CESR Applications for Medical Oncologists

  • November 23, 2022

In this article, we’ll be taking a closer look at the specific guidance on NHS applications for entry onto the Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for medical 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. 

An Introduction to CESR

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 medical 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 medical experience or knowledge as a medical 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.  

MRCP for Specialist Registration

Whilst it is always beneficial to complete MRCP (UK), particularly for doctors who have trained outside the UK or the EEA, 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 is 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 or CESR-CP route. 

The structure of medical oncology training in the UK 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 refers to 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; AND 
  • 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 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 & 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 
  • 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

Gathering Evidence for a CESR Application

Domain 1 – Knowledge, skills and performance 


  • Primary Medical Qualification (PMQ) 
  • Specialist medical qualification(s) 
  • Curriculum or syllabus (if undertaken outside the UK) 
  • Specialist registration outside the UK 
  • Honours and prizes 
  • Other relevant qualifications 

Assessments and appraisals

  • Appraisals and assessments 
  • RITAs, ARCPs and training assessments 
  • 360˚ and multi-source feedback 
  • Awards and discretionary points letters 
  • Personal development plans (PDP) 

Logbooks, records of daily clinical practice and portfolios

  • Logbooks 
  • Consolidation, cumulative data sheets, summary lists and annual caseload statistics 
  • Medical reports 
  • Case histories 
  • Referral letters discussing patient handling 
  • Patient lists 
  • Departmental (or trust) workload statistics and annual caseload statistics 
  • Rotas, timetables and job plans 
  • Courses relevant to curriculum 
  • Portfolios (electronic or revalidation) 

Details of posts and duties (including both training and experience posts)

  • Employment letters and contracts of employment 
  • Job descriptions 
  • Job plans 

Research, publications and presentations

  • Research papers, grants, patent designs 
  • Publications within specialty field 
  • Presentations, poster presentations 


  • CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences 
  • CPD registration points from UK Medical Royal College (or equivalent body overseas) 
  • Membership of professional bodies and organisations 
  • Teaching timetables 
  • Lectures 
  • Feedback or evaluation forms from those taught 
  • Letters from colleagues 
  • Attendance at teaching or appraisal courses 
  • Participation in assessment or appraisal and appointments processes 

Domain 2 – Safety and quality

Participation in audit, service improvement

  • Audits undertaken by applicant 
  • Reflective diaries 
  • Service improvement and clinical governance meetings 


  • Health and safety 

Domains 3 - Communication, partnership and teamwork


  • Colleagues 
  • Patients 

Partnership and teamwork

  • Working in multidisciplinary teams 
  • Management and leadership experience 
  • Chairing meetings and leading projects 

Domain 4 – Maintaining trust 

Acting with honesty and integrity

  • Honest and integrity 
  • Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities) 
  • Data protection 

Relationships with patients

  • Testimonials and letters from colleagues 
  • Thank you letters, cards from colleagues and patients 
  • Complaints and responses to complaints 

For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for medical 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. 

Application Submission

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: 

  • .doc 
  • .pdf 
  • .ppt 
  • .xls 

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: 

  • Specialty details 
  • Qualification details and professional experience 
  • Details of your referees 
  • Registration and licensing history 
  • Evidence summary 
  • Details of your verifiers 
  • Final declaration and payment 

Additional Evidence 

Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:  

  • What evidence they’ve accepted  
  • What evidence they’re unable to accept (including the reasons for this)  
  • Advice and guidance on how your application could be strengthened  

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

How long does it take to complete?

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. 

Cost of CESR Applications

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. 

How long does it take to receive a decision?

The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application. 

#IMG Tips

  1. Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.  
  2. Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures. 
  3. Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.  
  4. Ensure that the evidence you collect demonstrates your competence across the whole of the Medical Oncology curriculum, not just your sub-specialty.    
  5. Remember to refer to the most up-to-date Medical Oncology CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.  
  6. 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. 
  7. 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). 
  8. 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. 
  9. 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.





Getting started 

Attaining Specialist Registration through the CESR pathway can be a long but very rewarding process. Look at our introduction to CESR for medical 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: 



Relevant Jobs

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We are currently looking for an experienced Clinical Oncologist, who works with both chemotherapy and radiotherapy treatments for a large acute hospital in the Midlands, England.

You\'d be joining a team of 8 clinical and 2 medical oncology consultants at the modern Oncology Centre (opened in mid 2010\'s), to help support and develop site-specific services in outpatient and chemotherapy as part of the development of the centre. 

There are 3 Elekta LINACS with VMAT and IGRT, using Mosaiq and Raystation for RT planning on site, along with 35 chemo day chairs used across 3 hospitals under this NHS trust.


  • FRCR Clinical Oncology or equivalent
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12 - 24 months fixed term (subject to be renewed)


  • Attractive salary and relocation package
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Specialty & Special Interests:
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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.

This position aims to strengthen the Oncology team, focusing on lung cancer care and Stereotactic Ablative Body Radiotherapy (SABR). Situated at the dynamic centre within the \"good\"-rated trust, the role contributes to systemic treatment advancements and ongoing research. The Oncology Department at the Combined Haematology Oncology Centre caters to 1-1.5 million residents. Designated as a Cancer Centre since 1996, the Centre collaborates with neighboring hospitals, fostering a multidisciplinary approach. The purpose-built Cancer Centre, equipped with advanced imaging, provides nurse-led services, chemotherapy units, and home-delivered immunotherapy.

The post holder is expected to: 

  • Participate in all facets of departmental activity.

Career development at the Trust includes access to CESR support, specialty training, and opportunities for external duties. The forward-thinking Oncology department initiated SABR practices in 2021 and maintains a dynamic research team supporting various clinical trials.

Life in the area, a historic home of the Royal Navy, offers cultural richness and proximity to scenic countryside. A thriving artistic community, excellent schools, and various development projects contribute to the vibrant atmosphere. The area combines city conveniences with picturesque villages, making it an excellent place to raise a family!

This comprehensive opportunity integrates the Consultant role, SABR RT specialisation, CESR support, and coastal life in the UK, creating a fulfilling and enriching professional and personal experience. 


EEA Candidates: 

  • Recognised European Medical Degree or Specialist Qualification

Non-EEA Candidates:

  • FRCR or equivalent qualification 

UK Based Candidates: 

  • FRCR qualification

This is a great opportunity for any experienced consultant clinical oncologist working towards CESR in Clinical oncology specialist registration in the UK.

A Cancer Centre in Wales are looking for a Consultant or Specialist in Medical Oncology with a sub-specialty interest in AOS/Melanoma. They are considering either UK or Overseas trained doctors for a permanent or fixed term contract type. The trust will support with CESR support and/or those looking to enter specialty training in the NHS.

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What is the Welsh Health Board like?

The Health Board are one of the biggest healthcare groups in the UK, providing primary, community, mental health and acute hospital services for the population of around 390,000. They have a budget of around £1bn and employ approximately 12,500 staff. Besides their three major hospital sites, they are also responsible for community hospitals, health centres, clinics, mental health units, community teams, GP practices and other services provided by dentists, opticians and pharmacists. Their mission is to improve the health, wealth and wellbeing of the people of Wales and the rest of the world.

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This Cancer Centre provides a high degree of specialisation for all the major cancers. It has one dedicated ward of 30 beds (with scope to increase to 36 beds at periods of high demand) for both oncology and haematology patients, together with a chemotherapy and haematology day unit, and an aseptic unit on site. There are also two laminar flow rooms for patients requiring bone marrow/stem cell transplantation and one dedicated room for radioactive isotope therapy.

There is a state of the art telemedicine facility allowing regular multi-professional meetings between oncologists, physicians, surgeons and AHPs in Wales. The system has the capacity to transmit and view both high quality radiological images and histopathological slides.  

The staff are highly experienced, consisting of nurses, radiographers, research officers and admin staff. The new consultant will be joining a friendly and forward-thinking consultant team of clinical and medical oncologists who are committed to delivering highest standards of cancer care, alongside a large team of other clinical and non-clinical professionals.

What Career Development and Opportunities are available?

The Cancer Centre is heavily involved in training which takes place at all levels from undergraduate lectures and clinical teaching, through to Foundation and Core Medical trainee clinical and educational supervision, and higher specialist training. They will also provide excellent CESR support.

Life in South Wales

Based in South Wales, the area is fast becoming one of the most popular places to live in the UK. This waterfront location is actually Wales’s second most populated city and county, offering all the benefits and amenities of a built-up urban environment, alongside a 5 mile stretch of a pristine, sandy coastline. 

The city is home to multiple live music venues, showcasing everything from small gigs to orchestral performances. Annually, the city hosts a number of different festivals, attracting artists from across Wales and the UK. Today, new regeneration is planned which will only increase its popularity, amenities, and modernity. The city is experiencing a period of development and a resurgence of new business and investment, with the city council focusing on creating a culture of creativity and an emphasis on attracting tech led businesses.

The area also has good travel links. It is an easy drive to Port Talbot and Cardiff and you can get to London via the M4, and around Wales on the A48. There are also regular trains to Cardiff, Newport and London. For international and domestic flights, Cardiff Airport is just 44 miles away.

Am I eligible for this role?

EEA candidates: 
•    Recognised European Medical Degree or Specialist Qualification in Medical Oncology
•    Extensive experience in AOS/Melanoma oncology
Non-EEA candidates: 
•    MRCP
•    Extensive experience in AOS/Melanoma oncology
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•    Extensive experience in AOS/Melanoma oncology
•    Within 6-months of CESR or CCT in Medical Oncology

This is a great job for any experienced overseas Medical Oncologists working towards CESR and specialist registration in the UK.
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This is a high performing and friendly department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK, and a great opportunity for any overseas consultant oncologists looking for CESR support and great career development in a beautiful part of England.

What is the NHS Trust like?

This NHS Trust is the first NHS Trust on the English mainland to provide community, mental health and acute hospital services. It was formed from the merger of two trusts on the 1st April 2020. Now, they are preparing to merge with another trust so that they are better able to support the health of all the people in the area.

The trust provides a range of services from 13 community hospitals including outpatient and diagnostic services, 190 inpatient beds and seven Minor Injuries Units. They also provide specialist mental health services, healthcare for adults with learning disabilities, medical and surgical care, maternity services and cancer treatment services. The trust\'s facilities for the treatment of cancer have undergone a major expansion, culminating in the opening of the Cancer Centre in May 2009.

What is the Oncology Department like?

The Oncology Department provides Clinical and Medical Oncology inpatient and outpatient services as well as radiotherapy and chemotherapy to all common tumour sites. The new appointee will be joining an ambitious team of 12 Consultant Oncologists (8 Clinical & 4 Medical), 1 Associate Specialist (Medical Oncology), 3 Speciality Doctors, and a rotation of junior doctors who cover the inpatient ward. There are also two Clinical Oncology ST3 doctors. It is a research orientated department with a dedicated clinical trials team and are one of the highest recruiters within the South West and nationally for a number of trials. 

The new consultant will be working within the Cancer Centre which provides cancer care to a population of approximately 500,000. It has received a number of accolades since opening in 2009 for the high quality care delivered. These include CHKS ISO 9001 accreditation, Macmillan Quality Environment Mark score of 5 (out of 5) on all principles and in the 2018 National Cancer Patient Experience Survey, the Beacon Centre was ranked third overall which is an excellent reflection of the patient centred care delivered.

What Career Development and Opportunities are available?

There is real opportunity to progress through CESR at pace at this trust, with a strong desire for newly-qualified consultants to develop their specialty areas of interest and undertake in various cancer trials and research projects where possible. Research is encouraged here, particularly when this is appropriate to professional development and to the service development of the department. Opportunities are available with applications for funding co-ordinated by the Trusts Medical Directors and clinical trial recruitment to International, National and Regional trials is active in all tumour sites. This trust was also rated as an area of Outstanding Practice by CQC (2016), and with the highest GMC score in the South West for training.

Life in the area:

This area has diverse shopping, restaurants, and regularly hosts international music and sporting fixtures. It is located between various areas of outstanding natural beauty, featuring national hotspots for cycling, surfing, and climbing. There’s plenty to keep you occupied alongside the abundance of music festivals and local traditions. The area is in close proximity to both the beaches of North Devon and Cornwall, while also being less than two hours from the city of London. 

It also offers some of the best schools in the country. Ranging from public institutions to award winning state schools with one being ranked in the top 10 of A-level providers nationally for the last eight years.

Am I eligible for this role?

Non-EEA candidates: 

  • FRCR (Clinical Oncology)

EEA candidates: 

  • Recognised European Qualifications 

UK candidates: 

  • Within 6 - 12 months of completing CCT

Are you a Clinical Oncologist looking for a rewarding opportunity in the UK? An excellent NHS Foundation Trust is seeking a talented professional to join their oncology team. With a commitment to collaborative working, this NHS Foundation Trust provides excellent oncology services and ample opportunities for training, research, and career development. The trust is supportive of CESR applications.

The Oncology Department takes a collaborative approach to cancer care, with teams in two sites working together to provide comprehensive and sustainable services. Equipped with state-of-the-art technology, the Cancer Centres offer a multidisciplinary approach, supported by Acute Oncology Teams and a skilled team of healthcare professionals. The post holder will have the opportunity to immerse themselves in an NHS Role as part of a well-equipped, modern oncology department.

The department sits within an NHS Trust that is known to be the leading healthcare provider in East Anglia, serves a population of nearly 800,000 residents across two main hospitals, six community hospitals, and various clinics. With a budget exceeding £650 million, the NHS Foundation Trust invests in enhancing their hospitals and creating an ideal working environment. They prioritise the well-being of their staff and patients, offering exciting prospects for development, innovation, research, education, and training.

Additional to the opportunity of working for a great NHS Foundation Trust, living in the area offers a diverse and vibrant lifestyle. Essex, with its stunning coastline, beaches, and countryside, provides a great environment for families. The county offers a range of housing options, urban or rural, at affordable prices. With excellent transport links to London, you can enjoy the benefits of both city and countryside living. Furthermore, Essex boasts good schools and a high quality of life, making it an ideal place to settle and explore nature\'s playground.

Join them to make a significant impact in the field of oncology while enjoying a fulfilling career and a balanced lifestyle in a beautiful region of the UK.


To be eligible for this vacancy you will need the following:

EEA Candidates:

  • Recognised European Medical Degree or Specialist Qualification in Clinical Oncology
  • IELTS or OET

Non-EEA Candidates:

  • MRCP/FRCR/PLAB qualifications
  • Experience in Oncology
  • IELTS or OET

UK-Based Candidates:

  • MRCP or equivalent MD qualification
  • 2 years post-registration clinical practice

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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