CESR - a comprehensive guide for clinical oncologists

  • August 18, 2022
 

Overseas doctors from any country in the world can apply for Specialist Registration in the UK, provided certain eligibility criteria are met, though there are different routes available based on the doctor’s qualifications and training. 

In this blog we’ll be exploring Specialist Registration in clinical oncology for overseas clinical or radiation oncologists more closely. We’ll look at all aspects of Specialist Registration, focusing more closely on the Certificate of Eligibility for Specialist Registration (CESR), including the application process, costs, and eligibility criteria, along with some other topics, summarised in the headings below: 

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

Specialist Registration 

Specialist Registration in any CCT specialty means that you can be appointed to a substantive (or permanent) consultant position in the NHS. All clinical oncologists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience equivalent to a CCT in order to apply for Specialist Registration.  

For clinical oncologists, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.  

Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a clinical oncologist in the UK. 

Routes to Specialist Registration 

There are three types of certificates issued by the GMC for Specialist Registration, and the type of certificate you receive depends on the training route you followed. 

CCT for UK-trained Oncologists 

For doctors who have completed a GMC-approved training programme, an application must be made to the GMC for a CCT in their specialty within 12 months of their completion date in order to qualify. After this point, they will be required to use the CESR route to apply directly to the GMC if they wish to attain Specialist Registration. 

CCT for EEA-trained Oncologists 

Doctors who have trained outside the UK or Switzerland, but within an EEA country, will be awarded CCT (Certificate of Completion of Training) after a successful specialist registration application. Specialist Certifications from across the EU are deemed as equivalent by the GMC, and therefore a straightforward application can be made. You can read more about this in the Specialist Registration section under your country on the GMC website here

CESR-CP for doctors who have completed only part of a GMC-approved training programme

CESR(CP) is a simplified route to Specialist Registration 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. 

CESR for Overseas Oncologists 

For overseas doctors who have completed their full training outside of a GMC-approved training programme, CESR is the route they will usually take towards attaining Specialist Registration. This route does not require further training, rather the submission of an application.  

Clinical Oncology Positions in the NHS without CESR 

It is important to note that you can apply for more senior oncology roles such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register. 

Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS. 

In these NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK clinical oncology curriculum. 

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

Get in touch with us to find out more about senior positions in the NHS with CESR support. 

FRCR (Oncology) for Specialist Registration 

Whilst it is always beneficial to complete FRCR (Oncology), particularly for doctors who have trained outside the UK or an EEA country, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams. 

The standard test of knowledge in the Clinical Oncology curriculum are the FRCR (Oncology) exams, so passing these exams confirms the attainment of the competencies of the core curriculum. 

FRCR (Oncology) is only a requirement for doctors looking to attain Specialist Registration via the CCT route. 

Similarly, UK trainees would have completed MRCP (UK) before beginning their clinical oncology training, which is also not required for oncologists going through the CESR route. 

However, CESR applicants who have not successfully completed these exams must provide alternative evidence that demonstrates equivalent knowledge to oncologists who have passed the FRCR (Oncology) exams and the appropriate level of non-oncology expertise and that you can appropriately manage the acutely unwell patient. 

Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside of the evidence presented. 

You can read more about the evidence required in the specialty specific guidance here

CESR Equivalence Process 

Equivalence describes the process of assessing an overseas applicant’s training and experience against the current clinical oncology training programme requirements, in order to be awarded CESR. 

The equivalence process involves submitting a written body of evidence to the GMC, consisting of: 

  • training and/or competence 
  • skills and knowledge 

The Royal College of Radiologists will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision. 

Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there. 

Evidence Requirements for CESR in Clinical Oncology 

Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the Clinical Oncology Curriculum. If evidence is missing from any area of the curriculum, the application will fail. 

Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient. 

Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle 

Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.  

The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here

As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below: 

  • Domain 1 – Knowledge, skills, and performance 
  • Domain 2 – Safety and quality 
  • Domain 3 – Communication, partnership, and teamwork 
  • Domain 4 – Maintaining trust 

Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. 

The full list of evidence required for each domain can be found on the GMC website here

The Cost of CESR Applications 

All oncologists applying for Specialist Registration must pay a fee. As of 1st April 2022, for CESR, this fee is £1,727. For CESR-CP and CCT, the cost is £452. 

How long does it take to complete an application for CESR in Clinical Oncology? 

The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application. 

As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years. 

It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum. 

The indicative period of training for a CCT in clinical oncology is seven years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior oncologists. 

#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. Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures. 
  3. Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.  
  4. Ensure that the evidence you collect demonstrates your competence across the whole of the Clinical Oncology curriculum, not just your sub-specialty.    
  5. Remember to refer to the most up-to-date Clinical Oncology CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.  
  6. Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress. 
  7. Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a pro formas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier). 
  8. Ask an IMG Connect recruitment specialist about NHS oncology posts with CESR support. These are not always advertised by a Trust, but we can help you find a role which aligns well with your career goals in the NHS. 
  9. Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncology CESR aspirants and dedicated oncology recruiters.

In this group you will find tailored resources for oncology, including guidance on CESR applications, completely free to all doctors.

You can access our IMG Oncologists community here.

Sources 

https://www.rcr.ac.uk/clinical-oncology/careers-and-recruitment/specialist-registration-cesr 

https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr 

https://www.gmc-uk.org/-/media/documents/sat---ssg---clinical-oncology---dc3556_pdf-48456770.pdf 


Getting started 

Many oncology IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route. Take a look at our guide to CESR applications for oncology 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

£59,175 - £95,400

An NHS Trust in the South West of England is looking for a Specialty Doctor in Oncology with an interest in Acute Oncology and Chemotherapy Services. The Oncology department comprises a team of consultants, senior nursing staff, and a multidisciplinary team, supported by a large team of middle-grade doctors. This Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or MRCP/MRCPath 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

At least four years of postgraduate training, including two years in a relevant specialty, and full GMC registration are required for this role. Anyone with an interest in Acute Oncology and Chemotherapy Services should apply. The salary will be between £59,175 and £95,400 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide continuity of care for patients being treated in the Oncology Day Unit and supervise patients admitted to medical wards with chemotherapy-related side effects.
  • Participate in Acute Oncology Service (AOS) and multidisciplinary team (MDT) meetings, liaising with consultants and specialist teams.
  • Supervise chemotherapy administration, assess patients prior to treatment, and follow up on recently discharged patients.
  • Support clinical trials by assisting in patient recruitment and follow-up.

LIFE IN THE SOUTH WEST OF ENGLAND

This Trust is based in a lively city in the South West, offering a mix of urban and coastal living, with popular residential areas including city suburbs and the countryside. The region provides excellent schools, strong transport links across the UK, and a range of cultural and recreational opportunities for professionals and families. The city has played a crucial role in British maritime and engineering history and continues to be a hub for innovation and creativity.


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 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
£96,990 - £107,155

An NHS Trust in the West Midlands is looking for a Specialist Doctor in Clinical Oncology with an interest in Neuro-Oncology and Lower-GI cancers or Lung and thoracic malignancies. The Oncology department comprises a team of over 20 consultants and is supported by a large team of middle-grade doctors. This 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.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

10 years of oncology experience in a middle-grade role and full GMC registration are required for this role, and anyone with an interest in Neuro-Oncology and Lower-GI cancers or Lung and thoracic malignancies should apply. The salary will be between £96,990 and £107,155 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide specialist Clinical Oncology input, including expertise in radiotherapy and Systemic Anti-Cancer Therapy (SACT).
  • Support site-specific MDTs (Multidisciplinary Teams) in either Neuro-Oncology and Lower-GI cancers or Lung and thoracic malignancies.
  • Deliver outpatient and inpatient care, including radiotherapy planning and chemotherapy prescribing.
  • Contribute to the Acute Oncology Service and provide ward inpatient care.

LIFE IN THE WEST MIDLANDS

This Trust is located in a major city in the West Midlands, offering easy access to both vibrant urban areas and picturesque rural locations. Popular residential areas nearby include a mix of city living and countryside retreats. The region offers excellent schools, strong transport links to major UK cities, and a range of cultural, shopping, and leisure options. Historically, this area has played a vital role in Britain\'s industrial and automotive history and is home to a number of significant landmarks.


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 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
£96,990 - £107,155 N/A

An NHS Trust in the West Midlands is looking for a Specialist Doctor in Clinical Oncology with an interest in Neuro-Oncology and Lower-GI cancers. The Oncology department comprises a team of over 20 consultants and is supported by a large team of middle-grade doctors. This 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.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

10 years of oncology experience in a middle-grade role and full GMC registration are required for this role, and anyone with an interest in Neuro-Oncology and Lower GI should apply. The salary will be between £96,990 and £107,155 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide specialist Clinical Oncology input, including expertise in radiotherapy and Systemic Anti-Cancer Therapy (SACT).
  • Support site-specific MDTs (Multidisciplinary Teams) in Neuro-Oncology and Lower-GI cancers.
  • Deliver outpatient and inpatient care, including radiotherapy planning and chemotherapy prescribing.
  • Contribute to the Acute Oncology Service and provide ward inpatient care.

LIFE IN THE WEST MIDLANDS

This Trust is located in a major city in the West Midlands, offering easy access to both vibrant urban areas and picturesque rural locations. Popular residential areas nearby include a mix of city living and countryside retreats. The region offers excellent schools, strong transport links to major UK cities, and a range of cultural, shopping, and leisure options. Historically, this area has played a vital role in Britain\'s industrial and automotive history and is home to a number of significant landmarks.


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 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

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 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
105,504- 139,882
An NHS Trust in South East England is looking for a Consultant in Medical Oncology with an interest in Lower Gastrointestinal & Gynaecological cancers . The Oncology department comprises a team of consultants and is supported by a large team of specialty doctors and clinical fellows. This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or FRCR/MRCP 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, FRCR/MRCP (or equivalent), and oncology experience at SpR or equivalent level are required for this role. Anyone with an interest in Gynaecological cancers and dependent on experience or grade.

CORE DUTIES OF THIS ROLE

Provide high-quality oncology services, including radiotherapy and chemotherapy.
Participate in multidisciplinary team meetings and provide leadership for tumour site specialisations.
Supervise and mentor junior medical staff and actively contribute to teaching and research initiatives.
Engage in clinical governance and audit activities to ensure high standards of patient care.

LIFE IN KENT

Kent, known as \"The Garden of England,\" offers a mix of lively urban areas and tranquil rural settings. Canterbury is a vibrant city with a rich history and excellent amenities, while the surrounding countryside provides peaceful rural living options. The region boasts excellent schools, strong transport links to London and the continent, and a variety of leisure activities including historic landmarks, coastal attractions, and cultural festivals. Kent\'s historical significance as a cornerstone of England\'s heritage adds to its charm.

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 and recruitment practices.
-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 guided throughout by one of our dedicated relocation executives, including:
-Document gathering and checking.
-COS and visa application support if applicable.
-Assistance with sourcing short- and long-term accommodation.
-Travel arrangements.
-Family support for finding schools and other aspects of pastoral care.



 
105,504- 139,882

An NHS hospital in London is looking for a Locum Consultant in Medical Oncology with an interest in GI and Lung malignancies. The Oncology department comprises a team of 16 Consultant Oncologists and is supported by a multidisciplinary team of nurses, pharmacists, and radiographers. This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist registration or MRCP 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

Applicants should have full GMC registration, MRCP (or equivalent), and substantial experience in Medical Oncology. Interest in Lung  and GI malignancies is essential. The salary will be between £105,504- £139,882 dependent on experience.

CORE DUTIES OF THIS ROLE

  • Provide specialist care for Breast and Lower GI cancer patients, including outpatient and radiotherapy services.
  • Actively participate in multidisciplinary team meetings for Lung and GI malignancies.
  • Engage in research, clinical audits, and teaching activities to support professional development.
  • Contribute to the Acute Oncology Service (AOS) and provide clinical supervision for junior medical staff.

LIFE IN LONDON

London offers a dynamic and diverse environment with a mix of bustling urban areas and quieter suburban neighborhoods. It provides access to world-class educational institutions, excellent transport links, and a wide range of cultural, leisure, and historical attractions. London’s rich history and multicultural vibrancy make it an ideal location for both professional development and personal fulfillment.

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 and recruitment practices.
  • 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 guided throughout by one of our dedicated relocation executives, including:

  • Document gathering and checking.
  • COS and visa application support if applicable.
  • Assistance with sourcing short- and long-term accommodation.
  • Travel arrangements.
  • Family support for finding schools and other aspects of pastoral care.

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