Specialist Registration - CCT vs CESR vs CESR-CP 

  • April 06, 2023
 

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: 

Skip ahead to the relevant section if you know what you’re looking for. 

Specialist Registration

All doctors who wish to work as permanent consultants in the UK must show evidence of skills, knowledge and experience in order to apply for Specialist Registration. This registration in any specialty means you can be appointed to a substantive consultant post within the NHS. 

Specialist Registration is additional to full registration with the GMC. 

The 3 Types of Specialist Registration

There are three types of certificates issued by the GMC, and the type of certificate you will receive at the end of your training defines which training route you are on. 

The Certificate of Completion of Training (CCT) 

The CCT is the route to specialist registration for doctors who have completed a GMC-approved, specialty training programme through the relevant Royal College. 

To be eligible for CCT, an applicant’s entire training (including any core years) must have taken place within UK-approved training posts. Please see our blog on career pathways for a UK doctor in training

The Certificate of Eligibility for Specialist Registration - Combined Programme (CESR (CP))  

CESR(CP) is a simplified route for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK. 

Doctors on the CESR(CP) route count a combination of approved training and previous experience in non-approved posts (overseas) towards their training time. 

The Certificate of Eligibility for Specialist Registration (CESR) 

CESR is the route to specialist registration for doctors who have not completed a GMC-approved specialty training programme – doctors who have trained outside of the UK, Switzerland, and the EEA. 

These doctors apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK. 

Doctors who have completed their specialist training in the EEA or Switzerland are eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ). 

For an in-depth guide to CESR, take a look at our blog for overseas doctors here

Eligibility

Eligibility for Specialist Registration depends on your nationality, qualification and experience.  

To meet the minimum eligibility requirements to apply you must have either: 

A specialist qualification in the specialty you’re applying in

OR 

At least six months continuous specialist training in the specialty you’re applying in 

You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.  

In your application you must show that you meet the requirements of the CCT curriculum in your specialty.  

The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience. 

Applications and Evidence for Specialist Registration

CCT and CESR-CP 

Once you have been issued with your Outcome 6 has been issued, you must complete and return the relevant CCT/ CESR(CP) notification to your Royal College along with the following documents: 

  • Copies of any ARCPs that are not on your ePortfolio 
  • ARCPS/evidence of successful progression for any LAT/FTTA/SHO posts counting towards your training (this applies to doctors who were appointed above ST1 only) 

You will also need to complete an online GMC form. The link to this form will be emailed to you by the GMC and you should contact your Royal College if you do not receive it.  

The GMC has created a guide for each CCT specialty with the relevant royal college or faculty. You can see this here

CESR 
You will need to apply to the GMC, who will then send your application to the Royal College for evaluation. The application process for CESR can be lengthy and potentially stressful, so it is important that you read the GMC’s general guidance and specialty-specific guidance before starting to put together an application.  

You will need to provide a portfolio of evidence demonstrating that your specialist training or qualifications are equivalent to the award of a CCT in your specialism in the UK. This information is available for each specialty and Royal College on the GMC website here

If you apply for an NHS post which provides CESR support, your hospital should assist you in this process. 

Once the GMC has sent you a letter informing you that your application is complete and has been sent to your Royal College for assessment, the College is not permitted to discuss your case with you until the GMC has sent you a letter informing you of the decision. 

Benefits of Specialist Registration

Specialist registration allows doctors to take up permanent or substantive consultant positions. Without CCT, CESR or CESR-CP, a doctor may only take a Trust locum or fixed-term consultant posts. 

Fixed-term and locum posts offer of course offer less stability than permanent consultant posts and require extension. 

It is a legal requirement before taking a substantive, honorary or permanent NHS consultant post in the UK that doctors have their names entered on the GMC's Specialist Register. 

Senior Positions in the NHS

It is important to note that you can apply for more senior roles such as a specialty doctor (SAS), specialist grade or a locum consultant (locum consultants are not required to be on the Specialist Register).  

This way, you will have better pay and roles and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these jobs you can collect evidence of your competences.  

These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time. 

Cost

All doctors applying for Specialist Registration must pay a fee. The fees for 2021 are as follows: 

  • CCT - £439 
  • CESR-CP - £439 
  • CESR - £1,676 

#IMG Tips

  1. Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application. 
  2. Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum. 
  3. Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.   
  4. Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.  
  5. 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

40,000 - 82,400

An exceptional NHS job opportunity awaits a Middle Grade Microbiologist to join the Microbiology Pathology Department at North Tyneside General Hospital. Northumbria Healthcare NHS Foundation Trust, rated \"outstanding\" by the CQC, offers an innovative environment. The role involves diagnosing and managing infections caused by microorganisms, contributing significantly to patient well-being.

This is an ideal chance for overseas Microbiologists or Middle Grade Doctors to establish themselves in the UK NHS system, with potential CESR support. Suitable for EEA-specialized candidates or experienced IMGs seeking career advancement.

What is the NHS Foundation Trust like?

This NHS Foundation Trust is a dynamic organization with an £180 million turnover, employing 12,000 staff to serve 500,000 people across acute and community healthcare services. Recognized for excellence by the CQC in 2016 and 2019, it primarily serves an urban population but extends its care across a rural expanse from the River Tyne to the River Tweed, offering picturesque landscapes. The Trust operates three major hospitals and numerous community facilities, including the state-of-the-art Specialist Emergency Care Hospital. With ongoing capital investments, it ensures modern, purpose-built facilities and expands its services to meet evolving healthcare needs.

They provide an extensive array of specialties, boasting some of the region\'s largest specialist departments. These include the foremost trauma and orthopaedics service, a significant cardiology department, and one of the region\'s most expansive units for colorectal surgery services.

The NHS Foundation Trust prioritizes supporting its staff in achieving a healthy work-life balance, irrespective of individual circumstances. Applicants unable to work full-time due to personal reasons will still be considered for the position, and adjustments to job responsibilities can be discussed on a case-by-case basis upon appointment.

What is the Department & Team like?

The Clinical Support and Cancer Services Business Unit manages Radiology, Pharmacy, and Pathology departments, as well as cancer services, across several hospitals. These services also extend to six community hospitals. With modern facilities and dedicated staff, the Pathology department, including the microbiology laboratory, benefits from significant capital investment and supports medical education initiatives.

The Microbiology team offers clinical consultation services through various channels such as ward rounds, telephone, email, and multi-disciplinary team meetings. They collaborate closely with Infectious Diseases, Infection Prevention and Control, Public Health teams, and the laboratory. Encouragement for networking with Consultant Microbiologists in the Newcastle area is given to improve patient care across organizational boundaries.

The microbiology laboratory holds a central position within the hospital complex. It comprises 240 m² of laboratory space and 74 m² of office space, established during the hospital\'s original construction in 1987. Specimens from clinical areas within the North East site are transported to the laboratory via a vacuum air tube system, while collections from GP practices and other hospital sites across the region are managed through regular courier and van services.

Life like in North East

The North East of the UK offers a diverse landscape, blending urban hubs like Newcastle and Sunderland with picturesque rural areas. Residents enjoy a vibrant cultural scene, from historic sites like Durham Cathedral to sandy beaches along the Northumberland coast. The region hosts reputable universities such as Newcastle University and Durham University, complemented by excellent schools. Transportation links are robust, with rail and road networks connecting to major cities and airports like Newcastle International Airport. Housing options range from city center apartments to suburban family homes and quaint countryside cottages, catering to varied lifestyles and preferences.
 

52,530 - 82,240

An outstanding opportunity for a psychiatrist to join Forensic Psychiatry Department as Specialty Doctor that has received outstanding ratings from the CQC on three occasions. You will offer psychiatric input and conduct assessments, both psychiatric and physical, for patients on two wards. One ward is a self-contained low secure rehabilitation unit situated away from the main hospital premises, while the other is a medium secure rehabilitation ward. This role offers exposure to a broad spectrum of clinical presentations, including personality, affective, anxiety, psychotic, neurodevelopmental, and substance-related disorders. Moreover, it provides a platform for developing knowledge and understanding of forensic mental health sections. This position also offers CESR support for those seeking progression within the UK NHS Jobs system.

This is a great opportunity for overseas Specialty Doctors who want to establish themselves in the NHS, and grow their career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.

What is the NHS Trust like?

The Mental Health NHS Trust is a leading provider of mental health service serving a population of 1.2 million. With five main inpatient sites and 25 community locations, they offer comprehensive support for both mental and physical health needs, catering to young people and adults alike. From managing phobias and anxiety to addressing conditions like bipolar disorder and schizophrenia, their services are diverse and inclusive. They integrate community health services with mental health care, enabling simultaneous treatment of conditions such as diabetes and mental health issues, promoting holistic patient care.

Forensic Psychiatry Team & Department

The Forensic Service enjoys a stellar reputation, earning an \'Outstanding\' rating from the Care Quality Commission. The Forensic Service delivers care in low and medium secure environments, featuring specialized facilities such as the National Stalking Clinic and the Fixated Threat Assessment Centre (FTAC). These services focus on evaluating and managing risks for prominent individuals. 

The inpatient service consists of one acute assessment and treatment medium secure male 4 4 ward, four treatment and intervention medium secure male wards, one female medium secure ward, one medium secure and one low secure male learning disability ward, one low secure male FICU ward and 4 low secure male wards. There are currently 25 Consultant Forensic Psychiatrists in post, working with 5 senior psychiatric trainees who rotate with posts at other forensic psychiatric services in the region. There are 5 junior psychiatric trainees, coming from the UCH training schemes. The service currently employs 10 specialty doctors, working in the prisons and in the rehabilitation parts of the service.

Life in the area

The area offers a blend of urban and suburban living, providing both rural escapes and city conveniences. Residents can explore scenic parks or enjoy activities at different parks. The area boasts a range of quality schools and easy access to universities like Middlesex University. Transport links are excellent, with frequent trains to central London and nearby cities, as well as efficient connections to major airports. Housing options vary from historic cottages to modern apartments, catering to diverse preferences and lifestyles.

Career Development and Opportunities Available

With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD. 

Participation in research and educational activities will be encouraged.

ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:

  • Experience of working in Forensic Psychiatry (Desirable)

Non-EEA Candidates:

  • MRCPsych
  • Experience of working in Forensic Psychiatry (Desirable)

UK based applicants

  • Experience of working in Forensic Psychiatry (Desirable)
93,666 - 126,281

An excellent opportunity to join the dynamic team at an esteemed organization recognized for its excellence by the CQC. This is an opportune moment to become part of the Acute Medicine and Medicine Specialties Teams. With a strong history of achievements, they are committed to delivering exceptional patient-centered care. They seek a passionate and driven Acute and General Physicians to contribute to their mission of providing top-tier medical care across various clinical settings. This is a high performing and supportive department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK.

This is a great opportunity for overseas Consultants who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.

What is the NHS Foundation Trust like?

The NHS Foundation Trust stands as one of the nation\'s largest integrated healthcare organizations, delivering both hospital and community services to a populace exceeding 650,000 individuals. Renowned for their ambition and innovation, they boast a skilled workforce comprising over 7,000 dedicated colleagues. Operating across two acute sites for hospital services and encompassing centers and community hospitals in six towns for planned care, they extend their services even to patients\' residences.

Recognized as a high-performing entity with a history of accomplishments, the Trust has functioned as an integrated acute and community services provider since 2011 and achieved foundation trust status in 2007. Guided by their strategic framework \"Our Patients Matter,\" they articulate their short- and long-term objectives and delineate the path to their realization. This framework underscores their commitment to providing the safest, most compassionate, and seamlessly coordinated care to the communities they serve.

Within this NHS Foundation Trust, medical professionals are presented with a plethora of career prospects and exposure to diverse care settings rarely encountered elsewhere. Additionally, they have the opportunity to reside and practice in some of the most culturally rich and picturesque locations across the country!

What is the Department & Team like?

Within the Trust, there are 5 Care Groups: Urgent & Emergency Care, Integrated Medical Specialties, Surgery, Family Health, and Clinical Specialist Services. The Acute Care Team is housed under the Urgent & Emergency Care division. The Acute & General Medicine Department prides itself on delivering comprehensive and compassionate care to patients across a wide spectrum of medical conditions. Staffed by a dedicated team of consultants and junior doctors, the department ensures round-the-clock coverage to meet the needs of their patients. Their department handles a diverse range of cases, including but not limited to respiratory illnesses, cardiovascular conditions, gastrointestinal disorders, and infectious diseases. With access to state-of-the-art diagnostic and treatment facilities, including advanced imaging technologies and specialist clinics, they are equipped to provide timely and effective care to their patients.

The Acute & General Medicine Department boasts modern and well-equipped facilities, designed to optimize patient care and comfort. They have a 30-bedded Acute Medical Assessment Unit. On average, their department handles a significant number of acute and general medicine cases each year, reflecting the trust and confidence placed in their services by the community they serve. They prioritize patient safety, quality of care, and efficient service delivery, ensuring that each patient receives personalized attention and tailored treatment plans to facilitate their recovery and well-being.

The unit is adequately staffed and the working shifts are designed to ensure more doctors are present during the busy period of the day i.e. late evenings. They address the busy winter months by arranging extra locum cover during this busy period. In addition to the acute medicine registrar(s), there is a middle grade doctor, 1 IMT doctor and 4 FY1 doctors with staggered shifts throughout the day. In addition, there will be an on call registrar and 2 on call IMT doctors with staggered shifts. The night team comprises of one registrar, two FY2/IMT and one FY1 supported by an outreach nurse on most nights. 

What is life like in the area?

The North East of the UK offers a diverse mix of rural and urban settings, providing doctors with a range of living options. Residents can explore stunning coastal areas like Northumberland\'s beaches or venture inland to scenic national parks such as the North Pennines. The region is home to respected schools and universities, including Newcastle University. Transportation links are robust, with efficient road and rail networks connecting residents to major cities like Newcastle, Durham, and Sunderland, as well as international airports. Housing options range from quaint cottages in picturesque villages to modern apartments in vibrant city centers, catering to various lifestyles.

Career Development & Opportunities Available
 


ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:

  • Experience of working in Acute & General Medicine

Non-EEA Candidates:

  • MRCP
  • Experience of working in Acute & General Medicine

UK based applicants

  • Experience of working in Acute & General Medicine
52,530 - 82,400

Seeking a dynamic and motivated Dermatologist to join a Dermatology service in an NHS Foundation Trust rated \"good\" overall by the CQC. The NHS Trust provides a supportive environment for Specialty Doctors in Dermatology, including CESR support for IMGs seeking to establish their careers in the UK. Ideal for EEA-specialized candidates or experienced overseas dermatologists aiming to complete CESR.

What is the NHS Foundation Trust like?

The NHS Foundation Trust operates as a district general hospital. It oversees the management of two hospitals. This NHS Foundation Trust offers an exceptional work environment characterized by numerous dedicated teams committed to delivering top-notch patient care. They have embraced significant changes to their operational approach to effectively address the evolving landscape of the NHS, earning a Good rating from the Care Quality Commission in June 2018.

At this NHS Foundation Trust, they are pioneering the digital health revolution. Since implementing a comprehensive Electronic Patient Record system in 2017, they have embarked on a journey to establish ourselves as the safest, most efficient, and patient-centered trust within the NHS. The Electronic Patient Record system is just one component of their ongoing initiative to cultivate a digital ecosystem within the trust, ultimately striving to become a completely paper-free organization. This modernization endeavor opens up exciting avenues for future research and development in the rapidly evolving field of medicine. By joining the team, you have the opportunity to contribute to this innovative domain dedicated to enhancing patient care through advancements in technology.

Dermatology Team & Department

The Dermatology service sees 16,500 appointments yearly for diagnosing and treating various skin conditions, including skin cancers, lesions, eczema, psoriasis, urticaria, and Vulval conditions. The Dermatology Department is offering outpatient clinics and a comprehensive array of treatments, including minor operations. Additionally, a limited number of clinics and treatments are available at the newly established outpatient facility located in one of their sites.

The Dermatology service currently has over 5000 2ww Outpatient attendances per annum for the diagnosis and treatment of potential skin cancer. Outpatient clinics are run from both sites with an inpatient in-reach service run across their two sites. Facilities within the dermatology department include modern outpatient clinics, diagnostic services, and treatment rooms, ensuring a comfortable and efficient environment for patients and staff alike. They also collaborate closely with other specialties within the trust to provide multidisciplinary care when required, ensuring holistic management of complex cases.

Life in Yorkshire & Humberside

Yorkshire & Humberside offers a diverse mix of rural and urban settings, providing a range of living environments for doctors. Residents can enjoy scenic landscapes, including the Yorkshire Dales and Yorkshire Moors, ideal for outdoor activities like hiking and cycling. The region boasts top-quality schools and universities, such as the University of Leeds and the University of Sheffield. Transportation links are excellent, with easy access to major cities like Leeds, Sheffield, and Manchester via road and rail networks. Housing options vary from quaint villages to bustling city centers, catering to different preferences and lifestyles.

Career Development and Opportunities Available

With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD. 

Participation in research and educational activities will be encouraged.

ARE YOU ELIGIBLE FOR THIS ROLE?

All candidates must be GMC registered to be suitable for consideration.

EEA Candidates:

  • Experience of working in Dermatology
  • Relevant primary medical qualification

Non-EEA Candidates:

  • MRCP UK or PLAB
  • SCE dermatology desirable
  • Experience of working in Dermatology

UK based applicants:

  • Experience of working in Dermatology
93,666-126,281

An excellent opportunity for an experienced Consultant Old Age Psychiatrist to join an established NHS community clinic in London. The post if suitable for overseas psychiatrists, including candidates who are pursuing CESR. Specialists in Psychiatry, holding a specialist certification would be suitable for this post, based on experience entering at either Specialty Doctor or Consultant grade. 

WHAT IS THE DEPARTMENT & TEAM LIKE? 

The post offered is that of Specialist Psychiatrist in Older Adult Psychiatry, working in both the community mental health team and the memory clinic. In addition to this post, three additional CMHTs make up the older adult community service for the borough. The personnel of the CMHT include: medical staff, Community Psychiatric Nurses, Occupational Therapist, and Psychiatric Social Workers. There is a Psychological Therapy Department which provides therapy for older adults and which works across CMHTs in the Borough as does the Occupational Therapy Service.

The post holder will have responsibility for the diagnostic assessment and treatment of older adult psychiatric patients from the designated catchment area referred to and accepted by the service. Outpatient clinics and domiciliary visits in the community will constitute the majority of the direct clinical care provided by the post holder.

WHAT IS LIFE LIKE IN NORTH LONDON FOR PSYCHIATRISTS? 
This great world city is far more than just the capital of the United Kingdom of Great Britain and Northern Ireland. London is bustling, vibrant, multicultural and cosmopolitan. London is both old and new, a place where traditional pubs rub shoulders with the newest cocktail bars. Its most ancient castle is right next door to its newest skyscrapers. London\'s energy, as 8.6 million people go about their everyday lives, is tangible in every journey on the Underground, every stroll through a market and every walk along the banks of the River Thames. From the royal parks to the theatre stage, London really does have it all.

Working as a psychiatrist in London brings a range of exciting prospects. You will have the opportunity to work in some of the best mental health trusts in the UK, who will offer you the opportunity to constantly grow your medical and scientific knowledge and skills. In London you will have the opportunity to work in a wide range of settings, and as you progress through your career, you will have more opportunity to shape the way you work; you can develop research, work part time or full time and can combine your career with a wide range of other interests.


WHAT OPPORTUNITIES ARE AVAILABLE TO YOU AT THE TRUST?
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD. 

Participation in research and educational activities will be encouraged.

ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:

  • 6 years experience of working in Older Adult Psychiatry

  • Board Certified Specialist in Psychiatry (desirable)

Non-EEA Candidates:

  • MRCPsych (desirable)

  • 6 years experience of working in Older Adult Psychiatry

UK based applicants

  • 6 years experience of working in Older Adult Psychiatry

  • S12 (desirable)

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