This article delves into the specific guidance on GMC applications for entry onto the UK Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for clinical oncologists.
We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:
Skip ahead to the relevant section if you know what you’re looking for.
CESR, or the Certificate of Eligibility for Specialist Registration, is the route to specialist registration for doctors who have not completed a GMC-approved training programme, but can demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of the CCT in the UK.
CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a clinical or radiation oncologist, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.
Oncologists must prove to the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question.
In order to be eligible for CESR, doctors should have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist experience or knowledge as a clinical oncologist within a non-training post.
Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced oncologists will secure a post in the UK, and work towards CESR whilst in post.
Whilst it is always beneficial to complete FRCR (Oncology), particularly for doctors who have trained outside the UK or an EEA country, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams.
The standard test of knowledge in the Clinical Oncology curriculum is the FRCR exams, so passing these exams confirms the attainment of the competencies of the core curriculum.
FRCR (Oncology) is only a requirement for doctors looking to attain Specialist Registration via the CCT route.
Similarly, UK trainees would have completed MRCP (UK) before beginning their clinical oncology training, which is also not required for oncologists going through the CESR route.
However, CESR applicants who have not successfully completed these exams must provide alternative evidence that demonstrates equivalent knowledge to oncologists who have passed the FRCR (Oncology) exams and the appropriate level of non-oncology expertise and that you can appropriately manage the acutely unwell patient.
Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.
You can read more about the evidence required in the specialty specific guidance here.
Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current clinical oncology training programme requirements, in order to be awarded CESR.
The equivalence process involves submitting a written body of evidence to the GMC, consisting of:
The Royal College of Radiologists will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision.
Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.
Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the clinical oncology curriculum. If evidence is missing from any area of the curriculum, the application will fail.
Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.
Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle
Currency of Evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.
As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:
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.
Domain 1 – Knowledge, skills and performance
Qualifications
Assessments and appraisals
Logbooks, records of daily clinical practice and portfolios
Details of posts and duties (including both training and experience posts)
Research, publications and presentations
CPD and CME
Domain 2 – Safety and quality
Participation in audit, service improvement
Safety
Domains 3 - Communication, partnership and teamwork
Communication
Partnership and teamwork
Domain 4 – Maintaining trust
Acting with honesty and integrity
Relationships with patients
For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for clinical oncology.
Validating Evidence
Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.
All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.
All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.
Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.
Your electronic evidence can be in any of the following formats:
Formats outside of these are unlikely to be accepted.
The Online Application
You will be required to complete the following sections once you begin your application:
Additional Evidence
Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:
You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).
For further information about the online application process, see the GMC’s User Guide.
As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.
It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.
The indicative period of training for a CCT in clinical oncology is seven years (not including Foundation Training), 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 clinical or radiation oncologists.
All oncologists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,727.
For CESR-CP and CCT, the cost is £452.
The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.
Overseas doctors do not require CESR to work in the UK.
There are also roles for more senior oncologists such as a specialty doctor (SAS), specialist grade or acting consultant, where you will likely receive better pay and responsibilities that are more appropriate to your level of experience. While working in these positions, you can also collect evidence of your competences, particularly those specific to the UK clinical oncology curriculum.
Across the UK there are several NHS Trusts with well-established CESR programmes of support for oncology who have taken up a fixed term post with the view to completing CESR.
These positions also facilitate a faster route to working in UK and attaining Specialist Registration when compared to making an application for CESR from overseas, which can take an additional amount of time, depending on the country in which you completed your training.
In this group you will find tailored resources for oncology, including guidance on CESR applications, completely free to all doctors.
You can access our IMG Oncologists community here.
https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration
https://www.gmc-uk.org/-/media/documents/sat---ssg---clinical-oncology---dc3556_pdf-48456770.pdf
https://www.rcr.ac.uk/sites/default/files/clinical_oncology_curriculum_2021.pdf
Many senior IMG oncologists looking to develop their careers through Specialist Registration with the GMC may be eligible via the CESR route, and attaining CESR can be a long but very rewarding process. Look at our introduction to CESR for clinical oncologists for a full overview.
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.
An exciting NHS job opportunity is open for a Consultant Clinical Oncologist specializing in Lung & Breast Cancer at an NHS Trust that has been rated \"good\" over all by the CQC. This NHS Trust has undergone significant development, emphasizing patient and community care excellence. With £58 million in national funding, the Trust boasts a University Hospital status, prioritizing research, education, and training. The Care Quality Commission (CQC) lauds the Trust\'s outstanding performance, with 992 beds and 92% patient recommendation, serving a population of 675,000.
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The post holder is expected to:
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AM I ELIGIBLE FOR THIS ROLE?
EEA Candidates:
Non-EEA Candidates:
UK Based Candidates:
This is a great opportunity for any experienced consultant clinical oncologist working towards CESR in Clinical oncology specialist registration in the UK.
Non-EEA candidates:
EEA candidates:
UK candidates:
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AM I ELIGIBLE FOR THIS ROLE?
To be eligible for this vacancy you will need the following:
EEA Candidates:
Non-EEA Candidates:
UK-Based Candidates:
This is a great opportunity for any experienced Oncologist working towards CESR in the UK and Specialist Registration in Oncology. There will be opportunity to develop and lead on sub-specialist areas of cancer care.
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THE HEALTH BOARD
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AM I ELIGIBLE FOR THIS ROLE?
To be eligible for this vacancy you will need the following:
EEA Candidates:
Non-EEA Candidates:
UK-Based Candidates:
This is a great opportunity for any experienced Medical Oncologist working towards CESR in the UK and Specialist Registration in Oncology in the UK. There will be opportunity to develop and lead on sub-specialist areas of cancer care.