CESR - a comprehensive guide for psychiatrists
- January 20, 2022
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.
Here we explore specialist registration in psychiatry for overseas consultant psychiatrists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) in more detail, including the application process, costs, and eligibility criteria, along with some other topics, summarised in the headings below:
- What is Specialist Registration?
- What route to Specialist Registration is best for me as an overseas psychiatrist?
- Do I have to complete CESR before I can work in the UK?
- Do I need MRCPsych for Specialist Registration?
- What is the CESR equivalence process?
- What evidence do I need to submit for a CESR in psychiatry?
- How much does CESR cost?
- How long is the CESR application process?
- #IMG Tips
- How do I get started?
Skip ahead to the relevant section if you know what you’re looking for.
Specialist Registration
Specialist registration in any specialty means that you can be appointed to a substantive (permanent) consultant position in the NHS. All psychiatrists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to apply for Specialist Registration.
For psychiatrists, 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 psychiatrist 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 which training route you followed.
For overseas doctors who have completed their full training outside 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.
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.
Psychiatry Positions in the NHS without CESR
It is important to note that you can apply for more senior psychiatry 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 psychiatry curriculum.
These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.
MRCPsych for Specialist Registration
Whilst it is always beneficial to complete MRCPsych, overseas doctors looking to join the Specialist Register do not necessarily need to have completed the Royal College postgraduate exams.
The standard test of knowledge in the CCT curriculum is the MRCPsych exam, so passing these exams confirms the attainment of the competencies of the Core Curriculum.
MRCPsych is only a requirement for doctors looking to attain Specialist Registration via the CCT route.
However, if CESR applicants have not successfully completed these exams, they must provide alternative evidence that demonstrates equivalent knowledge to psychiatrists who have passed the MRCPsych exams.
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 the evidence presented.
CESR Equivalence Process
Equivalence describes the process of assessing an overseas applicant’s training and experience against the current psychiatry 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 Psychiatrists 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 Psychiatry
Skills & Experience: The evidence provided for a CESR application in psychiatry must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the General Psychiatry Curriculum, and the Advanced Module in the sub-specialty you are applying in. 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 800-1200 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 psychiatrists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.
How long does is the application process for CESR in Psychiatry?
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 psychiatrists, 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 psychiatry is six 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 psychiatrists.
#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.
- Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.
- 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 psychiatry curriculum, not just your sub-specialty.
- Remember to refer to the most up-to-date Psychiatry CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
- 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.
- Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
- Ask an IMG Connect recruitment specialist about NHS psychiatry 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.
- Join the IMG Psychiatrists community – as well as support on Royal College exams, our online community of international psychiatrists and dedicated psychiatry recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Getting started
Many psychiatry 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 psychiatry 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.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Relevant Jobs
Consultant Psychiatrist – Child and Adolescent Mental Health Service (CAMHS)
South Wales
A dynamic and transformational CAMHS service in South Wales is seeking a Consultant Psychiatrist with a strong interest in child and adolescent mental health. The successful candidate will join a well-established multidisciplinary team delivering specialist care across the region, contributing to service development and clinical leadership within a collaborative and forward-thinking environment. Doctors with MRCPsych, CESR interest, or a European Specialist qualification are encouraged to apply.
This is a fantastic opportunity to work within a progressive mental health service with access to regional tier 4 services and a population of approximately 380,000. The post supports the organisation’s strategic vision to integrate CAMHS more closely into community settings while developing clinical pathways in areas including eating disorders, complex care, youth justice, and neurodevelopmental disorders.
We welcome applications for full-time, part-time, or flexible working arrangements and will support CESR (Certificate of Eligibility for Specialist Registration) development on an individual basis.
JOB REQUIREMENTS AND DETAILS
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Salary: £109,725 – £145,478 dependent on Consultant experience.
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Full GMC registration with a licence to practise is essential.
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Eligibility for inclusion on the GMC Specialist Register or within six months of CCT.
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Section 12 approval (or eligibility within 6–12 months).
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Experience delivering psychiatric care in CAMHS or related services is required.
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A collaborative, developmental, and family-focused approach, with excellent communication and leadership skills, is highly valued.
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Opportunities for career development through CPD, peer supervision, quality improvement, and service leadership.
CORE DUTIES OF THIS ROLE
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Provide consultant-level psychiatric care to children and adolescents as part of a multidisciplinary CAMHS team.
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Lead clinical care planning, review, and treatment delivery in partnership with colleagues across mental health, health, education, and social care.
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Work closely with specialist regional services including adolescent inpatient units, eating disorder outreach services, and forensic CAMHS consultation teams.
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Participate in the CAMHS consultant on-call rota (with prospective cover).
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Contribute to service improvement, pathway development, and integrated working in line with strategic planning goals.
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Provide supervision and clinical leadership to junior medical staff and allied professionals.
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Participate in annual appraisal, job planning, and revalidation, with access to local peer groups and CPD.
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Uphold principles of clinical governance, information governance, and risk management across the CAMHS Directorate.
LIFE IN SOUTH WALES
South Wales offers a rare combination of coastal beauty, green open spaces, and urban convenience. With beautiful landscapes, affordable living, and excellent local amenities, it is an ideal location for professionals and families alike. The region is well-connected by public transport and road networks and offers easy access to nearby cities and airports.
Healthcare professionals in the area benefit from a supportive and inclusive working environment and access to a wide network of services across health, education, and social care.
If you are passionate about delivering outstanding CAMHS care and want to help shape future services in a supportive, innovative setting, we welcome your application. Please note that we may close this post early if sufficient applications are received.
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 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 be supported by one of our dedicated relocation executives, who will guide you through the process, including:
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Document gathering and checking.
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COS and Visa Application support, if applicable.
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Support sourcing short- and long-term accommodation.
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Travel arrangements and family support for finding schools and other aspects of pastoral care.
Consultant Psychiatrist – Acute Inpatient Service
South of England | Close to London
- Salary: £109,725 – £145,478 dependent on Consultant experience.
- Recruitment premia £15,000 over 3 years *subject to policy requirements
- Relocation allowance: up to £8000 *subject to policy requirements
An inclusive and progressive NHS mental health trust in the South of England is seeking a Consultant Psychiatrist with a strong interest in acute inpatient care. The successful candidate will join a compassionate and collaborative multidisciplinary team, providing high-quality psychiatric care to adults and clinical leadership across inpatient services. Doctors with MRCPsych, CESR interest, or a European Specialist qualification are encouraged to apply.
This is a fantastic opportunity to join a leading NHS Foundation Trust known for integrated working, a strong culture of kindness and respect, and its commitment to clinical excellence and innovation.
Applications are welcome for full-time, part-time, or flexible working patterns. CESR (Certificate of Eligibility for Specialist Registration) support is available and tailored to individual needs.
JOB REQUIREMENTS AND DETAILS
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Full GMC registration with a licence to practise is essential.
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Eligibility for inclusion on the GMC Specialist Register or within six months of CCT.
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Section 12 approval (or eligibility within 6–12 months).
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Clinical experience in managing acute adult mental illness in inpatient settings is required.
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Strong teamworking, communication, and leadership skills are essential.
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Ongoing opportunities for professional development through training, leadership pathways, teaching, and academic engagement.
CORE DUTIES OF THIS ROLE
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Provide Consultant-level psychiatric care to adult inpatients, in line with the Trust’s Acute Operational Policy.
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Deliver clinical leadership and active involvement in quality improvement initiatives.
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Work collaboratively with multidisciplinary teams and contribute to a recovery-focused, trauma-informed approach to care.
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Coordinate with specialist and community teams to ensure effective patient transitions and continuity of care.
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Supervise and support junior doctors, specialty trainees, and students.
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Participate in Consultant on-call rota (details available on request).
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Engage in audit, teaching, research, and service development activities.
LIFE IN THE SOUTH OF ENGLAND
Located in the South of England, this opportunity offers the perfect balance of professional fulfilment and quality of life. The area combines vibrant urban centres, picturesque countryside, and excellent transport links — with London just 30 minutes away by train, and both Heathrow and Gatwick airports nearby for easy international travel.
This region is known for its historic market towns, outstanding schools, and a wide range of cultural and recreational activities. Whether you\'re relocating alone or with family, it offers something for everyone — from city convenience to coastal calm.
The Trust is committed to inclusivity, wellbeing, and the development of its workforce, offering access to flexible working and a wide range of staff benefits.
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 interview preparation sessions.
-
Contract and offer negotiations for salary, relocation packages, tenure, and more.
Once you have accepted your new role, you’ll be supported by one of our dedicated relocation executives, who will guide you through the process, including:
-
Document gathering and checking.
-
COS and Visa Application support, if applicable.
-
Support sourcing short- and long-term accommodation.
-
Travel arrangements and family support for finding schools and other aspects of pastoral care.
Consultant Psychiatrist (General Adult Psychiatry) – Republic of Ireland
Location: Republic of Ireland - South
Salary: €222,215 to €266,925 per annum
Organisation: Health Service Executive (HSE), Ireland
Specialism: General Adult Psychiatry
Job Type: Inpatient and Community Services
A trust in the South of the Republic of Ireland is seeking a Consultant Psychiatrist with expertise in General Adult Psychiatry to lead a multidisciplinary team delivering both inpatient and community mental health services. The psychiatry department consists of a diverse and well-established team, including Consultant Psychiatrists, Nurse Team Leads, Community Mental Health Nurses, Occupational Therapists, Psychologists, Support Workers, and other allied health professionals.
This role offers an excellent opportunity to work across varied settings, contributing to high-quality care for adults with complex mental health needs. Applicants with European Specialist qualifications or UK CCT are strongly encouraged to apply, and both internationally based and Ireland-based doctors are welcome.
Job Requirements and Details
- Consultant-level experience in General Adult Psychiatry.
- Eligible for Medical Council of Ireland (MCI) registration with an equivalent European or UK specialist certification.
- Prior experience in adult mental health services is essential.
- Salary ranges from €222,215 to €266,925, depending on experience and qualifications.
Core Duties of the Role
- Provide clinical leadership in General Adult Psychiatry across both inpatient and community settings.
- Supervise and support the development of junior doctors and multidisciplinary colleagues.
- Deliver patient-centred care in collaboration with a skilled multidisciplinary team.
- Contribute to ongoing service development and quality improvement within the department.
Life in the Republic of Ireland – South Region
The South of Ireland is known for its high quality of life, combining vibrant urban life with the tranquillity of coastal and rural living. The region offers beautiful landscapes, excellent schools, rich cultural traditions, and a welcoming community. Well-connected transport links and a variety of recreational and family-oriented opportunities make it a fantastic place to live and work.
How IMG Connect Will Support You
By applying through IMG Connect, you will benefit from dedicated support throughout your relocation and recruitment journey, including:
- CV and application preparation tailored to Irish medical systems.
- Interview preparation, including two in-depth coaching sessions.
- Contract and salary negotiations to ensure you receive the best relocation package.
Once placed, our relocation team will assist with:
- Document collection and verification
- Visa and work permit guidance
- Short- and long-term accommodation solutions
- Travel planning and pastoral support for you and your family, including school search and local integration
This is an exciting opportunity to join a progressive and supportive mental health service, delivering high-impact care in General Adult Psychiatry within one of Ireland’s most scenic and vibrant regions.
Consultant Psychiatrist (Old Age Psychiatry) – Republic of Ireland
Location: Republic of Ireland - South
Salary: €222,215 to €266,925 per annum
Organisation: Health Service Executive (HSE), Ireland
Specialism: Old Age Psychiatry
Job Type: Inpatient and Community Services
A trust in the South of the Republic of Ireland is seeking a Consultant Psychiatrist with expertise in Old Age Psychiatry to lead a multidisciplinary team providing both inpatient and community services. The psychiatry department consists of a diverse team of professionals including Consultant Psychiatrists, Nurse Team Leads, Community Mental Health Nurses, Healthcare Support Workers, Care Home Liaison Nurses, Young Onset Dementia Nurses, Occupational Therapists, Psychologists, Dementia Post-Diagnostic Support, Care Managers, and other support staff.
This role offers a unique opportunity to work across both inpatient and community services, allowing for a broad and varied clinical experience in the field of old age mental health care. The position is open to both international applicants and those already based in Ireland, and those with equivalent qualifications such as a European Specialist qualification or CCT in the UK are strongly encouraged to apply.
Job Requirements and Details
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Consultant level experience in psychiatry.
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Eligible for Medical Council of Ireland (MCI) registration with equivalent European certification.
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Prior experience in Old Age Mental Health is essential.
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Salary will range from €222,215 to €266,925 depending on experience and qualifications.
Core Duties of the Role
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Provide clinical leadership in Old Age Psychiatry services across both inpatient and community settings.
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Supervise and support the training and professional development of junior doctors.
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Work collaboratively with the multidisciplinary team to provide high-quality care to patients.
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Participate in the development and improvement of services within the department.
Life in the Republic of Ireland - South Region
The South of Ireland offers a wonderful blend of vibrant urban areas and peaceful rural settings. With stunning coastlines, charming villages, and bustling cities, it’s an ideal location for both professional and personal life. Major cities offer excellent cultural, recreational, and family-oriented opportunities.
Transport links are efficient, and the region is home to highly regarded schools, a wealth of outdoor activities, and a rich cultural scene. Ireland\'s unique history and traditions provide a welcoming and enriching experience.
How IMG Connect Will Support You
When applying through IMG Connect, you’ll receive the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We will support you with:
-
CV preparation with a bespoke session with one of our specialists.
-
Application support with expert knowledge of Irish medical specialties and recruitment processes.
-
Interview preparation including at least two video calling interview sessions.
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Contract and salary negotiations for the best possible relocation package, including accommodation and other benefits.
Once you have accepted your new role, IMG Connect’s relocation team will guide you through the entire transition, including:
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Document gathering and verification.
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Visa and work permit assistance if required.
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Accommodation support for both short- and long-term housing.
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Travel and relocation assistance, including support for your family in finding local schools or any other necessary pastoral care.
This is an exciting opportunity to join a dynamic team and contribute to the ongoing development of services in the field of Old Age Psychiatry in the Republic of Ireland\'s South Region.
A Health Board on the South Wales coast is seeking a Consultant Psychiatrist to join a central clinic as part of an evolving mental health service committed to delivering a 24-hour single point of admission, supported by two treatment wards and five dynamic community mental health teams.
This is a fantastic opportunity to lead clinical change within a supportive and multidisciplinary environment, where collaboration with management and clinical colleagues is highly valued.
This opportunity is open to both UK-based and international doctors, with CESR portfolio support available to help progress toward specialist registration.
Job Requirements and Details
Qualifications: Full GMC registration with a licence to practise, MRCPsych preferred, CCT or equivalent specialist qualification and training in Psychiatry.
Experience: Applicants must have significant experience in general adult psychiatry.
Desirable: Previous leadership roles, community mental health experience, and involvement in service development or clinical governance.
Salary: £106,000 to £154,760 per annum, dependent on experience and length of service.
Core Duties of This Role
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Take overall clinical responsibility for outpatient care, including the development and oversight of Care and Treatment Plans.
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Provide leadership and supervision to the multidisciplinary team, with clear delegation of responsibilities.
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Contribute to service planning in line with the strategic direction of the Health Board.
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Provide educational supervision to junior medical staff, supporting training and development in line with Royal College guidelines.
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Actively participate in quality assurance, clinical governance, risk management, and clinical audit processes.
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Fulfil on-call commitments on a 1:14 rota, with prospective cover across the SBUHB area.
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Engage in continuous professional development, including annual job plan review and maintenance of Royal College CPD requirements.
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Opportunities for involvement in research and innovation are encouraged and supported.
Living and Working on the South Wales Coast
The South Wales coast offers a unique blend of coastal beauty and urban convenience. With stunning beaches, nearby national parks, and a thriving cultural scene, the region provides a high quality of life for professionals and families.
The area is well connected, with excellent schools, vibrant communities, and strong transport links to Cardiff, Bristol, and London. Whether you\'re seeking outdoor adventure or a peaceful place to call home, the South Wales coast offers an ideal setting for both work and leisure.
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 will assist you with:
-
CV preparation with a bespoke session from one of our NHS recruitment specialists.
-
Application support tailored to psychiatric roles and NHS expectations.
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Two comprehensive video interviews to prepare for your NHS panel.
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Contract negotiation including salary, relocation, and service expectations.
Post-offer, your IMG Connect relocation executive will guide you through:
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Visa sponsorship (including COS and application support).
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Accommodation search assistance.
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Family relocation support (schools, childcare, etc.).
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Local area orientation and integration advice.