
What is Specialist Registration?
What are the different types of Specialist Registration?
Am I eligible?
How do I apply for Specialist Registration and what evidence will I need?
What are the benefits of Specialist Registration?
Are other senior NHS posts available without Specialist Registration?
How much does Specialist Registration cost?
#IMG Tips
Skip ahead to the relevant section if you know what you’re looking for.
Specialist Registration
All doctors who wish to work as permanent consultants in the UK must show evidence of skills, knowledge and experience in order to apply for Specialist Registration. This registration in any specialty means you can be appointed to a substantive consultant post within the NHS.
Specialist Registration is additional to full registration with the GMC.
The 3 Types of Specialist Registration
There are three types of certificates issued by the GMC, and the type of certificate you will receive at the end of your training defines which training route you are on.
The Certificate of Completion of Training (CCT)
The CCT is the route to specialist registration for doctors who have completed a GMC-approved, specialty training programme through the relevant Royal College.
To be eligible for CCT, an applicant’s entire training (including any core years) must have taken place within UK-approved training posts. Please see our blog on career pathways for a UK doctor in training.
The Certificate of Eligibility for Specialist Registration - Combined Programme (CESR (CP))
CESR(CP) is a simplified route for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK.
Doctors on the CESR(CP) route count a combination of approved training and previous experience in non-approved posts (overseas) towards their training time.
The Certificate of Eligibility for Specialist Registration (CESR)
CESR is the route to specialist registration for doctors who have not completed a GMC-approved specialty training programme – doctors who have trained outside of the UK, Switzerland, and the EEA.
These doctors apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK.
Doctors who have completed their specialist training in the EEA or Switzerland are eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ).
For an in-depth guide to CESR, take a look at our blog for overseas doctors here.
Eligibility
Eligibility for Specialist Registration depends on your nationality, qualification and experience.
To meet the minimum eligibility requirements to apply you must have either:
A specialist qualification in the specialty you’re applying in
OR
At least six months continuous specialist training in the specialty you’re applying in
You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.
In your application you must show that you meet the requirements of the CCT curriculum in your specialty.
The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience.
Applications and Evidence for Specialist Registration
CCT and CESR-CP
Once you have been issued with your Outcome 6 has been issued, you must complete and return the relevant CCT/ CESR(CP) notification to your Royal College along with the following documents:
Copies of any ARCPs that are not on your ePortfolio
ARCPS/evidence of successful progression for any LAT/FTTA/SHO posts counting towards your training (this applies to doctors who were appointed above ST1 only)
You will also need to complete an online GMC form. The link to this form will be emailed to you by the GMC and you should contact your Royal College if you do not receive it.
The GMC has created a guide for each CCT specialty with the relevant royal college or faculty. You can see this here.
CESR
You will need to apply to the GMC, who will then send your application to the Royal College for evaluation. The application process for CESR can be lengthy and potentially stressful, so it is important that you read the GMC’s general guidance and specialty-specific guidance before starting to put together an application.
You will need to provide a portfolio of evidence demonstrating that your specialist training or qualifications are equivalent to the award of a CCT in your specialism in the UK. This information is available for each specialty and Royal College on the GMC website here.
If you apply for an NHS post which provides CESR support, your hospital should assist you in this process.
Once the GMC has sent you a letter informing you that your application is complete and has been sent to your Royal College for assessment, the College is not permitted to discuss your case with you until the GMC has sent you a letter informing you of the decision.
Benefits of Specialist Registration
Specialist registration allows doctors to take up permanent or substantive consultant positions. Without CCT, CESR or CESR-CP, a doctor may only take a Trust locum or fixed-term consultant posts.
Fixed-term and locum posts offer of course offer less stability than permanent consultant posts and require extension.
It is a legal requirement before taking a substantive, honorary or permanent NHS consultant post in the UK that doctors have their names entered on the GMC's Specialist Register.
Senior Positions in the NHS
It is important to note that you can apply for more senior roles such as a specialty doctor (SAS), specialist grade or a locum consultant (locum consultants are not required to be on the Specialist Register).
This way, you will have better pay and roles and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these jobs you can collect evidence of your competences.
These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.
Cost
All doctors applying for Specialist Registration must pay a fee. The fees for 2021 are as follows:
CCT - £439
CESR-CP - £439
CESR - £1,676
#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.
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 curriculum, not just your sub-specialty.
Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
Ask an IMG Connect recruitment specialist about NHS 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.
Most IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR or CESR-CP route. Take a look at our in-depth CESR overview 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.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Respiratory Medicine with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Respiratory Medicine in the NHS?
As a respiratory medicine or pulmonary specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Respiratory Medicine. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP to attain CESR in Respiratory Medicine?
No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Respiratory Medicine. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP (UK).
What is the indicative period of training for a CCT in Respiratory Medicine?
The indicative period of training for CCT in Respiratory Medicine is six years full-time training and it is highly unlikely that a CESR applicant could achieve these competencies required in less time.
The structure of the CCT training programme is:
2 years in Core Medical Training or Acute Care Common Stem (ACCS)
How does IMT fit into this? CMT no longer exists as of Aug 2019.
4 years training in Respiratory Medicine
Applicants need to demonstrate that they have achieved the competencies in both of these areas. For complete details have a read through the Respiratory Medicine Curriculum documentation.
Submitting Evidence
Do not submit original documents – this is very important.
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).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Respiratory Medicine Curriculum documentation. If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
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 – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
Summary
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for senior Respiratory doctors looking to work as NHS Consultants in Respiratory Medicine.
IMG Jobs
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The first exam in the FRCPath Histopathology series...
International histopathologists (or cellular or anatomical pathologists as commonly known) looking to secure a job in the NHS via the postgraduate qualification route will need to attain Fellowship of the Royal College of Pathologists. This can also be commonly referred to as FRCPath Histopathology.
The completion of Part 1 and Part 2 of the Royal College of Pathology qualification for Histopathology results in eligibility for GMC registration (with the addition of the English language component). The FRCPath qualification is recommended for overseas pathologists looking to securing senior jobs in the NHS.
The exams can be taken by IMGs from all over the world, provided certain eligibility criteria have been met. Here we’ll take a closer look into these and other important questions through the following topics:
An overview of FRCPath Histopathology
What is FRCPath Part 1 and how is it structured?
Changes to FRCPath Part 1 delivery
Am I eligible to sit this exam?
How much will the exam cost and how do I apply?
What is the best way to prepare for the exam?
#IMG Tips
I’ve passed the FRCPath Part 1 exam, what’s next?
Skip ahead to the relevant section if you know what you’re looking for.
An overview of FRCPath Histopathology
The FRCPath Histopathology exams are administered by the Royal College of Pathologists to test a doctor's knowledge and ability to apply this in the practice of histopathology within the scope of the Specialty Training Curriculum for Histopathology.
The exams are as follows:
FRCPath Part 1
FRCPath Part 2
To read more about the full FRCPath examination suite via our IMG resources, please click here.
Please note that only full FRCPath satisfies the requirements for GMC registration for overseas doctors taking the postgraduate route.
Alternative routes to GMC registration include PLAB and other licensing exams such as USMLE. You can find out more about alternative routes here.
For doctors who are interested in more senior roles in the NHS that are reflective of their current practice, we advise that FRCPath is the best route to take to GMC registration. Histopathology in the UK is consultant-led specialism; and many NHS job postings will have FRCPath as a requirement for doctors who are not on the Specialist Register.
FRCPath Part 1 breakdown
FRCPath Part 1 is the first exam in the Royal College of Pathologists qualification. It is broken down into three sections as follows:
The three-hour exam is designed to assess candidates’ overall knowledge and understanding of histopathology or cytopathology, including the full range of autopsy practices undertaken in a district general hospital in the UK and the basic science underpinning pathology, including molecular biology.
FRCPath Part 1 delivery
In response to the challenges of the COVID-19 pandemic, the Royal College of Pathologists has migrated the FRCPath Part 1 exam online.
This means FRCPath Part 1 may be taken from the comfort of your own home. This development allows the College to continue to offer the FRCPath Part 1 exam to both UK trainees and overseas pathologists.
For full details about the online FRCPath Part 1 exam, please see our blog here.
Eligibility
Candidates for FRCPath Part 1 will generally require experience of Histopathology specialty training to reach the standard required to pass the exam. The Royal College advise that candidates take this exam after one year of specialty training.
Exam dates, applications and cost
The cost of the exam is £673 and the exam are usually held twice a year, in spring and in autumn/winter.
Applications for each sitting open a few months prior and close after around 6 weeks. While waiting for exam dates to be finalised the College advise that candidates should apply early and will be able to withdraw their application for a full refund should the date be unsuitable.
For up-to-date information on exam and application dates, keep an eye on the College website here.
Preparation
There are many resources available to help you prepare for your FRCPath Part 1 exam. As always, we recommend that the best starting point for your study is the Royal College website, particularly the Curriculum for Specialty Training in Histopathology. Your exam is based on this curriculum so familiarising yourself with it as soon as possible will give you the best chance of success.
Other helpful resources for your study include:
Regulations and guidelines – before applying for FRCPath exams, the College recommends you read both the general and specialty-specific regulations and guidelines, found below:
General Regulations and Guidelines
Histopathology Regulations and Guidelines
Social media study groups – there are multiple study groups available across different platforms such as Telegram, Facebook, and WhatsApp. IMG Connect hosts study groups for FRCPath Part 1 – these forums bring together overseas histopathologists in one communicative, constructive, and moderated space for learning, sharing, and support.
If you are interested in joining the IMG Connect FRCPath Part 1 study group, please email info@imgconnect.co.uk to speak to request your admission.
Online courses, videos and other resources - there are some great online courses and resources available to prepare for the FRCPath Part 1 exam. These include everything from full mock exams to flashcards and YouTube videos. We’ve compiled all these which you can access here, through our IMG Resources library.
FAQs - There is also a Frequently Asked Questions (FAQs) document which the Royal College has compiled to help applicants who have questions about online examinations. You can read this here.
#IMG Tips
Prepare early – getting your revision going as soon as possible will help you avoid those last-minute cramming sessions and increase your chances of passing first time.
Speak to your colleagues and peers – there are so many study materials to choose from - who better to ask for recommendations than histopathologists who have been through the process or are going through it with you?
Familiarise yourself with the online format – there’s no bigger headache than a bad connection – go through your IT checks well in advance to avoid (most) hiccups on the day
Join the online histopathology community – connect with like-minded histopathologists and dedicated pathology recruiters in the IMG Histopathologists Facebook group.
I’ve passed the FRCPath Part 1 exam, what’s next?
Congratulations – this is a massive achievement! After a well-deserved break, it’s time to look forward to FRCPath Part 2. For more information on the final exam in the examination suite, take a look at our blog where we explore FRCPath Part 2 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 FRCPath exams, registrations & qualifications to help you find your dream job in the NHS - take a look at our IMG library.
Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below:
Are you an oncology IMG looking to sit your FRCR (Oncology) Part 1 (CO1) exam?
International doctors often wonder about the best ways to prepare for the first FRCR (Oncology) exam. There are many resources available online, but with so much geared towards UK applicants and trainees, it can be difficult to decide what is best suited to you as an overseas candidate.
Here we have compiled some of the best resources and guidance for overseas FRCR CO1 applicants preparing for the exam. We will also touch on some of the recent changes to the format, delivery, and availability of the exam in response to the COVID-19 pandemic.
The topics we’ll be discussing include the following – skip ahead to one of these sections if you know what you’re looking for:
What is FRCR (Oncology) Part 1 (CO1)?
How do I get started with my preparation?
What resources are available online?
How has COVID-19 affected the exam?
#IMG Tips
I’ve passed FRCR (Oncology) Part 1, what’s next?
FRCR (Oncology) Part 1
As a reminder, FRCR (Oncology) Part 1 or CO1 is the first exam in the FRCR (Oncology) examination suite. The full set of exams, Part 1, and Part 2A and 2B, or CO1, CO2A and CO2B are the exams required by international doctors to satisfy the requirements for GMC registration through the postgraduate route.
The assessment expects that candidates have a broad knowledge of subjects that relate to the investigation and management of patients with cancer.
The exam consists of five modules which are taken through four exam papers over two days. On each day, candidates may attempt any number of modules. Altogether the FRCR CO1 exam has 180 SBA (single best answer or multiple choice) questions.
The exam structure is as follows:
For an in-depth breakdown of each of the FRCR (Oncology) Part 1 modules, see our detailed blog, FRCR (Oncology) Part 1, through the IMG resources library, where you can also read an overview of the full FRCR (Oncology) examination suite.
Please note that only full FRCR satisfies the GMC’s postgraduate requirements for overseas doctors.
Preparation
We have discussed with IMGs the best way to prepare for the first FRCR (Oncology) exam and most recommended beginning with the Royal College website and resources, which they have compiled to aid in your preparation.
Curriculum: The FRCR (Oncology) exam is based on the Specialty Training Curriculum for Clinical Oncology, and as a rule of thumb, your revision should start here to ensure you are focusing on the exact material that will be in your exam. Knowing the curriculum is key and you can find these on the Royal College website here.
Royal College resources include:
Learning hub: the learning hub is available to members and contains many useful learning resources. This can be found here.
Purpose of assessment: this will help candidates understand the examination's purpose, the required level of candidate training and the application of results, available here.
Implementation tools: this is a range of tools which have been compiled by the College to support the new curricular which all students should have transferred to by August 2022 at the latest and can be accessed here.
Guidance notes – a document with detailed guidance on exam structure, content, requirements and marking which you can find here.
Sample questions: sample SBA questions with answers which can be found here.
Speedwell instructional video: a walkthrough video of the FRCR Part 1 exam format with guidance and instructions which can be found on the College YouTube channel.
Suggested reading list: a suggested list of core texts and additional reading put together by the College which is available here.
Examiners’ reports: this is a collection of generic reports written by examiners on the overall performance of candidates and individual questions as a guide for applicants for future sittings. These are available here.
Other helpful resources
There are several other resources available online, from flashcard-style revision materials to tips and advice from former candidates who have passed the exam:
The Clinical Oncology Registrar
This former candidate has compiled tips, guidance, and notes (including revision notes) on the First FRCR exam. These include revision advice, downloadable materials on key topics and links to good books and core materials to use. You can find the full blog here.
FRCR Oncology
A compilation of recommended books and notes shared by a former FRCR oncology candidate. There are general tips, as well as more detailed notes on the exam modules. These can be accessed here.
British Medical Journal
The BMJ has created an app-based physics revision resource with core questions on elements of the physics module, in the same multiple-choice format as will be seen in the exam. They are available at several price points depending on the duration of access, which ranges from £24.99 for one month to £139.99 for one year. This can be accessed here.
Brainscape
A set of flashcards with over 1300 questions across all modules. This free resource can be used as either revision or practice material and is located here.
FRCR Exam Prep
This website is home to exam tips, an online revision course for the physics module (including timed mock exams), sample cases and articles. The price of the physics course ranges from £25 for one month to £115 for one year. This can be found here.
How the exam has been affected by COVID-19
First FRCR (Oncology) is still taking place in person, but the number of exam centres has been reduced. For now, these are Belfast, Birmingham, Bridgend Wales, Crewe, Edinburgh, Glasgow, Leeds, and London. Overseas centres for now are in Hong Kong, India, and Malta.
For advice on preparation before applying for the exams, see the Royal College website here.
#IMG Tips
Start preparing early, but not too early – you want to avoid the misery of last-minute cramming, but not to burn out. Former candidates recommend starting about 6 months beforehand.
Get familiar with the curriculum – this is the home of the exam’s content – get to know this as well as possible to jumpstart your preparation for the exam.
Go through as many exam questions as possible – we know these are scattered all over the internet, but from those we’ve compiled in this handy guide you should have enough to keep you busy!
Join the conversation – join the IMG Oncologists Facebook group for access to a community of like-minded FRCR (Oncology) aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
I’ve passed the First FRCR oncology exam, what’s next?
Firstly, congratulations! This is an incredible achievement, and you deserve to treat yourself after all that hard work! With a pass in the First FRCR Oncology in hand, you can look ahead to the Final FRCR Oncology (CO2A and CO2B) exams. Once you have completed all parts of FRCR Oncology, you can apply for full GMC registration with a license to practice. Nice one.
We hope this is helpful for any overseas doctors preparing to sit their Final FRCR exam and the team here at IMG Connect wish you the best of luck!
Don’t forget to share your progress and successes with us using the hashtag #imgstories on social media, we love to hear from you.