GMC Registration can be a long and complex process. With several options available for overseas doctors to demonstrate evidence of their skills and knowledge, it might be difficult to decide the best route to take to register with the GMC.   For international doctors planning their route to the UK, the two most common and popular routes by far are the UK postgraduate qualifications (MRCEM for emergency medicine physicians) or PLAB. Here we provide a summary of both pathways and briefly consider their benefits to help you make the best choice in your journey to the UK as an IMG.  GMC Registration for Overseas Doctors PLAB for GMC Registration MRCEM for GMC Registration Which is better for me as an IMG: PLAB or MRCEM? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  GMC Registration for Overseas Doctors Registering with the GMC is a multi-stage process, including key timings actions and documents. To receive full registration, international doctors must provide evidence of:   What is often the most long and challenging part of the process is providing sufficient evidence of skills and knowledge, however, you can check whether you have a GMC-accepted postgraduate qualification here.  There are 5 ways in which an overseas doctor can demonstrate their skills and knowledge:  PLAB  Acceptable Postgraduate Qualification / Licensing Examination  Relevant European Qualification  Sponsorship / MTI  CESR / CESR-CP / CEGPR  Please note that only one type of evidence is required to demonstrate skills and knowledge for GMC registration.  Of these routes, the most accessible are PLAB and the Acceptable Postgraduate Qualification because they are two of the only routes that do not depend on the country you’ve trained in – the UK postgraduate exams and PLAB can be sat by doctors.  For a detailed breakdown of all the routes available to IMGs, see our blog here.  PLAB - Professional & Linguistics Assessment Board The first and most common route we’ll be discussing, which is particularly popular among junior doctors, is PLAB.  PLAB is a two-part exam (one written and one practical element), which assesses whether a candidate is at least as capable as a doctor starting the second year of their Foundation Programme Training (FY2 or F2) and can therefore work safely as an SHO (Senior House Officer) in the NHS.  The GMC has produced a useful video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.  MRCEM - UK Postgraduate Qualification for Emergency Medicine The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience.  For emergency medicine, this can be done by attaining Membership of the Royal College of Emergency Medicine. The Royal College of Emergency Medicine (RCEM) is the professional body that regulates the specialism of emergency medicine in the UK, and Membership of the College of the Royal College of Emergency Medicine (MRCEM) is the full qualification attained through these examinations.  Take a look at our IMG Resources library for complete guides on MRCEM to learn more.  You can also read our interview with Dr Behzad Rashid to learn about the experience of an IMG Emergency Medicine resident going through MRCEM.  PLAB vs MRCEM Both MRCEM and PLAB are respectable routes that demonstrate skills and knowledge and will allow an international doctor to register with the GMC and work in the UK. To decide which route of the two is best for you, you’ll need to consider the benefits of each and how they align with your needs and priorities in moving to the UK.  Seniority of Positions in the NHS It would be difficult for an overseas emergency medicine doctor to obtain a more senior post in the NHS without either MRCEM, a GMC-approved training programme, or extensive experience from a similar English-speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.  Training To practice as a consultant in the UK, you must have gone through specialty training and will need a GMC-recognised postgraduate qualification to do so, whether a qualification from the country in which you completed your specialty training, or MRCEM.  Due to the more specialised nature of MRCEM, we advise emergency medicine doctors to complete MRCEM, as many NHS Trusts will list MRCEM as a requirement on job descriptions. MRCEM also allows IMGs access to more senior roles and competitive salaries.   Time PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.  MRCEM has three stages, the last of which must be taken after at least 24 months of postgraduate experience with at least 6 months in emergency medicine and can take anywhere between 24-36 months to prepare from start to finish.  Cost MRCEM costs £1,115 for the three exams. Whilst the Primary and Intermediate SBA exams are delivered worldwide via computer-based testing company, the OSCE is delivered in London (UK), Kuala Lumpur (Malaysia), Chennai, Hyderabad, Mumbai and Kochi (India), so there may be the added expense of international travel.   PLAB costs £1,189, and whilst PLAB 1 can be sat in many overseas centres around the world, PLAB 2 is only delivered in the UK. You can find a list of overseas centres for PLAB 2 here.  So for both MRCEM and PLAB, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.  It’s also important to note that these costs can rise if re-sits of the exams are necessary.  Summary PLAB, as an exam which examines a doctor’s ability to work safely as an SHO, does not assess ability in emergency medicine specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine, I.e., emergency medicine.  PLAB allows doctors to enter the UK system much faster than other routes and for this reason alone, it is favoured by international doctors when considering their path to the UK.  MRCEM involves three more difficult examinations and takes more time to prepare for. However, for overseas doctors, attaining MRCEM will allow you to jumpstart your career in the UK, as you don't need PLAB or Core Training.  Additionally, MRCEM will facilitate the application for more senior roles in UK emergency medicine than PLAB.  #IMG Tips Determine your priorities – your goals and timeline for relocating to the UK are important in deciding which route is best for, and this is different for everyone.  Plan well ahead – depending on the route you choose, you may be embarking on a long journey through these exams, so plan how you will fit them into your life and how best to prepare to maintain a good work-life balance at the same time.  Find a support network – once you know which exams you will sit, find a support network of others who are also preparing for the exam.   Sources https://rcem.ac.uk/exam-mrcem/  https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab  https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/evidence-to-support-your-application  Getting started Once you’ve decided which exams are best for you, it’s time to delve deeper into the exams and what they entail. For more useful blogs and articles on PLAB or MRCEM, registrations and qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.   Don’t hesitate to get in touch with one our recruitment specialists if you would like to discuss your options in the NHS once you have completed PLAB or MRCEM.   For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

FRCR CR2A and CR2B and the final exams in the FRCR qualification.  Completions of all three parts of the Fellowship of the Royal College of Radiologists (FRCR) qualification results in eligibility for GMC registration, once the English language component has also been met.  The FRCR examinations are key to an international oncologist being able to secure senior oncology jobs in the NHS and can be taken by IMGs from any country, provided certain eligibility criteria have been met. In this article, we take a closer look at the following:  An overview of FRCR How are the Final FRCR exams structured? How are marks awarded for CR2A and CR2B? Am I eligible to sit Final FRCR? Where can I sit the exams and how much do they cost? How do I apply for the exams? What is the best way to prepare for FRCR CR2A and CR2B? I’ve passed the FRCR Radiology exams, what’s next? Skip ahead to the relevant section if you know what you’re looking for.  An Overview of FRCR Radiology FRCR Radiology is the set of three postgraduate examinations administered by the Royal College of Radiologists to test candidates’ knowledge and clinical understanding within the scope of the Specialty Training Curriculum for Clinical Radiology.  The exams within the exam suite are as follows:  You can read an overview of the full FRCR Radiology examination suite via our IMG Resources library.  Please note that only full FRCR satisfies the postgraduate requirements for overseas doctors.  Alternative routes to GMC registration include PLAB and other recognised GMC qualifications or licensing exams, which you can find out more about here.  A Deep Dive into FRCR Part 2A & 2B Final FRCR Part A  The Final FRCR Part A examination assesses knowledge of the sciences that underpin clinical radiology including physics as applied to imaging including molecular biology, medical statistics, radiological findings in pathological and normal conditions together with their differential diagnosis, management pathways, and radiological interventions.  The examination comprises two single best answer papers, each containing 120 questions and covering a broad range of the core curriculum. Exams are 3 hours for each sitting.  The paper comprises a mix of questions from across a wide range of the curriculum:  Cardiothoracic and Vascular  Musculoskeletal and Trauma  Gastro-intestinal  Genito-urinary, Adrenal, Obstetrics & Gynaecology and Breast Paediatric   Central Nervous and Head & Neck   Final FRCR Part B The Final FRCR Part B examination assesses different aspects of a candidate’s radiological skills, all of which are considered necessary for safe and effective radiological practice.  The exam has three components:   reporting (long cases) – 6 cases in 75 minutes rapid reporting – 30 plain radiographs in 35 minutes oral exam – 2 x 30-minutes vivas The stations are broken down in more detail below.  Reporting Station This component is built on the fact that A&E department is a large part a radiologist’s workload.   The station tests candidates’ ability to rapidly decide if an image is normal or abnormal and the provision of a diagnosis for the abnormality.  The images are all radiographs with the balance of normals within the images about 45-50%. Trauma cases are the majority, but some chest and abdominal radiographs are included as they would be in a typical session of A&E reporting in the workplace. Each abnormal case shows one significant diagnosable abnormality.  This part of the examination reproduces the situation of plain film reporting as a safe radiologist needs to be able to identify abnormalities when present and confidently exclude them when they aren’t.   Rapid Reporting Station The reporting component centres around the understanding that radiologists largely communicate their findings through written reports.   This element tests the ability of the candidate to make observations, distinguish the relevance of these findings, deduce a list of differential diagnoses, suggest the most likely diagnosis and discuss further management including further imaging where appropriate.  This part of the examination mirrors a mixed list of cross-sectional and fluoroscopic imaging, and a short, structured reporting sheet is provided. Each case can include any type of radiological imaging and often involves more than one e.g. plain film, CT and isotope study.   This written element of the examination aims to test the candidate’s ability to assess and interpret a variety of clinical cases across all modalities safely, and to accurately communicate their findings, conclusions and recommendations.  Oral Examination This mirrors the day-to-day clinical discussions and MDT meetings, which form an integral part of a radiologist’s workload.  The oral component further assesses the candidate’s powers of observation and interpretation, but in addition allows assessment of the candidate’s ability to discuss wide-ranging aspects of patient care as influenced by the radiological findings.   Candidates are expected to be able to integrate their observations with emerging clinical information to help refine their differential diagnosis. It also tests their ability to communicate effectively, their analytical and decision-making skills, and allows searching questions to explore their depth of knowledge and ensure that their practice supports patient safety.   This oral element aims to explore the candidates’ depth of knowledge and to test higher cognitive skills. The format allows for flexibility and for complexity to be built into the examiner’s questioning.  In total, the Final FRCR exam lasts 2 hours and 50 minutes.  Scoring Final FRCR Part A The examination is marked by the examination software Speedwell and the marking system shown below is used:   For each item correctly answered: +1 mark   For each item incorrectly answered: 0 marks   The examination is not negatively marked and therefore you are encouraged to provide an answer to all the questions.   You can find full information on the scoring system for the CR2A exam here.  Final FRCR Part B Reporting Eight marks are available for each case, with a maximum of 48 marks available. Candidate response  Mark  Excellent: a perfect answer, clear and confident  8  Good Pass: additional relevant material included in a "pass" grade answer  7  Pass: most observations made correctly; principal diagnoses correct  6  Borderline: appropriate for cases with two main diagnoses, but only one is mentioned; some observations missed  5  Fail: significant observations missed; correct diagnosis not made  4  No answer offered  3  Half marks may also be awarded.  Following the marking exercise each candidate will have a score between 18-48. An overall reporting mark is then awarded on the basis of total marks achieved using the scale below:  Total marks  Overall mark  18 - 25  4  25½ - 28  4½   28½ - 31  5  31½ - 34  5½   34½ - 37  6  37½ - 40  6½   40½ - 43  7  43½ - 46  7½   46½ - 48  8    Rapid reporting One mark is available per image, with a maximum of 30 marks available.  Image type  Candidate response  Mark  Normal Image    Correctly classified  +1  Incorrectly classified (appropriate false positive)  +½   No answer given  0  Abnormal Image        Correctly classified and correctly identified  +1  Correctly classified but incorrectly identified  0  Incorrectly classified (false negative)  0  No answer given  0    Following this, each candidate will have a score between 0-30. An overall rapid reporting mark is then awarded on the basis of total marks achieved using the scale below:  Total marks  Overall mark  0 - 24  4  24½   4½   25 - 25½   5  26 - 26½   5½   27  6  27½ - 28  6½   28½ - 29  7  29½   7½   30  8    Oral  Candidates are shown images by two pairs of examiners and can score a maximum of eight marks from each pair.  Performance description  Comments  Score  Very Poor Answer  Key findings missed even with help  Wrong or dangerous diagnosis  4  Poor Answer  Slow to spot abnormality  Poor differential diagnosis  Needed help to get correct answer  5  Principal findings seen  Some abnormalities seen with help  Principal diagnosis correct  Limited differential  6  Good Answer  Key findings spotted quickly  Correct deductions made and correct diagnosis Good differential offered  7  Excellent answer – all findings seen  Correct diagnosis and deductions  No errors  Succinct/accurate report  Excellent differential  8    Overall Pass Mark Once the marks have been combined, each candidate will have a score of 4-8 in each component of the examination (two orals, the reporting session and the rapid reporting session).  The pass mark in each component is 6, making the overall pass mark 24.   In addition, candidates must obtain a mark of 6 or above in a minimum of two of the four components. If a candidate scores less than 6 in three or more components, they fail the examination even if they have achieved a score of at least 24 overall.   You can find full information on the scoring system for the CR2B exam here.  Eligibility for Final FRCR Final FRCR Part A - to be eligible you must:  have passed FRCR Part 1  Final FRCR Part B - to be eligible you must:  have passed FRCR Part 1  have passed FRCR Part 2A  have acquired 34 months in a formal clinical radiology training post by the month of the examination (your training supervisor must provide confirmation that you have completed the required duration of training and received instruction covering the examination syllabus)  Exam Fees & Venues Part 2A The Part 2A exam is held twice a year, normally in spring and autumn.   You can see a breakdown of the fees for all UK and overseas centres below:  UK  Venues  Member fee  Non-member fee  Belfast, Bridgend Wales, Crewe, Edinburgh, Glasgow, Leeds, London, Plymouth  £427  £545  Global  Venues  Member fee  Non-member fee  Egypt  £427  £545  Hong Kong  £427  £545  India  £505  £643  Pakistan  £427  £545  Singapore  £493  £628    Part 2B The Part 2B exam is now held four times a year.  You can see a breakdown of the fees for all UK and overseas centres below:  UK  Venues  Member fee  Non-member fee  Belfast, Bridgend Wales, Crewe, Edinburgh, Leeds, London, Plymouth  £597  £759  Global  Venues  Member fee  Non-member fee  Egypt  £427  £545  India  £505  £643    Applications Applications are normally open for a few weeks, several months before the exam. Please refer to the examinations page for up-to-date information on application dates.  UK trainees (members) are given priority for examination places, followed by other member bookings and finally non-members. The window for each group is usually open for around a week before it opens to the next group.   All candidates should apply for the exams through the Royal College website here for Part 2A and here for Part 2B. More detailed information can also be found here in relation to preparation for the application.  Preparation There are many resources available online to aid in preparation for the FRCR Part 2A and 2B exams. We always recommend that the best place to start your preparation is the Specialty Training Curriculum for Clinical Radiology.  Using this as a blueprint for your preparation is the best way to ensure your study is focused on the most relevant and useful information as prescribed directly from teaching materials.   Other useful resources to aid your studies include:  Instructional video: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.  Guidance notes for Part 2A: a guidance document on key elements of the exam, found here.  Guidance notes for Part 2B: important information on the three sections of the exam, available here.  Sample questions: sample SBA and oral questions for the exams have been provided with answers on the RCR website, here for Part A and here for Part B.  Candidate reference sheet: a reference list of abbreviations and normal ranges for use during Part 2A, found here.  Examiners’ reports for Part 2B: this is a collection of generic reports written by examiners on the overall performance of candidates and individual questions as a guide for applicants for future sittings. These are available here.  Understand the SBA format and how to approach questions: this document also provides questions that have been used previously in the Final FRCR (Part A) Examination. You can find this here.  TNM Staging guidance - this document explains the knowledge required to answer questions related to this topic, available here.  Demonstration films: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.  Scoring system for Part 2B: key information on how each part of the exam is marked, found here.  For a detailed guide to the best guidance preparation and courses for the exams, see our blog here.  Sources https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2a-radiology-cr2a  https://www.rcr.ac.uk/sites/default/files/cr2a_purpose_of_assessment_statement_jan_22.pdf  https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2b-radiology-cr2b  https://www.rcr.ac.uk/sites/default/files/cr2b_purpose_of_assessment_statement.pdf  https://www.rcr.ac.uk/sites/default/files/cr2a_guidance_notes._jan_22.pdf  https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/CR2B_scoring_system.pdf  https://www.rcr.ac.uk/clinical-radiology/exams/5faf80dd-7d45-e911-a977-002248072781/dates-fees  https://www.rcr.ac.uk/clinical-radiology/exams/a91e7f01-7e45-e911-a977-002248072781/dates-fees  I’ve passed the FRCR exams! What’s next? Firstly, congratulations – attaining full FRCR is a massive achievement!  With all parts of the FRCR complete, you have completed the biggest component of the requirements for GMC registration. Once you have completed the English language component, you will be eligible for full GMC registration with a license to practice in the UK.  Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once you’ve passed FRCR.  For the latest news and updates on all things radiology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

PACES is the final exam in the MRCP UK examination series. Attaining full MRCP UK will facilitate registration with the GMC for overseas doctors, allowing you to secure a job in one of the many medical specialties in the NHS, depending on your experience and specialisation. In this article we will consider the following:  What is PACES? Am I eligible to sit MRCP PACES? What is the content and format?  How is PACES marked?  As an overseas candidate where can I take the exam? When should I take PACES? How can I prepare for the exam?  Passed? What next?  What is PACES? The Practical Assessment of Clinical Examination Skills (PACES) is designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialist training (ST3). The exam sets rigorous standards to ensures trainees are competent across a wide range of skills and are ready to provide high-quality care to patients. Am I eligible to sit MRCP PACES? You must have passed the Part 1 written examination within the last seven years before taking PACES. The Royal College strongly advises trainees to apply after competing two years practical experience and Part 2 of the examination. What is the content and format?  PACES is based on a format that is similar to OSCEs, a practical assessment in a clinical setting. There are five clinical stations with either patients with a given condition, or trained stand-ins (surrogates).  The exam is sat over a half-day and assesses seven core skills over five stations. IMGs can expect eight patient encounters assessed independently by a total of ten examiners (two at each station).  The seven core skills: Physical examination – demonstrate correct, thorough, systematic, appropriate and professional technique of physical examination. Identify physical signs – identifying physical signs correctly. Clinical communication – elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough and professional manner. Differential Diagnosis – create a sensible, clinically assessed differential diagnosis for a patient. Clinical Judgment – select an appropriate management plan for a patient or clinical situation. Select appropriate investigations or treatments for a patient that the candidate has clinically assessed. Managing patients concerns – seeks, detect, acknowledge and address patients or relatives concerns, confirming their understanding and demonstrate empathy. Maintain patient welfare – treat a patient or relative respectfully and sensitively in a manner that ensures their comfort, safety and dignity. The PACES Carousel: The Carousel consists of five stations, each assessed by two independent examiners. Candidates start at any of the five stations, moving round the carousel at 20-minute intervals, until completed. A five-minute period between each station is given.  Candidates are marked on clinical skills at each encounter in the examination. An encounter is when a candidate has an interaction with a patient or a surrogate. Stations 2 and 4 involve one encounter, whereas stations 1, 3 and 5 have two encounters.  How is PACES marked?  PACES is marked on seven skills, A-G, these are:  Skill A: Physical examination (stations 1, 3 and 5) Skill B: Identifying physical signs (stations 1, 3 and 5) Skill C: Clinical communication (stations 2, 4 and 5) Skill D: Differential diagnosis (stations 1, 2, 3 and 5) Skill E: Clinical judgement (all stations) Skill F: Managing patients’ concerns (all stations) Skill G: Maintaining patient welfare (all stations) Skill B, identifying physical signs, is often considered the most challenging skill to pass. As an overseas candidate, where and when can I take the exam? It is a little more complicated than Part 1 or 2 exams and exam slots are often in short supply. Whilst the Royal College is working hard to increase the number of spaces, it is not always possible to offer a place to all applicants. Priority is given to those candidates who are near the end of their stage 2 eligibility period. A full list of examination dates can be found here, please note these are subject to change. Examination centres are subject to change, so for up-to-date information, please see the Royal College website here. The examination is run at clinical centres across the UK (England, Scotland, Wales and Northern Ireland); these vary from diet to diet. When should I take PACES? Royal College performance data provides some food for thought when considering when to apply for PACES. The data suggests: Wait at least 36 months after graduation before applying. Those taking the exam before this period were less likely to pass. 24-36 months post-graduation – 50% pass rate 36-48 months after graduation – 77% Candidates that had already passed part 1 & 2 written examinations were significantly more likely to pass PACES at first attempt. How can I prepare for the exam?  With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:  Curriculum: Applicants are tested on a range of common and important disorders in General Medicine as set out in the Joint Royal Colleges Specialty Training Curriculum for Core Medical Training. We recommend getting to know the curriculum as early as possible, using it as a road map for your study plan.  It is recommended that to give yourself the best chance, you gain clinical experience involving care of emergency patients, adults and children.We advise you to regularly invite senior colleagues to observe and provide feedback on your clinical assessments, so you will be comfortable with the PACES format and give you confidence in approaching and examining patients with examiners present. PACES station 4 examiner guidance examples: This useful guide contains examples of the types of statements found in the examiner guidance section of station 4 scenarios.  This will help you to understand what the examiner is looking for.  PACES sample scenarios: These will provide you with the most accurate and relevant scenarios to prepare you for the real thing. Sample scenarios cover Station 2, 4 & 5 (‘history taking’, ‘communication skills and ethics’ and ‘clinical consultations’ respectively. Most of these have been previously used in a recent exam, but please note that during the exam you will only receive the section marked ‘information for the candidate’. Videos on what to expect on the day: These helpful videos will give you a true reflection of what to expect on the day of the exam, easing some of the pressure and ensuring you can focus on the task at hand.  PACES candidate video: Whilst there are lots of useful videos online that are easy to find, the PACES candidate video contains important information about the exam, and practical examples of how the exam will run.  Candidate guide notes: these guidenotes created by the Royal College help IMGs to understand what to expect on the day, from your arrival to the completion of the test.  It can also be useful to understand how IMGs have failed the exam in the past, as this will give you the best chance to pass first time. The ‘how I failed PACES’ guide provides tips to help you to identify where you might be going wrong, along with practical advice to help you to improve.  For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses - take a look at our blogs on exam tips and preparation.  Passed? What next?  First of all, congratulations! After you have passed all parts of MRCP (UK) you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.  IMG Jobs Specialise in gastroenterology, respiratory, neurology, dermatology, geriatrics or any other areas within specialist medicine? Search and find live specialist medicine NHS doctor jobs in the UK. General & Acute medicine? Search for live vacancies here. IMG Resources Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!   Get in Touch Get in touch using the buttons above (and below) to discuss specialist medicine job opportunities in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you. Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below:             

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  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.  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/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr  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:              

Are you an overseas emergency medicine doctor taking the postgraduate route to GMC registration through the MRCEM exams? Are you interested in sitting the exams in the future?  As part of IMG Stories, we introduce to you Dr Behzad Rashid, an emergency medicine doctor who has recently sat and passed the MRCEM Primary exam. Dr Rashid will be sharing with you his experiences of the first of the Royal College of Emergency Medicine exams, taking you through his preparation, experience of sitting the exam and sharing some hot tips for international MRCEM aspirants.  Tell us about yourself... what should the IMG Community know about Behzad Rashid?  I am a Resident Emergency Medicine Physician, currently working in Pakistan and have worked in A&E since completing my internship. I started off as a medical officer, and then began an A&E residency programme in my country. I would say a combination of hard work and fate are the reason why I am where I am today.  What motivated you to sit the MRCEM exams?  I had booked a space on the PLAB 1 exam, however, due to COVID, it was unfortunately cancelled (three times in fact). By the third time, I’d had enough. I decided to progress my career in Pakistan because I felt I wasn’t getting anywhere with the exam bookings, and everything was very uncertain at that time.  Even though time felt like it had stopped, it was actually flying by. I therefore decided to sit the residency exam in Pakistan. I worked in A&E at the time and had heard about the MRCEM exams from my colleagues. Due to the lockdown, they had just announced that the exam could now be taken online, even within the comfort of your own home. I was ready to go all in and grind my way through both exams, so I studied and succeeded in clearing both PLAB 1 and MRCEM Primary.  At what point in your career and training did you sit the MRCEM Primary exam?  There wasn’t anything in particular that made me realise that I was ready to sit this exam, besides the fact that COVID had been ruining my plans. I was going through a difficult time, and A&E was something I dearly wanted to pursue. I saw an opportunity, and I took it.  Applications can be frustrating… how did you find the application process for the exam?  The whole process took me about 30-45 minutes to complete.  The details of application and exam are available on the website, and whilst a bit tedious, it is a straightforward process. Based on the RCEM’s eligibility criteria for the first exam, you only need to have graduated with an approved medical degree in order to sit the exam.   Since I was planning to sit the exam in my own country, I was provided with some options for exam centres. There were multiple private exam centres nearby, and I did not want to sit the exam at home and risk the internet issues others had experienced. I booked my exam for 8 am, because that's when I function best, and I would recommend that everyone books whatever time of day you think you would perform best.  How far in advance did you start preparing for the MRCEM Primary?  I booked the exam 4 months in advance (around the end of October, with the exam in Dec). Everyone has their own method of studying, and for some, this may not be enough time, so whatever schedule has worked for you in the past - stick to it. In my opinion this exam requires about 3-4 months of studying if you are unemployed or have any daily commitments, and about 5-6 months if you are working or have a very busy schedule.   Often IMGs are a bit at a loss to get support... did you benefit from speaking to senior colleagues or peers about the exam? Did you study with other candidates?  I was in touch with a few individuals who had already sat the exam. They guided me through the application process and resources I could use to prepare. They were also the ones who entertained my idea in preparing for both exams at once, and they believed that I could succeed in both.   You don’t need a lot of friends, just the right ones who will push and support you in your journey.   You were preparing for PLAB at the same time as the Royal College exams...how do you feel studying for PLAB 1 compares to your experience of MRCEM Primary?  PLAB 1 and MRCEM Primary are completely different exams.  PLAB 1 focuses on the application of medical knowledge in common day-to-day scenarios that a doctor would encounter in the UK. MRCEM Primary is more of a theoretical assessment of the basics i.e. anatomy and physiology of emergency related scenarios. This became even more apparent after I’d gone over the curriculum provided by the GMC and RCEM, which is honestly the best part of the exams. I would not say that one is easier than the other – they assess different things.  I focused on the blueprint/curriculum for each exam and made sure to get in as many MCQs as possible. That gave me a better overview of what I would actually be tested on.  Emergency medicine doctors are notoriously busy...in the months leading up to the exam, how much time did you spend a week on preparation?  In my case, I had to appear for the MRCEM Primary first, and then a week later for the Pakistan Residency (FCPS I) exam. Since work was extremely hectic, and I felt that I was not able to set aside much time to prepare for both, I quit my job to study for the exams and managed my time throughout the day to study and prepare for both (around 12 hours each day).  It goes without saying that any goal without a plan is just a wish. I divided my day into 2 halves where I would wake up at 5am, and study till 12pm, take a break (which included sleeping, eating or working out), then start off again at 5pm and go at it till 10pm. The first half would be MCQS and making Anki flash cards, second half would be to review the cards I had pending for that day. I would throw in a mock exam every week to see where I stood at that point, correct my mistakes and make cards on those as well. I stuck to this routine for 3 months and by the end of the 3 months, I had a deck of about 2000 Anki flash cards, divided into two groups for the 2 exams, and that is all I would review because I was confident that is all they would test me on.  How did you manage to juggle other commitments whilst studying for the exam (without panicking)?  During COVID, I was pretty much stranded by myself in Pakistan. My family lived in a different country, and I had limited interactions with the family I did have around me. This bizarre period of isolation and confusion gave me ample time to prepare for my exams. Being alone did get frustrating at times, and anxiety would creep up on me, but the hunger to clear my exams and progress my career gave me tunnel vision and cancelled out all the other noise.  The preparation for 2 examinations was an enlightening and humbling experience. My goal is to reach out to students and help them understand what works best for them. I’d be more than happy to provide students with any resources (Including my Anki flash cards) they need. However, there isn’t a cookie cutter plan that will suit everyone - I did what was best for me in my circumstances, and you must do the same.  What resources did you use to prepare and practice for the MRCEM Primary exam?  I used the curriculum provided by the MRCEM on their website which you will find here.  Along with that I was using the MRCEM Success question bank, which I have to say is an excellent resource. The actual exam was very close to the MCQs provided, which is why I would highly recommend it.  I am also an avid user of Anki. It has helped me ace exams in med school, the MRCEM primary, FCPS I and even the PLAB 1. I have never made any notes from any textbooks, and I honestly think hardcovers will eventually become obsolete. I would highly recommend making your own cards since that allows you to work at your own pace and address any weak points. I would love to share my own deck of Anki cards as well, which covers everything provided in the MRCEM curriculum. Feel free to add more to this deck and pay it forward.  Let's face it, exams are not everyone's favourite day out... so on the day of the exam, what did you do to relax?  I woke up early and decided not to go over any cards. I’m the type of exam-taker who enjoys working out and listening to music before an exam. At that point, I know what I know, and that is all I know. So I drank a nice cup of coffee and got some cardio done while listening to music.   What was your experience like on the day?  My exam was around 8:30am, so the drive was about 5 minutes to the exam hall and I got there around 30 minutes before it started. The invigilator was friendly and after leaving my personal belongings in a small locker, they provided a sheet of paper and stationary at the centre. The computer prompted me to start once the invigilator asked me to, and everything after that went smoothly. The invigilators are ready to help you with your queries if you experience any problems during the exam as well.  What was the most challenging part of the exam?  In my honest opinion, I did not come across anything that would throw me off. After going over the curriculum, and having a plan, I just stuck to that plan and followed it till the end.  In hindsight, would you have done anything differently?  I was already taking the most extreme measures by preparing for multiple exams and taking time off work, given everything was shut down during COVID. I have no regrets and cannot think of anything I’d have done differently.  What nuggets of advice would you give to any MRCEM Primary aspirants?  The best thing about the Royal College exams is that they provide a curriculum of what you should know, and they would never ask anything more than that. I would highly recommend you go over that and familiarise yourself with the content you will be tested on. Question banks might provide extra information to give you a different perspective of the subject, however the real exam sticks to its curriculum. If you know what you are required to know, preparation for the exam becomes easier.  What are your plans going forward?  I'm planning on appearing for the PLAB 2 and the MRCEM Intermediate soon. I have already started preparing my Anki deck for the intermediate as well, so wish me luck and stay tuned for that as well.   To learn more about the RCEM exams, see our IMG Resources library. For news and updates on all things emergency medicine, follow us on social media and join the conversation.             

Overseas radiologists often ask us how to best prepare for the Final FRCR Part 2A and 2B exams. With so much online content geared towards UK trainees, it can be difficult to know what is best suited to you as an international candidate.  Here we have compiled some of the best advice and resources available to help overseas radiologists prepare for their Royal College (RCR) exams. We’ll also address some of the changes to the exam, both the format, administration and availability of the exam for IMGs.  The topics we’ll cover are as follows:  A recap of FRCR CR2A and CR2B What resources are available for IMGs?  Royal College Resources Courses Books #IMG Tips Skip ahead to the relevant section if you know what you’re looking for.  An Overview of FRCR CR2A and CR2B As a quick reminder, Final FRCR refers to the final two exams in the Royal College of Radiologists examination suite for clinical and diagnostic radiologists. The full series - Part 1, Part 2A and 2B – is required by overseas radiologists when applying for GMC registration through the postgraduate route.  FRCR CR2A assesses knowledge of the pathology, imaging techniques, congenital abnormalities and radiological findings that underpin clinical radiology practice.   The FRCR 2A exam consists of 2 papers sat on the same day; each paper containing 120 single-best-answer questions (240 questions in total). Each paper lasts 3 hours.  CR2B is not an exit exam but is a key step in a trainee's progress towards independent reporting. The exam assesses several aspects of the candidate's radiological skills, all of which are considered necessary for safe and effective radiological practise.  Part 2B has 3 separate sections as below:  Rapid reporting - 30 plain radiographs in 35 minutes  Reporting (long cases) - 6 cases in 75 minutes  Oral (viva) - 2 x 30-minute vivas  In total, the exam lasts 2 hours and 50 minutes.  For a full overview of the FRCR exam series, see our blog here. Preparation & Revision Resources After discussing with IMGs the best way to approach preparing for the Final FRCR exams, most recommended beginning with the Royal College website and resources, which they have put together to aid in your preparation.  Curriculum: The FRCR exams are based on the Specialty Training Curriculum for Clinical Radiology. As a rule of thumb, your revision should start here to ensure you are focusing on the exact material that will be in your exam. Knowing the curriculum is key and you can find these on the Royal College website here.  Royal College Resources Instructional video: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.  Guidance notes for Part 2A: a guidance document on key elements of the exam, found here.  Guidance notes for Part 2B: important information on the three sections of the exam, available here.  Sample questions: sample SBA and oral questions for the exams have been provided with answers on the RCR website, here for Part A and here for Part B.  Candidate reference sheet: a reference list of abbreviations and normal ranges for use during Part 2A, found here.  Examiners’ reports for Part 2B: this is a collection of generic reports written by examiners on the overall performance of candidates and individual questions as a guide for applicants for future sittings. These are available here.  Understand the SBA format and how to approach questions: this document also provides questions that have been used previously in the Final FRCR (Part A) Examination. You can find this here.  TNM Staging guidance - this document explains the knowledge required to answer questions related to this topic, available here.  Demonstration films: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.  Scoring system for Part 2B: key information on how each part of the exam is marked, found here.  Courses There are several online courses which provide preparation for the exams, including mock exams and insight into exam technique. As with all courses, we advise that you register your interest as soon as possible to avoid disappointment as they are in very high demand.  Please note these courses are subject to change and candidates are advised to book early (up to one year in advance in some cases), as spaces are often limited. Places may become available at the last minute, so make sure you add your name to a waiting list if possible.  Midlands FRCR 2A Review Course This is an in-person revision course for the FRCR Part 2A exam held in Leicester. The course provides a refresher course covering a range of important topics, an interactive lecture-based course delivered in a ‘single best answer format’ and tips and tricks from trainees with recent experience of the exam. Duration - 3 days Cost - £350 London Heathrow FRCR 2B Preparation Course This is a two-day course aimed at clinical trainees who are preparing for their FRCR CR2B. The course offers a minimum of 4 viva sets, 4 long case sets along with 4 rapid reporting packets. A further 2 lectures would also be included during the 2 days.  The course is delivered live virtually.  Duration - 2 days Cost - £500 Red Dot Radiology Courses These are in-person revision courses for Part 2B which cover rapid reporting as well as focused days on chest x-rays. The courses are live online via an interactive video and are led by FRCR qualified UK-based radiologists.   Duration - 1 day Cost - £165 Aunt Minnie Courses This is an online two-day course that runs twice a year and concentrates on Aunt Minnie cases that you may encounter in your FRCR 2B exam. The course is split into mini tests, workshops and exam tips to ensure candidates remain refreshed and stimulated.   Duration - 2 days Cost - £350 Books FRCR CR2A  Grainger & Allison’s Diagnostic Radiology  Fundamentals of Diagnostic Radiology - Brant & Helms  Primer of Diagnostic Imaging - Weissleder  Radiology Review Manual - Wolfgang Dahnert  Crack the Core Exam – Prometheus Lionhart  Fundamentals of Skeletal Radiology – Clyde A. Helms  Get Through Final FRCR 2A: SBAs - Teck Yew Chin, Susan Cheng Shelmerdine  RSBAs for the FRCR Part 2A - Richard Lindsay    FRCR CR2B  Rapid Review of Radiology - Shahid Hussain, Sherif Latif, Adrian Hall  Top 3 Differentials in Radiology - William O'Brien  Long Cases for the Final FRCR 2B - Rebecca Hanlon  Aunt Minnie's Atlas and Imaging-specific Diagnosis - Thomas Pope  Final FRCR Part B Viva: 100 Cases - Richard White, Robin Proctor, Ian Zealley  Chapman & Nakielny's Aids to Radiological Differential Diagnosis – Stephen Davies  #IMG Tips  Familiarise yourself with the exam content – the best way to do this is through the syllabus and curriculum  Prepare early – the earlier you begin your revision, the more structured and relaxed the entire process can be and the more likely you are to pass!  Invest in the right resources and courses – many resources from books to courses come at a cost – think about your own preferred style of learning and choose the resources that best suit you! Have any colleagues going through the exams or already passed? See if you can borrow or split the cost of resources.  Practise, practise, practise – this is of course a given...practise makes perfect and getting used to the format and being able to go through many sample questions will set you up well for the exam!  Sources  https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2a-radiology-cr2a   https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2b-radiology-cr2b  https://www.rcr.ac.uk/sites/default/files/clinical_radiology_curriculum_2020.pdf  Getting started  We hope this is helpful for any overseas doctors preparing to sit their Final FRCR exam and the team here at IMG Connect wish you the best of luck!  Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.             

As there is no hard and fast rule for what position you will have after gaining a UK qualification, it is important for IMGs to understand the posts that are available to you after completing FRCR (Oncology).  FRCR (Oncology) is a highly beneficial qualification to achieve, but it does not guarantee you a consultant position in the NHS.  This can be a confusing area for overseas clinical and radiation oncologists, but this blog aims to de-mystify the subject. This article will explain the following topics:  What is FRCR (Oncology) and how does it fit into the UK training programme? What grade will IMGs, new to the NHS, be offered with FRCR (Oncology)? Can I take a permanent consultant post if I have FRCR (Oncology)? CESR opportunities for clinical oncologists in the NHS Skip ahead to the relevant section if you know what you’re looking for.  FRCR (Oncology) within the UK Oncology Training Programme Fellowship of the Royal College of Radiologists (Oncology) or FRCR (Oncology) is the postgraduate qualification awarded by the Royal College of Radiologists, the body responsible for the specialties of clinical oncology and clinical radiology throughout the UK.   FRCR (Oncology) is a three-part exam which is a necessary part of the training programme of clinical oncologists in the UK.   For trainees who have chosen to pursue clinical oncology, FRCR (Oncology) Part 1 or CO1 must be passed by the end of ST4.  Clinical oncology trainees will then sit Final FRCR (Oncology), also known as Part 2A and 2B or CO2A and CO2B, usually from ST6 to ST7.   These final exams are important in that they assess a trainee’s knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.  Any UK-trained clinical oncologist applying for a CCT in order to work as a substantive consultant must have completed full FRCR (Oncology).  As shown above, UK trainees will also have completed MRCP (UK), although this is not required for overseas clinical oncologists.  Positions for Doctors new to the NHS with FRCR (Oncology) As an IMG with full FRCR (Oncology), you will be eligible for consultant grade positions in the UK.   You are not guaranteed a consultant position, particularly if you do not have previous consultant position in your home country, but you will certainly be able to attain more senior positions in the NHS, such as a specialty doctor (SAS) or specialist grade.  Consultant positions are the most senior in the UK, and thus the highest paid position for doctors within the NHS pay system.  For further information on how NHS pay scales work for consultants, please see our detailed article here.  Of course, this is assuming that you have also completed the other necessary components to make you eligible for GMC registration.  Alongside your postgraduate qualification, you will need to have passed an English Language Test (either IELTS or OET).   Additionally, you must obtain a Certificate of Good Standing, and submit this to the GMC. Upon the receipt of these three components, you will receive full GMC registration.  Permanent Consultant Posts with FRCR (Oncology) To take up a permanent consultant position in the NHS, you would need to have Specialist Registration. Specialist Registration (more specifically CESR for most overseas doctors) allows you to take up permanent or substantive consultant roles in the NHS.  The type of consultant position you would be eligible for with FRCR (Oncology) is a locum consultant post.  Firstly, we should clarify the meaning of the term ‘locum consultant’ in the UK. The NHS has two types of locums - Trust locums and Agency locums.   If you are an IMG with full registration, but you are not on the Specialist Register, you are only able to take on consultant positions as a trust locum, but no permanent positions.  Trust locums are hired on a fixed-term contract and are able to better acclimatize themselves to the NHS system, whilst receiving the support and guidance to work towards consultant positions and CESR.  Please note, you can only work as an agency locum if you have a British passport.  CESR Opportunities in the NHS  CESR or the Certificate of Eligibility for Specialist Registration is a route of entry to the Specialist Register for those doctors who have not followed a GMC-approved training programme.  You can read more about CESR in Clinical Oncology through our IMG Resources library here.  IMG Connect are able to help you to secure senior roles such as specialty doctor (SAS), specialist grade or locum consultant in Trusts that offer CESR support.  In these roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. These Trusts have a lot of experience in supporting overseas doctors to progress their careers through CESR.  You can collect evidence of your competences, particularly those specific to the UK Clinical Oncology curriculum and those you may not be able to achieve outside the UK.  These positions also facilitate a faster route to the UK than applying directly through 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.  Getting started  We hope this blog has been helpful in clarifying your questions about securing senior posts in the NHS with FRCR (Oncology). If you have any further questions regarding the postgraduate exams, CESR or Oncology in the NHS - feel free to contact us directly.  Join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncologists and dedicated oncology recruiters. In this group you will find tailored support for oncology IMGs, including access to our NHS and CESR webinars, completely free to all doctors. You can access our IMG Oncologists community here. Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.               

FRCEM is a crucial step when working towards either CCT or CESR in Emergency Medicine.  International Medical Graduates (IMGs) from any country in the world can sit some FRCEM examinations, provided certain eligibility criteria are met. For overseas doctors attaining FRCEM is not a route to GMC registration and you are better suited to the MRCEM pathway. These are summarised below along with a broad look at the following topics: What is FRCEM? FRCEM Route Eligibility for overseas doctors FRCEM Primary Examination FRCEM Intermediate Certificate FRCEM Final Examination As an overseas candidate where can I take the exam and how much will it cost me? How do I apply? How to prepare and what resources are available Passed? What next? What is FRCEM? Fellowship of the Royal College is awarded to candidates who pass three examination components.  There have been a few changes to the MRCEM and FRCEM examination structure over the last few years, as such there are currently two routes to an accreditation in Emergency Medicine, both leading to RCEM Membership. These two routes are: Membership of the Royal College of Emergency Medicine (MRCEM) Fellowship of the Royal College of Emergency Medicine (FRCEM) As of August 2018, applicants beginning the process will be able to sit one set of exams leading to the award of Fellowship of the Royal College of Emergency Medicine (FRCEM). FRCEM is one of several routes an overseas emergency medicine doctor can take full GMC registration. Read our blogs on acceptable postgraduate qualifications and PLAB if you are unsure what route to take. For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCEM or FRCEM would be the best route to take. Understand the MRCEM pathway in this article above. FRCEM Examination route: The Fellowship Examinations consists of the following components: FRCEM Primary Examination one, three-hour written paper FRCEM Intermediate Certificate Short Answer Question Paper (SAQ) Situations Judgement Paper (SJP) FRCEM Final Examination  Critical Appraisal (Short Answer Question Paper) Quality Improvement Project (QIP) Clinical Short Answer Question Paper Objective Structured Clinical Examination (OSCE)  Eligibility for overseas doctors: FRCEM Primary: To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes. FRCEM Intermediate: To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme and have passed FRCEM Primary Examination after 1st August 2016. You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012. FRCEM Final Examination: To be eligible you must have FRCEM Primary and FRCEM Intermediate Certificate, attained after 1st August 2016. However, the requirements make it incredibly dififcult to attain outside of the UK - so you are best advised to attain MRCEM, work in the UK and then work towards FRCEM whilst practicing in the NHS. The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the FRCEM examinations. Remember, you will need to have a pass of 7.5 average in all areas of IELTS to complete your GMC registration. FRCEM Primary Examination: The FRCEM Primary Examination is mapped to the Emergency Medicine 2015 Curriculum. More detailed information is provided in the RCEM Basic Sciences Curriculum (June 2010). The exam consists of one 3-hour paper of 180 single best answer questions (SBAQs) so you must choose one best answer from a choice of five feasible answers.  The paper will examine all the domains of knowledge in the Basic Sciences Curriculum including: Anatomy Physiology Pathology Microbiology Pharmacology Evidence Based Medicine FRCEM Intermediate Certificate: FRCEM Intermediate Certificate is comprised of two papers: Short Answer Question paper (SAQ): A single 3-hour paper of 60 questions, each worth 3 marks.  Unlike single best answer questions (SBAQs) you will not have the advantage of having a list of options to choose from. Instead you will have to compose your answer independently. The blueprint for the FRCEM intermediate is as follows: Curriculum Category Questions Common Competences 7 Clinical Presentations – Core Major & Acute Presentations  18 Anaesthetic Competences CT1&2 4 ICM within ACCS 2 Acute Presentations – Additional Adult ST3 6 Paediatric Presentations – Makor & Acute Presentations  11 Practical Procedures (ACCS) 12 Total  60 Situational Judgement Paper (SJP): A two-hour paper of 120 single best answer questions. This written paper is designed to test your ability to understand & respond appropriately to real world clinical situations, assessing you against the Common Competencies in the Emergency Medicine Training Curriculum 2015.  FRCEM Final Examination: From August 2018 the FRCEM Final consists of the following components: FRCEM Critical Appraisal (Short Answer Question Paper)  FRCEM Quality Improvement Project (QIP)  FRCEM Final Clinical Short Answer Question Paper  FRCEM OSCE  Each component tests individual skill sets and as such may be sat independently. FRCEM Critical Appraisal: A 90-minute Short Answer Question Paper. FRCEM Quality Improvement Project (QIP): This replaced the CTR from 1st August 2016. The QIP is a written submission that should be completed whilst working in Emergency Medicine at a level above ST3 or SHO. It should focus on quality improvement in Emergency Medicine, and may focus on either adult or paediatric Emergency Medicine. Any candidates who have not been awarded FRCEM by 31st July 2018, irrespective of any previous passes in CTR, are required to pass the new FRCEM QIP. Clinical Short Answer Question paper (SAQ): The SAQ is a 3-hour paper consisting of 60, 3-mark questions. A summarised blueprint for the FRCEM Final SAQ is as follows.  A fuller version can be found on the RCEM website here. HST Major and Acute Presentations 25 questions Additional Paediatric Practical Procedures 3 questions Practical Procedures (HST) 11 questions Ultrasound 3 questions Clinical Presentations - Core Major & Acute Presentations 6 questions Common Competencies 2 questions Anaesthetic Competences CT1&2 1 question ICM within ACCS 1 question Acute Presentations - Additional Adult ST3 2 questions Paediatric Presentations - Major & Acute Presentations 3 questions Practical Procedures (ACCS) 3 questions FRCEM Final OSCE: The exam is set in a practical setting and tests your ability to apply knowledge & experience directly to patients – rather than reciting learned knowledge. The exam consists of 16, 8-minute stations with one minute provided in between stations for reading time. As with many other final stages to Royal College exams – FRCEM Final OSCE will make use of manikins or actors and you will be observed by an examiner after being presented with a clinical case to assess. Examiners will not engage with you – only observe and mark. A brief summary of the curriculum for OSCE is found below: Stations Curriculum 1 Core Acute 2a Resuscitation 2b 3 Core Major 4 Common Competencies 5 Common Competences 6 Anaesthetic Competences 7a Paediatric Resuscitation 7b 8 Paediatric Acute 9 Paediatric Major 10 HST Major 11 HST and Adult Acute 12 Practical Skills 13 Paediatric Practical Skills 14 Non-technical Skills  As an overseas candidate where can I take the exam and how much will it cost me? Examination and application dates are regularly updated by the Royal College and can be found here.  Please remember, applications made outside the application period will not be accepted. Examination Location Fees FRCEM Primary Short Answer Question Paper UK £310 Iceland, Malaysia, Oman, India £390 FRCEM Intermediate Certificate SAQ UK £305 Iceland, Malaysia, Oman £385 FRCEM Intermediate Cert. (SJP) UK £200 Kuala Lumpur £200 FRCEM Final Clinical SAQ UK £300 FRCEM Final Critical Appraisal SAQ UK £240 FRCEM Final QIP N/A £150 FRCEM Final OSCE London £420 How can I apply? All applications are made online and links to all application forms and windows are available here. It is worth noting, the application can take some time to complete so it is always advisable to apply well in advance of the deadlines. Please remember, applications submitted after the application period will not be accepted.  How do I prepare for each exam and what resources are available? With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.  Curriculum:  Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015. We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.  Information Packs: These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day: FRCEM Primary FRCEM Intermediate FRCEM Final Examination SAQ Blueprint: The blueprint for the new Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here. SJP Blueprint: A blueprint of the new Intermediate SJP exam can be found on page 11 FRCEM Intermediate examination pack, downloaded from the RCEM website here. Sample questions:  Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below: Primary – sample questions Intermediate Certificate – sample SJP questions Final – successful QIP Reducing referral rates of paediatric patients to plastic surgery Management of fractured neck of femurs in the ED Final – unsuccessful QIP Critical Appraisal Questions – Advice to Candidates  Critical Appraisal – Most Frequently Offered Answers Glossary of Terms:  The royal college uses many terms that may cause confusion, so take plenty time to understand the terms and definitions used in this guide. Candidates are expected to be rigorous in their use of these terms. Glossary of terms used in RCEM exams. Examination Report: The Royal College recently began to publish reports on the performance of those sitting FRCEM examinations. Below is the first report published and helps to break down results for those in training and those out of training.  2018 Examination report. Online resources:  There are lots of resources online, such as videos on YouTube, FRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.  For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connects Top Tips for exam preparation. As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present. Should I take a course to prepare for the OSCE? Whilst it is not essential to take a course when preparing for the MRCEM or FRCEM OSCE - there is no doubt it will help your preparations both technically and mentally, and should be considered an investment towards your future career plans. Have a read of our blog on recommended MRCEM courses for Emergency Medicine doctors. Passed? What next?  First of all, congratulations! After you have passed all parts of FRCEM, you will be on a firm path towards attaining your Specialist Registration in Emergency Medicine. FRCEM is not a route for GMC registration as doctors will already be in the UK, however those attaining MRCEM can do so from outside the UK, and use MRCEM as a route to GMC registration. For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

NHS Hospitals across the UK are offering specialty doctor job plans in Psychiatry with the opportunity for programmed CESR support, giving psychiatrists the chance to quickly work towards Specialist Registration.   For experienced IMGs, this is a new and relatively quick route to your first consultant post in Psychiatry.  By taking up a service level job as an SAS Doctor with CESR support as part of the job plan, many overseas psychiatrists are securing a great start to their career in the NHS that is suited to their senior level experience, whilst taking the time to acclimatize to the NHS and their Trust.  CESR Programmes for Specialty Doctors  By taking such posts in the NHS, you can join diverse, dynamic and inspiring groups of specialty doctors and acting consultants all on the way to achieving Specialist Registration as part of a tailored programme. You can read more about CESR for psychiatrists here. In offering such job opportunities, Trusts will provide a supportive environment with protected time to fulfill all the requirements of the CESR application in Psychiatry and its sub-specialties, gaining career-enhancing experiences as you do.    Acting up, dedicated peer groups, coaching & mentoring, scheduled learning and study time are some of the benefits that you could receive in one of these roles.   In such roles you will typically receive hands on support from consultant colleagues and exposure to a wide range of experience to specifically aid competency achievement for your CESR application in relation to the Specialty Specific Guidance (SSG) for your sub-specialty.  In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience.  Some Mental Health Trusts will also provide the following as part of their CESR programme:    A number of Supported Professional Activity (SPAs) sessions per week   Tailored experience to your CESR portfolio  Regular clinical supervision   A CESR mentor   Involvement in academic programmes and medical student teaching   Support in gaining research competencies   SAS Tutor support  CESR / SAS support forums and meetings  Finding SAS Roles with CESR Support  If you are an overseas doctor looking for a Specialty Doctor job with the chance to work towards your Certificate of Eligibility for Specialist Registration (CESR) in Psychiatry, speak to the IMG Connect team to discuss if this is a suitable route for you.  We have opportunities across the UK for international psychiatrists to take advantage of the CESR programme.  You can also send your CV to info@imgconnect.co.uk or register here. It takes less than 30 seconds to register!  IMG Jobs  Search and find live Psychiatry jobs in the NHS with CESR support IMG Resources Library  Browse our library for more useful articles on NHS jobs in psychiatry, salaries for doctors in the UK and postgraduate qualifications for psychiatrists and much more!  Connect with us  Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.  For access to a community of like-minded psychiatry IMGs and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.    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.               

Overseas doctors from any country in the world can apply for Specialist Registration in the UK, provided certain eligibility criteria are met, though there are different routes available based on the doctor’s qualifications and training.  In this blog we’ll be exploring Specialist Registration in clinical oncology for overseas clinical or radiation 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 to Specialist Registration is best for me as an overseas oncologist? Do I have to complete CESR before I can work in the UK? Do I need FRCR (Oncology) for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in clinical 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  Specialist Registration in any CCT specialty means that you can be appointed to a substantive (or permanent) consultant position in the NHS. All clinical 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 clinical oncologists, 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 clinical 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 doctors who have completed only 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 of 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.   Clinical Oncology Positions in the NHS without CESR  It is important to note that you can apply for more senior oncology 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 clinical 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.  FRCR (Oncology) for Specialist Registration  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 are the FRCR (Oncology) 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 of the evidence presented.  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 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:  training and/or competence  skills and knowledge  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.  Evidence Requirements for CESR in Clinical 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 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:  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 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 Clinical 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 clinical oncology is seven 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 Clinical Oncology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Clinical 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 pro formas 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 clinical and radiation oncology CESR aspirants and dedicated oncology recruiters. 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. Sources  https://www.rcr.ac.uk/clinical-oncology/careers-and-recruitment/specialist-registration-cesr  https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr  https://www.gmc-uk.org/-/media/documents/sat---ssg---clinical-oncology---dc3556_pdf-48456770.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 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:              

For overseas psychiatrists looking to register with the GMC and find a psychiatry job in the NHS, one option is to complete the Membership of the Royal College of Psychiatrists examinations - MRCPsych. Here we will take a detailed look at the MRCPsych exams, fees and centres.  International Medical Graduates (IMGs) from any country in the world can sit the MRCPsych examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics: What is MRCPsych? What is the exam content and format? Eligibility for overseas doctors Assessment Portfolio Sponsorship Requirements How do I apply? How much will it cost me? Where can I sit the exams? How can I prepare for the MRCPsych examinations Passed? What next? The Royal College of Psychiatrists is the professional body responsible for the specialty of Psychiatry throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession. What is MRCPsych?  The MRCPsych examinations are the central component of training for psychiatrists in the UK and the examinations are designed to test your knowledge of basic medical sciences as well as the clinical skills required for diagnosis and management within psychiatry.  For international doctors, MRCPsych is one of the two main routes IMGs can take to full GMC registration - you can find a range of articles covering these routes in our resource library here: Royal College or PLAB route.  For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCPsych would be the best route to take. Overseas doctors must be registered with a recognised medical board in their country of residence and should have undertaken 3 years of training and MRCPsych (UK) is a prerequisite to anyone wishing to go on to a specialist training post as a physician in the UK What is the exam content and format?  The MRCPsych examinations consist of two written papers (Paper A + Paper B) and one clinical examination (CASC).  Typically, a UK Psychiatrist would sit Paper A from FY2. Candidates will then progress through MRCPsych examinations from CT1 – CT3, before going on to specially training for CCT.  Paper A – The scientific and theoretical basis of psychiatry – 3 hours This is a written paper, worth 150 marks and comprising 150 questions made up of approximately two thirds multiple choice questions (MCQ) and one third extended matching item questions (EMI).  It covers the following sections of the syllabus:  Paper A is now taken online.  Paper B - Critical review and the clinical topics in psychiatry – 3 hours This is a written paper, worth 150 marks and comprising 150 questions made up of approximately one third covering critical review and two thirds covering clinical topics.  It covers the following sections of the syllabus:  Paper B is now taken online.  CASC - Clinical Assessment of Skills and Competencies The CASC is based on a format that is similar to OSCEs. Specifically, the examination consists of two circuits which must be completed on the same day. In total, the circuit includes 16 stations, made up of:  five stations on history taking, including risk assessment five stations on examination, including physical and mental state six stations on patient management  Stations consist of several elements with instructions provided to all candidates, marked against the examiners construct.  These have a standardised format with elements in common between stations of a similar type. Find out more here. The CASC exam is taken in person. Eligibility for overseas doctors The MRCPsych examinations can be taken by both:   Doctors from the EU, who are working overseas Non-Eu doctors who are working overseas Each examination has different criteria, to complete the full MRCPsych, an overseas doctor must be registered with a recognised medical board in their country of residence and complete the Assessment Portfolio for Overseas Candidates demonstrating that they have complete 3 years of equivalent training.  Furthermore, prior to taking CASC, overseas candidates must demonstrate competencies in Psychotherapy AND Child & Adolescent Psychiatry or Learning Disability. For each part of the exam the Royal College suggest the following eligibility criteria:  MRCPsych Paper A You are eligible for Paper A if you are a fully registered medical practitioner.  MRCPsych Paper B It is a recommended to have at least 12 months experience in psychiatry before taking this examination.  Clinical Assessment of Skills and Competencies (CASC): You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC AND You have a pass in both Paper A and B AND You can demonstrate you have sponsorship in place. Sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.  In addition, overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination. Assessment Portfolio for Overseas Candidates: As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC. In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans: be observed interviewing patients in ward rounds for specified reasons  be observed interviewing patients in out-patient or community settings or other contexts for specified reasons  be assessed via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor be assessed formally in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.   Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.  Sponsorship requirements International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.  Sponsorship is required by all applicants for entry to the CASC examination and your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations. Acceptable sponsors are:  College Tutor Training Programme Director Educational Supervisor Head of School Director of Medical Education (or equivalent) Head of Department of Psychiatry Consultant responsible for employee/trainee appraisal Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment. How do I apply?  To apply you will need to complete an online application form. It takes about 15 – 20 minutes. You can sit Paper A and B in any order. You will be required to enter contact details and training history, including your medical registration. Payment is made by credit/debit card.  If applying for the CASC, you will also need to provide the contact details of your sponsor. It is important to note that the online form for Paper A, B and CASC will only be available during the published application dates and must be submitted before the closing date and time. Applications submitted after, will not be accepted. How much will it cost me? Candidate Paper A Paper B CASC PMPT Trainees and Affiliates (UK & Ireland Centres) £496 £446 £1,024 Non-PMPT Trainees and Affiliates (UK & Ireland Centres) £550 £495 £1,137 Where and when can I sit the examinations? The good news is that changes have been made in response to the COVID-19 pandemic, and Paper A and B can be taken online, making it much easier for IMGs to complete the MRCPsych examinations and work towards their GMC registration in a normal time frame. To maintain the integrity fo the CASC exam, delivery will be in-person only from September 2023. You can sit the examination from your home country with details on submissions and preparation for an online exam available on the Royal College website. For up-to-date information on application and exam dates, please see the Royal College website here. How do I prepare for the MRCPsych examinations?  With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:  Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams.  Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry  Current critical review syllabus: For Paper B candidates will need to ensure that they make optimal use of the MRCPsych Paper B Critical review Evidence Based Practice Syllabic Content.  Sample Papers: These will help you prepare and polish your exam techniques and are a good idea to regularly benchmark your knowledge against the syllabus. In addition sample questions will help you work quickly on the day, you will already know what to expect. Please note: you may be required to be a member to access these.  Paper A sample questions Paper B sample questions  Marking schemes (Paper A and B): Candidates pass or fail the written papers based on their performance, and not how well you perform against other candidates. As such, it is a good idea to understand how the exam is worked, so you can maximise your exam skills, giving you the best chance of a pass.  Marking schemes can be found here.  Marking scheme (CASC): A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.  Written papers marksheet example: Again, this is a useful tool to help you familiarise yourself with the exam format and improve your test skills. An example marksheet can be found here.  CASC examination guide: The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.  CASC preparation videos: Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.  CASC Blueprint: This helpful summary details stations in some detail and gives a useful overview of the exam format.  The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.  As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present. Passed? What's next?  First of all, congratulations! After you have passed all parts of MRCPsych you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK. Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.  For access to a community of like-minded psychiatry IMGs and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.    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.               

The first exam in the FRCPath Histopathology series...  Overseas histopathologists may have questions about the best ways to prepare for the FRCPath Part 1 exam. With so many resources available online, but many of them geared towards UK trainees, it can be difficult to know what is best suited to you as an international candidate.  In this blog we have compiled some of the best resources and guidance for FRCPath Part 1 aspirants. We will also quickly cover some of the recent changes to the exam regarding its delivery and availability in response to the COVID-19 pandemic.  Here we’ll take a closer look into these and other important questions through the following topics:  What is FRCPath Part 1? How do I get started with my preparation? What resources are available online? How has COVID-19 affected the exam? #IMG Tips I’ve passed FRCPath Part 1, what’s next? Skip ahead to the relevant section if you know what you’re looking for.  FRCPath Part 1  FRCPath Histopathology Part 1 is the first exam in the two-part examination series, administered by the Royal College of Pathologists. The content of the exam can be broken down into three sections:  The three-hour exam is designed to assess candidates’ overall knowledge and understanding of histopathology or cytopathology, including the full range of autopsy practices undertaken in a district general hospital in the UK and the basic science underpinning pathology, including molecular biology.  For an in-depth guide to the FRCPath Part 1 exam, or for a breakdown of the full FRCPath Histopathology exam suite, visit our IMG resources library.  Please note that only full FRCPath satisfies the GMC’s postgraduate requirements for overseas doctors.  How to get started with preparation for FRCPath Part 1  The best way for IMGs to begin their exam preparation is with the Royal College website and resources. The FRCPath Histopathology exams are based on the Curriculum for Specialty Training in Histopathology and as a rule, this should always be the starting point for your revision. This will ensure you are focusing on the exam material that will feature in your exam – knowing the curriculum is key! You can find this on the Royal College website here.  Royal College resources include:  Regulations and guidelines – before applying for FRCPath exams, the College recommends you read both the general and specialty-specific regulations and guidelines, found below:  General Regulations and Guidelines  Histopathology Regulations and Guidelines FAQs - There is also a Frequently Asked Questions (FAQs) document which the Royal College has compiled to help applicants who have questions about online examinations. You can read this here.  Other helpful resources include:  Oxbridge Medica - FRCPath Part 1 Revision Course  This is a 4-day, exam-oriented online revision course. The course includes live-streamed lectures across four days and covers all the major topics of the examination syllabus. The speakers have knowledge of the Royal College exam - some of them are examiners, and all are experienced teachers. The course can be found here.  Duration  4 days  Cost  £300 (£75 deposit)  Next start date  TBC   Pathology Online Hub - FRCPath Part 1 Orientation Course This is a preparatory course aimed at overseas candidates. The course includes an introduction to the exam, including a mock exam with a detailed discussion of answers and exam tips. The course can be found here.  Duration  1 day  Cost  £40   Next start date  TBC   Pathology Online Hub - FRCPath Part 1 Comprehensive Course This is a preparatory course aimed at non-UK candidates, including particularly basic and extended questions on the UK system. The course covers topics which are unique to the UK system and includes a one-hour practice mock similar to the exam format and a detailed discussion of the answers with feedback. The course can be found here.  Duration  1 day  Cost  £45   Next start date  TBC    Reading materials  There is no set reading list or official course for FRCPath Part 1 in Histopathology, however the following books come highly recommended by IMGs who have passed the Part 1 exam:  Practical Applications in Histopathology, Cytopathology & Autopsy – Dr Limci Gupta (£78)  FRCPath, Part 1: Examination Preparation Guide – S. Steele (£22.18)  Sternberg's Diagnostic Surgical Pathology Review - Pier Luigi Di Patre, Darryl Carter (£91.95)  Wheater’s Functional Histology – Barbara Young, Phil Woodford, Geraldine O’Dowd (£44.95)  Robbins and Cotran Atlas of Pathology - Edward Klatt (+/- £45)  (Designed to complement Robbins and Cotran Pathologic Basis of Disease, 8th Edition and Robbins Basic Pathology, 8th Edition)  How have the exams been affected by COVID-19?  In response to the challenges of the COVID-19 pandemic, the Royal College of Pathologists has migrated the FRCPath Part 1 exam online.  Candidates all over the world are now able to take the exam from their home countries. This development allows the College to continue to offer the FRCPath Part 1 exam to both UK trainees and overseas pathologists, with minimal disruptions to the exam schedule.  For full details about the online FRCPath Part 1 exam, please see our blog here.  #IMG Tips  Prepare early – getting your revision going as soon as possible will help you avoid those last-minute cramming sessions and increase your chances of passing first time.  Speak to your colleagues and peers – there are so many study materials to choose from - who better to ask for recommendations than histopathologists who have been through the process or are going through it with you?  Familiarise yourself with the curriculum – we cannot stress this enough! Every country’s qualification and practice differ, so being well-versed in the curriculum is the first step on your path to success in the exam. Prepare for the online format in advance – make sure to fully complete your IT checks well in advance to avoid tech issues on the day (and save yourself an unnecessary headache). Find a support network – a great way to do this is to join IMG Histopathologists, an online pathology community of UK and NHS histopathology aspirants and dedicated histopathology recruiters. You’ll find advice, guidance and updates about all things histopathology for IMGs. Join the conversation here.  I’ve passed the FRCPath Part 1 exam, what’s next?  Great stuff! This is a massive achievement, and you deserve to treat yourself after all your hard work. With a pass in hand, it's time to look ahead to FRCPath Part 2. For more information on the final exam in the examination series, take a look at our blog where we explore the FRCPath Part 2, including how to sit the final exam, fees and preparation and results.   Head to our IMG library for more useful articles on the FRCPath exams, GMC registration and qualifications you need to help you find your dream job in the NHS.  For regular news and updates, follow IMG Connect on social media using the links below: