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
A large NHS teaching hospital in the East Midlands is looking for a Consultant in Clinical Oncology with an interest in lung, gynaecology, and/or colorectal cancer. The oncology department comprises a team of over 20 consultants and is supported by a large team of specialty doctors and junior trainees.
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 Clinical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist Registration or FRCR are most encouraged to apply.
FRCR (or equivalent) and extensive oncology experience are required for this role, and anyone with an interest in lung, gynaecology, and/or colorectal cancer should apply. The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
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Provide comprehensive non-surgical oncology services, including radiotherapy and chemotherapy clinics, for patients across lung, gynaecology, and/or colorectal tumour sites.
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Participate in the oncology on-call rota (1:12) and provide reciprocal cover for colleagues during periods of leave.
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Support the education and training of junior doctors, specialty doctors, ACPs, and medical students.
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Contribute to clinical governance, service development, and research initiatives across the Trust.
LIFE IN THE EAST MIDLANDS
This role is based in the East Midlands, a region that offers the perfect balance of urban convenience and rural charm. Residents can enjoy city living in Derby 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 Peak District on its doorstep, the East Midlands is a popular choice for healthcare professionals relocating to the UK.
HOW WILL IMG CONNECT SUPPORT YOU?
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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
-
Support sourcing short- and long-term accommodation
-
Travel Arrangements
This exceptional opportunity beckons Consultant Histopathologists specializing in Gynae oncopathology to become integral members of an NHS Trust that is a global beacon in cancer research and treatment. This role offers a chance to contribute to a consultant-led, subspecialist histopathology team, making a significant impact on the forefront of cancer care. We invite enthusiastic candidates to explore this exciting career prospect through NHS Jobs in the UK.
The NHS Foundation Trust, standing as Europe\'s largest comprehensive cancer center, commands an impressive annual budget of £360 million, employing over 3,500 staff, including 335 medical professionals. Acknowledged for its excellence, the Trust consistently ranks among the top four in national surveys, affirming its commitment to delivering high-quality patient care. The Histopathology Department, under the leadership of esteemed professionals, manages a substantial caseload, processing around 21,000 surgical pathology accessions annually. This involves the examination of approximately 280,000 slides, with a notable 1,000 cases annually seeking second opinions, underscoring the department\'s dedication to providing comprehensive diagnostic support.
This role is tailor-made for ambitious consultants looking to expand their career horizons. The well-funded department is a hub for impactful research, underscored by its recognition in a recent CQC report as an area of outstanding practice. The NHS Foundation Trust has a strong reputation for education and training, supporting junior doctor training programs across various specialties.
Living in London, a vibrant metropolis, provides a unique lifestyle enriched by cultural diversity. Residents can explore scenic spots like Hyde Park and the Thames River. World-renowned schools, including Imperial College London and University College London, contribute to the city\'s intellectual vibrancy. Excellent transport links facilitate easy travel within the city and to major cities and airports. Housing options, ranging from historic townhouses to modern apartments, accommodate diverse preferences, ensuring a comfortable and enriching life for medical professionals in the heart of London.
Apply now for a dynamic career at the forefront of cancer care, complemented by the vibrant and diverse urban lifestyle offered by the capital city.
AM I ELIGIBLE FOR THIS ROLE?
Non-EEA candidates:
- FRCPath
- Experience in Histopathology (sub specialised in Gynae oncopathology)
EEA candidates:
- Specialist certification in Histopathology
- Experience in Histopathology (sub specailised in Gynae oncopathology)
UK candidates:
- CCT, CESR or within 6-12 months of specialist registration
- Experience in Histopathology (sub specialised in Gynae oncopathology)
A hospital in the Channel Islands is looking for a Staff Grade Doctor in General Medicine with interests in Respiratory, Renal, or Care of the Elderly. The department comprises a team of consultants and is supported by a large team of middle-grade doctors. This role is open to both international applications and UK-based doctors, though those with European Specialist 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
Full registration with the General Medical Council and a minimum of 2 years of post-qualifying experience are required for this role, and anyone with an interest in Respiratory, Renal, or Care of the Elderly should apply. The salary will be between £58,742 and £97,050 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Provide high-quality care across both inpatient and outpatient services within the chosen specialty.
- Participate in the middle-grade tier rota, including on-call duties.
- Support the clinical management of patients in various units, including emergency and intensive care.
- Collaborate with consultants and multidisciplinary teams to ensure continuous service improvement.
LIFE IN THE CHANNEL ISLANDS
The hospital is located in a vibrant town, with popular residential areas offering both urban and rural living options. The region offers excellent schools, efficient transport links, and a wide range of leisure activities for both adults and families, including beautiful beaches, sports facilities, and cultural events. The area has a rich history, having been a strategic location during World War II and now boasting a unique blend of cultural influences.
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
A UK-based mental health service is seeking a Consultant Child & Adolescent Psychiatrist to join their Neurodevelopmental Team. This is a part-time (0.8 FTE), permanent post, offering an exciting opportunity to take on a senior clinical leadership role within a well-established specialist service for children and adolescents with complex neurodevelopmental conditions.
The team operates within a multidisciplinary framework, delivering comprehensive assessments, pharmacological treatment, and evidence-based care for young people. The role is ideal for experienced consultants looking to shape service delivery while maintaining strong clinical involvement.
This opportunity is also open to international applicants, particularly those eligible for inclusion on the GMC Specialist Register and who will be applying via CESR.
JOB REQUIREMENTS AND DETAILS
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Job Title: Consultant Child & Adolescent Psychiatrist – Neurodevelopmental Team
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Contract: 8 Programmed Activities (PAs) per week – Part-Time
- Contract Type: Permanent
- Salary: £105,000 – £139,000 (pro rata, dependent on experience)
Applicants must have:
- Full GMC registration with a licence to practise
- GMC Specialist Register in Child & Adolescent Psychiatry
- Section 12(2) MHA approval, or a willingness to complete this upon appointment
- Experience working in child, adolescent, or neurodevelopmental psychiatric services
- Strong leadership, multidisciplinary collaboration, and communication skills
- The ability to travel independently across service sites, including schools and service users\' homes
CORE DUTIES OF THIS ROLE
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Lead on psychiatric assessments, diagnosis, and pharmacological treatment planning for young people with complex and/or high-risk neurodevelopmental presentations.
- Provide consultation and guidance to the multidisciplinary team, as well as external agencies including paediatrics, schools, Tier 4 providers, and primary care.
- Maintain clinical oversight for young people under the care of the team, participating in emergency assessments and the consultant out-of-hours rota.
- Attend and contribute to weekly multidisciplinary team meetings and clinical formulations.
- Collaborate with carers, families, and professionals to co-create effective, evidence-based care plans.
- Support transitions from child to adult mental health services in line with protocol.
- Fulfil duties under the Mental Health Act, including conducting assessments and contributing to reports and tribunals as required.
- Maintain clear and timely medical documentation and support audit and quality improvement initiatives.
MANAGEMENT & STRATEGIC RESPONSIBILITIES
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Provide senior clinical leadership in partnership with the non-medical Clinical Team Lead.
- Contribute to the development of service-wide clinical guidelines and care pathways.
- Support service planning and transformation initiatives based on emerging need.
- Actively participate in governance activities, clinical audit, and performance monitoring.
- Engage with stakeholders and external partners at strategic and operational levels.
LIFE IN THE REGION
This role is based in a well-connected and scenic part of the UK, ideal for those who enjoy a balance between urban accessibility and countryside living. With excellent road and rail links, London is just 1 hour by train and car, offering easy commuting and travel.
The area is highly attractive for families, with access to top-rated schools, green open spaces, and a vibrant local community. Whether you\'re seeking historic towns, cultural attractions, or tranquil rural retreats, this region offers something for everyone.
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.
An NHS teaching hospital in Kent is looking for a Consultant in Clinical Oncology with an interest in urology. The Oncology department comprises a team of over 40 Clinical and Medical Oncology consultants and is supported by a large team of middle-grade doctors, fellows, and trainees.
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 Clinical 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.CCT in Clinical 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
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Provide high-quality specialist care to melanoma patients attending the Kent Oncology Centre.
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Attend relevant MDT meetings and coordinate treatment planning with other specialists.
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Participate in departmental research initiatives and contribute to national and local clinical trials.
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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