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
JOB REQUIREMENTS AND DETAILS
- FRCPath or equivalent and Full GMC Registration are required.
- The salary will be competitive and dependent on experience.
CORE DUTIES OF THIS ROLE
- Provide histopathology services for diagnostics.
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LIFE IN THE REGION
The position is based in a city offering a mix of urban amenities and scenic rural living options. Families will find excellent schools, easy access to transport, and a range of leisure activities. The region has a rich cultural and historical significance.
An NHS district general hospital in the North of Scotland is looking for a Consultant Clinical Oncologist with an interest in Lung, Head & Neck, or Breast cancer. The oncology department comprises a team of 7 consultants and is 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 or FRCR (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
FRCR, full GMC registration with specialist registration or within 6 months of CCT, along with broad experience in prescribing radiotherapy and SACT, are required for this role, and anyone with an interest in Lung, Head & Neck, or Breast radiotherapy should apply. The salary will be between £107,144 and £142,369 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
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Manage a subspecialty caseload in Lung, H&N or Breast radiotherapy, delivering high-quality care and treatment planning.
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Participate in MDT meetings, clinical governance, research and teaching activities.
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Contribute to acute oncology on-call cover and peripheral clinics across the region.
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Lead or support the development of new services or innovations in clinical delivery within the department.
LIFE IN THE SCOTTISH HIGHLANDS
This job is based in the Scottish Highlands, a region known for both its bustling city of Inverness and rural escapes like Beauly or Fort Augustus.
The Highlands offer excellent schools, strong transport links including rail and air connections, and year-round recreational options from hiking to arts festivals. The city also has a vibrant cultural and social scene for families and professionals alike.
Rich in heritage, the Highlands are home to some of Scotland’s most renowned history—from clan culture to castles—making this region both a scenic and significant place to live and work.
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:
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CV Preparation with a bespoke session with one of our specialists
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Application support with expert knowledge of NHS specialisms & recruitment practice
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At least two video calling interview preparation sessions
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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:
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Document gathering and checking COS and Visa Application support if applicable
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Support sourcing short- and long-term accommodation
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Travel Arrangements Family support for finding schools and any other aspects of pastoral care
An NHS acute hospital in the South East is looking for a Specialist Acute Physician with an interest in Same Day Emergency Care and Ambulatory Medicine. The Acute Internal Medicine department comprises a team of 13 consultants and is supported by a large team of middle grade doctors. This Acute Medicine job is open to both international applications and UK-based doctors, though those with European Specialist or MRCP (UK) qualifications 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
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CORE DUTIES OF THIS ROLE
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Provision of the Acute Internal Medicine service, including same day emergency care, inpatients on the AMU, and the Short Stay Unit
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Receiving referrals from primary care to provide clinical advice and triage for potential admissions
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Supervision of junior doctors and alternative workforce, including advice on treatment plans
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Participation in clinical education and governance activities, and supporting development of the department
LIFE IN THE SOUTH EAST
This role is based in a major coastal city in the South East, with nearby living options ranging from lively urban centres to scenic rural towns. The region offers strong transport connections, reputable schools, and a wide range of leisure pursuits including historic attractions, beaches, and outdoor activities. Known for its maritime heritage, this area has longstanding ties to British naval and defence 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
An NHS teaching hospital in the West Midlands is looking for a Locum Consultant in Microbiology with an interest in clinical microbiology, infection control, and antimicrobial stewardship. The Microbiology department comprises a team of 5 consultant microbiologists and is supported by a large team of middle grade doctors. This Microbiology job is open to both international applications and UK-based doctors, though those with European Specialist or FRCPath qualifications 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
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CORE DUTIES OF THIS ROLE
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Provide clinical microbiology advice for inpatients and outpatients, including infection control and antimicrobial therapy recommendations.
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Participate in multidisciplinary team meetings such as OPAT, diabetic foot, and spinal infection MDTs.
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Be part of a 1:7 on-call rota, providing microbiology advice out-of-hours to hospital and community services.
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Contribute to laboratory report validation, audit activities, and CPD, including teaching junior doctors and medical students.
LIFE IN STOKE
This role is based in Stoke-on-Trent. Many staff choose to live in Stoke itself for urban convenience, or in nearby towns like Stone or rural Cheshire for a quieter lifestyle. The area is well-served by excellent transport links, schools, and local amenities, with plenty of leisure activities including country parks, theatres, and restaurants. Stoke-on-Trent has a rich industrial heritage and is famously known as the heart of the UK’s pottery industry, offering cultural and historical interest alongside modern healthcare innovation.
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 the North of England is looking for a Consultant in Medical Oncology with all interests considered. The oncology department comprises a team of consultants and is supported by a large team of middle grade doctors. This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist Registration or MRCP (UK) 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 with a licence to practise and inclusion (or eligibility within 6 months) on the Specialist Register in Medical Oncology are required for this role. The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
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Manage and treat patients with cancers as part of the site-specific MDTs.
-
Provide on-call and acute cover for oncology inpatients and new inpatient referrals on a rotational basis (1 week out of 8).
-
Attend weekly multi-disciplinary meetings.
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Hold an honorary lecturer position at a local medical school and participate in undergraduate teaching.
-
Participate in clinical research as appropriate.
-
Train and teach specialty trainees in medical oncology.
LIFE IN THE NORTH OF ENGLAND
This role is based in the North of England, a region that offers the perfect balance of urban convenience and rural charm. Residents can enjoy city living in York or find quieter settings in the nearby countryside and villages. The area boasts outstanding schools, excellent transport links, and a wide variety of cultural, sporting, and outdoor activities. With its strong ties to Britain’s industrial heritage and the beautiful countryside on its doorstep, the North of England is a popular choice for healthcare professionals relocating to the UK.
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
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