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 district general hospital in the West Midlands is looking for a Specialist Grade Haematologist with an interest in haemato-oncology, laboratory haematology and blood transfusion. The Haematology department comprises a team of 3 consultants and is supported by a large team of middle grade doctors. This Haematology job is open to both international applications and UK-based doctors, though those with European Specialist or FRCPath (or equivalent) are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
FRCPath (or equivalent) and broad experience in clinical and laboratory haematology are required for this role, and anyone with an interest in clinical trials, haemato-oncology, education, or blood transfusion should apply. The salary will be between £96,990 to £107,155 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
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Provide clinical support in both inpatient and outpatient settings, working closely with consultants and the multidisciplinary team.
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Participate in the delivery of chemotherapy and specialist care via the dedicated oncology/haematology unit.
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Contribute to clinical governance, teaching of junior doctors and nurse practitioners, and development of service pathways.
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Assist with laboratory haematology duties including blood film reporting, and advise on transfusion and diagnostic services.
LIFE IN THE WEST MIDLANDS
This hospital is located in a picturesque region of the West Midlands, with access to both rural retreats and small city living. Residents enjoy a mix of traditional market towns and vibrant city centres, with good schools, easy rail access to Birmingham, and plenty of green spaces for outdoor activities. The area has deep historical roots, from medieval cathedrals to Roman forts, offering a unique combination of 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 hospital in South East England is looking for a Consultant in Clinical Oncology with an interest in Upper and Lower GI cancers. The Oncology department comprises a team of four Clinical Oncologists and a Consultant Radiographer, supported by a large team of middle-grade doctors. This Clinical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist Registration, GMC Specialist Register, CCT, or CESR are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
GMC registration with a license to practice, CESR, or a GMC-recognised qualification such as FRCR is required for this role. Anyone with an interest in Upper and Lower GI cancer should apply. The salary will be between £105,504 – £139,882 dependent on experience.
CORE DUTIES OF THIS ROLE
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Provide expert oncology care for patients diagnosed with Upper and Lower GI cancers, overseeing treatment plans and managing patient care.
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Participate in multidisciplinary team (MDT) meetings across sites to coordinate treatment.
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Contribute to research and clinical trials within the Oncology department, promoting innovation in GI cancer treatment.
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Engage in teaching opportunities with medical students and junior doctors, especially in preparation for the launch of a new postgraduate medical programme.
LIFE IN SOUTH EAST ENGLAND
This hospital is located in the South East of England, a region known for its mix of lively coastal cities and peaceful countryside towns. It offers great transport links to London, top-performing schools, and diverse leisure options, including historic landmarks, nature trails, and vibrant cultural scenes. The area is rich in maritime and military history, making it a unique and engaging place to live and work.
HOW WILL IMG CONNECT SUPPORT YOU?
-
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 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 district general hospital in Yorkshire is looking for a Consultant Dermatologist with an interest in skin cancer and minor skin surgery. The Dermatology department comprises a team of locum consultants, an experienced Specialty Doctor, and a Biologic Nurse Consultant, supported by a large team of middle grade doctors. This Dermatology job is open to both international applications and UK-based doctors, though those with European Specialist or MRCP (UK) or SCE are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
Full GMC registration and significant experience in general dermatology and minor surgery, are required for this role. Anyone with an interest in skin cancer management and dermatological surgery should apply. The salary will be between £109,725 and £145,478 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Deliver high-quality general dermatology services, including urgent and routine outpatient clinics.
- Participate in subspecialty clinics, particularly for skin cancer diagnosis, management, and surgery.
- Contribute to departmental management, teaching, and supervision of junior doctors and medical students.
- Support service development and clinical governance through audit, guideline development, and education initiatives.
LIFE IN THE NORTH OF ENGLAND
???????This hospital is situated in the north of England, with popular residential areas including vibrant cities and picturesque countryside locations. Urban dwellers may enjoy city life in places like Sheffield or Leeds, while rural enthusiasts might prefer the surrounding villages and national parks. The region offers great schools, excellent transport connections, and a wide variety of leisure activities for all lifestyles. Historically significant for its industrial roots, the area remains a vital and evolving part of British 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 cancer centre in Northern Ireland is seeking a Consultant Clinical Oncologist with a specialist interest in Upper GI and Breast cancers. The department includes 11 oncology consultants and is supported by a team of middle grade doctors and specialty trainees. This position is open to both UK-based and international doctors, particularly those with FRCR or European Specialist Registration.
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 have full GMC registration and at least 6 years of postgraduate experience in Clinical Oncology. The salary for this role is between £88,799 and £119,723, dependent on experience.
CORE DUTIES OF THIS ROLE
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Manage patients with Upper GI and Breast cancers across inpatient and outpatient settings.
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Engage in tumour site-specific MDTs and contribute to treatment planning and decision-making.
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Support the training and mentoring of oncology registrars and junior doctors.
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Contribute to service development, teaching, and clinical governance.
LIFE IN NORTHERN IRELAND
Based in the north-west region of Northern Ireland, this location offers both city and rural living, with access to scenic countryside, the coast, and neighbouring towns. The area features well-rated schools, convenient transport infrastructure, and rich opportunities for cultural, historical, and recreational pursuits. It’s a growing destination for healthcare professionals seeking balance between professional development and quality of life.
HOW WILL IMG CONNECT SUPPORT YOU?*
-
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.
CORE DUTIES OF THIS ROLE
- Deliver Haematology services across multiple NHS hospital sites, with inpatient care based at the main centre.
- Conduct outpatient clinics, lab-based diagnostics, MDT participation, and administrative responsibilities.
- Participate in the on-call rota (1 in 8), including weekend ward rounds and lab duties.
- Support the development of junior doctors and engage in audit, research, and quality improvement.
The hospital is based in the central belt of Scotland, with urban living options like Glasgow and more rural choices such as the Clyde Valley. The region offers a good range of schools, strong public transport, and plenty of leisure activities for both professionals and families. Historically rich and industrially significant, this area has evolved into a hub for modern healthcare delivery and research.
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
- 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