CESR - a comprehensive guide for medical oncologists
- September 22, 2022
Doctors from any country can apply for Specialist Registration in the UK, provided they meet certain eligibility criteria, though there are different routes available based on the doctor’s training and qualifications.
In this blog we’ll be exploring Specialist Registration in medical oncology for overseas medical 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:
- What is Specialist Registration?
- What route is best for me as an overseas oncologist?
- Do I have to complete CESR before I can work in the UK?
- Do I need MRCP (UK) for Specialist Registration?
- What is the CESR equivalence process?
- What evidence do I need to submit for a CESR in medical oncology?
- 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
Holding Specialist Registration in any CCT specialty means that you can be appointed to a substantive (or permanent) consultant position in the NHS. All medical 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 oncologists, attaining specialist registration will mean you are qualified to practice independently as a medical oncology consultant in the NHS.
Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a medical 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 Oncologists who have complete 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 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.
You can read a detailed breakdown of Specialist Registration in the UK in our IMG Resources library.
Medical Oncology Positions in the NHS without CESR
It is important to note that you can apply for senior oncology roles in the NHS, such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register.
Similarly, CESR is not required by overseas doctors before moving to the UK to work in the NHS.
In these senior NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. Within these positions, you can collect evidence of your competences, particularly those specific to the UK medical 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.
MRCP (UK) for Specialist Registration
Whilst it is always beneficial to complete MRCP (UK), particularly for doctors who have trained outside of 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 Medical Oncology curriculum are the MRCP (UK) exams, so passing these exams confirms the attainment of the competencies of the core curriculum.
MRCP (UK) is only a requirement for doctors looking to attain Specialist Registration via the CCT route.
The structure of the programme is an indicative two years in Core Medical Training or Acute Care Common Stem (ACCS), followed by an indicative four years of training in Medical Oncology. Therefore, applicants need to demonstrate the appropriate level of acute medicine expertise as well as competencies in medical oncology.
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 medical 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 Physicians 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 Medical 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 Medical 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 medical 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
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.
CESR Application Cost
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 Medical 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 medical oncology 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 oncologists.
#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 Medical Oncology curriculum, not just your sub-specialty.
- Remember to refer to the most up-to-date Medical Oncology 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 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.
- Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded MRCP aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
Sources
https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration
https://www.gmc-uk.org/-/media/documents/sat---ssg---medical-oncology---dc2310_pdf-48455474.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 medical 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
An NHS hospital in the North of England is looking for a Consultant Medical Oncologist with interest in lung and breast cancers. The Oncology department comprises a team of experienced oncologists, specialist nurses, and research staff, offering high-quality patient care and research opportunities. TAnyone 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, GMC Specialist Register (or within 6 months), CESR, or a suitable Royal College qualification are most encouraged to apply.
- The salary will be between £105,504 - £139,882 per annum, dependent on experience and grade.
CORE DUTIES OF THIS ROLE
- Provide specialist care in a chosen cancer site, including systemic anti-cancer therapies (SACT), immunotherapy, and targeted treatments.
- Participate in multidisciplinary team (MDT) meetings across hospital sites.
- Engage in clinical research and trials, working alongside a well-established research team.
- Support the teaching and supervision of junior doctors, registrars, and medical students.
- Contribute to the 1:8 consultant on-call rota, including weekend ward rounds.
LIFE IN THE NORTH OF ENGLAND
This region offers a perfect mix of city and countryside living, with bustling urban centres and tranquil rural retreats. Those looking for city life can enjoy vibrant city centres, while those seeking peace and quiet can explore beautiful national parks and historical towns.
The area boasts high-performing schools, excellent transport links, and a wide range of leisure activities, including outdoor adventures, cultural festivals, and international travel connections.
With a rich industrial heritage and stunning architecture, the region has played a pivotal role in British history, making it an exciting and dynamic place to live and work.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- 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
An NHS hospital in Bath, South West England is looking for a Consultant Clinical or Medical Oncologist with an interest in either Breast, Urology and/or Colorectal Cancers. The Oncology department comprises a team of 12 Clinical Oncologists, 8 Medical Oncologists, and is supported by a large team of middle-grade doctors, specialist nurses, and research staff. This Oncology job is open to both international applications and UK-based doctors.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
- Experience and interest in Breast, Urology and/or Colorectal Oncology is required.
- The salary will be between £105,504 - £139,882 per annum, dependent on experience and grade.
CORE DUTIES OF THIS ROLE
- Manage patients with Breast, Urology and/or Colorectal Cancers, including systemic anti-cancer therapies (SACT), immunotherapy, and targeted treatments.
- Provide expert care in oncology inpatient and outpatient settings and contribute to multidisciplinary team (MDT) meetings.
- Participate in clinical research, with access to a well-established clinical trials unit and national research collaborations.
- Engage in teaching and mentoring junior doctors, registrars, and medical students, with opportunities for leadership in education and training.
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
An NHS hospital in the South East of England is looking for a Consultant Clinical Oncologist with an interest in Breast Oncology. The Oncology department comprises a team of experienced Medical and Clinical Oncologists, supported by a large team of middle-grade doctors and a robust research unit. This Oncology job is open to both international applications and UK-based doctors, though those with European Specialist or a suitable Royal College qualification 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 or specialist registration with the General Medical Council (GMC) or eligibility within six months is required for this role. Anyone with an interest in breast cancer should apply. The salary will be between £105,504 and £139,882 per annum, dependent on experience and grade.
CORE DUTIES OF THIS ROLE
- Manage breast cancer patients, working closely with multidisciplinary teams across the region.
- Deliver systemic anti-cancer therapies (SACT), including chemotherapy, immunotherapy, and targeted treatments.
- Participate in breast cancer multidisciplinary team (MDT) meetings.
- Supervise and teach junior doctors, registrars, and medical students.
LIFE IN THE SOUTH EAST
The South East of England offers a mix of coastal and countryside living, with excellent urban options and picturesque rural retreats. The region provides easy access to London and international travel, making it a convenient yet scenic place to live and work.
The area is home to top-performing schools, a thriving job market, and fantastic leisure activities, including watersports, hiking trails, and cultural festivals. There is a strong medical and academic presence, with opportunities for research and collaboration.
Historically, the region played a key role in shaping England, from medieval battles to its significant contributions to maritime history. The blend of heritage and modern development makes it an exciting place to live and work.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- 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
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
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