Respiratory medicine SCE is the higher postgraduate qualification delivered by the Royal College of Physicians as a specialist qualification for respiratory medicine doctors.
It is one of 11 SCEs offered by the Royal College and offers physicians a postgraduate qualification which demonstrates to prospective employers the achievement of a standard equivalent to UK specialist doctors.
Here we take a closer look at the MRCP (UK) Respiratory Medicine Specialty Certificate Examination for doctors who have chosen to specialise in respiratory medicine. We cover the content of the exam, as well as fees and the eligibility criteria, all summarised below along with a broad look at the following topics:
What is the respiratory medicine SCE?
Where does the SCE fit into my training?
What is the structure of the respiratory medicine SCE?
How do I apply for the exams and what do they cost?
Where can I sit the exams as an overseas respiratory medicine doctor?
How should I prepare for the exams as an IMG?
I’ve passed? What’s next?
Skip ahead to the relevant section if you know what you're looking for.
MRCP (UK) Respiratory Medicine SCE
The respiratory medicine specialty certificate exams are administered as a compulsory component of assessment for Certificate of Completion of Training (CCT) in respiratory medicine for all UK trainees.
The purpose of an SCE is to:
ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants
complement workplace-based assessments
provide a rigorous national assessment to establish public confidence
offer a challenge similar to sub-specialty certification examination in North America
SCE as part of Training in Respiratory Medicine
Since the MRCP(UK) exams are taken during the Internal Medicine Training years (ST1-ST3), the respiratory medicine SCE allows physicians to demonstrate that they are able to practice independently at a consultant level.
The SCE has no official entry requirements (both for UK and overseas candidates); however, UK trainees would normally take the SCE in their penultimate year of higher specialty training (ST6). UK trainees should have made at least one attempt by the time of their penultimate year assessment.
For in-depth guide to the MRCP exams, see our IMG Resources library here.
Exam Structure
The SCE assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum. This should be taken as an indication of the likely number of questions – the actual number may vary:
Topic
Number of questions
Airways disease
35
Interstitial lung disease (ILD)
25
Disorders of the pleura and mediastinum, including pneumothorax
25
Pulmonary infections
35
Pulmonary vascular disease
20
Sleep-related breathing disorders and hypoventilation
5
Thoracic oncology
35
Other*
20
Total
200
*Other: Critical and high-dependency care of respiratory disease; Genetic and developmental lung disease; Lung transplantation; Pharmacology; Practical procedures; Statistics
The questions in each category are distributed across both papers.
All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.
Respiratory Medicine SCE Applications
SCEs are held once a year and applications are made online through My MRCP(UK) account, within the Upcoming Exams section of the Royal College website.
The application process is as follows:
Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)
Request a preferred test country and city
Pay applicable examination fee
Application is confirmed via an automatically generated email
Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.
The Royal College of Physicians has created a helpful video guide on SCE applications which you can watch here.
Cost
The cost of the SCE exams are as follows:
UK centres: £665
International centres: £833
Exam Centres
UK Centres
Candidates who choose to sit the respiratory medicine SCE in the UK must contact Pearson VUE to book their test. There are up to 137 test centres throughout the UK for each SCE, and the Royal College of Physicians advise that candidates should book their exam as early as possible to secure their preferred test centre, as bookings operate on a first come first served basis.
International Centres
Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. The Royal College of Physicians will pass this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the date of the examination. If the exam is not available in a requested location, candidates will be offered a choice of the nearest available test centres.
Please note, international candidates should not book their own test centre with Pearson VUE - attempting to do so may delay a candidate's application.
The full list of international SCE test centres can be found here.
Preparation and Resources for the Respiratory Medicine SCE
It can be difficult for IMGs to know where to start with their preparation and revision. This list should provide a good starting point for any international respiratory medicine doctors preparing to sit the SCE:
Curriculum - Applicants are tested on a range of common and important disorders in Respiratory Medicine as set out in the Joint Royal Colleges’ Curriculum for Respiratory Medicine Specialist Training. We recommend getting to know the curriculum as early as possible and using it as a blueprint for your study.
Guidelines - These tools are helpful for supplementing your knowledge:
American Thoracic Society
British Thoracic Society
European Respiratory Society
National Institute for Health and Care Excellence (NICE)
Scottish Intercollegiate Guidelines Network (SIGN)
Journals
American Journal of Respiratory and Critical Care Medicine
CHEST
European Respiratory Journal
Thorax
Sample questions: It is a good idea to regularly assess your knowledge and progress using example questions from the current exam syllabus. You can find these here.
For an overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses, check out at our blog: IMG Connects Top Tips for exam preparation.
I’ve passed? What’s next?
First of all, congratulations - this is a massive achievement! With your MRCP(UK) and Respiratory Medicine SCE in hand, you can apply for a full GMC registration with a license to practice. Once the GMC has approved your application, you can work as a doctor in the UK. Great stuff!
Don’t hesitate to get in touch with an IMG medicine recruitment specialist to discuss GMC registration, respiratory medicine positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.
To receive the latest news and updates, including the Royal Colleges, GMC registration and the NHS, follow us on social media and join the conversation.
Vacancies for Dermatologists from outside the UK can be found in a variety of ways, which for some doctors can sometimes be time-consuming and confusing.
Working with IMG Connect will give you easy access to vacancies for consultants, clinical fellows, registrars, specialty doctors, trust doctors, as well as LAS posts.
The IMG Connect job search is a dedicated online recruitment service for overseas doctors looking to secure a job in the NHS. View out latest Doctor Jobs in the NHS, here.
Save time and get expert advice based on your preferences
Performing a job search online can take up a lot of your time, so at IMG Connect we are here to do the time-consuming work for you. Upon registering, you will have a dedicated consultant whose role is to find jobs that match your skills, and apply for NHS jobs on your behalf.
You can receive jobs updates by E-mail to view new posts to suit your job search every day.
Create a profile – it takes 30 seconds
It really is that easy, so why not take advantage of our resources, time and energy to find you the right job in the NHS suited to your preferences. By providing us with some key details we can quickly assess which jobs are best suited to your preferences, and even email you job alerts for new exciting roles which we think will interest you!
We understand you, and our clients
When looking for a Dermatology job in the NHS, it can be hard to try to find out key information before applying, such as:
What specialty specific training there will be?
Am I likely to get a training post after taking this role?
Can the trust support CESR applicants and is their CESR programme established enough for my needs?
What career progression is available for me within the Dermatology Specialty?
What is the job plan and how much time will I spend on the ward?
What is it like to work and live there?
What salary will I get paid, and can I get extra pay for additional shifts?
It can be tricky to get all the answers you want before applying online, so we spend our time getting to know both our clients and you, finding out as much key information as possible to help you to make the right decisions. Including details on the Dermatology department, hospital & trust, as well as an overview of what it is like to live in the area, including housing and the cost of living, as well as access to schools for your children, childcare and finding work for spouses.
Making an impact
We will also provide you with top tips on CV writing, job applications and interviews, ensuring that your application and interview makes the most impact with our NHS clients.
Making it personal
Once registered, you can quickly search and apply for NHS jobs using our job search, and take advantage of many useful articles written to support you through your journey to the UK. In addition, when you sign up to 'job alerts' we will automatically email you each time a relevant Dermatology vacancy comes available that you may be interested in.
Once logged in, you can also save job details and make applications.
By registering with IMG Connect, you will:
Have a dedicated consultant who understands your preferences and will do the time-consuming job searches and applications for you.
Find your ideal NHS position among thousands of unadvertised vacancies - from consultant to registrar, or specialty doctor to SHO.
Be the first to hear about new vacancies – registering with IMG Connect means that your CV will gain priority with our NHS clients, and will professionally represented by international recruitment experts.
To help you find a job in the NHS simply follow these easy steps:
Register with IMG Connect
Fill in the 'Personal details' section.
Arrange a chat with your dedicated IMG Consultant
Sign up to receive 'job alerts’
Search our live Dermatology jobs
Searching for Dermatology jobs in the NHS could not be easier
If you want to find out more about the many different Dermatology roles available within the NHS - it only takes a minute to register with IMG Connect and receive expert advice and representation. We have helped many overseas Dermatologists into consultant, specialty doctor, registrar, clinical fellow and staff grade NHS roles, whilst offering expert guidance to many more IMGs on NHS doctor pay, royal college qualifications and English language testing. We’d be happy to help you!
GMC Registration can be a long and complex process. With a few options available for clinical 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 essentially two main pathways to consider: PLAB and the postgraduate route - FRCR (Oncology).
Whilst these are the most common routes to GMC registration, this is not an exhaustive list. There are other options such as Royal College sponsorship and GMC-approved qualifications or licensing exams, and you can read more about these here.
Here we provide a summary of both pathways and briefly consider their benefits.
PLAB for GMC Registration
FRCR (Oncology) for GMC Registration
Which is better for me as an overseas pathologist, PLAB or FRCR (Oncology)?
#IMG Tips
How do I get started?
Professional & Linguistics Assessment Board (PLAB)
The first and most common route which is often a popular choice 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.
FRCR (Oncology) - UK Postgraduate Qualification for Clinical or Radiation Oncologists
The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience. Within clinical or radiation oncology, this can be done by attaining Fellowship of the Royal College of Radiologists. The Royal College of Radiologists is the professional body that regulates the specialism of clinical oncology in the UK.
Fellowship of the Royal College of Radiologists (FRCR Oncology) is the full qualification attained through these postgraduate exams for clinical or radiation oncology. The exams assess a candidate’s knowledge and clinical understanding against the Specialty Training Curriculum for Clinical Oncology. FRCR (Oncology) has three components, with two written and one clinical and oral element.
For complete guides on FRCR (Oncology), take a look at our IMG Resources library.
It is important to note that the FRCR (Oncology) exams are for clinical or radiation oncologists only. Overseas clinical oncologists are not required to also sit the MRCP (UK) exams.
PLAB vs FRCR (Oncology)
FRCR (Oncology) is a legitimate route that demonstrates skills and knowledge and will allow oncologists 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 exam, as well as 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 clinical oncologist to obtain a more senior post within the NHS without FRCR (Oncology), 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.
FRCR (Oncology) has three stages, the last of which must be taken after at least 36 months of postgraduate experience in clinical or radiation oncology.
These exams can take anywhere from between 24-36 months to prepare from start to finish.
Cost
The FRCR (Oncology) exams cost just over £1,600, but all the exams are sat in person and there are only a few overseas exam centres.
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 within the UK.
SO, for PLAB 2, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.
It’s important to note that 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 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., 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.
FRCR (Oncology) involves three more difficult examinations and takes more time to prepare for. However, for overseas oncologists, attaining FRCR (Oncology) will allow you to jumpstart your career in the UK, as you will not need PLAB or Core Training.
The Royal College of Radiologists’ exams will facilitate the application for more senior roles in UK oncology 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 community - 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.
Getting started
Once you’ve decided which exams are best for you, it’s time for a deep dive into the exams and what they entail. For more useful blogs and articles on PLAB, FRCR (Oncology), 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 or postgraduate qualifications, please get in touch with our oncology specialists here. We’d be more than happy to help you.
For advice, guidance and news and updates about all things oncology for IMGs, join the conversation through the links below
In this blog we will explore MRCPsych Clinical Assessment of Skills and Competencies (CASC) including dates, exam locations, fees and eligibility.
In our exploration of CASC, we will take a broad look at the following topics:
What is the format of the CASC exam?
How is the CASC marked?
Am I eligible?
Assessment Portfolio for Overseas Candidates
Sponsorship requirements
How do I apply?
How much will it cost me?
Where can I sit the CASC exam?
How do I prepare for the CASC exam?
Passed? What next?
For a more general overview of the MRCPsych examinations, click here.
MRCPsych CASC is a practical exam taking the format of an OSCE and tests your clinical skills in a range of competencies.
What is the format of the CASC exam?
The CASC format is like an OSCE (Objective Structured Clinical Examination).
The exam is made up of two circuits of individual stations which will test your clinical skills:
The morning circuit will have 4 minutes to read the instructions and 7 minutes to complete the task
The afternoon circuit will have 90 seconds to read the instructions and 7 minutes to complete the task.
The sixteen CASC station exam is made up of:
five stations focused on History Taking, including risk assessment
five stations focused on Examination - both physical and mental state, including capacity assessment.
six stations focused on patient Management
Each circuit follows the topics below:
Circuit 1:
6 stations focused on Management
1 x station focused on Examination
1 x station focused on History Taking
4 minutes reading
7 minute task
Circuit 2:
4 x stations focused on Examination
4 x stations focused on History Taking
90 seconds reading
7 minute task
How is the CASC marked?
You can find details on how the test is marked here. See also marksheets for your information.
History Marksheet
Management Marksheet
Examination Marksheet
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Am I eligible for the CASC exam?
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC.
AND
You have a pass in both Paper A and B
AND
You can demonstrate the following:
AND
You have sponsorship in place – sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.
Overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Assessment Portfolio for Overseas Candidates:
As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC.
In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans:
observation in interviewing patients in ward rounds for specified reasons
observation in interviewing patients in out-patient or community settings or other contexts for specified reasons
assessment via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
formal assessment in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy.
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
Sponsorship requirements:
International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC examination.
Your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
You will be required to provide the sponsor’s title, full name and email.
Acceptable sponsors are:
College Tutor
Training Programme Director
Educational Supervisor
Head of School
Director of Medical Education (or equivalent)
Head of Department of Psychiatry
Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
How do I apply?
To apply you’ll need to complete the Royal College online application form. This form is only available during the published application dates and must be submitted prior to the closing date, if you miss the cut-off, your application will not be considered.
You will need to provide the following:
Personal details
Primary Medical Qualifications & Registration
Training
Written paper selection
Sponsor evidence for Assessment Portfolio for Overseas Candidates
How much will it cost me?
At the end of your application you will be directed to an online payment system where you can pay be credit or debit card, so make sure you have your details ready.
Once your application is complete you will receive two confirmation emails, one to confirm receipt of the application and one to confirm the payment has been received.
The fees for MRCPsych CASC for 2023 are as follows:
PMPT Trainees and Affiliates - £1,054
Non-PMPT Trainees and Affiliates - £1,171
Where can I sit the CASC exam?
The final diet of the CASC exam which will involve online delivery will be in May 2023. From September 2023, the exam will be back in-person, being delivered in the UK with international test centres to be confirmed from 2024.
Examination dates can be found here and results from the CASC examinations will be released around 1 month later.
How do I prepare for the CASC examination?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams.
Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry
Marking scheme (CASC): A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
CASC examination guide: The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos: Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint: This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggests taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
IMG Psychiatrists MRCPsych CASC Study Course
This is a tailored MRCPscyh CASC course for overseas psychiatrists sitting the CASC exam. This course offers weekly sessions beginning with an overview and in-depth breakdown of the exam and its various domains, including marking and station requirements. This is followed by small group role play sessions to allow IMGs preparing for the exam to practice stations across various scenarios with feedback on each station, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
The course is supplemented by additional advice and guidance on MRCPsych as a whole, GMC registration support, as well as guidance and webinars on other topics such as finding work in the NHS, relocation support and specialist registration.
You can access our IMG Psychiatrists CASC Study Course by joining the Facebook group here.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Find the right materials for you – whether its online courses, books or flashcards, try to figure out what the best materials are to jumpstart your preparation
Speak to your peers and colleagues – your senior colleagues may have been through this process themselves and may have helpful tips and guidance to share. Or maybe you’ll find a like-minded peer with whom you can be study buddies! Take advantage of those around you to support you on this journey.
Practise, practise, practise - Our IMGs have shared that it’s crucial that you practice your clinical examinations as often as possible, preferably under the supervision of a senior colleague which will allow you to receive feedback.
Join the online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation.
I've passed, what’s next?
Once you’ve passed MRCPsych CASC, you’ve completed the Royal College of Psychiatrists examination suite. Great stuff, this is a massive achievement! Armed with this and your English language test, you are ready to apply for full GMC registration with license to practice.
You may want to start looking for NHS jobs and with the click of a button, you can receive them directly to your inbox. To receive jobs postings which you can tailor to your desired grade, specialty and sub-specialism, sign up here.
As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.
Getting started
If you have any questions about any element of CASC, the Royal College exams as a whole or any other queries related to the processes involved in IMGs coming to the UK to work in the NHS, please get in touch and one of our psychiatry specialists will be more than happy to assist you.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Training in the NHS offers an extensive training scheme and career development for psychiatrists, with the quality and depth of this programme being recognised as a gold standard throughout the international medical community.
In line with developments and progression in psychiatry across the field and around the world, training provided to UK psychiatry trainees is regularly reviewed and updated. This should make the training programme attractive to UK graduates, as well as IMG psychiatrists seeking the best training programmes for their field and career development.
In this article, we will explore the training pathway for psychiatrists in the UK, with a broad look at the following topics:
What is the NHS Training Pathway?
How do you enter the training pathway?
What does the specialty training programme look like for psychiatry?
What happens after completing the psychiatry training programme?
Can I enter specialty training in the UK as an IMG?
The NHS Training Pathway
The NHS training pathway refers to the complete programme for UK trainees, from foundation training to the completion of specialist or higher training, where candidates may be eligible for a CCT within their chosen specialism, such as General psychiatry or any of its sub-specialties.
It is important for IMGs to understand this process, as it clarifies what stage they can most likely enter the system if they are interested in training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors will receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).
Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area, such as psychiatry – for psychiatry, this first stage is known as Core Psychiatry Training (CT).
Specialty Training in Psychiatry
The UK Specialty Training programme in Psychiatry is 6 years long, and whilst doctors may pass through training quicker depending on how quickly they achieve their competencies, this is rarely the case and psychiatrists will usually take the indicated time, or slightly longer to complete the Specialty Training programme.
Successful applicants entering year one of core psychiatry training (CT1), will follow the Royal College of Psychiatrists’ 2017 Specialist Training in Psychiatry Curriculum.
The Psychiatry training programme
The psychiatry specialty training scheme operates both as a run-through and uncoupled programme, though it is more often un-coupled.
Depending on where your application is successful, you may complete your period of core training, as well as the Royal College exams before making a further application for the next stage of training (requiring two applications). Alternatively, you may be able to apply for run-through training, which guarantees you complete both Core and Higher training in one region, as you are recruited for the full duration of Specialty Training.
Foundation Training (FY1 – FY2)
The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills.
Selection
Here, trainees will either choose whether to enter GP (General Practitioner) training, internal medicine training (IMT) or core training in psychiatry (CT).
Core Psychiatry Training (CT1 – CT3)
This part of training takes place from year 1 to 3, where trainees will work and train in several different sub-specialties within psychiatry. They will gain a broad understanding of psychiatry by rotating between 6-month posts in the following sub-specialties:
General and Community Psychiatry - including Assertive Outreach, Crisis Home Treatment, Outreach for Homeless People, Early Intervention for Psychosis, Rehabilitation and Liaison Psychiatry.
Old Age Psychiatry - including Memory Clinics, Community Teams, Domiciliary Clinics, Young Onset Dementia, Day Hospital and Liaison Psychiatry.
Child and Adolescent Psychiatry - including Specialist Adolescent and Academic Psychiatry.
Substance Misuse
Learning Disability Psychiatry - including Specialist Asperger Services.
Forensic Psychiatry - including all levels of security.
By the end of CT3, trainees will need to have completed the MRCPsych exams.
Please note, trainees must pass the MRCPsych Paper A, Paper B and CASC exams in order to progress to higher psychiatry training.
For more information of the Royal College of Psychiatrists examination suite, take a look at our IMG Resources library here.
There are two opportunities per year to apply to core psychiatry training. Information about how to apply, including the person specifications, is available via the North West Deanery, who manage the recruitment process.
Selection
Here, trainees who are not currently training in a run-through programme will make applications to a deanery for higher psychiatry training in their chosen specialty. Selection is open by national competition.
Higher Psychiatry Training (ST4 – ST6)
This training takes place from years 4 – 6, where trainees will complete 3 years of yearly rotations in their chosen speciality, building on their core training and develop increasing levels of competence in clinical psychiatry.
There will also be opportunities to work in other sub-specialties including: addictions, eating disorders, neuro-psychiatry, perinatal and social & rehabilitation psychiatry.
Trainees will usually be allocated a certain number of PAs (programmed activities) weekly for special interest or research purposes. As well as sub-specialty opportunities, these can also be used towards educational opportunities such as local training days/conferences in relevant domains, from clinical leadership to humanities.
Completion of the Psychiatry Specialty Training Programme
Upon completion of the training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in General Adult Psychiatry of one of its sub-specialisms. This will be based on criteria set out in the curriculum by the Royal College. You can find the 2021 curriculum here.
At this point, the psychiatrists are entered onto the specialist register and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their psychiatry training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.
Joining the Psychiatry Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Psychiatry in the UK, however it is very competitive.
IMGs interested in UK specialty training must have:
Full GMC registration
Completion of a minimum 12-month (FY1 equivalent) internship
English language test
PLAB
AND
12 months post-internship experience by the time you start begin ST1
Although UK trainees are not given priority for specialty training places, it can be very difficult to join the Psychiatry Specialty Training programme without NHS experience.
So here you have it, a broad overview of the NHS Psychiatry Specialty Training pathway for UK trainees. This training scheme is the core of psychiatry training in the UK, and for IMGs looking to join the training programme, understanding of the pathway allows you to better align your overseas training with the relevant stage you wound enter into Specialty Training in the UK.
Getting started
If you have any further questions about the UK training pathway or your route to the UK as an overseas psychiatrist, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Experienced overseas Emergency Medicine trust doctors, or consultants who have completed specialist training, can apply for specialty doctor posts in the NHS with CESR programmes included in the job plan.
So, if you are committed, motivated and enthusiastic in embracing the CESR application once in the UK, this could be the best route towards gaining entry to the specialist register. Many trusts are piloting such projects, which will support you via a CESR programme tailored to your needs.
Specialist Register for Emergency Medicine
All consultants (other than a locum consultant appointments) must be on the specialist register of the General Medical Council (GMC). To be eligible to apply for specialist registration with the GMC, doctors must have successfully completed a GMC-approved training programme leading to CCT, or applied for a certificate confirming Eligibility for Specialist Registration (CESR).
Doctors who have not completed a full GMC-approved training programme and wish to have their training, qualifications and experience assessed for eligibility for entry onto the specialist register must make an application under The General and Specialist Medical Practice Order for a CESR.
Working with IMG Connect & our NHS Clients
Working with our NHS clients, we are offering CESR Specialty doctor roles, with the opportunity of being mentored by CESR Consultants to guide you in your application toward CESR and to participate in a job plan that is tailored to your needs.
Such CESR programmes are locally developed and targeted for both International Doctors coming to work in the NHS and non-trainees wanting to apply for a CESR in Emergency Medicine.
As an Emergency Medicine doctor your CESR programme will include dedicated one-to-one mentoring and a course mapped on the GMC domains for successful completion of your application.
Benefits of the CESR programme
Such Specialty doctor vacancies will give you the benefit of support on your journey to achieving consultant status, give you the opportunity to adapt to working in the NHS, and help you to further your career at the most senior level.
Furthermore, job plans will typically provide you with a dedicated mentor for CESR applicants by Emergency Medicine CESR Consultants who will take you through the application process.
In some circumstances practical experience will be delivered via simulation and workshops where you are at the centre of the learning experience.
Most NHS trusts have experienced Emergency Medicine CESR consultants who will be available to give you support, mentorship and coaching.
The post are intended to provide the emergency medicine clinician with the support and training required to successfully complete all aspects of the CESR process and attain specialist registration, allowing you to take a substantive emergency medicine post and work as a consultant in the NHS.
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Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Are you an overseas psychiatrist taking the postgraduate route to GMC registration? Are you just beginning your journey through the MRCPsych exams?
Today, we’re back with Dr Kevin Li, who will be sharing some top tips on the MRCPsych Paper A and Paper B for overseas MRCPsych A & B aspirants. Kevin is a brilliant psychiatry specialty doctor who relocated to the UK from Hong Kong, having passed the MRCPsych and received full GMC registration with license to practice.
1. Start with the Royal College website
This is the best place to begin as it has key information including the syllabus - on which the exam is based, helping to guide the course of your preparation and revision.
2. Don’t use resources that are more than 3 years old – 5 years maximum
The curriculum and syllabus for Specialty Training in Psychiatry are updated regularly, so it’s best to find and use resources that are as up-to-date as possible.
3. Don’t combine study for Paper A and Paper B
Focus on each paper as an individual element – they each have different requirements, including what sections of the syllabus they are targeting and how much experience you must have before sitting the exam.
4. Divide your time according to the marks weighting of the sections
For example, general adult and critical review have the most marks in the exam, with 20% and 33.5% respectively, so you should prioritise these in your revision, then try to spend a proportionate amount of time on each section based on the marks it holds.
5. Perfect what you know
If there are any areas you are experienced or confident in, try to perfect these in order to gain the most marks possible in what you find to be the least challenging areas. These areas may also be easier to revise if they are better aligned with your training and practice to date.
6. Which exam should you sit first? It depends
If you want to pass the exams as quickly as possible, it makes sense to apply for the nearest upcoming diet of whichever exam comes first.
Knowledge wise Paper B has more sections and requires a lot more time and practice, particularly for critical review calculations. This combined with the Royal College’s advice of having 12 months’ experience in psychiatry before sitting the exam means that for most people, sitting Paper A first is the best choice.
7. Use diagrams for more challenging topics
Find or better still, create diagrams to better illustrate and explain the mor difficult to understand topics. Especially where you have little experience of a topic, it can be helpful to represent it visually.
8. Keep difficult topics fresh in your mind
If you need longer than 3 months to prepare for either exam, either leave the more difficult topics to the end of your revision or begin with them and be sure to revisit them at the end. You may not retain this information long-term, so it’s important to have it as fresh in your mind as possible when coming up to the exam.
9. Take time off before the exam for intense study
If you can, try to put some time aside in the week(s) coming up to the exam to for a final push of intense study before the exam.
10. Practice is key
Books are great resources for increasing your overall psychiatry knowledge, however they are not necessarily the best resources for the Paper A and Paper B exams. Question banks and past papers such as SPMM are very useful in preparing for the MRCPsych Paper A & B.
Getting started
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
For news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
The postgraduate route to GMC registration, whilst not the fastest, can be the most rewarding in the long run. The MRCPsych exams are the central components of psychiatry training in the UK, and as an international psychiatrist, this is the route that allows you to most closely align your qualifications with the requirements of more senior jobs in the NHS.
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.
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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.
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