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:
Are you an overseas physician looking to move to the UK? Here, you can hear first-hand the experiences of an international general physician who has been through the process, from completing their MRCP and GMC registration, to securing an NHS job and relocating to the UK?
IMG Stories is our series introducing you to international doctors who we have helped to relocate to the UK - sharing their personal journeys from working overseas to securing a new job as a doctor in the NHS.
Today we introduce you to Rehan Qureshi, a brilliant general medicine specialty doctor who relocated to the UK from Saudi Arabia with his wife, children and his mother in 2020. Having passed the MRCP and English language exams, Rehan received full GMC registration with license to practise. He is now working in the NHS at Scarborough General Hospital in the north of England – where he is making a fantastic impact on the service and wider community.
Tell us about yourself - what should the IMG community know about Rehan Qureshi?
I'm a physician with a special interest in acute and renal medicine and over 19 years of multi-centre clinical experience. My other areas of interest are clinical research, healthcare quality and patient safety, medical education as well as medical leadership.
What motivated you to move to the UK?
I was practicing overseas where despite working very hard, I had very limited prospects in terms of career progression and growth. I have always admired the NHS’ policy of ‘fair and equal opportunities for all’, and I view the UK in general as a fair and multicultural society.
Tell us about your experience with the Royal College of Physicians exams...
Honestly, these were some very hard times … as a family, it was quite tough for us while I was taking my MRCP exams. Each time I failed, my wife cried … but I didn't because I knew, the only way to get through the process and past failure was resilience! That helped and in the end I passed!
Do you have any tips or advice for overseas doctors who are currently working towards MRCP?
Never lose hope. Set a goal, work hard towards it and keep trying until you succeed! Avoid negativity and people who discourage you. Remember, MRCP is very much doable, though not easy. Practice is the key!
How did you manage to navigate and juggle the different aspects of registration whilst working?
I divided my day into four parts: work, MRCP, family and rest. I'd ususally finish work by 5pm and immediately begin my MRCP practice from 5pm - 8pm at the hospital. After getting back home at about 8:30pm, I'd have time for dinner and to spentd a couple of hours with family before going to sleep. The weekends were definitely better, but I'd still spend at least 6 hours in the library. I'd suggest you start your intense preparation no sooner than 6 months in advance. You need to work hard, but try to avoid burnout. For me, it worked.
Did you have any major or unexpected issues with the GMC registration process or your visa application?
I had none at all - everything went smoothly.
How did you find a medical oncology job within the NHS?
To be honest, I connected with Marcus & Ruaidhri, who did everything for me. They actually made my journey to getting my first NHS job a piece of cake! This was to the extent that when we arrived in the UK and reached our hotel, (at a time when the UK was in lockdown due to COVID), we had all our groceries promptly delivered by them. What more could anyone ask for? I knew some friends who were working with other agencies that left everything to them. With how much IMG Connect had helped me, I used to ask Ruaidhri questions to help my friends as well.
My advice: find yourself an agency that is known to be responsible and is keen to truly help. I personally found IMG connect very very helpful!
Tell us about your journey to the UK...
It was scary to travel at a time when the UK was in lockdown and COVID-19 cases were so high. However, my journey was made very simple, since all the logistics including visas were sorted by Ruaidhri, so we did not face any unnecessary hassle. I would say, it was a very smooth transition, we enjoyed two weeks of quarantine as we had been longing to spend some quality time together as a family and enjoy a good rest before starting up again.
What has been your experience working with IMG Connect?
The support I received on this journey was amazing. I absolutely could not ask for more. For the first time in my life, I traveled without any need to think or worry about logistics because they were being so well-managed by Ruaidhri and his team at IMG connect. My wife and I were traveling with young children and my elderly mother, and I must say, we have been taken care of very well!
How are you settling into life in the UK?
We have been settling in very well. In Scarborough, we have a beach that my children enjoy going to, and they also love their new school. Not for a single day have we felt that we are in a country of different culture, ethnicity or faith. My daughter had a pleasant surprise when her school teacher greeted her with 'Eid Mubarak' on the day of Eid festive, which was a great welcome during our first time celebrating Eid in the UK. The UK is truly wonderful and people are very welcoming here. It's beautifully blended multi-cultural society and we consider the UK our home now.
What have you enjoyed most about living in Scarborough in particular?
So many things: the beach, the variety of fun activities for children - like steam engine trains and parks. We've even enjoyed snow for the first time. Fish and chips are great! Traveling in the UK is absolutely easy and fun and there's so much to do and see.
What opportunities have become available to you through your work?
I am really enjoying my current role. Within a year of joining the NHS as a specialty doctor, I now hold 4 different roles: I'm a senior lecturer at Hull York Medical School, an SAS regional representative for RCP London, an SAS Teaching Fellow and a member of the RCPQI. I’m also starting my postgraduate certificate in health professions education funded by the HEE. I have the support of mt Trust with my CESR application and have been given the opportunity for research and to become a medical examiner.
For comparison, I was in my previous position for a decade, and only had one role with no career progression prospects.
What’s next for you now that you’re working in the UK?
I think you should always aim high with your goals. I aim to establish myself as a clinical leader as well as an academic leader, a clinical researcher and principal investigator. In the short term, I look forward to taking on the new 'Specialist' role and making progress on my CESR application with my hospital's support.
What’s been the biggest challenge you’ve faced in moving to the UK?
This would be my mother's visa. I'm an only child, so I couldn't relocate without her. Before finding IMG connect, many agencies had contacted me with job opportunities and all refused to help with my mother's visa. IMG Connect on the other hand, never give up. Marcus & Ruaidhri, perhaps, enjoy such challenges :-) Ruaidhri literally went out on a limb to help me on this. He contacted people, introduced me to an agency, helped me prepare the entire case and finally - we got it done and my mother was given her visa! I can't tell you what a huge relief it was. A big thank you to Ruaidhri, Marcus and the entire team at IMG Connect for this!
Have you experienced any culture shocks living in the UK?
Not at all! As I said, the UK is a multicultural, multi-faith country. People here in Yorkshire are very welcoming. We can easily find Halal food from local shops which also sell vegetarian food. We have a mosque in town, and there are separate prayer rooms for both male and female Muslim staff in the hospital. We feel so at home here.
What have you missed about Saudi Arabia the most?
We've definitely missed our old friends, and relatives.
Is there anything you wish you’d known before you began your journey to live and work in the UK?
I already had most of the information I needed before I came by Ruaidhri and Marcus, so there was nothing that came as a shock or surprise to me.
Do you have any tips or advice for international doctors who want to move to the UK?
I have a couple of pieces of advice. Firstly, if you are struggling to progress in your career, consider relocating to the UK. Here, it does not matter who you are, or where you come from. What matters is how dedicated and hardworking you are and I think your hard work always pays off. The NHS is a great institution and wonderful place to work. Secondly, I'd say consider taking an specialty doctor role. It's a great position where you'll have career prospects to develop as a locum consultant and enjoy a good work-life balance.
Moving to live and work in the UK is a big decision to make but can be massively rewarding in many ways. International doctors have the chance to find a new home and the NHS presents an incredible opportunity to secure rewarding jobs, progress within their field and explore adjacent opportunities such as CESR (for non-EEA doctors), writing publications and research. Whatever route an overseas doctor may take on their journey to the UK, IMG Connect is here to support them through every step and welcome them to the IMG Connect family.
To receive the latest news and updates on the Royal Colleges, GMC registration and the NHS, as well as more #IMGStories, follow us on social media and join the conversation.
The confirmation of maintenance is an essential part of your Tier 2 UK visa application.
Your Tier 2 visa application will be immediately rejected without a confirmation of maintenance, here we'll take a close look at its purpose, how to get one from your employer and what happens if you can't.
What is the Confirmation of Maintenance?
The Confirmation of Maintenance can also be known as an NHS Letter of Maintenance.
It is a confirmation from your sponsor that they will maintain and accommodate you, if necessary, for your first month of employment.
Usually this is confirmed on your Certificate of Sponsorship (CoS) along with evidence of prospective earnings.
Please note, a letter from your hospital certifying maintenance is not an acceptable method of certification.
What is the purpose?
The certification is used to ensure that you and any dependents joining are able to support themselves without recourse to public funds.
Will my hospital offer maintenance?
Most Tier 2 sponsors guarantee their prospective employees’ maintenance by stating on the CoS they will cover the applicant’s maintenance and accommodation costs for the first month of employment in the UK.
Only ‘A-rated’ sponsors have this option which covers the vast majority of employers with Tier 2 sponsorship licenses.
What if my trust will not guarantee maintenance?
This is unusual but not unheard of.
If the Trust will not guarantee maintenance, then you must prove that you have personal savings of at least £945 continuously for a 90-day period, no more than 31 days prior to the date of your application.
This would be included as part of your Tier 2 visa application.
IMG Jobs
Search and find live NHS doctor jobs in the UK
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Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & hospital locations for you.
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.
The NHS specialty training programme for clinical oncologists is recognised around the world. The quality and depth of oncology training and career development in the UK is recognised as a gold standard across the globe, making it a major attraction for many IMGs when considering a career in the UK.
The NHS training programme for oncology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of oncology around the world and throughout the profession.
In this article, we will explore the training pathway for clinical oncologists in the UK, covering the following topics:
What is the NHS Training Pathway?
How do you enter the training pathway?
What does the specialty training programme look like for clinical oncology?
What happens after completing the clinical oncology training programme?
Can I enter specialty training in the UK as an IMG?
Skip ahead to the relevant section if you know what you’re looking for.
The NHS Training Pathway for Clinical Oncologists
The NHS training pathway refers to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training and being awarded a CCT.
It is a good idea for overseas trainees to familiarise themselves with this as it helps to provide an understanding of at what stage they can most likely enter the system, either in a training or non-training post.
Entering the NHS Training Pathway
After graduating from medical school, doctors receive provisional GMC registration, allowing them to enter the Foundation programme (a two-year work-based training programme).
Upon completion of the first year of this programme (FY1), doctors will gain full GMC registration with license to practice and will be able to apply for further study and training in a specialised area i.e. medicine. This is known as Internal Medicine Training (IMT), formerly known as Core Training (CT).
Specialty Training in Clinical Oncology
The Specialty Training programme in Clinical Oncology runs over a 6-year period, and doctors will usually take the indicated time, or slightly longer to complete the Specialty Training programme.
Successful applicants entering into year one of specialty training (ST1), will follow the Royal College of Radiologists’ 2021 Clinical Oncology Specialty Training Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.
Clinical oncology training as an uncoupled programme
Clinical oncology specialty training begins at ST3, so after foundation training, there are two options open to trainees before they can start specialist clinical oncology training:
Internal Medical Training (IMT)
Acute Care Common Stem (ACCS)
For IMT, this is a two-year training period and the ACCS training programme lasts 3 years.
Both pathways are followed by an open competition to enter a higher specialty training post. It is important to note that the application following core training is competitive and does not guarantee a specialty training post.
Clinical oncology higher specialty training is indicatively a five-year clinical training programme (including Oncology Common Stem), leading to single accreditation in clinical oncology.
There are a few critical progression points during higher specialty training in clinical oncology, and trainees will also be subject to an annual review of progress via the ARCP process. They will have to complete all the curriculum requirements including passing the MRCP and FRCR (Oncology) exams prior to obtaining CCT.
Foundation Training (FY1 – FY2)
The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills and forms the bridge between medical school and speciality training.
This first year of Foundation Training (or FY1) is referred to as an internship. For IMGs applying for GMC registration, it is essential you can meet the requirements for an internship.
Selection
Here, trainees will either choose to either Internal Medicine Training (IMT), Acute Care Common Stem training (ACCS), or training to become a general practitioner (GP Training).
Specialty Training (ST1 – ST7)
Internal Medicine Stage 1 Training (ST1 – ST2)
Year one trainees begin at ST1 of the Internal Medicine Training Programme. In this first stage, trainees develop a solid foundation of professional and generic clinical capabilities, preparing them for participation in acute medicine at a senior level and to manage patients with acute and chronic medical problems in outpatient and inpatient settings. The curriculum for IMT Stage 1 Training can be found here.
The two-year training period culminates in trainees sitting the MRCP (UK) exams. For more information on the Royal College of Physicians examination suite, take a look at our IMG Resources library here.
Please note, trainees must have gained full MRCP prior to beginning Specialty Training in Oncology.
Selection
Here, trainees will either choose to continue with Internal Medicine Training for a further year, to continue with training in a specialty that supports acute hospital care, or to provide primarily out-patient based services in e.g. oncology.
Clinical oncology recruitment into ST3 posts usually occurs after 2 years of Internal Medicine Stage 1 training. However, trainees who complete the full three-year IMT programme are also eligible and there is no preferential selection for trainees who have completed either two or three years of training.
Oncology Common Stem (ST3)
The Oncology Common Stem (OCS) has a duration of one year and usually takes place in year 3 of specialty training (ST3). Here, the focus is on a trainee’s development of generic capabilities-in-practice (CiPs) expected of all doctors, as well as the common CiPs relating to the key areas of overlap between medical and clinical oncology.
Clinical Oncology and Medical Oncology are the two main medical specialities that manage patients with non-haematological malignancy. They often work in partnership with each other, and both offer systemic therapy to patients, but only clinical oncologists administer radiotherapy and there are other differences in work-pattern, approach and focus.
During OCS training, trainees will gain knowledge of radiotherapy planning and delivery. This will enable them to coordinate the care of cancer patients with the wider multidisciplinary team (MDT), managing patients throughout a treatment pathway.
The new curricular structure of the OCS means that trainees who successfully complete the training year will have gained the necessary competencies to progress to ST4 in either clinical or medical oncology.
For oncologists wishing to pursue clinical oncology, the first exam in the Fellowship of the Royal College of Radiologists assessment series, First FRCR (Oncology) (Part 1/ CO1), must be passed by the end of ST4.
Candidates do not need to have held a clinical oncology training post to attempt the exam however, so candidates are eligible to sit the exam during ST3.
Click here to learn more about the full FRCR (Oncology) examination suite.
Clinical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST7)
Once trainees have completed the OCS, they will then move onto a subsequent higher specialty-specific programme of their choice I.e. clinical oncology. This programme lasts for four years and takes place from ST4 to ST7, the focus here being to acquire clinical oncology specific CiPs, culminating in trainees’ achievement of Fellowship of the Royal College of Radiologists (FRCR Oncology).
The higher specialty-specific programme for clinical oncologists is administered by the Royal College of Radiologists, so the Medical Oncology SCE is not a requirement for clinical oncologists.
Trainees will then sit the Final FRCR (Oncology) Part 2A and 2B exams (CO2A and CO2B), usually from ST6 to ST7. This is to assess their knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.
Completion of the Clinical Oncology Specialty Training Programme
Upon completion of the clinical oncology training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Clinical Oncology. This will be based on high-level learning outcomes – capabilities in practice (CiPs) set out in the curriculum by the Royal College. You can find the 2021 curriculum here.
At this point, clinical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register for clinical oncology and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their clinical or radiation oncology 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 Clinical Oncology Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Clinical Oncology in the UK, however it is very competitive.
IMGs interested in UK specialty training must have:
Full GMC registration
Completion of a minimum 12-month (FY1 equivalent) internship
English language test
PLAB or a recognised European Medical Degree
AND
12 months post-internship experience by the time you start begin ST1
Please note, whilst UK trainees are not given priority for specialty training spaces, it can be extremely difficult to join the Specialty Training programme if you do not have previous NHS experience.
So there you have it, the NHS Specialty Training pathway for clinical oncology trainees. The training programme forms the basis of clinical oncology training in the UK, and for overseas clinical or radiation oncologists interested in joining the training programme, good knowledge of the pathway allows you to better understand the alignment of your overseas training with the relevant stage of Specialty Training for clinical oncology in the UK.
Join the IMG Oncologists Facebook group for access to a community of like-minded oncologists and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below:
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.
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As part of the Tier 2 visa application process you may need a Tuberculosis Test Clearance Certificate....
In this short article we take a quick look at who will require a TB Test Clearance Certificate, what the process will be and what to do once you have received yours.
Do I need the Tuberculosis Test Clearance Certificate?
You will need to have a tuberculosis test if you’re coming to the UK for more than 6 months and are a resident in any of these listed countries.
What is the process?
It is important to note that if you require one, you will need to arrange an X-Ray testing for TB at a clinic approved by the UK Home Office. This can be checked using the same link above.
If the result of the x-ray is not clear, you may have to give a sputum sample (phlegm coughed up from your lungs).
If the test shows you do not have TB, you’ll be given a certificate which is valid for 6 months from the date of your x-ray.
Who does not need to be tested?
You will not need a TB test if any of the following apply:
You’re a returning UK resident and have not been away for more than 2 years
OR
You lived for at least 6 months in a country where TB screening is not required by the UK, and you’ve been away from that country for no more than 6 months
How are children tested?
All children must see a clinician who’ll decide if they need a chest x-ray. Children under 11 will not normally have a chest x-ray.
You must take your child to an approved clinic and complete a health questionnaire.
If the clinician decides your child does not have TB, they’ll give you a certificate. Include this certificate with your child’s UK visa application.
Once I have my clearance certificate what should I do?
Don’t hesitate to get in touch with your IMG Consultant with any further questions on UK visas and immigration including certificates of sponsorship, letters of maintenance, criminal record checks and tier 2 visa applications.
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Since the UK voted to leave the EU in 2016, the countries exit (now commonly known as Brexit), has raised many questions in the healthcare sector centred on the implications for workforce management and planning.
With some European doctors publicly stating that they either intend to leave the UK, or are uncertain as to the future plans to remain a staff member of the NHS, their decisions pose important questions – are European doctors welcome in the NHS and what is being done to encourage doctors to stay in post?
Speaking with senior NHS figures, it is clear that the contribution of European doctors and healthcare professionals is greatly valued. To add, workforce managers and service leads have advised in no uncertain terms that they do not wish to lose any of their workforce, far from it – services up and down the country are trying to attract more doctors to their services. Brexit they say, is an unfortunate stumbling block at a time when demand is increasing for healthcare. It is therefore a major hurdle that the NHS needs to overcome in order to continue to bring experienced healthcare staff to the UK.
What might not be clear among the bad press surrounding Brexit, is that in 2018, the Government actually relaxed its rules on the immigration of overseas doctors seeking relocation to the UK, considerably increasing the number of Visas made available.
Further evidence of the demand for overseas doctors can be found in the recent White Paper advising the government to add all grades and specialties of medicine to the shortage occupation list. Whilst this is yet to become government policy, the report makes clear the ever-growing demand for European and Non-European doctors.
With ministers agreeing to expand the number of doctors allowed into the UK and changes to the shortage occupation lists in the pipeline, Brexit very much goes against the grain.
So, with a conflicting backdrop of Brexit set against the welcoming approach to European doctors in the NHS, where does recruitment of the best doctors to the UK stand?
Sources tell us that the government is set to continue to encourage doctors to the UK, taking on board proposals to increase the shortage occupation list to all medical doctors, as well as many other areas of healthcare professionals. Good news.
The issue that the NHS faces, is the growing media storm and political posturing around the Brexit debate. This toxic masculinity and surge to the right of centre in British right-wing politics is putting a large number of Europeans off their previously planned immigration. It can also be said that this atmosphere has triggered a small but growing exodus from the NHS.
The government now finds itself in a position where it is trying to explain its response to demand for staff in the NHS and its plans for Brexit, both very different approaches and rhetoric – can it have it both ways?
Focusing on NHS services, Directors, lead consultants and HR managers cannot be clearer – all Europeans doctors will be welcomed with open arms, and all current members of the NHS are highly valued for their continuing contributions. The praise goes further, Royal Colleges from all specialties, the General Medical Council and the British Medical Association have all unequivocally stated that they wish to support their European colleagues.
In addition, these organisations have increased their efforts to attract European candidates in an effort to combat the negative publicity brought about by Brexit. But, Brexit is having an immediate impact on retention, planning and hiring of new staff.
The NHS in England alone was short of nearly 10,000 doctors, with latest figures across the whole of the UK showing further increases in demand. Such figures do not reveal the full picture, with locums filling many posts, the real number of vacancies is likely 25% higher.
NHS operating departments continue to make it clear that staffing is their main problem when trying to combat the rising need for a varied healthcare system. What can be done to combat the negative stem caused by Brexit, and redress the balance in favour of the NHS?
Some attempts have been made in recent years to increase numbers in University as well as attracting junior doctors to the MTI scheme, however such efforts have fallen short.
In fact, the NHS will need to build its reliance on quality overseas doctors to take up fixed term and permanent service posts, an attractive option compared to either expensive temporary staff, or facing the prospect of competing for UK trainees, whose numbers remain very low.
Our hope is that there will be continued drive to employ talented and committed international doctors to help deliver services.
Starting with the local needs of each hospital or Trust in detail to create bespoke searches for the best talent, the best quality staff can be found. And rather than finishing at the point of placement, retention and after care services that ensure overseas doctors settle into their roles quickly, feel valued and integrate in their communities are crucial to successful relocation and retention. Such an approach will offset the negativity mindset and decrease in available candidates brought about by Brexit.
Supporting doctors with practical support & information surrounding their relocation ensures that they can focus on their work. Offering advice on engaging with their communities and new team can bring about a positive mindset. And connecting employers with a wider pool of candidates, most suited to the Trust values and fit, can ensure prolonged partnerships with European and non-European doctors.
All in all, staffing demands caused by Brexit, coupled with the need to increase the skills base in the NHS, can be offset with agencies and HR departments being accountable for the challenges they face. Turning things around in the attraction of workforce supply to the NHS.
What we know so far is that the status of already registered doctors is guaranteed. What is not clear is whether the current arrangements for registration will remain the same, with European Mutual Recognition continuing unaffected.
In all Brexit outcomes, the NHS will need to engage in more international recruitment. Take rural and hard to reach areas, as a good example of where even without Brexit, NHS organisations face challenges to attract greater staffing numbers.
With improved partnerships, focused on overseas recruitment, we can jointly attempt to maintain the number of EEA doctors remaining and joining the medical register.
In summary, the NHS remains an attractive place for overseas doctors to work and train, and the NHS remains committed to supporting all European colleagues and future colleagues. However, the challenge to recruit the best and most committed candidates is growing. Demand is increasing for overseas recruitment; we all must pay our part to maintain the positive impact that employing and supporting Europeans doctors has on our patient care.
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