CESR - a guide for overseas doctors
- November 10, 2021
Here we look briefly at the CESR route available to overseas consultants and exerienced senior doctors who wish to secure a job in the NHS and relocate to the UK.
Many IMGs have recently asked if they would be eligible for the CESR route to Specialist registration. International Medical Graduates (IMGs) from any country in the world can apply for CESR, provided certain eligibility criteria are met.
To help answer this question we have put together a short article to explain further, including the following topics:
- What is CESR?
- What is the Equivalence process?
- Who is the CESR for? Who can apply?
- What does the CESR route involve?
- Are there other senior NHS positions available?
- Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK
- What are the achieved standards?
- How can I prepare my evidence for CESR applications?
- What if my application is not successful?
CESR is suitable for those who have already been practising overseas for many years.
What is CESR?
The CESR is for doctors who wish to join the GMC (General Medical Council) Specialist Register, and whose specialist training, qualifications or experience was partly or completely acquired outside an approved CCT (Certificate of Completion of Training) programme in the UK.
It is equivalent to a CCT and certifies that the recipient has all the competences defined in the CCT curriculum, known as specialist registration.
What is the Equivalence process?
Equivalence describes the process of assessing an overseas applicant’s training and experience against the current training programme requirements, in order to gain a Certificate of Eligibility for Specialist Registration (CESR) for the Specialist Register held by the General Medical Council.
The process involves submitting a written body of evidence to the GMC of:
- training and/or competence
- skills and knowledge
Each Royal College will assess the 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.
Who is the CESR for? Who can apply?
If you have training, qualifications and experience in a CCT specialty but have gained these partly or completely outside an approved CCT training programme (for example, you have trained outside the UK or EEA), you may apply for a CESR in a CCT specialty.
What does the CESR route involve?
In a nutshell, you will need to compile a portfolio of evidence to prove you have achieved the equivalent skills and experience of a doctor who has completed a full GMC-approved training programme.
You can collect this evidence prospectively through non-training jobs.
Is it the right route for me? Yes, if…
- You have already completed specialty training back home
If you have already completed Specialty Training, then you’re unlikely to want to repeat it.
- You haven’t completed training, but you have too much experience in your specialty to apply for training posts.
In both scenarios, even if you are willing, you may be overqualified to apply for training.
Doctors who have complete specialist training overseas or via a non-CCT pathway may be eligible for entry without further training. You can check using the guidelines below:
You will need to demonstrate all specialty learning outcomes specified in the relevant CCT curriculum.
Are there other senior NHS positions available?
It is important to note that you can apply for more senior roles such as a SAS doctor, specialty doctor or a locum consultant (locum consultants are not required to be on the Specialist Register).
This way you will have better pay and the roles and responsibilities are more appropriate to your level of experience compared to a junior trainee. While working in these jobs you can collect evidence of your competences.
This is also a quicker route to the UK than the CESR route, which can take a substantial amount of time.
Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK:
It is a legal requirement that doctors must have their names entered on the General Medical Council's (GMC's) Specialist Register before taking up substantive NHS consultant posts in the UK.
What are the achieved standards?
To apply you will need to have either a specialist qualification or have undertaken a period of specialist training (not less than 6 months anywhere in the world).
Your application is measured against the GMC standard.
The GMC break down the standard into four domains mirroring the headings of Good Medical Practice.
The GMC recommend that you allocate the evidence you provide with your application in the following way:
Domain 1: Knowledge, Skills and Performance - 75%
Domain 2: Safety and Quality - 20%
Domain 3: Communication, Partnership and Teamwork - 5% (combined for
Domain 4: Maintaining Trust - 5% (combined for both domains 3 & 4)
The full list of evidence needed for each specialty is provided here.
How can I prepare my evidence for CESR applications?
As CESR applications are currently a completely paper-based process it is important to think about the evidence you present. You should:
- Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.
- Make sure that your evidence is current and of the highest possible quality.
- Always note any curriculum changes – you will be assessed against the most recent one
- Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.
- Throughout your application you should refer to the Specialty Specific Guidance in your specialty (or the most relevant if applying in a non-CCT specialty).
- You should also refer to the relevant CCT curriculum in your specialty; as this is the standard that all CCT applicants will be measured against.
- Look thoroughly at the GMC guidance available and get advice on your application from the GMC before you apply.
- Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
The GMC has strict guidelines for presenting evidence, including verification, anonymising and translating documents. We strongly advise all IMGs to take a look here and familiarise themselves with the criteria.
What if my application is not successful?
Following an unsuccessful application, you can apply for a review within 12 months of receiving your decision from the GMC. You can apply for a review of the GMC’s decision on the grounds that:
- You now have additional evidence to submit that addresses the areas of your application in which you were previously unsuccessful
- You believe that there has been a procedural error or unfairness in the processing of your original application.
Please refer to the GMC guidance for further information on applying for a review.
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Relevant Jobs
An excellent NHS job opportunity for an experienced Acute Medicine Consultant to join this NHS Trust as a Consultant working in an established acute medicine department in the UK. This NHS job offers CESR Portfolio Pathway support and international applications from IMGs are welcome.
The NHS Trust
This NHS Trust provides integrated acute and community services to around 900,000 people. As one of the top-performing NHS trusts in the UK, it is renowned for its high-quality patient care, research, and innovation. The Trust aims to deliver outstanding care and services, fostering a culture of continuous improvement and professional development. It is dedicated to developing new treatments and technologies that improve patient outcomes and enhance the overall healthcare experience.
The Acute Medicine Department & Team
The Acute Medicine department at this NHS Trust is a dynamic and supportive environment that deals with a high volume of emergency cases. The team consists of experienced consultants, junior doctors, nurses, and allied health professionals who work collaboratively to provide comprehensive care. The department is equipped with state-of-the-art facilities and offers a wide range of diagnostic and therapeutic services, ensuring patients receive timely and effective treatment. The team is dedicated to delivering high standards of care, participating in national clinical audits, and contributing to research initiatives.
Continued Professional Development
This NHS job offers further training and accreditation within acute medicine, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interests. The department is committed to the professional growth of its staff, offering numerous opportunities for continuous medical education, participation in clinical research, and leadership development programs. The Trust supports a culture of learning and innovation, ensuring that all staff members can achieve their career aspirations while delivering exceptional patient care.
Location
This NHS Trust is located in a region renowned for its stunning natural beauty, including two national parks and a picturesque coastline. The area boasts a high quality of life with affordable living costs, excellent schools, and a safe, welcoming community. The region offers a rich cultural heritage with numerous festivals, museums, and theatres, along with a variety of outdoor activities such as hiking, cycling, and water sports. With excellent transport links, including rail and road networks, it is easy to travel to other parts of the UK.
Am I eligible for this role?
UK based candidates:
- Experience in Acute Medicine
EEA candidates:
- Experience in Stroke Medicine
- European Specialist Qualification
Non-EEA candidates:
- MRCP
- Experience in Stroke Medicine
An exciting opportunity has arisen within the Acute Medicine Department. They are looking to appoint an Acute & General Internal Medicine Consultant, a great opportunity to further your medical career in the UK. This NHS job offers CESR Portfolio Pathway support, and international applications from IMGs are welcome.
The successful candidate will be the clinical lead and will drive the development and transformation of acute medicine, where patient-centered care is at the heart of the services. The role involves working within the Acute Assessment Unit, which consists of a 25-bed inpatient area including a 5-bed enhanced care area and an adjacent 6-space Ambulatory Emergency Care Unit.
Health Service
Working for this health service is professionally rewarding, offering high-quality, patient-centered care. Their clinicians lead in developing and managing services, supported by strong links with UK specialists. With a generous study leave budget, doctors are encouraged to pursue further education. Exciting developments include a new general hospital and a new mental health inpatient unit. They foster strong relationships between mental health, primary, and secondary care, promoting joint learning and teaching in their modern education center.
The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department. This is a unique opportunity to help shape an integrated care system with closer political engagement than in the UK.
Department & Team
Medicine in this health service is fully integrated by age and specialty, with three medical wards: . The EAU has a 5-bedded Enhanced Care Area and a separate intensive care unit led by intensivists. The AEC Unit is supported by a SAS doctor and consultants. The department comprises a 16-bed EAU, staffed by 11 consultants, 8 SAS doctors, 7 FY1 doctors, 2 FY2 doctors, and 6 Clinical Fellows, organized into 8 medical teams and the EAU team.
The specialty of Acute Medicine is based within the Emergency Assessment Unit (EAU). The service includes a 25-bed Acute Assessment Unit (AAU) featuring 5 enhanced care beds and an Ambulatory Emergency Care (AEC) Unit. The post holder will work across both the AAU and the AEC.
Continued Professional Development
The health service offers further training & accreditation within psychiatry, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interest. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. Health & Community Services supports Continuing Medical Education with time and financial support, offering study leave of 30 days in 3 years, and an annual study leave allowance.
Life in the area
Living in the area presents significant financial benefits. The flat income tax rate is notably advantageous compared to the U.K., and they provide a generous public sector pension scheme that isn\'t constrained by U.K. lifetime or annual contribution limits. The Consultant Contract closely mirrors the U.K. model but offers higher incremental levels. Incremental progression is automatic from points 1 to 17 on the pay scale based on satisfactory performance, while formal applications are necessary for points 18 to 20.
Am I eligible for this role?
UK based candidates:
• Experience in Acute & General Internal Medicine
EEA candidates:
• Experience in Acute & General Internal Medicine
• European Specialist Qualification
Non-EEA candidates:
• MRCP
• Experience in Acute & General Internal Medicine
A Northern English NHS Trust is looking for a Consultant Histopathologist to join their team at. They are considering either UK or overseas-trained doctors for a permanent contract type. The trust will support with CESR support for those who are looking to attain CESR and Specialist Registration. This is a high performing and friendly department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK.
This is a great job for any overseas Pathologists looking for CESR-support and great career development in a beautiful part of England.
What is the NHS Foundation Trust like?
The NHS Foundation Trust offers top-notch hospital and community healthcare services to a population exceeding 400,000 individuals across several areas/ With two primary hospital locations boasting a combined total of 553 beds, and their hospitals situated approximately 15 miles apart - along with a community hospital, the Trust ensures comprehensive care coverage. Its extensive range of services and specialties includes Bariatric Services, Orthopaedics, Urology, Cardiology, Diabetes Care, Elderly Care, Emergency Care, Gastroenterology, Obstetrics and Gynecology, Radiology, Respiratory Medicine, Rheumatology, Stroke Care, Critical Care, Neonatology, Pain Services, and Pathology.
What is the department & team like?
The Histopathology Department is staffed by a dedicated team of consultants and junior doctors committed to delivering outstanding patient care. The team comprises experienced consultants and supportive junior doctors, ensuring comprehensive coverage and expertise in diagnosing a wide array of cases. The department is actively involved in the diagnosis and management of diverse histopathology and cytology cases, encompassing oncological, gastrointestinal, dermatological, and respiratory conditions, among others.
They offer a range of treatments tailored to meet the specific needs of each patient, with a focus on delivering timely and accurate diagnoses to support effective treatment plans. Equipped with advanced facilities and state-of-the-art technology, the department boasts modern laboratory equipment and diagnostic tools. These resources enable them to efficiently process and analyze histopathological specimens, facilitating prompt and precise diagnoses.
On average, the histopathology department handles a substantial volume of cases each year, covering a broad spectrum of pathology types. Through the collaborative approach and commitment to excellence, they strive to uphold the highest standards of patient care and contribute to advancements in diagnostic medicine.
Career Development & Opportunities Available
The Trust and Histopathology team are dedicated to supporting their doctors career development through. For example, the new appointee will have the opportunity for the development of teaching experience as they would be expected to undertake formal and informal teaching of trainees within the department, and participate with other consultants in teaching/lectures as part of the Trust’s postgraduate education program. There will also be the opportunity for the development of personal research interests through the Research and Development Department. Research is highly encouraged at this trust and is undertaken during SPA sessions. The new consultant will also be able to increase their experience in MDTs, as these are regularly held within the department.
Life in North East
The North East of the UK offers a diverse blend of rural and urban settings, providing both tranquility and vibrant city life. Residents can explore scenic landscapes such as the Northumberland Coast or enjoy cultural attractions in cities like Newcastle upon Tyne. The region boasts esteemed universities like Durham and Newcastle, along with quality schools. Transportation links are well-established, connecting the area to major cities and airports. Housing options vary from historic properties in market towns to modern developments in bustling urban centers, catering to diverse preferences and lifestyles.
AM I ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Histopathology
- Specialist European Qualification in Anatomic Pathology
- Full and Specialist registration (and with a licence to practise) with the General Medical Council (GMC), or be eligible for registration within six months of interview.
- An understanding of Clinical Governance
Non-EEA Candidates:
- FRCPath
- Full and Specialist registration (and with a licence to practise) with the General Medical Council (GMC), or be eligible for registration within six months of interview.
- An understanding of Clinical Governance
UK based applicants
- Full GMC registration
- Within 6 - 12 months of completing CCT
- An understanding of Clinical Governance
We are looking to recruit a Consultant Psychiatrist to a Crisis & Assessment Team role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.
The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.
Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.
The Department & Team
The Crisis and Assessment Team (CAT) serves as the primary gateway to adult and older people\'s mental health services, conducting assessments in the community and emergency settings, alongside medical reviews. They collaborate closely with law enforcement, responding to Adult Protection Notices and coordinating mental health law assessments. This role within the CAT focuses on streamlining referrals, providing short-term crisis interventions, and ensuring individuals receive appropriate ongoing care. You\'ll engage with both working-age adults and older adults, with responsibilities extending to police referrals and mental health law assessments during standard working hours, with on-call commitments.
Continued Professional Development
Professional development is integral to their ethos, offering CESR Portfolio Pathway support, access to specialty training, and opportunities for sub-specialist development. They prioritize ongoing learning through conferences, local CME events, and a generous study leave allowance.
Life in the area
Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.
Am I eligible for this role?
UK based candidates:
- Experience in General Adult Psychiatry
- Specialist Registration or locum consultant experience
EEA candidates:
- Experience in General Adult Psychiatry
- European Specialist Qualification
Non-EEA candidates:
- MRCPsych
- Experience in General Adult Psychiatry
We are looking to recruit a Consultant Psychiatrist to an Old Age role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.
The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.
Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.
What is the health & community service like?
Working in this location is professionally rewarding, offering high-quality, patient-centered care. Clinicians lead in developing and managing services, supported by strong links with UK specialists. With a generous study leave budget, doctors are encouraged to pursue further education. Exciting developments include a new general hospital and a new mental health inpatient unit. The service fosters strong relationships between mental health, primary, and secondary care, promoting joint learning and teaching in a modern education center.
What is the department & team like?
The inpatient services are currently undergoing extensive refurbishment, including two wards for older adults. One ward offers 14 assessment beds for individuals over 65 experiencing functional mental health issues, with some flexibility for those under 65. The other ward provides 10 assessment beds for patients with dementia. Following the refurbishment, the latter ward will feature 8 acute assessment beds and 8 transitional/step-down beds for those with dementia or enduring mental health problems who cannot be supported in local nursing or residential homes.
The Older Adults Community Mental Health Team (OACMHT) manages a caseload of about 300 patients, including new referrals triaged by the Crisis and Assessment team, providing both short-term treatment and long-term care coordination. The role involves providing medical support to the OACMHT alongside two other consultants and a staff grade doctor.
The post holder will join an established team, comprising 2 WTE older adult consultants, 1.0 WTE Associate Specialist (Memory Assessment Service), 2.0 WTE staff grades (inpatient and community), and 1.0 WTE F1 doctor (inpatients and community). Dedicated administrative support includes a 0.5 WTE medical secretary and ward and team secretarial support.
Continued Professional Development
This position offers further training and accreditation within psychiatry, including CESR Portfolio Pathway support, access to specialty training, and the opportunity to develop sub-specialist interests. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. The organization supports Continuing Medical Education with time and financial support, offering study leave of 30 days in 3 years and an annual study leave allowance. Regular case discussions, teaching sessions, and MDT supervision ensure ongoing professional development, meeting the Royal College of Psychiatrists\' CPD requirements.
Living in the Area
Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.
Am I eligible for this role?Am I eligible for this role?
UK based candidates:
- Experience in Old Age Psychiatry
- Specialist Registration or locum Consultant Experience
- Experience in Old Age Psychiatry
- European Specialist Qualification
- MRCPsych
- Consultant experience in Old Age Psychiatry