CESR - a guide for overseas doctors
- November 10, 2021
Here we look briefly at the CESR route available to overseas consultants and exerienced senior doctors who wish to secure a job in the NHS and relocate to the UK.
Many IMGs have recently asked if they would be eligible for the CESR route to Specialist registration. International Medical Graduates (IMGs) from any country in the world can apply for CESR, provided certain eligibility criteria are met.
To help answer this question we have put together a short article to explain further, including the following topics:
- What is CESR?
- What is the Equivalence process?
- Who is the CESR for? Who can apply?
- What does the CESR route involve?
- Are there other senior NHS positions available?
- Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK
- What are the achieved standards?
- How can I prepare my evidence for CESR applications?
- What if my application is not successful?
CESR is suitable for those who have already been practising overseas for many years.
What is CESR?
The CESR is for doctors who wish to join the GMC (General Medical Council) Specialist Register, and whose specialist training, qualifications or experience was partly or completely acquired outside an approved CCT (Certificate of Completion of Training) programme in the UK.
It is equivalent to a CCT and certifies that the recipient has all the competences defined in the CCT curriculum, known as specialist registration.
What is the Equivalence process?
Equivalence describes the process of assessing an overseas applicant’s training and experience against the current training programme requirements, in order to gain a Certificate of Eligibility for Specialist Registration (CESR) for the Specialist Register held by the General Medical Council.
The process involves submitting a written body of evidence to the GMC of:
- training and/or competence
- skills and knowledge
Each Royal College will assess the 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.
Who is the CESR for? Who can apply?
If you have training, qualifications and experience in a CCT specialty but have gained these partly or completely outside an approved CCT training programme (for example, you have trained outside the UK or EEA), you may apply for a CESR in a CCT specialty.
What does the CESR route involve?
In a nutshell, you will need to compile a portfolio of evidence to prove you have achieved the equivalent skills and experience of a doctor who has completed a full GMC-approved training programme.
You can collect this evidence prospectively through non-training jobs.
Is it the right route for me? Yes, if…
- You have already completed specialty training back home
If you have already completed Specialty Training, then you’re unlikely to want to repeat it.
- You haven’t completed training, but you have too much experience in your specialty to apply for training posts.
In both scenarios, even if you are willing, you may be overqualified to apply for training.
Doctors who have complete specialist training overseas or via a non-CCT pathway may be eligible for entry without further training. You can check using the guidelines below:
You will need to demonstrate all specialty learning outcomes specified in the relevant CCT curriculum.
Are there other senior NHS positions available?
It is important to note that you can apply for more senior roles such as a SAS doctor, specialty doctor or a locum consultant (locum consultants are not required to be on the Specialist Register).
This way you will have better pay and the roles and responsibilities are more appropriate to your level of experience compared to a junior trainee. While working in these jobs you can collect evidence of your competences.
This is also a quicker route to the UK than the CESR route, which can take a substantial amount of time.
Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK:
It is a legal requirement that doctors must have their names entered on the General Medical Council's (GMC's) Specialist Register before taking up substantive NHS consultant posts in the UK.
What are the achieved standards?
To apply you will need to have either a specialist qualification or have undertaken a period of specialist training (not less than 6 months anywhere in the world).
Your application is measured against the GMC standard.
The GMC break down the standard into four domains mirroring the headings of Good Medical Practice.
The GMC recommend that you allocate the evidence you provide with your application in the following way:
Domain 1: Knowledge, Skills and Performance - 75%
Domain 2: Safety and Quality - 20%
Domain 3: Communication, Partnership and Teamwork - 5% (combined for
Domain 4: Maintaining Trust - 5% (combined for both domains 3 & 4)
The full list of evidence needed for each specialty is provided here.
How can I prepare my evidence for CESR applications?
As CESR applications are currently a completely paper-based process it is important to think about the evidence you present. You should:
- 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 current and of the highest possible quality.
- Always note any curriculum changes – you will be assessed against the most recent one
- Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.
- Throughout your application you should refer to the Specialty Specific Guidance in your specialty (or the most relevant if applying in a non-CCT specialty).
- You should also refer to the relevant CCT curriculum in your specialty; as this is the standard that all CCT applicants will be measured against.
- Look thoroughly at the GMC guidance available and get advice on your application from the GMC before you apply.
- Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
The GMC has strict guidelines for presenting evidence, including verification, anonymising and translating documents. We strongly advise all IMGs to take a look here and familiarise themselves with the criteria.
What if my application is not successful?
Following an unsuccessful application, you can apply for a review within 12 months of receiving your decision from the GMC. You can apply for a review of the GMC’s decision on the grounds that:
- You now have additional evidence to submit that addresses the areas of your application in which you were previously unsuccessful
- You believe that there has been a procedural error or unfairness in the processing of your original application.
Please refer to the GMC guidance for further information on applying for a review.
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At least two video calling interview preparation sessions
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Document gathering and checking
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- 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
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- Document gathering and checking
- COS and Visa Application support if applicable
- Support sourcing short- and long-term accommodation
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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
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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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This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or MRCP are most encouraged to apply.CCT in Medical Oncology or equivalent experience, including CESR pathway candidates.
-
The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Provide high-quality specialist care to melanoma patients attending the Kent Oncology Centre.
-
Attend relevant MDT meetings and coordinate treatment planning with other specialists.
-
Participate in departmental research initiatives and contribute to national and local clinical trials.
-
Contribute to training and supervision of junior doctors and participate in clinical governance activities.
Life in Kent
The area offers the best of both worlds: urban living in towns like Maidstone and Tunbridge Wells, and tranquil countryside villages such as Lenham or Goudhurst.
Kent boasts a wide range of excellent primary and secondary schools, including several grammar schools, and is well connected to London via high-speed rail and road. Residents enjoy easy access to historic castles, the coast, national parks, shopping, and outdoor activities—perfect for both adults and families.
Known as the “Garden of England,” Kent holds historical significance with its Roman heritage, medieval cathedrals, and coastal defense legacy, offering a unique blend of culture and natural beauty.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV Preparation with a bespoke session with one of our specialists
-
Application support with expert knowledge of NHS specialisms & recruitment practice
-
At least two video calling interview preparation sessions
-
Contract and offer negotiations for salary, relocation packages, tenure, and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new role, including:
-
Document gathering and checking
-
COS and Visa Application support, if applicable
-
Support sourcing short- and long-term accommodation
-
Travel arrangements
-
Family support for finding schools and any other aspects of pastoral care
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Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
This oncology job is open to both international applications and UK-based doctors, though those with European Specialist registration or MRCP are most encouraged to apply.
Anyone with an interest in upper and lower GI oncology should apply.
The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Provide systemic therapy services for patients with upper and lower GI cancers across UHMB sites.
-
Participate in multidisciplinary team meetings for lung and upper GI cancer and support associated administrative duties.
-
Lead and contribute to acute oncology services across the Trust (no on-call required).
-
Support teaching, supervision, and mentorship for junior medical staff and trainees.
LIFE IN LANCASHIRE AND SOUTH CUMBRIA
The area is rich with excellent schools, convenient rail and road links, and beautiful scenery for outdoor enthusiasts. Historically, the region has played a key role in British shipbuilding and industrial development and today combines coastal charm with cultural heritage and modern living.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV Preparation with a bespoke session with one of our specialists
-
Application support with expert knowledge of NHS specialisms & recruitment practice
-
At least two video calling interview preparation sessions
-
Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
-
Document gathering and checking
-
COS and Visa Application support if applicable
-
Support sourcing short- and long-term accommodation
-
Travel Arrangements
-
Family support for finding schools and any other aspects of pastoral care