Specialist Registration - CCT vs CESR vs CESR-CP
- November 22, 2021
Here we take a closer look at the routes available to overseas consultants & experienced doctors who wish to join the GMC’s Specialist Register.
IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.
To shed some light on the routes to Specialist Registration, we've put together a short article to explain further, including the following topics:
- What is Specialist Registration?
- What are the different types of Specialist Registration?
- Am I eligible?
- How do I apply for Specialist Registration and what evidence will I need?
- What are the benefits of Specialist Registration?
- Are other senior NHS posts available without Specialist Registration?
- How much does Specialist Registration cost?
- #IMG Tips
Skip ahead to the relevant section if you know what you’re looking for.
Specialist Registration
All doctors who wish to work as permanent consultants in the UK must show evidence of skills, knowledge and experience in order to apply for Specialist Registration. This registration in any specialty means you can be appointed to a substantive consultant post within the NHS.
Specialist Registration is additional to full registration with the GMC.
The 3 Types of Specialist Registration
There are three types of certificates issued by the GMC, and the type of certificate you will receive at the end of your training defines which training route you are on.
The Certificate of Completion of Training (CCT)
The CCT is the route to specialist registration for doctors who have completed a GMC-approved, specialty training programme through the relevant Royal College.
To be eligible for CCT, an applicant’s entire training (including any core years) must have taken place within UK-approved training posts. Please see our blog on career pathways for a UK doctor in training.
The Certificate of Eligibility for Specialist Registration - Combined Programme (CESR (CP))
CESR(CP) is a simplified route for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK.
Doctors on the CESR(CP) route count a combination of approved training and previous experience in non-approved posts (overseas) towards their training time.
The Certificate of Eligibility for Specialist Registration (CESR)
CESR is the route to specialist registration for doctors who have not completed a GMC-approved specialty training programme – doctors who have trained outside of the UK, Switzerland, and the EEA.
These doctors apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK.
Doctors who have completed their specialist training in the EEA or Switzerland are eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ).
For an in-depth guide to CESR, take a look at our blog for overseas doctors here.
Eligibility
Eligibility for Specialist Registration depends on your nationality, qualification and experience.
To meet the minimum eligibility requirements to apply you must have either:
A specialist qualification in the specialty you’re applying in
OR
At least six months continuous specialist training in the specialty you’re applying in
You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.
In your application you must show that you meet the requirements of the CCT curriculum in your specialty.
The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience.
Applications and Evidence for Specialist Registration
CCT and CESR-CP
Once you have been issued with your Outcome 6 has been issued, you must complete and return the relevant CCT/ CESR(CP) notification to your Royal College along with the following documents:
- Copies of any ARCPs that are not on your ePortfolio
- ARCPS/evidence of successful progression for any LAT/FTTA/SHO posts counting towards your training (this applies to doctors who were appointed above ST1 only)
You will also need to complete an online GMC form. The link to this form will be emailed to you by the GMC and you should contact your Royal College if you do not receive it.
The GMC has created a guide for each CCT specialty with the relevant royal college or faculty. You can see this here.
CESR
You will need to apply to the GMC, who will then send your application to the Royal College for evaluation. The application process for CESR can be lengthy and potentially stressful, so it is important that you read the GMC’s general guidance and specialty-specific guidance before starting to put together an application.
You will need to provide a portfolio of evidence demonstrating that your specialist training or qualifications are equivalent to the award of a CCT in your specialism in the UK. This information is available for each specialty and Royal College on the GMC website here.
If you apply for an NHS post which provides CESR support, your hospital should assist you in this process.
Once the GMC has sent you a letter informing you that your application is complete and has been sent to your Royal College for assessment, the College is not permitted to discuss your case with you until the GMC has sent you a letter informing you of the decision.
Benefits of Specialist Registration
Specialist registration allows doctors to take up permanent or substantive consultant positions. Without CCT, CESR or CESR-CP, a doctor may only take a Trust locum or fixed-term consultant posts.
Fixed-term and locum posts offer of course offer less stability than permanent consultant posts and require extension.
It is a legal requirement before taking a substantive, honorary or permanent NHS consultant post in the UK that doctors have their names entered on the GMC's Specialist Register.
Senior Positions in the NHS
It is important to note that you can apply for more senior roles such as a specialty doctor (SAS), specialist grade or a locum consultant (locum consultants are not required to be on the Specialist Register).
This way, you will have better pay and roles and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these jobs you can collect evidence of your competences.
These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.
Cost
All doctors applying for Specialist Registration must pay a fee. The fees for 2021 are as follows:
#IMG Tips
- Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.
- Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.
- Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.
- Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
- Ask an IMG Connect recruitment specialist about NHS posts with CESR support, these are not always advertised by a Trust, but we can help you to find a role which aligns well with your career goals in the NHS.
Most IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR or CESR-CP route. Take a look at our in-depth CESR overview for more information on how to apply and what to expect. If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Relevant Jobs
An NHS teaching hospital in Kent is looking for a Consultant in Clinical Oncology with an interest in urology. The Oncology department comprises a team of over 40 Clinical and Medical Oncology consultants and is supported by a large team of middle-grade doctors, fellows, and trainees.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
-
This Clinical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or FRCR are most encouraged to apply.CCT in Clinical Oncology or equivalent experience, including CESR pathway candidates.
-
The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Provide high-quality specialist care to melanoma patients attending the Kent Oncology Centre.
-
Attend relevant MDT meetings and coordinate treatment planning with other specialists.
-
Participate in departmental research initiatives and contribute to national and local clinical trials.
-
Contribute to training and supervision of junior doctors and participate in clinical governance activities.
Life in Kent
The area offers the best of both worlds: urban living in towns like Maidstone and Tunbridge Wells, and tranquil countryside villages such as Lenham or Goudhurst.
Kent boasts a wide range of excellent primary and secondary schools, including several grammar schools, and is well connected to London via high-speed rail and road. Residents enjoy easy access to historic castles, the coast, national parks, shopping, and outdoor activities—perfect for both adults and families.
Known as the “Garden of England,” Kent holds historical significance with its Roman heritage, medieval cathedrals, and coastal defense legacy, offering a unique blend of culture and natural beauty.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV Preparation with a bespoke session with one of our specialists
-
Application support with expert knowledge of NHS specialisms & recruitment practice
-
At least two video calling interview preparation sessions
-
Contract and offer negotiations for salary, relocation packages, tenure, and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new role, including:
-
Document gathering and checking
-
COS and Visa Application support, if applicable
-
Support sourcing short- and long-term accommodation
-
Travel arrangements
-
Family support for finding schools and any other aspects of pastoral care
An NHS general hospital in Wales is seeking a Locum Consultant in Geriatric Medicine with a special interest in Orthogeriatrics. The department includes a team of 9 consultants and is supported by a large middle grade doctor team. This Geriatric Medicine role welcomes both UK-based and international applicants, especially those holding MRCP(UK) or equivalent qualifications.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
Applicants should hold full GMC registration and MRCP, with solid experience in general and geriatric medicine. Subspecialty interest in Geriatric Medicine is desirable
CORE DUTIES OF THIS ROLE
- Oversee inpatient care for 15–20 patients alongside a multidisciplinary team
- Supervise and collaborate with junior medical staff and allied professionals.
- Provide one outpatient clinic per week in geriatric medicine or a relevant subspecialty.
- Take part in education, audits, and continuous service improvement projects.
LIFE IN WALES
This role is based in a picturesque Welsh town offering both urban convenience and rural tranquility, with popular residential areas including charming market towns and countryside villages.
The region provides great schooling options, strong transport connections, and plenty of family-friendly leisure activities.
Historically rich, the area features medieval architecture and has played a significant role in Welsh and British history.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- CV Preparation with a bespoke session with one of our specialists
- Application support with expert knowledge of NHS specialisms & recruitment practice
- At least two video calling interview preparation sessions
- Contract and offer negotiations for salary, relocation packages, tenure and more
- Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
- Document gathering and checking
- COS and Visa Application support if applicable
- Support sourcing short- and long-term accommodation
- Travel Arrangements
- Family support for finding schools and any other aspects of pastoral care
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
This oncology job is open to both international applications and UK-based doctors, though those with European Specialist registration or FRCR are most encouraged to apply.
Anyone with an interest in gynae and upper GI oncology should apply.
The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
Provide systemic therapy services for patients across UHMB sites.
Participate in multidisciplinary team meetings and support associated administrative duties.
Lead and contribute to acute oncology services across the Trust (no on-call required).
Support teaching, supervision, and mentorship for junior medical staff and trainees.
LIFE IN LANCASHIRE AND SOUTH CUMBRIA
The area is rich with excellent schools, convenient rail and road links, and beautiful scenery for outdoor enthusiasts. Historically, the region has played a key role in British shipbuilding and industrial development and today combines coastal charm with cultural heritage and modern living.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
CV Preparation with a bespoke session with one of our specialists
Application support with expert knowledge of NHS specialisms & recruitment practice
At least two video calling interview preparation sessions
Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
Document gathering and checking
COS and Visa Application support if applicable
Support sourcing short- and long-term accommodation
Travel Arrangements
Family support for finding schools and any other aspects of pastoral care
An NHS teaching hospital, in Kent is looking for a Consultant in Medical Oncology with an interest in Melanoma. The Oncology department comprises a team of over 40 Clinical and Medical Oncology consultants and is supported by a large team of middle-grade doctors, fellows, and trainees.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
-
This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or MRCP are most encouraged to apply.CCT in Medical Oncology or equivalent experience, including CESR pathway candidates.
-
The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Provide high-quality specialist care to melanoma patients attending the Kent Oncology Centre.
-
Attend relevant MDT meetings and coordinate treatment planning with other specialists.
-
Participate in departmental research initiatives and contribute to national and local clinical trials.
-
Contribute to training and supervision of junior doctors and participate in clinical governance activities.
Life in Kent
The area offers the best of both worlds: urban living in towns like Maidstone and Tunbridge Wells, and tranquil countryside villages such as Lenham or Goudhurst.
Kent boasts a wide range of excellent primary and secondary schools, including several grammar schools, and is well connected to London via high-speed rail and road. Residents enjoy easy access to historic castles, the coast, national parks, shopping, and outdoor activities—perfect for both adults and families.
Known as the “Garden of England,” Kent holds historical significance with its Roman heritage, medieval cathedrals, and coastal defense legacy, offering a unique blend of culture and natural beauty.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV Preparation with a bespoke session with one of our specialists
-
Application support with expert knowledge of NHS specialisms & recruitment practice
-
At least two video calling interview preparation sessions
-
Contract and offer negotiations for salary, relocation packages, tenure, and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new role, including:
-
Document gathering and checking
-
COS and Visa Application support, if applicable
-
Support sourcing short- and long-term accommodation
-
Travel arrangements
-
Family support for finding schools and any other aspects of pastoral care
An NHS specialist cancer centre in Lancashire and South Cumbria is looking for a Consultant in Medical Oncology with an interest in upper and lower GI cancers. The oncology department comprises a team of 8 consultants and is supported by a large team of middle grade doctors.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
This oncology job is open to both international applications and UK-based doctors, though those with European Specialist registration or MRCP are most encouraged to apply.
Anyone with an interest in upper and lower GI oncology should apply.
The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Provide systemic therapy services for patients with upper and lower GI cancers across UHMB sites.
-
Participate in multidisciplinary team meetings for lung and upper GI cancer and support associated administrative duties.
-
Lead and contribute to acute oncology services across the Trust (no on-call required).
-
Support teaching, supervision, and mentorship for junior medical staff and trainees.
LIFE IN LANCASHIRE AND SOUTH CUMBRIA
The area is rich with excellent schools, convenient rail and road links, and beautiful scenery for outdoor enthusiasts. Historically, the region has played a key role in British shipbuilding and industrial development and today combines coastal charm with cultural heritage and modern living.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV Preparation with a bespoke session with one of our specialists
-
Application support with expert knowledge of NHS specialisms & recruitment practice
-
At least two video calling interview preparation sessions
-
Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
-
Document gathering and checking
-
COS and Visa Application support if applicable
-
Support sourcing short- and long-term accommodation
-
Travel Arrangements
-
Family support for finding schools and any other aspects of pastoral care