From the 30th of November 2023, the UK’s General Medical Council will introduce significant changes to the application process for Specialist Registration, namely CESR (Certificate of Eligibility for Specialist Registration) and CEGPR (Certificate of Eligibility for GP Registration). These changes focus on the evidence required in creating an application for Specialist Registration.  What are the new changes to the CESR and CEGPR process? Doctors who are applying for Specialist or GP Registration will now need to demonstrate that their knowledge, skills, and experience align with the high-level learning outcomes of the GMC-approved UK curriculum in the relevant specialty. These generic professional capabilities will be incorporated into specialty curricula and will therefore be equally demonstrated by UK trainees at the end of their approved training.   Why are these changes being made? The current system for CESR and CEGPR applications requires the mapping of evidence to the detailed CCT (Certificate of Completion of Training) curriculum in a specific specialty. The goal of this change is to ensure that doctors have a comprehensive understanding of the core competencies needed to practice effectively in their chosen specialty, whilst allowing the GMC the flexibility to accept a wider range of evidence.  This change is significant because it shifts the focus from a narrow and specific curriculum to a broader and more comprehensive approach. By aligning with the high-level learning outcomes, doctors will be better equipped to provide quality care and meet the evolving needs of patients.   What will the new system be called? The GMC has confirmed that both the CESR and CEGPR will be known as ‘Portfolio Pathway’ from 30th November 2023. This will be a more appropriate name which aligns with the evidence of knowledge, skills and experience required for practising as an eligible Specialist or GP in the UK.  Sources https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/cesr-cegpr-application-process/changes-we-are-making-to-cesr-and-cegpr-applications  https://www.gmc-uk.org/registration-and-licensing/join-the-register/applying-for-specialist-or-gp-registration/changes-to-how-doctors-demonstrate-the-standard-required-for-specialist-and-gp-registration/what-is-changing  Connect with us  Get in touch with us to find out more about achieving CESR or CEGPR as an IMG and join our upcoming CESR workshop and webinars on the GMC registration process and working in the UK as a doctor.              

Many junior doctors applying for Specialty Training in the UK will need to take the MSRA or Multi-Specialty Recruitment Assessment.   The MSRA plays an important role in the shortlisting and assessment process for entry into postgraduate training in several specialties for ST1 and CT1 level jobs, by assessing essential competencies.  In this blog, we will be taking a closer look at the assessment, focusing on some key questions summarised below:  Who needs to sit the MSRA? How is the assessment formatted? What is the structure of the MSRA? Where can I take the MSRA and how much does the assessment cost? How can I prepare for the assessment? #IMG Tips Skip ahead to the relevant section if you know what you’re looking for.  MSRA Specialties At present, the MSRA is being used within the following specialties:  ACCS-Emergency Medicine  Anaesthetics  Child and Adolescent Psychiatry  Clinical Radiology  Community Sexual & Reproductive Healthcare  Core Psychiatry Training  Core Surgical Training  General Practice  Neurosurgery  Nuclear Medicine  Obstetrics and Gynaecology  Ophthalmology  Not every specialty uses the MSRA in the same way, however on the whole, candidates’ scores from the MSRA are used as part of CT and ST recruitment to shortlist for interviews and selection centres, as well as making up part of your overall ranking (with the rest coming from interviews selection centres).   For example in 2023, GP, CAMHS, and Core Psychiatry Training will not have any interviews or selection centres and 100% of your rank will be determined by your MSRA scores. Core Surgical Training will also be using the MSRA in shortlisting for the first time this year.  MSRA Format The MSRA is a single computer-based exam comprising two papers: Professional Dilemmas (PD) and Clinical Problem Solving (CPS). As an exam used across many specialties for entry into Specialty Training, the MSRA assesses a foundation level of competence.  There is an optional five-minute break between the two papers. If candidates choose to take a longer break, the extra time will be subtracted from the time available to complete the CPS paper.  A combination of question types is used within the assessment, primarily extended matching questions (EMQ) and single best answer (SBA) questions, however the assessment may also include multiple best answer (MBA) questions: up to 3 correct answers, picture questions: may include skin lesions, blood reports, ECGs etc., and algorithm questions – drag boxes to the right part of the algorithm or select the correct answer from a list.  Structure of the MSRA The MSRA last 170 minutes and is divided into two sections: Professional Dilemmas (PD) and Clinical Problem Solving (CPS).  Professional Dilemmas (PD)  The Professional Dilemmas (PD) paper is a Situational Judgement Test (SJT) which measures how a candidate’s judgement regarding challenging professional dilemmas they may face.  The PD paper is not a test of knowledge of problem-solving ability or knowledge specific to specialty training within any specialty, but aims to assess professional attributes which are considered important for successful progression through training and performance in one’s clinical role.   Time: 95 minutes  Number of questions: 50  Context: the PD component is set within the context of Foundation Training with the candidate assuming the role of an F2 doctor. There is also a mixture of settings such as a hospital (across a variety of wards or placements), general practice and out-of-hours clinics.  Core competencies: professional integrity, coping with pressure, empathy and sensitivity (you can find more information on the behavioural indicators linked to these competencies here).  Clinical Problem Solving (CPS)  The Clinical Problem Solving (CPS) paper assesses a candidate’s ability to apply clinical knowledge and make clinical decisions in everyday practice.  Again, the CPS scenarios are based on Foundation level clinical practice. They test a candidate’s ability to synthesise and apply medical knowledge (not just knowledge recall).  Questions may relate to the investigation, diagnosis or management of common and important diseases as well as rare presentations.  Time: 75 minutes  Number of questions: 86  Context: the CPS covers 12 clinical topic areas relevant to general medicine. Each test paper includes a balance of scenarios which cover all 12 topics, including:   Cardiovascular   Dermatology / ENT / Eyes  Endocrinology / Metabolic  Gastroenterology / Nutrition  Infectious disease / Haematology / Immunology / Allergies / Genetics  Musculoskeletal   Paediatrics   Pharmacology and therapeutics  Psychiatry / Neurology   Renal / Urology   Reproductive   Respiratory  Core competencies: investigation, diagnosis, emergency, prescribing, management (you can find more information on these domains here).  Exam Centres for the MSRA The MSRA is held remotely and is delivered in partnership with Work Psychology Group and Pearson VUE. Candidates will need to register for an account with Pearson VUE and once invited, they can book an assessment at a centre, date and time of your choosing (subject to availability).  The MSRA is delivered globally on several consecutive days in many Pearson VUE Computer Testing Centres. You can find your nearest Pearson VUE assessment centre by visiting the Pearson VUE website.  The exam itself is free to sit, but depending on the centre you choose, there may be additional travel and accommodation costs. It’s therefore advisable to book your seat as soon as possible for the best chance of securing a nearby centre.  Preparation for the MSRA On the whole, your previous (and current) experience working as a junior doctor will have prepared you for most of the questions and scenarios within the MSRA, although to different extents, depending on where you have gained your experience.   However, as your MSRA scores are often added to the interview score to determine overall rank, or even to exempt you from interview, it may be advantageous to attempt to score as highly as possible.  Blueprint: First and foremost, you should use the MSRA blueprint to better understand the target domains.  Sample questions: Sample questions for both papers are available on the Health Education England Medical Education Hub. You can access these here.  Commercial resources: Exam revision courses, books and online question banks are available, although these are not officially endorsed, and you can find some of the most popular providers below:  Medibuddy  Passtest  eMedica  Passmedicine  4,000 Question bank and mock tests  1,950 Question bank and mock tests  2,200 Question bank and mock tests  2,500 Question bank and mock tests  £30 - £50  £35 - £55  £49 - £119  £25 - £30   #IMG Tips Start early – Once you have decided to sit the test, plan well in advance to give yourself enough time to prepare and score as highly as possible.  Take a test tutorial – You can take a practice test to familiarise yourself with the controls and screen layouts in advance – see Pearson VUE or Oriel for details.  Negative marking - One mark is given for each correct answer and negative marking is not used within the assessment, so try to answer all questions, even when unsure.  Read carefully - Read the instructions and questions carefully – you may often be looking for the most suitable answer, rather than the only correct one.  Sources https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/general-practice-gp/how-to-apply-for-gp-specialty-training/what_x0027_s-in-the-msra/structure-of-the-msra   https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/general-practice-gp/how-to-apply-for-gp-specialty-training/taking-the-msra   https://www.bmj.com/careers/article/a-guide-to-the-multi-specialty-recruitment-assessment-msra-   https://heeoe.hee.nhs.uk/sites/default/files/msra_test_blueprint_information_nov_2019.pdf   The MSRA is a key examination for many IMGs developing their careers by entering Specialty Training. UK training programmes are very competitive and particularly for overseas doctors unfamiliar with the NHS system, taking the time for extensive preparation for the MSRA can greatly impact your chances of being successful in joining a training programme.  Read more useful articles on exams, NHS jobs and salaries in our IMG Resources library.  For regular news and updates, follow IMG Connect on social media using the links below:              

Getting to grips with the different titles given to doctors in the UK can be difficult, not least because they may differ from those used in other countries and there may be several titles to describe a certain role.  It is important for overseas doctors to have a working knowledge of the different doctor titles in the UK in order to understand how their experience may translate to the UK in terms of seniority of roles as well as the pay they may be entitled to.  In this blog we will be breaking down all the different names given to UK doctors (both in and out of training), clarifying the meaning of these terms to paint a clearer picture of designations in the NHS.  We will cover these titles within the following groups:  Doctors in Training Doctors in non-Training Jobs Broad Terms for UK Doctors Doctors in Training Doctors in GMC-approved training programmes have designations according to the period and specific year of their training – generally the abbreviation of the training, followed by a number.  Foundation Training Other Titles / Designations: F1, F2, FY1, FY2, F3+, SHO, Junior Doctor, Trainee  These are doctors in a Foundation Programme, having graduated from medical school. In the UK, this is a 2-year programme equivalent to an internship.   During Year 1 of Foundation Training, doctors are referred to as F1/ FY1 and during Year 2, they are F2/ FY2.  Although Foundation Training lasts two years, doctors who may be unsure of which specialty to pursue may work in non-training jobs before applying to a training post. The naming structure for these roles is the same, depending on the years in their role.  Core Training Other Titles / Designations: CT1, CT2, CT3, ST1, ST2, ST3, SHO, Junior Doctor, Trainee  These are doctors in Core Training who are at the initial stage of an ‘uncoupled’ training programme. An uncoupled training programme is one in which there is a break in training where doctors are required to apply to higher specialty training upon completion of core training. Core training usually lasts from two to three years.  For ‘run-through’ training programmes, doctors at ST1 would have come from Foundation Training and have automatic entry into higher specialty training through their initial application to ST1.  Specialty Training Other Titles / Designations: ST3+, StR, SHO, Junior Doctor, Trainee  Higher specialty training generally begins at ST3/ ST4 and can go up to ST9 depending on the specialty.  The curriculum for each specialty will provide the typical training period, however this is indicative (doctors may take longer than this to complete their specialty training for any number of reasons).  SHO The term SHO stands for Senior House Officer, less commonly known as a House Officer. This is an older term for a very junior doctor, typically equivalent to an F1/ F2, although the term can be used to describe doctors up to CT2 (up to higher specialty training).  Trainee The term trainee can refer to any doctor in a training programme (generally from CT1 to ST9). These doctors may be referred to as residents in other countries. This can but does not generally include doctors in Foundation Training.  Doctors in non-Training Jobs Doctors in non-training positions are often given titles which align with their training counterparts, so it’s easier to understand at what level they are practising, but there are no hard and fast rules.  SHO Other Titles / Designations: Junior Clinical Fellow, Junior Doctor, Middle Grade  As with doctors in training, a non-training SHO would typically be equivalent to an F1/ F2, but it may be more common for a doctor not in training to have this title since an equivalent doctor in training would most likely be referred to as an F1/ F2.  Senior Clinical Fellow Other Titles / Designations: Junior Doctor This is a slightly confusing term which is usually for doctors at ST3+ level and generally have not completed a UK training programme. The role of these doctors often includes a combination of research and specialist clinical work.  SAS Doctor Other Titles / Designations: Senior Doctor, Specialist  SAS stands for Staff grade, Associate Specialist, and Specialty Doctor. These doctors will have at least four years of full-time postgraduate training, two of which have been in their relevant specialty.  They are experienced and senior doctors in fixed term or permanent posts (outside a UK training programme) and can work across primary, community and inpatient care.  Many SAS doctors have made a positive choice to step into a SAS position from a traditional consultant training pathway. This could be for reasons such as geographical stability or wanting to familiarise themselves with the NHS system before working up to a consultant position. Broader Terms There are also several terms which may more broadly be used to describe a doctor's level.  Junior Doctor This term can be used to describe anyone from F1 up to ST9These are qualified doctors in clinical training.  Registrar Other Titles / Designations: SpR, Junior Doctor, Middle Grade  This is another slightly older term. Registrar or SpR (Specialty Registrars) refers to the main training grade where doctors are undertaking higher specialty training (this is the earliest you can specialise).   It can refer to both trainees and non-trainees and is generally equivalent to ST3 and above (doctors who have completed their foundation training but are still in training in a specialty area of medicine). This term is therefore commonly used to describe more senior trainees and generally aligns with its use overseas.  Senior Doctor Other Titles / Designations: Specialist Grade, Specialty Doctor, Associate Specialist, GP, Consultant  As ‘junior doctor’ and ‘senior doctor’ are indicative of whether or not a doctor is in training, senior doctors are those able to practise independently – those working as a consultant, SAS doctor or GP.  Consultant Other Titles / Designations: Senior Doctor  Consultants are senior doctors that have completed full medical training in a specialised area of medicine. They usually work in hospitals or community settings. They have clinical responsibilities and administrative responsibilities in managing SAS and junior doctors.  There are two types of consultants:  Substantive - These are consultant who have been appointed to the Specialist Register for their area of medicine by the GMC. These doctors will either have completed a GMC-approved training programme (CCT) or completed an application for CESR or CESR-CP. You can learn more about Specialist Registration for overseas doctors here.  Locum - These are consultants who are appointed into an equivalent consultant post but are not required to be on the Specialist Register. Locum consultants are unable to take up a permanent position (only fixed term). A locum consultant’s work tends to be more clinical, however there may also be teaching and management responsibilities involved. It is also important to distinguish between two types of locums here: Trust Locums and Agency Locums. As the name suggests, agency locums work with a private agency and will generally receive an hourly wage. Trust locums on the other hand are appointed by the NHS Trust themselves and will be on a fixed-term contract which can be renewed.  GP GP stands for General Practitioner, and these are doctors who are responsible for the primary care of patients, covering illnesses and ailments across many specialist areas.  GPs are fully trained and are allowed to practice independently without supervision and all qualified GPs are listed on the GMC’s GP Register.  Unlike is often the case in overseas healthcare systems, general practitioners are not synonymous with doctors specialising in general medicine, so a general practitioner overseas may not necessarily have the same title in the UK.  Locum Doctor These are doctors who are covering a role within a healthcare setting.  All doctors (aside from F1 doctors) can work as locums. Like all practising physicians, locum doctors are fully registered with, and regulated by, the GMC.  Sources https://www.bma.org.uk/advice-and-support/international-doctors/life-and-work-in-the-uk/toolkit-for-doctors-new-to-the-uk/doctors-titles-explained    Hopefully, this article goes some way to demystify these terms and titles for international doctors interested in working in the UK. For more information including working in the NHS, doctors' benefits and salaries and how to register with the GMC, take a look through our IMG Resources library.              

This article delves into the specific guidance on GMC applications for entry onto the UK Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for clinical oncologists.  We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:  What is CESR and who is it for? Do overseas oncologists need FRCR (Oncology) for CESR? What is the CESR equivalence process? What evidence is required for a CESR in clinical oncology? Where will I find this evidence? How do I submit a CESR application? How long does it take to complete? How much does CESR cost? How long does it take to receive a decision? Do I have to complete CESR before I can work in the UK? #IMG Tips Skip ahead to the relevant section if you know what you’re looking for.  An Introduction to CESR CESR, or the Certificate of Eligibility for Specialist Registration, is the route to specialist registration for doctors who have not completed a GMC-approved training programme, but can demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of the CCT in the UK.   CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a clinical or radiation oncologist, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.  Oncologists must prove to the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question.   In order to be eligible for CESR, doctors should have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist experience or knowledge as a clinical oncologist within a non-training post.  Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced oncologists will secure a post in the UK, and work towards CESR whilst in post.   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 is the FRCR exams, so passing these exams confirms the attainment of the competencies of the core curriculum.  FRCR (Oncology) is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  Similarly, UK trainees would have completed MRCP (UK) before beginning their clinical oncology training, which is also not required for oncologists going through the CESR route.  However, CESR applicants who have not successfully completed these exams must provide alternative evidence that demonstrates equivalent knowledge to oncologists who have passed the FRCR (Oncology) exams and the appropriate level of non-oncology expertise and that you can appropriately manage the acutely unwell patient.  Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.  You can read more about the evidence required in the specialty specific guidance here.  The CESR Equivalence Process Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current clinical oncology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence; AND  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.  Gathering Evidence for a CESR Application Domain 1 – Knowledge, skills and performance  Qualifications  Primary Medical Qualification (PMQ)  Specialist medical qualification(s)  Curriculum or syllabus (if undertaken outside the UK)  Specialist registration outside the UK  Honours and prizes  Other relevant qualifications  Assessments and appraisals Appraisals and assessments  RITAs, ARCPs and training assessments  360˚ and multi-source feedback  Awards and discretionary points letters  Personal development plans (PDP)  Logbooks, records of daily clinical practice and portfolios Logbooks  Consolidation, cumulative data sheets, summary lists and annual caseload statistics  Medical reports  Case histories  Referral letters discussing patient handling  Patient lists  Departmental (or trust) workload statistics and annual caseload statistics  Rotas, timetables and job plans  Courses relevant to curriculum  Portfolios (electronic or revalidation)  Details of posts and duties (including both training and experience posts) Employment letters and contracts of employment  Job descriptions  Job plans  Research, publications and presentations Research papers, grants, patent designs  Publications within specialty field  Presentations, poster presentations  CPD and CME CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences  CPD registration points from UK Medical Royal College (or equivalent body overseas)  Membership of professional bodies and organisations  Teaching timetables  Lectures  Feedback or evaluation forms from those taught  Letters from colleagues  Attendance at teaching or appraisal courses  Participation in assessment or appraisal and appointments processes  Domain 2 – Safety and quality  Participation in audit, service improvement Audits undertaken by applicant  Reflective diaries  Service improvement and clinical governance meetings  Safety Health and safety  Domains 3 - Communication, partnership and teamwork  Communication  Colleagues  Patients  Partnership and teamwork Working in multidisciplinary teams  Management and leadership experience  Chairing meetings and leading projects  Domain 4 – Maintaining trust  Acting with honesty and integrity Honest and integrity  Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)  Data protection  Relationships with patients Testimonials and letters from colleagues  Thank you letters, cards from colleagues and patients  Complaints and responses to complaints  For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for clinical oncology.  Validating Evidence   Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.   All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.  Application Submission All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.  Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.  Your electronic evidence can be in any of the following formats:  .doc  .pdf  .ppt  .xls  Formats outside of these are unlikely to be accepted.  The Online Application You will be required to complete the following sections once you begin your application:  Specialty details  Qualification details and professional experience  Details of your referees  Registration and licensing history  Evidence summary  Details of your verifiers  Final declaration and payment  Additional Evidence  Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:   What evidence they’ve accepted   What evidence they’re unable to accept (including the reasons for this)   Advice and guidance on how your application could be strengthened   You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).  For further information about the online application process, see the GMC’s User Guide.  How long does it take to complete? As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in clinical oncology is seven years (not including Foundation Training), so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior clinical or radiation oncologists.  Cost of CESR Applications All oncologists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,727.  For CESR-CP and CCT, the cost is £452.  How long does it take to receive a decision? The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  Clinical Oncology Jobs in the NHS without CESR Overseas doctors do not require CESR to work in the UK.  There are also roles for more senior oncologists such as a specialty doctor (SAS), specialist grade or acting consultant, where you will likely receive better pay and responsibilities that are more appropriate to your level of experience. While working in these positions, you can also collect evidence of your competences, particularly those specific to the UK clinical oncology curriculum.  Across the UK there are several NHS Trusts with well-established CESR programmes of support for oncology who have taken up a fixed term post with the view to completing CESR.   These positions also facilitate a faster route to working in UK and attaining Specialist Registration when compared to making an application for CESR from overseas, which can take an additional amount of time, depending on the country in which you completed your training.  #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 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 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.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---clinical-oncology---dc3556_pdf-48456770.pdf   https://www.rcr.ac.uk/sites/default/files/clinical_oncology_curriculum_2021.pdf   Getting started Many senior IMG oncologists looking to develop their careers through Specialist Registration with the GMC may be eligible via the CESR route, and attaining CESR can be a long but very rewarding process. Look at our introduction to CESR for clinical oncologists for a full overview.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS.              

In this article, we’ll be taking a closer look at the specific guidance on NHS applications for entry onto the Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for medical oncologists.  We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:  What is CESR and who is it for? Do overseas oncologists need MRCP for CESR? What is the CESR equivalence process? What evidence is required for a CESR in medical oncology? Where will I find this evidence? How do I submit a CESR application? How long does it take to complete? How much does CESR cost? How long does it take to receive a decision? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  An Introduction to CESR CESR, or the Certificate of Eligibility for Specialist Registration, is the route to specialist registration for doctors who have not completed a GMC-approved training programme, but can demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of the CCT in the UK.   CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a medical oncologist, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.  Oncologists must prove to the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question.   In order to be eligible for CESR, doctors should have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist medical experience or knowledge as a medical oncologist within a non-training post.  Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced oncologists will secure a post in the UK, and work towards CESR whilst in post.   MRCP for Specialist Registration Whilst it is always beneficial to complete MRCP (UK), particularly for doctors who have trained outside the UK or the EEA, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the Medical Oncology curriculum is the MRCP (UK) exams, so passing these exams confirms the attainment of the competencies of the core curriculum.  MRCP (UK) is only a requirement for doctors looking to attain Specialist Registration via the CCT or CESR-CP route.  The structure of medical oncology training in the UK is an indicative two years in Core Medical Training or Acute Care Common Stem (ACCS), followed by an indicative four years of training in Medical Oncology. Therefore, applicants need to demonstrate the appropriate level of acute medicine expertise as well as competencies in medical oncology.  You can read more about the evidence required in the specialty specific guidance here.  CESR Equivalence Process Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current medical oncology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence; AND  skills and knowledge  The Royal College of Physicians will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Medical Oncology Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Medical Oncology curriculum. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit & Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of Evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 – Knowledge, skills and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  Gathering Evidence for a CESR Application Domain 1 – Knowledge, skills and performance  Qualifications  Primary Medical Qualification (PMQ)  Specialist medical qualification(s)  Curriculum or syllabus (if undertaken outside the UK)  Specialist registration outside the UK  Honours and prizes  Other relevant qualifications  Assessments and appraisals Appraisals and assessments  RITAs, ARCPs and training assessments  360˚ and multi-source feedback  Awards and discretionary points letters  Personal development plans (PDP)  Logbooks, records of daily clinical practice and portfolios Logbooks  Consolidation, cumulative data sheets, summary lists and annual caseload statistics  Medical reports  Case histories  Referral letters discussing patient handling  Patient lists  Departmental (or trust) workload statistics and annual caseload statistics  Rotas, timetables and job plans  Courses relevant to curriculum  Portfolios (electronic or revalidation)  Details of posts and duties (including both training and experience posts) Employment letters and contracts of employment  Job descriptions  Job plans  Research, publications and presentations Research papers, grants, patent designs  Publications within specialty field  Presentations, poster presentations  CPD and CME CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences  CPD registration points from UK Medical Royal College (or equivalent body overseas)  Membership of professional bodies and organisations  Teaching timetables  Lectures  Feedback or evaluation forms from those taught  Letters from colleagues  Attendance at teaching or appraisal courses  Participation in assessment or appraisal and appointments processes  Domain 2 – Safety and quality Participation in audit, service improvement Audits undertaken by applicant  Reflective diaries  Service improvement and clinical governance meetings  Safety Health and safety  Domains 3 - Communication, partnership and teamwork Communication Colleagues  Patients  Partnership and teamwork Working in multidisciplinary teams  Management and leadership experience  Chairing meetings and leading projects  Domain 4 – Maintaining trust  Acting with honesty and integrity Honest and integrity  Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)  Data protection  Relationships with patients Testimonials and letters from colleagues  Thank you letters, cards from colleagues and patients  Complaints and responses to complaints  For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for medical oncology.  Validating Evidence Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.   All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.  Application Submission All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.  Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.  Your electronic evidence can be in any of the following formats:  .doc  .pdf  .ppt  .xls  Formats outside of these are unlikely to be accepted.  The Online Application You will be required to complete the following sections once you begin your application:  Specialty details  Qualification details and professional experience  Details of your referees  Registration and licensing history  Evidence summary  Details of your verifiers  Final declaration and payment  Additional Evidence  Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:   What evidence they’ve accepted   What evidence they’re unable to accept (including the reasons for this)   Advice and guidance on how your application could be strengthened   You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).  For further information about the online application process, see the GMC’s User Guide.  How long does it take to complete? As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in medical oncology is six years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior oncologists.  Cost of CESR Applications All oncologists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,727.  For CESR-CP and CCT, the cost is £452.  How long does it take to receive a decision? The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  #IMG Tips 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  Attaining Specialist Registration through the CESR pathway can be a long but very rewarding process. Look at our introduction to CESR for medical oncologists for a full overview.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:              

For international doctors looking to work in the UK, it is important to understand the salary you will be offered with your NHS job and how this can be different depending on the country you are working in within the UK.   The NHS follow pay guidelines that are used to fairly and uniformly determine consultant pay, however these do differ across countries in the UK.   What is an SAS doctor? SAS stands for Staff grade, Associate Specialist, and Specialty Doctor. They will have at least four years of full-time postgraduate training, two of which have been in their relevant specialty.  They are experienced and senior doctors in fixed term or permanent posts (outside a training pathway).  Many SAS doctors have made a positive choice to step into a SAS position from a traditional consultant training pathway. This could be for reasons such as geographical stability or wanting to familiarise themselves with the NHS system before working up to a consultant position.  SAS doctors maintain their skills through the CPD system and there are routes, through gaining CESR (Specialist Registration) or applying for a training post, for SAS doctors to become consultants if they wish to.  Basic Pay Specialist Grades and Specialty Doctors in England and the other home countries have their own contracts in place for senior doctors. These contracts are based on a full-time work commitment of 10 programmed activities (PAs) per week, each having a time-tabled value of four hours.   The basic pay thresholds in the UK are shown below:  England Scotland Wales Northern Ireland England SAS doctors currently earn a basic rate of between £52,530 and £82,400 as Specialty Doctors and from £83,945 to £95,275 as Specialist Grade doctors in England.  Specialty Doctor  Years of experience  Basic Salary  0 (min)  £52,530 1  2  3  £60,519 4  5  6  £67,465 7  8  9  £74,675 10  11  12  £82,400 13  14  15  16  17    Associate Specialist / Specialist Grade  Years of experience  Basic Salary  0 (min)  £83,945 1  2  3  £87,000 4  5  6  £95,275 The most recent full pay circular for England can be found here.  Scotland SAS doctors currently earn a basic rate of between £45,193 and £84,272 as Specialty Doctors and from £63,361 to £103,074 as Associate Specialists in Scotland. Specialty Doctor  Years of experience  Basic Salary  0 (min)  £45,193  1  £49,057  2  £54,080  3  £56,772  4  £60,651  Threshold 1  5  £64,516  6  7  £68,466  8  9  £72,418  10  Threshold 2  11  £76,370  12  13  14  £80,321  15  16  17  £84,272    Associate Specialist  Years of experience  Basic Salary  0 (min)  £63,361  1  £68,454  2  £73,546  3  £80,271  4  £86,099  Threshold 1  5  £88,517  6  7  £91,673  8  9  £93,880  10  Threshold 2  11  £96,945  12  13  14  £100,008  15  16  17  £103,074  The most recent full pay circular for Scotland can be found here.  Wales SAS doctors currently earn a basic rate of between £51,765 and £81,200 as Specialty Doctors and from £82,722 to £93,887 as Specialists in Wales. Specialty Doctor  Years of experience  Basic Salary  1  £51,765 2  3  4  £59,637 5  6  7  £66,482 8  9  10  £73,587  11  12  13  £81,200 14  15  16  17  18    Specialist  Years of experience  Basic Salary  1  £82,722 2  3  4  £88,305 5  6  7  £93,887 The most recent full pay circular for Wales can be found here.  Northern Ireland SAS doctors currently earn a basic rate of between £51,000 and £80,000 as Specialty Doctors and from £81,500 to £92,500 as Associate Specialists in Northern Ireland. Specialty Doctor Years of experience  Basic Salary  Pay Point 0   £51,000   1   1 2 3   £58,756   2 4 5 6   £65,500  3 7 8 9   £72,500 4 10 11 12   £80,000 5 - top 13 14 15 16 17   Specialty Doctor Years of experience  Basic Salary  Pay Point 1   £81,500   1   2 3 4   £87,000   2 5 6 7 £92,500  3 (top)   The most recent full pay circular for Northern Ireland can be found here.  Job Planning and Programmed Activities As part of your contract, your job plan will be created in partnership with your new NHS employer. This is an annual agreement that sets out your duties, responsibilities and objectives for the length of your contract.  There are four basic categories of contractual work which will be included in your job plan: direct clinical care (DCC), supporting professional activities (SPAs), additional responsibilities and external duties.  There are ways that consultants will be able to earn more than the basic rates above and these can include additional rotas and PAs. This will also be discussed in the creation of your job plan.  Sources https://www.nhsemployers.org/system/files/2023-02/Pay%20and%20Conditions%20Circular%20%28MD%29%202-2023.pdf  https://www.sehd.scot.nhs.uk/pcs/PCS2022(DD)01.pdf  https://www.nhs.wales/files/pc-resources/042023-md-circular/  https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-hsc-tc8-03-2022.PDF  Getting started NHS Trusts can interpret the NHS consultant pay scales above and an international doctor’s experience in different ways, so use this blog as a guideline for understanding what you may be eligible for when coming to work in the NHS.  Your IMG Consultant is happy to assist with any negotiations related to your job plan to ensure your experience is taken into account.  For more information on NHS doctor benefits and pay arrangements in the UK, take a look at our IMG Resources library.              

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:              

As an overseas doctor looking to work in the UK, it is essential to understand the salary that comes along with your NHS job and how this can be different from one country in the UK to another.   Whilst the NHS has guides that are used to fairly and uniformly determine consultant pay, these do differ across the UK.   Basic Pay  Consultants in England and the other home countries each have their own consultant contracts in place. These are based on a full-time work commitment of 10 programmed activities (PAs) per week, each having a time-tabled value of four hours.   The basic pay thresholds in England and their equivalents in the rest of the home countries are shown below:  England  Scotland Wales Northern Ireland England  Consultants currently earn a basic rate of between £93,666 and £126,281 in England.  Threshold  Years completed as a consultant  Basic Salary  1  0  £93,666 2  1  £96,599 3  2  £99,532 4  3  £102,465        5  4        £105,390 5  6  7  8        6  9        £112,356 10  11  12  13        7  14        £119,323 15  16  17  18  8  19+  £126,281 The most recent full pay circular for England can be found here.  The National Clinical Impact Award (NCIA) scheme aims to reward consultants who contribute most to the delivery of safe and high-quality care and the improvement of NHS services. You can apply for a new award after you have completed a full year in an eligible role.  Scotland  Consultants currently earn a basic rate of between £96,963 and £128,841 in Scotland.  Threshold  Years completed as a consultant  Basic Salary  1  1 (starting salary)  £96,963  2  2  £99,011  3  3  £101,957  4  4  £104,906        5  5        £107,846  6  7  8  9        6  10        £114,846  11  12  13  14        7  15        £121,846  16  17  18  19  8  20+  £128,841  The most recent full pay circular for Scotland can be found here.  All consultants who have reached point five of the pay scale are eligible for consideration for discretionary points, except for distinction award holders. Consultants granted discretionary points are not normally considered again for two years, although this may vary.  Wales  Consultants currently earn a basic rate of between £87,354 and £113,408 in Wales.  Threshold  Years completed as a consultant  Basic Salary  1  0 (starting salary)  £87,354 2  1  £90,137 3  2  £94,789 4  3  £100,191  5  4  £106,363 6  5  £109,882 7  6  £113,408 The most recent full pay circular for Wales can be found here.  Please note that the pay scale above is for substantive or permanent doctors in Wales.  For locum consultants, there is a fixed pay point of £100,381 which will apply regardless of years of consultant experience.  Commitment awards are available to all consultants after three years’ service at the top of the consultant pay scale, who demonstrate their commitment through satisfactory job plan reviews. They are then eligible at three-yearly intervals, until they have achieved eight award levels.  Northern Ireland  Consultants currently earn a basic rate of between £88,799 and £119,723 in Northern Ireland.  Threshold  Years completed as a consultant  Basic Salary  1  1 (starting salary)  £88,799  2  2  £91,581  3  3  £94,362  4  4  £97,141        5  5        £99,913  6  7  8  9        6  10        £106,520  11  12  13  14  7  15  £113,124  8  16+  £119,723  The most recent full pay circular for Northern Ireland can be found here.  Job Planning and Programmed Activities  As part of your contract, your job plan will be created in partnership with your new NHS employer. This is an annual agreement that sets out your duties, responsibilities and objectives for the length of your contract.  There are four basic categories of contractual work which will be included in your job plan: direct clinical care (DCC), supporting professional activities (SPAs), additional responsibilities and external duties.  There are ways that consultants will be able to earn more than the basic rates above and these can include additional rotas and PAs. This will also be discussed in the creation of your job plan.  Getting started  NHS Trusts can interpret the NHS consultant pay scales above and an international doctor’s experience in different ways, so use this blog as a guideline for understanding what you may be eligible for when coming to work in the NHS.  Your IMG Consultant is happy to assist with any negotiations related to your job plan to ensure your experience is taken into account.  For more information on NHS doctor benefits and pay arrangements in the UK, take a look at our IMG Resources library.               Sources  https://www.nhsemployers.org/sites/default/files/2021-08/Pay-and-Conditions-Circular-MD-3-2021.pdf   https://www.sehd.scot.nhs.uk/pcs/PCS2022(DD)01.pdf  https://www.nhs.wales/files/pc-resources/042023-md-circular/  https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-tc8-2-2020.pdf 

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.               

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 doctors, there are several routes you can use to apply for GMC registration in the UK. The route that is right for you, depends on your qualification and experience.  GMC registration is essential for doctors practicing in the NHS, therefore it is important for overseas doctors to determine the most suitable route before securing a role.  This article will help you to identify the appropriate GMC application route for you as an IMG and will give you guidance on the steps you need to take, covering key areas including the following:  What is the GMC? What do I need for GMC registration? Routes to GMC registration: PLAB Accepted Postgraduate Qualifications / Licensing Exams Relevant European Qualifications Sponsorship & MTI Specialist Registration – CESR, CESR-CP & CEGPR #IMG Tips How do I get started? Please skip ahead to the relevant section if you know what you’re looking for.  The General Medical Council  The GMC is the body in the UK which is responsible for licensing and revalidating every doctor. Therefore, for every doctor practicing in the UK, GMC registration is essential – you cannot practice in the UK without full GMC registration with a license to practise.  The primary responsibility of the General Medical Council is to ‘protect, promote and maintain the health and safety of the public’ in addition to improving medical education and practice across the UK.  Requirements for GMC Registration  Registering with the GMC is a multi-stage process, including key timings, actions and documents. For full GMC registration, international doctors must provide evidence of:   1. (EEA doctors) Sufficient skill and knowledge – as an EEA physician, this would be your recognised EEA qualification.   OR   1. (non-EEA doctors) Sufficient skill and knowledge – as a non-EEA physician, this would either be PLAB, your Royal College postgraduate qualification (e.g. MRCP) or a GMC-approved qualification.   AND  2. English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).  AND   3. Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.  There are several steps involved in the registration process, but these are the three main components required in order to be eligible.  To understand the registration process more fully, read our blog on GMC registration for overseas doctors here.  PLAB  The PLAB exam is a two-part licensing exam that assesses a doctor’s ability to work safely as an SHO in the UK. As such, it does not demonstrate ability in any particular medical specialty.   For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries.   If taking this option, doctors can then take up training or a more senior post once they have established themselves in the NHS. Take a look at our comprehensive guides on PLAB for more information.  Is PLAB suitable for me?  The PLAB route may be suitable for you if:  You have not completed an internship, or your internship does not meet the acceptable pattern OR; You have completed an acceptable pattern of internship, but have no other clinical postgraduate experience OR; You are currently in or have completed postgraduate training (residency), and you want a faster route to full GMC registration.  Acceptable Postgraduate Qualifications or Licensing Exams  The GMC has produced a list of postgraduate qualifications which are accepted as sufficient evidence of the necessary knowledge, skills and experience required for full registration.  If these postgraduate qualifications are more than 3 years old when your application is made, you will have to provide further evidence of your recent medical experience.  UK Postgraduate Qualifications  Attaining a Royal College qualification is a preferred path for doctors who have already chosen their field of specialism i.e., pathology.   For senior doctors taking this route, they will gain access to more senior, well-paid jobs in the specialism of their choice.  For example, the Royal College of Physicians is the professional body that regulates all medicine specialties in the UK, and Membership of the Royal College of Physicians (MRCP UK) is the qualification attainable by examination. For overseas doctors, attaining full MRCP (UK) will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior medicine roles in the UK.  Take a look at our complete guides on the Royal Colleges in the UK through our IMG Resources library to understand more.   The full list of UK postgraduate qualifications can be found here.  Overseas Postgraduate Qualifications  There are also some overseas qualifications that meet the same standards as UK postgraduate qualifications, although they are not necessarily the same in every aspect.  You can find the full list of UK and overseas qualifications here.  Licensing Exams  Doctors who have passed an acceptable overseas registration exam can apply for full GMC registration.   You are eligible for to apply via this route if you:  graduated from a medical school outside the UK or Switzerland  and you:  hold an acceptable primary medical qualification  have completed an internship  have passed one of the following overseas registration exams:  United States Medical Licensing Exam (USMLE): Step 1, Step 2 clinical knowledge and Step 2 clinical skills; For Step 2 clinical skills, your pass must be between 16 April 2004 and 13 March 2020.  Medical Council of Canada Qualification Examination 2 (taken in English) on or before 27 October 2020  The Australian Medical Council Clinical Examination on or before 5 March 2020  have passed each part of the exam including the knowledge tests and clinical skills components in four attempts or less. If you sat any part of the exam more than four times before passing, you will not be eligible for this application.  Is the postgraduate/ licensing exam route suitable for me?  The postgraduate route to GMC registration is a popular one and facilitates the attainment of more senior roles in the NHS than for example PLAB (when combined with the relevant experience).  If you have already completed an acceptable postgraduate qualification in your home country, this is the most suitable pathway for you, as you will not have to sit additional exams.  The same goes for acceptable licensing exams, which also exempts overseas physicians from PLAB.  If you have not passed an acceptable overseas postgraduate qualification or licensing exam, you would have to complete the relevant UK postgraduate qualification.  Relevant European Qualification  If you hold a medical qualification awarded in the EEA or Switzerland, it may be classed as a Relevant European Qualification (REQ). You can find out whether your qualification is classed as a REQ by selecting your country through this link. Each country’s page covers the qualifications you would need to send to the GMC to support your application for entry onto the Medical Register, GP and Specialist Registers, and where appropriate, provisional registration with a licence to practice.  Is the REQ route suitable for me?  The Relevant European Qualification route to GMC registration is suitable for you if you hold a specialist certification that is recognised by the GMC. You can verify this through your country’s GMC page here.  Sponsorship & MTI  Some institutions can provide sponsorship for GMC registration. Doctors who receive sponsorship are therefore exempted from PLAB or the need to have an acceptable postgraduate qualification or licensing exam.  MTI  The Medical Training Initiative (MTI) is a training programme that provides junior doctors from all over the world the opportunity to gain clinical training and development in the UK for a maximum of 24 months.   Although doctors practicing in the UK must be registered with the GMC, for MTI candidates, registration is typically supported by the Royal College, some NHS Trusts also have the right to register MTI doctors.  You can read more about the MTI scheme here.  Sponsorship  There are several types of sponsorship available to overseas doctors, such as sponsorship offered by NHS Trusts through International Fellowships or sponsorships for specific posts.   If you apply for GMC registration through sponsorship, you’ll have to satisfy the sponsor that you possess the knowledge, skills and experience required for practising as a fully registered medical practitioner in the UK.  Each sponsor may have their own scheme which has been pre-approved by the GMC, and since each scheme differs from the next, we advise that you check the sponsor’s official website and contact them for more information.  A key aspect of all sponsors' criteria is that a doctor applying for GMC sponsorship must have been engaged in medical practice for three out of the last five years including the most recent 12 months. It is important to meet these minimum criteria for the best chance of providing sufficient evidence to support your application.  The complete list of GMC-approved sponsors, including NHS Trusts and Royal Colleges, can be found here.  Is the sponsorship route suitable for me?  MTI is best suited to junior doctors and those who wish to return to their home country after the training period, whereas the criteria for other types of sponsorship can be more varied.  Specialist Registration  The Specialist Register is a register of doctors who can take up substantive consultant (permanent) posts in the UK. All doctors who wish to work as substantive consultant in the UK must show evidence of skills, knowledge, and experience in order to apply for Specialist Registration.   Specialist Registration is additional to full registration with the GMC. You can read more about the types of GMC registration here.  Doctors eligible for Specialist Registration apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK.   Doctors who have completed their specialist training in the EEA or Switzerland may be eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ) and are awarded a CCT after a successful application.  CESR is the route to Specialist Registration for doctors who have not completed a GMC-approved specialty training programme i.e. doctors who have trained outside of the UK, Switzerland, and EEA countries. This is often the preferred route of IMGs.   For an in-depth guide to CESR, look at our blog for overseas doctors here.  Is Specialist Registration suitable for me?  Specialist Registration may be suitable for you if you (at minimum):  1. Hold a specialist qualification in the specialty you’re applying in  OR  2. Have at least six months of continuous specialist training in the specialty you’re applying in  You will have to provide evidence of your eligibility as part of your application, as well as evidence that you meet the requirements of the CCT curriculum in your specialty.  The indicative period of training to be awarded a CCT ranges from 5 years to 9 years in the UK (depending on the specialty), so if you have less training than this, it is unlikely that you will have the full evidence required for a successful application for Specialist Registration.  #IMG Tips  In short, there are routes that depend on qualifications or exams from countries you’ve trained in: licensing exams, acceptable postgraduate qualifications, or REQs; or if you do not hold any of these: MTI, UK postgraduate exams or PLAB.  Use the GMC route finder to double-check you are pursuing a route to registration that you are eligible for.  If your route requires additional exams, begin your preparation for these well in advance and always start with the syllabus or curriculum for your exam!  Read through the GMC’s page on required documents – the necessary documents can change, as the GMC adapts to changes in healthcare and current issues such as the COVID-19 pandemic.  If you’ll be completing exams to register with the GMC, complete these or begin the process before you focus on English language testing – your IELTS or OET only have a 2-year validity period!  Getting started  So, there you have it, the main routes to GMC registration for IMGs. Once you have determined your route to GMC registration, it’s time to either begin gathering the required documents for your application or begin your preparation for any exams you’ll need to sit.  Have you already registered with the GMC, or looking to get started? Get in touch with us here to discuss finding an NHS post. If you have any other questions, please feel free to get in touch with our team.  For advice, guidance and news and updates for IMGs, join the conversation through the links below.             

Training in the NHS offers an extensive training scheme and career development for psychiatrists, with the quality and depth of this programme being recognised as a gold standard throughout the international medical community.  In line with developments and progression in psychiatry across the field and around the world, training provided to UK psychiatry trainees is regularly reviewed and updated. This should make the training programme attractive to UK graduates, as well as IMG psychiatrists seeking the best training programmes for their field and career development.  In this article, we will explore the training pathway for psychiatrists in the UK, with a broad look at the following topics:  What is the NHS Training Pathway? How do you enter the training pathway? What does the specialty training programme look like for psychiatry? What happens after completing the psychiatry training programme? Can I enter specialty training in the UK as an IMG? The NHS Training Pathway  The NHS training pathway refers to the complete programme for UK trainees, from foundation training to the completion of specialist or higher training, where candidates may be eligible for a CCT within their chosen specialism, such as General psychiatry or any of its sub-specialties.  It is important for IMGs to understand this process, as it clarifies what stage they can most likely enter the system if they are interested in training in the UK.  Entering the NHS Training Pathway  After graduating from medical school, doctors will receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).  Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area, such as psychiatry – for psychiatry, this first stage is known as Core Psychiatry Training (CT).  Specialty Training in Psychiatry  The UK Specialty Training programme in Psychiatry is 6 years long, and whilst doctors may pass through training quicker depending on how quickly they achieve their competencies, this is rarely the case and psychiatrists will usually take the indicated time, or slightly longer to complete the Specialty Training programme.  Successful applicants entering year one of core psychiatry training (CT1), will follow the Royal College of Psychiatrists’ 2017 Specialist Training in Psychiatry Curriculum.   The Psychiatry training programme  The psychiatry specialty training scheme operates both as a run-through and uncoupled programme, though it is more often un-coupled.  Depending on where your application is successful, you may complete your period of core training, as well as the Royal College exams before making a further application for the next stage of training (requiring two applications). Alternatively, you may be able to apply for run-through training, which guarantees you complete both Core and Higher training in one region, as you are recruited for the full duration of Specialty Training.  Foundation Training (FY1 – FY2)  The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills.  Selection  Here, trainees will either choose whether to enter GP (General Practitioner) training, internal medicine training (IMT) or core training in psychiatry (CT).   Core Psychiatry Training (CT1 – CT3)  This part of training takes place from year 1 to 3, where trainees will work and train in several different sub-specialties within psychiatry. They will gain a broad understanding of psychiatry by rotating between 6-month posts in the following sub-specialties:  General and Community Psychiatry - including Assertive Outreach, Crisis Home Treatment, Outreach for Homeless People, Early Intervention for Psychosis, Rehabilitation and Liaison Psychiatry.  Old Age Psychiatry - including Memory Clinics, Community Teams, Domiciliary Clinics, Young Onset Dementia, Day Hospital and Liaison Psychiatry.  Child and Adolescent Psychiatry - including Specialist Adolescent and Academic Psychiatry.  Substance Misuse  Learning Disability Psychiatry - including Specialist Asperger Services.  Forensic Psychiatry - including all levels of security.  By the end of CT3, trainees will need to have completed the MRCPsych exams.  Please note, trainees must pass the MRCPsych Paper A, Paper B and CASC exams in order to progress to higher psychiatry training.  For more information of the Royal College of Psychiatrists examination suite, take a look at our IMG Resources library here.  There are two opportunities per year to apply to core psychiatry training. Information about how to apply, including the person specifications, is available via the North West Deanery, who manage the recruitment process.  Selection  Here, trainees who are not currently training in a run-through programme will make applications to a deanery for higher psychiatry training in their chosen specialty. Selection is open by national competition.  Higher Psychiatry Training (ST4 – ST6)  This training takes place from years 4 – 6, where trainees will complete 3 years of yearly rotations in their chosen speciality, building on their core training and develop increasing levels of competence in clinical psychiatry.  There will also be opportunities to work in other sub-specialties including: addictions, eating disorders, neuro-psychiatry, perinatal and social & rehabilitation psychiatry.   Trainees will usually be allocated a certain number of PAs (programmed activities) weekly for special interest or research purposes. As well as sub-specialty opportunities, these can also be used towards educational opportunities such as local training days/conferences in relevant domains, from clinical leadership to humanities.  Completion of the Psychiatry Specialty Training Programme  Upon completion of the training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in General Adult Psychiatry of one of its sub-specialisms. This will be based on criteria set out in the curriculum by the Royal College. You can find the 2021 curriculum here.  At this point, the psychiatrists are entered onto the specialist register and can now take permanent consultant posts in the NHS.  Specialist Registration for overseas doctors  Doctors who completed part or all of their psychiatry training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.  Joining the Psychiatry Specialty Training Programme as an IMG  It is possible for overseas doctors to join the Specialty Training programme in Psychiatry in the UK, however it is very competitive.   IMGs interested in UK specialty training must have:  Full GMC registration   Completion of a minimum 12-month (FY1 equivalent) internship  English language test  PLAB  AND  12 months post-internship experience by the time you start begin ST1  Although UK trainees are not given priority for specialty training places, it can be very difficult to join the Psychiatry Specialty Training programme without NHS experience.  So here you have it, a broad overview of the NHS Psychiatry Specialty Training pathway for UK trainees. This training scheme is the core of psychiatry training in the UK, and for IMGs looking to join the training programme, understanding of the pathway allows you to better align your overseas training with the relevant stage you wound enter into Specialty Training in the UK.  Getting started  If you have any further questions about the UK training pathway or your route to the UK as an overseas psychiatrist, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   For access to a community of like-minded MRCPsych aspirants 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.              

In this article, we’ll be taking a closer look at the specific guidance on NHS applications for entry onto the Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for psychiatrists.  We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:  What is CESR and who is it for? Do overseas psychiatrists need MRCPsych for CESR? What is the CESR equivalence process? What evidence is required for a CESR in psychiatry? Where will I find this evidence? Submitting a CESR Application How much does CESR cost? How long does it take to receive a decision? How long does it take to complete? Do I have to complete CESR before I can work in the UK? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  An Introduction to CESR  The CESR, or Certificate of Eligibility for Specialist Registration, is the route to specialist registration for psychiatrists who have not completed a GMC-approved training programme but who are able to demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of CCT in the UK.   CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a psychiatrist, attaining specialist registration will mean you are qualified to practice independently as a psychiatry consultant in the NHS.  Psychiatrists must satisfy the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question. Doctors who have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist medical experience or knowledge as a psychiatrist within a non-training post, and are currently practicing, may apply to the GMC for assessment of their competencies.  Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced psychiatrists will secure a post in the UK, and work towards CESR whilst in post. Typically, CESR is a preferred route towards specialist registration for overseas trained psychiatrists.  An overseas psychiatrists training may not have covered all the ground of the CCT curriculum, but they may be able to show competence in the missing area through experience in a fixed term Specialty Doctor, Specialty Grade, Associate Specialist, or Acting Consultant post in the NHS. In this case, overseas psychiatrists will likely complete the MRCPsych exams to gain GMC registration and start working in the NHS, before completing CESR.   MRCPsych for Specialist Registration  Overseas doctors looking to join the Specialist Register are not required to have completed the Royal College postgraduate exams. In this case, MRCPsych is only a requirement for doctors looking to attain Specialist Registration via the CCT route.   The standard test of knowledge in the CCT curriculum is the MRCPsych exam, so passing these exams confirms the attainment of the competencies of the core Curriculum.  However, if CESR applicants have not successfully completed MRCPsych, they must provide alternative evidence that demonstrates equivalent knowledge to psychiatrists who have passed the exams.  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.  This is not to be confused with the requirements for registering for a full licence to practice with the GMC – many overseas applicants choose to complete MRCPsych. Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a psychiatrist in the UK.  You can read more about the full MRCPsych examination suite in our IMG Resources library.  The CESR Equivalence Process  Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current psychiatry training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence; AND  skills and knowledge  The Royal College of Psychiatrists 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 Psychiatry  Skills & Experience: The evidence provided for a CESR application in psychiatry must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the General Psychiatry Curriculum, and the Advanced Module in the sub-specialty you are applying in. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit & Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800 - 1200 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 – Knowledge, skills and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  Gathering Evidence for a CESR Application  Domain 1 – Knowledge, skills and performance  Qualifications  Primary Medical Qualification (PMQ)  Specialist medical qualification(s)  Curriculum or syllabus (if undertaken outside the UK)  Specialist registration outside the UK  Honours and prizes  Other relevant qualifications  Assessments and appraisals  Appraisals and assessments  RITAs, ARCPs and training assessments  360˚ and multi-source feedback  Awards and discretionary points letters  Personal development plans (PDP)  Logbooks, records of daily clinical practice and portfolios  Logbooks  Consolidation, cumulative data sheets, summary lists and annual caseload statistics  Medical reports  Case histories  Referral letters discussing patient handling  Patient lists  Departmental (or trust) workload statistics and annual caseload statistics  Rotas, timetables and job plans  Portfolios (electronic or revalidation)  Details of posts and duties (including both training and experience posts)  Employment letters and contracts of employment  Job descriptions  Job plans  Research, publications and presentations  Research papers, grants, patent designs  Publications within specialty field  Presentations, poster presentations  CPD and CME  CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences  CPD registration points from UK Medical Royal College (or equivalent body overseas)  Membership of professional bodies and organisations  Teaching timetables  Lectures  Feedback or evaluation forms from those taught  Letters from colleagues  Attendance at teaching or appraisal courses  Participation in assessment or appraisal and appointments processes  Domain 2 – Safety and quality  Participation in audit, service improvement  Audits undertaken by applicant  Reflective diaries  Service Improvement and clinical governance meetings  Safety  Health and safety  Domain 3 - Communication, partnership and teamwork  Communication  Colleagues  Patients  Partnership and teamwork  Working in multidisciplinary teams  Management and leadership experience  Chairing meetings and leading projects  Domain 4 – Maintaining trust  Acting with honesty and integrity  Honest and integrity  Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)  Data protection  Relationships with patients  Testimonials and letters from colleagues  Thank you letters, cards from colleagues and patients  Complaints and responses to complaints  Additional areas of evidence  Topics Covered in the MRCPsych Exams  Paper A:  Behavioural science and sociocultural psychiatry  Basic psychology  Social psychology  Social science and sociocultural psychiatry   Human development   Basic neurosciences  Neuroanatomy  Neurophysiology   Neurochemistry   Molecular genetics  Neuropathology   Clinical psychopharmacology  General principles  Pharmacokinetics   Pharmacodynamics  Adverse drug reactions   Classification and assessment in psychiatry  Paper B:  Organisation and delivery of psychiatric services   General adult psychiatry   Prevalence/incidence, aetiology, presentation, treatment and outcome of psychiatric disorder in adulthood   Disorders related to pregnancy and childbirth   General hospital psychiatry   Emergency psychiatry   Eating disorders   Psychosexual disorders   Old age psychiatry   Psychotherapy   Dynamic psychotherapy   Family therapy   Cognitive-behavioural therapies   Other therapeutic models   Effectiveness of psychotherapy   Group therapy   Child and adolescent psychiatry   Substance misuse/addictions   Forensic psychiatry   Relationship between crime and mental disorder   Psychiatry and the criminal justice system   Practicing psychiatry in a secure setting   Human rights legislation as it affects patients and psychiatric practice   Learning disability   Services   Epidemiology/Aetiology   Clinical   Research methods, statistics, critical review and evidence-based practice   Translation of clinical uncertainty into an answerable question   Systematic retrieval of the best available evidence   Critical appraisal of the evidence   Application of the results in practice   Evaluation of performance  All these topics covered in the MRCPsych exams can be found in the Core Training in Psychiatry curriculum.   For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for psychiatry.  Validating the evidence   Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.   All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.  Submitting a CESR Application  All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.  Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.  Your electronic evidence can be in any of the following formats:  .doc  .pdf  .ppt  .xls  Formats outside of these are unlikely to be accepted.  The Online Application  You will be required to complete the following sections once you begin your application:  Specialty details  Qualification details and professional experience  Details of your referees  Registration and licensing history  Evidence summary  Details of your verifiers  Final declaration and payment  Additional Evidence  Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:   What evidence they’ve accepted   What evidence they’re unable to accept (including the reasons for this)   Advice and guidance on how your application could be strengthened   You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).  For further information about the online application process, see the GMC’s User Guide.  The Cost of CESR Applications  All psychiatrists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.  How long does it take to receive a decision?  The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  How long does it take to complete?   As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior psychiatrists, 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 psychiatry 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 psychiatrists.  NHS Positions in the NHS without CESR  It is important to note that you can apply for more senior psychiatry roles such as a specialty doctor (SAS), specialist grade or acting consultant without being on the Specialist Register.  Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS.  When compared to a trainee post, you will likely receive better pay and responsibilities that are more appropriate to your level of experience. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK psychiatry curriculum.  Across the UK there are several NHS Trusts with well-established CESR programmes of support for psychiatrists who have taken up a fixed term post with the view to completing CESR.   These positions also facilitate a faster route to working in UK and attaining Specialist Registration when compared to making an application for CESR from overseas, which can take an additional amount of time.   #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 psychiatry curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Psychiatry 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).  Choose your referees carefully - they will need to be able to comment on direct observation of your clinical competences. At least six (from the last 5 years) are required but it would be preferable to give provide eight to ten (based on previous experience).   Reconstruct your CV from scratch so that it matches the application form - if you submit a CV that doesn’t contain the required information or you have not submitted all evidence as mentioned on the CV, this will delay your application.   Request a CV consultation with one of our experts Ask an IMG Connect recruitment specialist about NHS psychiatry 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 IMG Psychiatrists community – as well as support on Royal College exams, our online community of international psychiatrists and dedicated psychiatry recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.  Getting started  Attaining Specialist Registration through the CESR pathway can be a long but very rewarding process. Look at our introduction to CESR for psychiatrists for a full overview.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   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.              

There are several routes a haematologist can take to register with the GMC and practice in the NHS.    Haematologists looking to secure a job in the NHS must satisfy certain criteria before fully registering with the GMC (General Medical Council) to receive a license to practice. For haematology, these criteria depend on where you received your training, and the qualifications you hold. In this blog, we’ll be giving you a snapshot of the steps you need to take to begin your journey to the UK as an overseas haematologist. We’ll be covering the following:  Will my training be recognised in the UK? How do I demonstrate my knowledge and skills as an EEA haematologist? How do I demonstrate my knowledge and skills as a non-EEA haematologist? How can I demonstrate my English language skills? What is a certificate of good standing and how do I get one? What do I need to register with the GMC? Will I need a visa to work in the UK? Skip ahead to the relevant section if you know what you’re looking for.  Recognition of training  For haematologists who trained in an EEA country (all countries inside the EU, also Lichtenstein, Iceland, Switzerland & Norway), there are several options potentially available to you.  Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either GMC registration; check the relevant GMC page here.  Knowledge and Skills for EEA Haematologists  Basic Medical Training: If you meet the requirements for basic medical training, you will not need to demonstrate your medical knowledge and skills to work as a doctor in the UK, and would therefore not need to complete a Royal College postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, without Specialist Registration.  Specialist Training / Residency: If you meet the criteria for entry onto the Specialist Register, then once you have completed the GMC application process, you would be granted Specialist Registration in haematology and can be appointed as a substantive or permanent consultant in the NHS. So as a haematologist, if you hold a Relevant European Specialist qualification, you would be put on the specialist register for haematology and can be appointed as a substantive haematologist in the NHS.  As an EEA haematologist, the main hurdle you will face will be demonstrating that your English skills are of a high enough standard to practice safely as a doctor in the NHS.  Therefore, for European haematologists, this is most likely the easiest route to becoming GMC-registered and being able to practice haematology in the UK.  If you do not meet the GMC requirements for your training to be approved for general or specialist registration, other routes you may consider to GMC registration include PLAB, or (via the postgraduate route) the Royal College exams for haematology (FRCPath). You can find out more about these alternative routes here.  Knowledge and Skills for non-EEA Haematologists  If you qualified as a haematologist outside the EEA, then you will have to demonstrate that both your medical knowledge and skills AND English Language capabilities meet the level required to practice safely in the UK.  Haematologists who have trained from outside the UK and EEA must demonstrate to the GMC they have sufficient knowledge & skills to practice safely in the UK. This can be done through three main routes:  Professional & Linguistics Assessment Board (PLAB): The PLAB exam is a two-part exam that assesses a doctor’s ability to work safely as an SHO in the NHS, as such it does not demonstrate ability in haematology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries. If taking this option, haematologists can then take up training or a more senior post once they have established themselves in the NHS. Take a look through our comprehensive guides on PLAB.  Royal College of Pathologists: The Royal College of Pathologists is the professional body that regulates the specialism of haematologists in the UK, and Fellowship of the Royal College of Pathologists (FRCPath) is the full qualification attainable by examination. For overseas doctors, attaining FRCPath will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior roles in UK pathology. Take a look at IMG Resources library for a complete guide to FRCPath to learn more.  Please note that only UK trainee haematologists are required to also complete the MRCP (UK) examinations. You can read more about this here.    GMC-recognised or equivalent qualifications: Some overseas qualifications and licensing exams are recognised by the GMC and accepted for registration purposes. This is to say these qualifications or licensing exams are considered as meeting the same standards as the Royal College qualifications.  To find out if your qualification is accepted by the GMC, take a look at our blog: Overseas accepted postgraduate qualifications  English Language Testing  Both EEA and non-EEA haematologists, regardless of experience and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below:  IELTS – a guide for overseas doctors  OET – a guide for overseas doctors  Experience in English-speaking countries  For doctors who have at least two years of their most recent experience in an English-speaking country, you can use a reference from your current employer or employers over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.  Certificate of Good Standing  All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.  The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. You can find out which medical regulatory authority to contact via the GMC website here.  If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.  Please note that each certificate is only valid for three months from the date it's signed and must be valid when we approve your application.  GMC Registration  Once you’ve completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:  English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).  AND  Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.  AND  (EEA haematologists) Sufficient skill and knowledge – as an EEA haematologist, this would either be your recognised EEA qualification.  (Non-EEA haematologist) Sufficient skill and knowledge – as a non-EEA haematologist, this would either be PLAB, MRCP or a GMC-approved qualification.  To understand the registration process more fully, read our article on GMC registration for overseas doctors here.  Visas  If you or your family are from the EU, Switzerland, Norway, Iceland or Liechtenstein and started living in the UK by 31 December 2020, you may be able to apply to the free EU Settlement Scheme. Otherwise, you will need to apply for a visa from the Home Office.  A Tier 2 visa is the document given to a skilled worker by the UK Home Office following a job offer from a UK employer with a valid Tier 2 Sponsorship License. The list of valid Tier 2 Sponsors can be found here.  Understand Tier 2 visas and Certificates of Sponsorship in depth by taking a look at our article: Tier 2 Visa application process & documents needed.  Wondering whether you can relocate with your family? Take a look at our blog on the Tier 2 dependent visa below: Tier 2 Dependent visa - Can I bring my family with me to the UK?  So there you have it! Hopefully this clarifies any questions or doubts you may have on your route to the UK as a haematologist planning a career in the NHS. If you have any questions, or wish to know more about the haematology job market then get in touch with our team.  For regular news and updates on all things pathology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

The Dermatology SCE is the higher postgraduate qualification provided by the Royal College of Physicians as a specialist qualification for dermatologists. It is one of 11 SCEs offered by the College and offers physicians a higher postgraduate qualification than MRCP which can be used to demonstrate to prospective employers the achievement of a standard equivalent to UK specialist doctors.  Here we take a closer look at the MRCP (UK) Dermatology Specialty Certificate Examination for doctors who have chosen to specialise in dermatology. We cover the content of the exam, as well as fees and the eligibility criteria, which we’ve summarised below with a broad look at the following topics:  What is the SCE in Dermatology? Where does the SCE fit into my training? What is the structure of the Dermatology SCE? How do I apply for the exams and what do they cost? Where can I sit the exams as an overseas dermatologist? How should I prepare for the exams as an IMG? I’ve passed? What’s next? Skip ahead to the relevant section if you know what you're looking for.  MRCP (UK) SCE in Dermatology  The dermatology specialty certificate exam is administered as a compulsory element of assessment towards the Certificate of Completion of Training (CCT) in dermatology for all UK trainees.   The purpose of an SCE is to:  ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants  complement workplace-based assessments  provide a rigorous national assessment to establish public confidence  offer a challenge similar to sub-specialty certification examinations in North America  The SCE as Part of Training in Dermatology  Since the MRCP(UK) exams are taken during the Internal Medicine Training years (ST1-ST3), the dermatology SCE allows physicians to demonstrate that they are able to practice independently at a consultant level.  The SCE has no fixed entry requirements (both for UK and overseas candidates); however, UK trainees would normally sit the SCE in their penultimate year of higher specialty training (ST6). UK trainees should have made at least one attempt at the dermatology SCE by the time of their penultimate year assessment.  For an in-depth guide to the MRCP exams, see our IMG Resources library here.  Exam Structure  The SCE comprises 200 questions which assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum. This should be taken as an indication of the likely number of questions for each section – the actual number may vary:  Topic  Number of questions  Cutaneous allergy  10  Dermatopathology  10  Dressings & wound care  10  Formulation & systemic therapy  10  General dermatology & dermatology in primary health care  50  Genito-urinary disorders and oral medicine  10  Infectious disease  10  Paediatrics & genetics  30  Photodermatology  10  Psychodermatology  5  Skin biology & research  15  Skin oncology  20  Skin surgery and cosmetic dermatology  10  Total  200  There are two three-hour papers, with the questions in each category distributed across both papers.  All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.  Dermatology SCE Applications  The SCEs are held once a year and all applications are made online through the My MRCP(UK) account, found in the Upcoming Exams section of the Royal College website.   The application process is as follows:  Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)  Request a preferred test country and city  Pay applicable examination fee  Application is confirmed via an automatically generated email  Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.  The Royal College of Physicians has created a helpful video guide on SCE applications which you can watch here.  Cost  The cost of the SCE exams are as follows:  UK centres: £665  International centres: £833  Exam Centres  UK Centres  Candidates who choose to sit the dermatology SCE in the UK must contact Pearson VUE to book their test. There are around 137 test centres throughout the UK for each SCE, and the Royal College of Physicians advise that candidates should book their exam as early as possible to secure their preferred test centre, since bookings operate on a first come first served basis.  International Centres  Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. The Royal College of Physicians passes this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the examination date. If the exam is not available in the requested location, candidates will be offered a choice of the nearest available test centres.  Please note, international candidates should not book their own test directly with Pearson VUE - attempting to do so may delay a candidate's application.  The full list of international test centres for the SCE can be found here.  Preparation and Resources for the Dermatology SCE  It can be difficult for IMGs to know where to start with their preparation and revision, particularly as the exam requires a wide breadth of knowledge around the curriculum and should involve reading textbooks, journals and guidelines.  This list should provide a good starting point for any international dermatologists preparing to sit the SCE:  Curriculum - Applicants are tested on a range of common and important disorders in Dermatology as set out in the Joint Royal Colleges of Physicians Training Board’s Specialty Training Curriculum for Dermatology. We recommend getting to know the curriculum as early as possible and using it as a blueprint for your study.   Below are some other good reading materials and sources:  Textbooks  Rook's Textbook of Dermatology - Eds DA Burns, SM Breathnach, N Cox, CE Griffiths Textbook of Pediatric Dermatology - Eds AD Irvine, PH Hoeger, AC Yan Dermatology - Eds JL Bolognia, JL Jorizzo, RP Rapini McKee’s Pathology of the Skin - JE Calonje, T Brenn, A Lazar, P McKee Journals  British Journal of Dermatology (BJD) Clinical and Experimental Dermatology (CED) Journal of the American Academy of Dermatology (JAAD) Journal of Investigative Dermatology The Journal of the American Medical Association (JAMA) Websites  British Association of Dermatologists (BAD) British Society for Investigative Dermatology (BSID) British Society for Cutaneous Allergy British Society for Medical Dermatology British Society for Dermatological Surgery (BSDS) DermIS (dermatology image resource) eMedicine online reference DermNet NZ (New Zealand dermatology society) Dermatology e-learning resource Sample questions: It is a good idea to regularly assess your knowledge and progress using example questions from the current exam syllabus. You can find these here.  For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, check out at our blog: IMG Connects Top Tips for exam preparation.  I’ve passed? What’s next?  Congratulations – what an achievement! With your higher postgraduate qualification, you will be able to apply for NHS roles above ST3 which are likely more suited to your seniority and experience – nice one.  Don’t hesitate to get in touch with an IMG medicine recruitment specialist to discuss GMC registration, dermatology positions in the NHS, salaries, suitable UK locations and hospitals for you, and relocation.  To receive the latest news and updates, including the Royal Colleges, GMC registration and the NHS, follow us on social media and join the conversation.              

The NHS offers an extensive training scheme and career development for histopathologists, and the quality and depth of this programme is recognised as a gold standard across the medical community.  The training provided to UK histopathology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of pathology around the world and across the profession. This makes the training programme attractive to UK graduates, as well as overseas histopathologists seeking the best training programmes for their field.  In this article, we will explore the training pathway for histopathologists in the UK, covering the following topics:  What is the NHS Training Pathway? How do you enter the training pathway? What does the specialty training programme look like for histopathology? What happens after completing the histopathology training programme? Can I enter specialty training in the UK as an IMG? The NHS Training Pathway  The NHS training pathway is the name given to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training within I.e. within histopathology.  It is important for IMGs to understand this as it helps to provide an understanding of at what stage they can most likely enter the system if they are interested in training in the UK.  Entering the NHS Training Pathway  After graduating from medical school, doctors with receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).  Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area I.e. histopathology – this is known as Specialty Training (ST).  Specialty Training in Histopathology  The Specialty Training programme in Histopathology is 5 years long, and whilst doctors may pass through training quicker depending on how quickly they achieve their competencies, this is rarely the case and histopathologist will usually take the indicated time, or slightly longer to complete the Specialty Training programme.  Successful applicants entering into year one of specialty training (ST1), will follow the Royal College of Pathologist’s 2021 Histopathology Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.   Histopathology training as a run-through programme  Unlike some specialisms where you complete a period of core training before entering into specialty training (requiring two applications), histopathology specialty training works as a run-through programme. You only have to apply once, at the beginning of the programme, as you are recruited for the full duration of Specialty Training.  Foundation Training (FY1 – FY2)  The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills.  Specialty Training (ST1 – ST5+)  ST1) Year one trainees enter the training programme. In this first stage, trainees will initially develop knowledge of laboratory work, with basic training in all areas of cellular pathology.  Training starts with a 1-2 week induction from the training school. This includes some time in the lab seeing how specimens are prepared and processed. Trainees are taught how to use a microscope, how to approach simple cases under the microscope and the principles of macroscopic assessment and sampling (AKA ‘cut up’). Many training schools do a separate autopsy induction.  When not at block teaching weeks, trainees are rotating through the various specialities in histopathology.  ST2 – ST3 This part of training takes place from year 2 to year 3, with the focus on achieving the FRCPath Part 1 Exam. This will normally be taken after 18 – 24 months of training.  Trainees will consolidate and develop their knowledge base from ST1. Year two trainees are given more independence and are expected to be able to cut up most specimens by the end of this stage.   In many deaneries, this is the time when trainees complete rotations in sub specialities including paediatric pathology, neuropathology and oral pathology. Trainees may rotate to placements in local district general hospitals to gain valuable experience in managing a general histopathology workload.  Autopsy and cervical cytology training continue as mandatory elements of ST2-ST3. Some trainees choose not to continue these specialities when they have completed this stage.  The FRCPath Part 1 exam aims to determine whether you have successfully acquired a core body of knowledge that will underpin your ability to practise in Histopathology.  For more information of the first exam in the Royal College of Pathologists examination suite, take a look at our IMG Resources library here.  Please note, trainees must pass the FRCPath Part 1 examination at the end of ST3 in order to progress to ST4.  Selection  Here, trainees will either choose to continue with general histopathology or peruse subspecialisation in neuropathology, paediatric/perinatal pathology, cytopathology or forensic pathology. ST3 – ST4 This training takes place from years 3 – 4, where trainees will either continue with general histopathology or peruse subspecialisation in neuropathology, paediatric/perinatal pathology, cytopathology or forensic pathology. Trainees are expected to be competent in the macroscopic and microscopic assessment of all specimens, and will also receive training in leadership, management and teaching in preparation for their future roles as consultants.  The focus during this stage is also on achieving the FRCPath Part 2 Exam, thereby obtaining the status of Fellow of the Royal College of Pathologists.  This final exam is designed to test your practical skills and understanding, and show that you can apply your expertise appropriately and safely.  Trainees who wish to continue in general histopathology may opt to sit further exams in cervical cytopathology and autopsy practice if they wish to continue these as a consultant.  To learn more about the final exam in the in FRCPath examination suite, read our detailed blog here.  Please note, trainees must pass the FRCPath Part 2 examination at the end of ST4 in order to progress to ST5.  ST5+ This is the final stage of training before CCT during which histopathology trainees may wish to peruse special interests in particular subspecialties, such as gastrointestinal, skin or gynaecological pathology. Having passed the FRCPath Part 2 exam, trainees will continue to take on responsibility to enable the transition to independent practice required of those with CCT, i.e. signing out reports without consultant review.  Completion of the Histopathology Specialty Training Programme  Upon completion of the training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Histopathology. This will be based on criteria set out in the curriculum by the Royal College. You can find the 2021 curriculum here.  At this point, the histopathologists are entered onto the specialist register and can now take permanent consultant posts in the NHS.  Specialist Registration for overseas doctors  Doctors who completed part or all of their histopathology training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.  Joining the Histopathology Specialty Training Programme as an IMG  It is possible for overseas doctors to join the Specialty Training programme in Histopathology in the UK, however it is very competitive.   IMGs interested in UK specialty training must have:  Full GMC registration   Completion of a minimum 12-month (FY1 equivalent) internship  English language test  PLAB  AND  12 months post-internship experience by the time you begin ST1  Although UK trainees are not given priority for specialty training places, it can be very difficult to join the Specialty Training programme without NHS experience.  So here you have it, the NHS Specialty Training pathway for trainees in a nutshell. This training scheme is the core of training for histopathologists in the UK, and for IMGs looking to join the training programme, understanding of the pathway allows you to better align your overseas training with the relevant stage you would enter into Specialty Training in the UK.  If you have any further questions about your route to the UK as an overseas histopathologist, FRCPath, or any other aspect of GMC Registration, the NHS or the UK, please get in touch with us here.   We'd also like to invite you to join the IMG Histopathologists online community - as well as support on Royal College exams, our Facebook group of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.  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:             

The NHS offers an extensive training scheme and career development for medical oncologists, and the quality of this programme is recognised as a gold standard across the medical community.  The training provided to UK medical oncology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of oncology around the world and throughout the profession.  In this article, we will explore the training pathway for medical oncologists in the UK, covering the following topics:  What is the NHS Training Pathway? How do you enter the training pathway? What does the specialty training programme look like for medical oncology? What happens after completing the medical oncology training programme? Can I enter specialty training in the UK as an IMG? Skip ahead to the relevant section if you know what you’re looking for.  The NHS Medical Oncology Training Pathway  The NHS training pathway is the name given to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training within i.e. within medical oncology.  It is important for IMGs to understand this as it helps to provide an understanding of at what stage they can most likely enter the system if they are interested in postgraduate training in the UK.  Entering the NHS Training Pathway  After graduating from medical school, doctors with receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).  Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area I.e. medicine – this is known as Internal Medicine Training (IMT), formerly known as Core Training (CT).  Specialty Training in Medical Oncology  The Specialty Training programme in Medical Oncology runs over a 6-year period, and doctors will usually take the indicated time, or slightly longer to complete the Specialty Training programme.  Successful applicants entering into year one of specialty training (ST1), will follow the Joint Royal Colleges of Physicians Training Board 2021 Medical Oncology Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.   Medical oncology training as an uncoupled programme  As medical oncology is a medicine specialty, aspiring oncology trainees will complete a period of core/ internal medicine training that lasts a period of two years.  This is followed by an open competition to enter a higher specialty training post. It is important to note that the application following core training is competitive and does not guarantee a specialty training post.  Medical oncology higher specialty training will be in total (including OCS) an indicative four-year clinical training programme leading to single accreditation in the specialty. There are no critical progression points during higher specialty medical oncology training, though trainees will be subject to an annual review of progress via the ARCP process and will have to complete all curriculum requirements including passing the medical oncology Specialty Certificate Examination (SCE) prior to obtaining CCT.  Foundation Training (FY1 – FY2)  The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills and forms the bridge between medical school and speciality training.  Selection  Here, trainees will either choose to enter into either Internal Medicine Training or into training to become a general practitioner.   Specialty Training (ST1 – ST6+)  Internal Medicine Stage 1 Training (ST1 – ST2)   In this first stage of the Internal Medicine training programme, trainees develop a solid foundation of professional and generic clinical capabilities, preparing them for participation in acute medicine at a senior level and to manage patients with acute and chronic medical problems in outpatient and inpatient settings. You can find the Curriculum for Internal Medicine Stage 1 Training here.  This will culminate in trainees sitting the MRCP (UK) exams. For more information on the Royal College of Physicians examination suite, take a look at our IMG Resources library here.  Please note, trainees must pass the MRCP examinations prior to beginning Specialty Training in Medical Oncology.  Selection  Here, trainees will either choose to continue with Internal Medicine Training for a further year, to continue with training in a specialty that supports acute hospital care, or to provide primarily out-patient based services in e.g. oncology.  Medical oncology recruitment into ST4 posts usually occurs after 2 years of Internal Medicine Stage 1 training. However, trainees who complete the full three-year IMT programme are also eligible and there is no preferential selection for trainees who have completed either two or three years of training.  Oncology Common Stem (ST3)  The Oncology Common Stem (OCS) has a duration of one year and usually takes place in year 3 of specialty training. Here, the focus is on a trainee’s development of the common oncology capabilities relating to the key areas of overlap between the two specialties (medical and clinical oncology), as well as continuing to develop the generic capabilities expected of all doctors.   Clinical Oncology and Medical Oncology are the two main medical specialities that manage patients with non-haematological malignancy. They often work in partnership with each other, and both offer systemic therapy to patients, but only clinical oncologists administer radiotherapy and there are other differences in work-pattern, approach and focus.  Medical oncologists will have the scientific understanding which underpins radiation-based cancer treatments. During the OCS training year, trainees will gain knowledge of radiotherapy planning and delivery. This will enable them to coordinate the care of cancer patients with the wider multidisciplinary team (MDT), managing patients throughout a treatment pathway.  The curricula for medical and clinical oncology have been aligned to reflect this relationship and include aspects of common training that constitute the Oncology Common Stem (OCS), improving transferability and flexibility for trainees who wish to move between the two specialties.  Please note that medical oncology trainees will not be expected to independently plan or deliver radiation-based cancer treatments.  Medical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST6)  Following successful completion of OCS, medical oncology trainees will complete a subsequent higher specialty-specific programme, this takes place from year 4 – 6. The focus here for trainees is on acquiring medical oncology-specific capabilities, alongside consolidation and further development of the common oncology and generic capabilities.  Trainees will then sit the Medical Oncology Specialty Certificate Examination, usually in the penultimate year of higher specialty training. The globally-recognised exam offers medical oncologists a postgraduate qualification which demonstrates achievement of a standard required of UK specialist trainees.  Please note, the medical oncology SCE is a compulsory component of assessment for the achievement of Certificate of Completion of Training (CCT).  To learn more about the medical oncology SCE, read our detailed blog here.  Completion of the Medical Oncology Specialty Training Programme  Upon completion of the medical oncology training programme, the choice is made whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Medical Oncology. This will be based on high-level learning outcomes – capabilities in practice (CiPs) set out in the curriculum by the Royal College. You can find the 2021 curriculum here.  At this point, medical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register and can now take permanent consultant posts in the NHS.  Specialist Registration for overseas doctors  Doctors who completed part or all of their medical oncology training outside the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.  Joining the Medical Oncology Specialty Training Programme as an IMG  It is possible for overseas doctors to join the Specialty Training programme in Medical Oncology in the UK, however it is very competitive.   IMGs interested in UK specialty training must have:  Full GMC registration   Completion of a minimum 12-month (FY1 equivalent) internship  English language test  PLAB  AND  12 months post-internship experience by the time you begin ST1  Please note, whilst UK trainees are not given priority for specialty training spaces, it can be extremely difficult to join the Specialty Training programme without prior NHS experience.  So here you have it, the NHS Specialty Training pathway for medical oncology trainees in a nutshell. The training programme forms the basis of medical oncology training in the UK, and for overseas oncologists interested in joining the training programme, good knowledge of the pathway allows you to better understand the alignment of your overseas training with the relevant stage of Specialty Training for medical oncology in the UK.  Join the IMG Oncologists Facebook group for access to a community of like-minded oncologists 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. 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:             

Here we take a closer look at the routes available to overseas consultants & experienced doctors who wish to join the GMC’s Specialist Register.   IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.  To shed some light on the routes to Specialist Registration, we've put together a short article to explain further, including the following topics:  What is Specialist Registration? What are the different types of Specialist Registration? Am I eligible? How do I apply for Specialist Registration and what evidence will I need? What are the benefits of Specialist Registration? Are other senior NHS posts available without Specialist Registration? How much does Specialist Registration cost? #IMG Tips Skip ahead to the relevant section if you know what you’re looking for.  Specialist Registration All doctors who wish to work as permanent consultants in the UK must show evidence of skills, knowledge and experience in order to apply for Specialist Registration. This registration in any specialty means you can be appointed to a substantive consultant post within the NHS.  Specialist Registration is additional to full registration with the GMC.  The 3 Types of Specialist Registration There are three types of certificates issued by the GMC, and the type of certificate you will receive at the end of your training defines which training route you are on.  The Certificate of Completion of Training (CCT)  The CCT is the route to specialist registration for doctors who have completed a GMC-approved, specialty training programme through the relevant Royal College.  To be eligible for CCT, an applicant’s entire training (including any core years) must have taken place within UK-approved training posts. Please see our blog on career pathways for a UK doctor in training.  The Certificate of Eligibility for Specialist Registration - Combined Programme (CESR (CP))   CESR(CP) is a simplified route for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK.  Doctors on the CESR(CP) route count a combination of approved training and previous experience in non-approved posts (overseas) towards their training time.  The Certificate of Eligibility for Specialist Registration (CESR)  CESR is the route to specialist registration for doctors who have not completed a GMC-approved specialty training programme – doctors who have trained outside of the UK, Switzerland, and the EEA.  These doctors apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK.  Doctors who have completed their specialist training in the EEA or Switzerland are eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ).  For an in-depth guide to CESR, take a look at our blog for overseas doctors here.  Eligibility Eligibility for Specialist Registration depends on your nationality, qualification and experience.   To meet the minimum eligibility requirements to apply you must have either:  A specialist qualification in the specialty you’re applying in OR  At least six months continuous specialist training in the specialty you’re applying in  You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.   In your application you must show that you meet the requirements of the CCT curriculum in your specialty.   The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience.  Applications and Evidence for Specialist Registration CCT and CESR-CP  Once you have been issued with your Outcome 6 has been issued, you must complete and return the relevant CCT/ CESR(CP) notification to your Royal College along with the following documents:  Copies of any ARCPs that are not on your ePortfolio  ARCPS/evidence of successful progression for any LAT/FTTA/SHO posts counting towards your training (this applies to doctors who were appointed above ST1 only)  You will also need to complete an online GMC form. The link to this form will be emailed to you by the GMC and you should contact your Royal College if you do not receive it.   The GMC has created a guide for each CCT specialty with the relevant royal college or faculty. You can see this here.  CESR  You will need to apply to the GMC, who will then send your application to the Royal College for evaluation. The application process for CESR can be lengthy and potentially stressful, so it is important that you read the GMC’s general guidance and specialty-specific guidance before starting to put together an application.   You will need to provide a portfolio of evidence demonstrating that your specialist training or qualifications are equivalent to the award of a CCT in your specialism in the UK. This information is available for each specialty and Royal College on the GMC website here.  If you apply for an NHS post which provides CESR support, your hospital should assist you in this process.  Once the GMC has sent you a letter informing you that your application is complete and has been sent to your Royal College for assessment, the College is not permitted to discuss your case with you until the GMC has sent you a letter informing you of the decision.  Benefits of Specialist Registration Specialist registration allows doctors to take up permanent or substantive consultant positions. Without CCT, CESR or CESR-CP, a doctor may only take a Trust locum or fixed-term consultant posts.  Fixed-term and locum posts offer of course offer less stability than permanent consultant posts and require extension.  It is a legal requirement before taking a substantive, honorary or permanent NHS consultant post in the UK that doctors have their names entered on the GMC's Specialist Register.  Senior Positions in the NHS It is important to note that you can apply for more senior roles such as a specialty doctor (SAS), specialist grade or a locum consultant (locum consultants are not required to be on the Specialist Register).   This way, you will have better pay and roles and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these jobs you can collect evidence of your competences.   These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  Cost All doctors applying for Specialist Registration must pay a fee. The fees for 2021 are as follows:  CCT - £439  CESR-CP - £439  CESR - £1,676  #IMG Tips Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.  Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.    Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Ask an IMG Connect recruitment specialist about NHS posts with CESR support, these are not always advertised by a Trust, but we can help you to find a role which aligns well with your career goals in the NHS.  Most IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR or CESR-CP route. Take a look at our in-depth CESR overview for more information on how to apply and what to expect. If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.  Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:              

There are several routes a European oncologist can take to GMC registration and medical or clinical (radiation) oncology in the NHS.  All European oncologists looking to secure a job in the NHS will need to satisfy certain criteria before they can register for full GMC (General Medical Council) registration to practice in the NHS. As an oncologist, these criteria depend on where in the world you trained, and the qualifications you hold. In this blog, we’re giving you a snapshot of the steps you need to take to start your journey to the UK, as a European-qualified oncologist. We will be covering the following:  Is my training recognised as an EEA doctor? How do I demonstrate my knowledge and skills? How can I demonstrate my English language skills? What is a certificate of good standing and how do I get one? What do I need to register with the GMC? EEA Doctors  Firstly, it is important to note that where we refer to EEA in this article, this refers specifically to all countries inside the EU, including Lichtenstein, Iceland, Switzerland & Norway. If you trained & qualified as an oncologist inside the EEA or Switzerland, then you will have a few different options potentially available to you.  Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either general or specialist registration, check the relevant GMC page here.  Knowledge and Skills Basic Medical Training: If you have met the basic medical training requirements, this would mean that you would not need to demonstrate your medical knowledge and skills to work as a doctor in the UK and would not need to complete a UK- recognised postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, but not Specialist Registration.   Specialist Training / Residency: If you have met the criteria listed for your country, then once you have completed the GMC application process, you would be granted Specialist Registration in oncology and can be appointed as a substantive or permanent consultant in the NHS. So as an oncologist, if you hold a Relevant European Specialist qualification, you would be put on the specialist register for medical or clinical oncology and can be appointed as a substantive oncologist in the NHS.  Therefore, the main hurdle that you will face as an EEA doctor will be demonstrating that your English skills are of a high enough standard to practice safely and proficiently as a doctor in the NHS.  As a European oncologist, this is in most cases the easiest route to becoming GMC-registered and being able to practice oncology in the UK.  If you do not meet the GMC requirements for your training to be approved for full or specialist registration, other routes you may consider to GMC registration include PLAB or (via the postgraduate route) the Royal College exams for either clinical oncology (FRCR) or medical oncology (MRCP). You can find out more about these alternative routes here.  English Language Testing All EEA oncologists, regardless of experience, and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below:  IELTS – a guide for overseas doctors OET – a guide for overseas doctors Certificate of Good Standing All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they have been registered or licensed with in the last five years.   The medical regulatory authority may send you a certificate of past good standing if you are not currently registered or licensed with them. You can find out which medical regulatory authority to contact vis the GMC website here.  Please note that each certificate is only valid for three months from the date it is signed and must be valid when the GMC approve your application.  If there is no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.  GMC Registration Once you have completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:  English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years) AND  Sufficient skill and knowledge – as an EEA oncologist, this would either be your recognised primary medical degree, or your recognised specialist European qualification (REQ)  AND  Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing To understand the registration process more fully, read our on GMC registration for overseas doctors here.  So, there you have it! Hopefully any medical or radiation oncologist planning a career in the NHS should have their route to the UK clarified. If you ever have some questions or wish to know more about the oncology job market, then get in touch with our team.  Join the IMG Oncologists Facebook group for access to a community of like-minded oncologists and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, completely free to all doctors. You can access our IMG Oncologists community here. For regular news and updates on all things oncology, follow IMG Connect on social media using the links below:             

IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.  Here we explore specialist registration in histopathology for overseas consultant pathologists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) specifically, including the application, 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 pathologist? Do I have to complete CESR before I can work in the UK? Do I need FRCPath for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in histopathology? 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 specialty means that you can be appointed to a substantive (permanent) consultant position in the NHS. All physicians who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to gain Specialist Registration.   Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a histopathologist in the UK.  Routes to Specialist Registration  There are three types of certificates issued by the GMC for specialist registration across all specialties, and the type of certificate you receive depends on which training route you followed.  For pathologists 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, but rather the submission of an application.   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.   Pathology Positions in the NHS without CESR  It is important to note that you attain more senior histopathology roles in the NHS, 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 histopathology curriculum.  These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  FRCPath for Specialist Registration  Whilst it is always beneficial pathologists to complete FRCPath, overseas doctors looking to join the Specialist Register do not necessarily need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the CCT curriculum are the FRCPath exams, so passing these exams confirms the attainment of the competencies of the Histopathology Curriculum.  FRCPath is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  However, if CESR applicants have not successfully completed these exams, they must provide alternative evidence that demonstrates equivalent knowledge to histopathologists who have passed the FRCPath exams.  Even if the competencies covered by the exams require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.  CESR Equivalence Process  Equivalence describes the process of assessing an overseas applicant’s training and experience against the current histopathology 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 Pathologists 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 Histopathology  Skills & Experience: The evidence provided for a CESR application in histopathology must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the Curriculum for Specialty Training in Histopathology. If evidence is missing from any area of the curriculum, the application may be unsuccessful.  Capabilities in Practice: The Royal College of Pathologists has divided the Training Curriculum into 11 different Capabilities in Practice (CiPs) – each comes along with its own descriptor and guidance on where such CiPs would be evidenced.  Applicants are required to gather evidence by area of competence and attach this under the relevant section of the online application.  Generic CiPs  Able to function effectively within healthcare and other organisational and management systems to deliver consistent high-quality patient care.  Able to work within ethical and legal frameworks across all aspects of clinical practice.  Communicates effectively and is able to share decisionmaking, while maintaining appropriate situational awareness, professional behaviour and professional judgement.  Maintains patient safety at the forefront of clinical working. Can utilise quality improvement activity realistically within the constraints of the role.  Able to contribute to and support research.  Behaves as an educator in the context of the role and promotes educational culture.  Able to self-appraise, learn and adapt.  Histopathology-specific CiPs  Able to demonstrate leadership and management within the laboratory setting for the benefit of patient care.  Able to use laboratory and other services effectively in the investigation, diagnosis, and management of patients, relatives, and the deceased.  Able to manage and contribute to a multidisciplinary team effectively.  Able to take, manage and interpret pathological specimens accurately and safely, mindful of risks to self and others.  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 histopathology applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.  How long does it take to complete a CESR in Histopathology application?  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 histopathologists, 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 histopathology is five 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 pathologists.  #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 histopathology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Histopathology Specialty Training Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the 11 CiPs 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 histopathology posts with CESR support. These are not always advertised by the Trusts, but we can help you find a role which aligns well with your career goals in the NHS.  Join the IMG Histopathologists community – as well as support on Royal College exams, our online community of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.  Getting started  Many pathology 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 Histopathology 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 histopathology 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:              

The NHS specialty training programme for clinical oncologists is recognised around the world. The quality and depth of oncology training and career development in the UK is recognised as a gold standard across the globe, making it a major attraction for many IMGs when considering a career in the UK.  The NHS training programme for oncology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of oncology around the world and throughout the profession.   In this article, we will explore the training pathway for clinical oncologists in the UK, covering the following topics:  What is the NHS Training Pathway? How do you enter the training pathway? What does the specialty training programme look like for clinical oncology? What happens after completing the clinical oncology training programme? Can I enter specialty training in the UK as an IMG? Skip ahead to the relevant section if you know what you’re looking for.  The NHS Training Pathway for Clinical Oncologists  The NHS training pathway refers to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training and being awarded a CCT.  It is a good idea for overseas trainees to familiarise themselves with this as it helps to provide an understanding of at what stage they can most likely enter the system, either in a training or non-training post.   Entering the NHS Training Pathway  After graduating from medical school, doctors receive provisional GMC registration, allowing them to enter the Foundation programme (a two-year work-based training programme).  Upon completion of the first year of this programme (FY1), doctors will gain full GMC registration with license to practice and will be able to apply for further study and training in a specialised area i.e. medicine. This is known as Internal Medicine Training (IMT), formerly known as Core Training (CT).  Specialty Training in Clinical Oncology  The Specialty Training programme in Clinical Oncology runs over a 6-year period, and doctors will usually take the indicated time, or slightly longer to complete the Specialty Training programme.  Successful applicants entering into year one of specialty training (ST1), will follow the Royal College of Radiologists’ 2021 Clinical Oncology Specialty Training Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.   Clinical oncology training as an uncoupled programme  Clinical oncology specialty training begins at ST3, so after foundation training, there are two options open to trainees before they can start specialist clinical oncology training:  Internal Medical Training (IMT)  Acute Care Common Stem (ACCS)  For IMT, this is a two-year training period and the ACCS training programme lasts 3 years.  Both pathways are followed by an open competition to enter a higher specialty training post. It is important to note that the application following core training is competitive and does not guarantee a specialty training post.  Clinical oncology higher specialty training is indicatively a five-year clinical training programme (including Oncology Common Stem), leading to single accreditation in clinical oncology.  There are a few critical progression points during higher specialty training in clinical oncology, and trainees will also be subject to an annual review of progress via the ARCP process. They will have to complete all the curriculum requirements including passing the MRCP and FRCR (Oncology) exams prior to obtaining CCT.  Foundation Training (FY1 – FY2)  The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills and forms the bridge between medical school and speciality training.  This first year of Foundation Training (or FY1) is referred to as an internship. For IMGs applying for GMC registration, it is essential you can meet the requirements for an internship.   Selection  Here, trainees will either choose to either Internal Medicine Training (IMT), Acute Care Common Stem training (ACCS), or training to become a general practitioner (GP Training).   Specialty Training (ST1 – ST7)  Internal Medicine Stage 1 Training (ST1 – ST2)   Year one trainees begin at ST1 of the Internal Medicine Training Programme. In this first stage, trainees develop a solid foundation of professional and generic clinical capabilities, preparing them for participation in acute medicine at a senior level and to manage patients with acute and chronic medical problems in outpatient and inpatient settings. The curriculum for IMT Stage 1 Training can be found here.  The two-year training period culminates in trainees sitting the MRCP (UK) exams. For more information on the Royal College of Physicians examination suite, take a look at our IMG Resources library here.  Please note, trainees must have gained full MRCP prior to beginning Specialty Training in Oncology.  Selection  Here, trainees will either choose to continue with Internal Medicine Training for a further year, to continue with training in a specialty that supports acute hospital care, or to provide primarily out-patient based services in e.g. oncology.  Clinical oncology recruitment into ST3 posts usually occurs after 2 years of Internal Medicine Stage 1 training. However, trainees who complete the full three-year IMT programme are also eligible and there is no preferential selection for trainees who have completed either two or three years of training.  Oncology Common Stem (ST3)  The Oncology Common Stem (OCS) has a duration of one year and usually takes place in year 3 of specialty training (ST3). Here, the focus is on a trainee’s development of generic capabilities-in-practice (CiPs) expected of all doctors, as well as the common CiPs relating to the key areas of overlap between medical and clinical oncology.  Clinical Oncology and Medical Oncology are the two main medical specialities that manage patients with non-haematological malignancy. They often work in partnership with each other, and both offer systemic therapy to patients, but only clinical oncologists administer radiotherapy and there are other differences in work-pattern, approach and focus.  During OCS training, trainees will gain knowledge of radiotherapy planning and delivery. This will enable them to coordinate the care of cancer patients with the wider multidisciplinary team (MDT), managing patients throughout a treatment pathway.  The new curricular structure of the OCS means that trainees who successfully complete the training year will have gained the necessary competencies to progress to ST4 in either clinical or medical oncology.  For oncologists wishing to pursue clinical oncology, the first exam in the Fellowship of the Royal College of Radiologists assessment series, First FRCR (Oncology) (Part 1/ CO1), must be passed by the end of ST4.  Candidates do not need to have held a clinical oncology training post to attempt the exam however, so candidates are eligible to sit the exam during ST3.  Click here to learn more about the full FRCR (Oncology) examination suite.  Clinical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST7)  Once trainees have completed the OCS, they will then move onto a subsequent higher specialty-specific programme of their choice I.e. clinical oncology. This programme lasts for four years and takes place from ST4 to ST7, the focus here being to acquire clinical oncology specific CiPs, culminating in trainees’ achievement of Fellowship of the Royal College of Radiologists (FRCR Oncology).  The higher specialty-specific programme for clinical oncologists is administered by the Royal College of Radiologists, so the Medical Oncology SCE is not a requirement for clinical oncologists.  Trainees will then sit the Final FRCR (Oncology) Part 2A and 2B exams (CO2A and CO2B), usually from ST6 to ST7. This is to assess their knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.  Completion of the Clinical Oncology Specialty Training Programme  Upon completion of the clinical oncology training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Clinical Oncology. This will be based on high-level learning outcomes – capabilities in practice (CiPs) set out in the curriculum by the Royal College. You can find the 2021 curriculum here.  At this point, clinical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register for clinical oncology and can now take permanent consultant posts in the NHS.  Specialist Registration for overseas doctors  Doctors who completed part or all of their clinical or radiation oncology training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.  Joining the Clinical Oncology Specialty Training Programme as an IMG  It is possible for overseas doctors to join the Specialty Training programme in Clinical Oncology in the UK, however it is very competitive.   IMGs interested in UK specialty training must have:  Full GMC registration   Completion of a minimum 12-month (FY1 equivalent) internship  English language test  PLAB or a recognised European Medical Degree  AND  12 months post-internship experience by the time you start begin ST1  Please note, whilst UK trainees are not given priority for specialty training spaces, it can be extremely difficult to join the Specialty Training programme if you do not have previous NHS experience.  So there you have it, the NHS Specialty Training pathway for clinical oncology trainees. The training programme forms the basis of clinical oncology training in the UK, and for overseas clinical or radiation oncologists interested in joining the training programme, good knowledge of the pathway allows you to better understand the alignment of your overseas training with the relevant stage of Specialty Training for clinical oncology in the UK.  Join the IMG Oncologists Facebook group for access to a community of like-minded oncologists and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors. You can access our IMG Oncologists community here. For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below:              

There are several routes a medical oncologist can take to register with the GMC and practice oncology in the NHS.  Medical oncologists looking to secure a job in the NHS must satisfy certain criteria before they can be fully registered with the GMC (General Medical Council) and receive a license to practice in the NHS. For oncology, these criteria depend on where you received your training, and the qualifications you hold.   In this blog, we’re giving you a snapshot of the steps you need to take to start your journey to the UK, as an overseas oncologist. We’ll be covering the following:  How do I demonstrate my knowledge and skills as an EEA oncologist? How do I demonstrate my knowledge and skills as a non-EEA oncologist? How can I demonstrate my English language skills? What is a certificate of good standing and how do I get one? What do I need to register with the GMC? Will I need a visa to work in the UK? Skip ahead to the relevant section if you know what you're looking for. Evidence of knowledge and skills for EEA medical oncologists  For oncologists who trained in an EEA country (all countries inside the EU, also Lichtenstein, Iceland, Switzerland & Norway), there are several options potentially available to you.  Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either GMC registration, check the relevant GMC page here.  Basic Medical Training If you have met the requirements for basic medical training, you would not need to demonstrate your medical knowledge and skills to work as a doctor in the UK, and would therefore not need to complete a Royal College postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, but not Specialist Registration.  Specialist Training / Residency Not all European Specialist qualifications are accepted by the GMC. If you have met the GMC’s criteria pertaining to your county, then you should be eligible for Specialist Registration in oncology. So as a medical oncologist, if you hold a Relevant European Specialist qualification, you would be put on the specialist register for medical oncology and can be appointed as a substantive oncologist in the NHS.  Please note, the criteria that is outlined on your country’s GMC registration page must be met. If your training was undertaken prior to the dates mentioned by the GMC – your qualifications will not be accepted.   For EEA oncologists, the main hurdle that you will face will be demonstrating that your English skills are of a high enough standard to practice safely as a doctor in the NHS.  As a European oncologist, this is most likely the easiest route to becoming GMC-registered and being able to practice oncology in the UK.  If you do not meet the GMC requirements for your training to be approved for general or specialist registration, other routes you may consider to GMC registration include PLAB, or (via the postgraduate route) the Royal College exams for medical oncology (MRCP). You can find out more about these alternative routes here.  Evidence of knowledge and skills for non-EEA oncologists If you qualified as a medical oncologist outside the EEA, then you will have to demonstrate that both your medical knowledge and skills AND English Language capabilities meet the level required to practice safely in the UK.  Oncologists who've trained from outside the UK and EEA and must demonstrate to the GMC they have sufficient knowledge & skills to practice safely in the UK. For medical oncologists this can be done through one of three main routes:  Professional & Linguistics Assessment Board (PLAB) The PLAB exam is a two-part exam that assesses a doctor’s ability to work safely as an SHO in the NHS, as such it does not demonstrate ability in oncology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries. If taking this option, medical oncologists can then take up training or a more senior post once they have established themselves in the NHS. Take a look through our comprehensive guides on PLAB.  Royal College of Physicians Attaining a Royal College qualification is a preferred path for doctors who have already chosen their field of specialism i.e. medical oncology. Oncologists taking this route will gain access to more senior, well-paid jobs in the NHS. The Royal College of Physicians is the professional body that regulates the specialism of medical oncology in the UK, and Membership of the Royal College of Physicians (MRCP) is the full qualification attainable by examination. For overseas doctors, attaining MRCP will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior roles in UK oncology. Take a look at IMG Resources library for complete guides on MRCP to learn more.  GMC-recognised or equivalent qualifications Some overseas qualifications and licensing exams are recognised by the GMC and accepted for registration purposes. This is to say these qualifications or licensing exams are considered as meeting the same standards as the Royal College qualifications.  To find out if your qualification is accepted by the GMC, take a look at our blog: Overseas accepted postgraduate qualifications  English Language Testing Both EEA and non-EEA oncologists, regardless of experience, and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below:  IELTS – a guide for overseas doctors OET – a guide for overseas doctors Experience in English-speaking countries  For doctors who have at least two years of their most recent experience in an English-speaking country, you can use a reference from your current employer or employers over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.  Certificate of Good Standing All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.  The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. You can find out which medical regulatory authority to contact via the GMC website here.  If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.  Please note that each certificate is only valid for three months from the date it's signed and must be valid when we approve your application.  GMC Registration Once you’ve completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:  English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).  AND  Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.  AND  (EEA oncologists) Sufficient skill and knowledge – as an EEA oncologist, this would either be your recognised EEA qualification.  (Non-EEA oncologists) Sufficient skill and knowledge – as a non-EEA oncologist, this would either be PLAB, MRCP or a GMC-approved qualification.  To understand the registration process more fully, read our article on GMC registration for overseas doctors here.  Visas  If you or your family are from the EU, Switzerland, Norway, Iceland or Liechtenstein and started living in the UK by 31 December 2020, you may be able to apply to the free EU Settlement Scheme. Otherwise, you will need to apply for a visa from the Home Office.  A Health & Care visa (Tier 2 visa) is the document given to a skilled worker by the UK Home Office following a job offer from a UK employer with a valid Tier 2 Sponsorship License. The list of valid Tier 2 Sponsors can be found here.  Understand Tier 2 visas and Certificates of Sponsorship in depth by taking a look at our article: Tier 2 Visa application process & documents needed.  Wondering whether you can relocate with your family? Take a look at our blog on the Tier 2 dependent visa below: Tier 2 Dependent visa - Can I bring my family with me to the UK?  IMG Oncologists Join the IMG Oncologists Facebook group for access to a community of like-minded FRCR (Oncology) aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors. You can access our IMG Oncologists community here. So, there you have it! Hopefully this helps to clarify any worries or doubts you may have on your route to the UK as a medical oncologist planning a career in the NHS. If you have any questions or would like to know more about the medical oncology job market, then get in touch with our team.  For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below:              

There are several routes an overseas histopathologist can take to GMC registration & practicing anatomic pathology in the NHS. All pathologists looking to secure a job in the NHS, whether you are from inside or outside of Europe, will need to satisfy certain criteria to fully register with the General Medical Council before they can practice in the NHS. As a histopathologist, the criteria you need to meet depends on where you trained, and what qualifications you hold. This article is designed to give you a snapshot of the steps you need to take to start your journey to the UK, no matter where in the world you live. We’ll be covering the following:  How do I demonstrate my knowledge and skills as an EEA histopathologist? How do I demonstrate my knowledge and skills as a non-EEA histopathologist? How can I demonstrate my English language skills? What is a certificate of good standing and how do I get one? What do I need to register with the GMC? Will I need a visa to work in the UK? Evidence of knowledge and skills for EEA histopathologists For histopathologists who trained in an EEA country (all countries inside the EU, including Lichtenstein, Iceland, Switzerland & Norway), there are a number of different options potentially available to you.  Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either general or specialist registration, check the relevant GMC page here.  Basic Medical Training: If you have met the basic medical training requirements, this would mean that you would not need to demonstrate your medical knowledge and skills to work as a doctor in the UK and would not need to complete a UK- recognised postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, but not Specialist Registration.   Specialist Training / Residency: If you have met the criteria listed for your country then you once you completed your GMC application process you would be granted Specialist Registration in your Specialty and can be appointed as a substantive or permanent consultant in the NHS. So as a pathologist, if you hold a Relevent European Specialist qualification then you would be on the specialist register for histopathology, and can be appointed as a substantive histopathologist in the NHS. So, the main hurdle that you will face is demonstrating that your English skills are of a high enough standard to practice safely as a doctor in the UK & NHS.  As a European histopathologist, this is in most cases the easiest route to becoming GMC-registered and being able to practice in the UK.  If you do not meet the GMC requirements for your training to be approved for full or specialist registration, other routes you may consider to GMC registration include PLAB or (via the postgraduate route) the Royal College exams for Histopathology (FRCPath). You can find out more about these alternative routes here.  Evidence of knowledge and skills for non-EEA histopathologists  If you qualified as a histopathologist outside the EEA, then you will have to demonstrate that both your medical knowledge and skills AND English Language capabilities meet the level required to practice safely in the UK.   Histopathologists who've trained from outside the UK and EEA must demonstrate to the GMC they have sufficient knowledge & skills to practice safely in the UK. For histopathologists this can be done through one of three main routes:  Professional & Linguistics Assessment Board (PLAB) The PLAB exam is a two-part exam that assesses a doctor’s ability to work safely as an SHO in the NHS, as such it does not demonstrate ability in pathology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries. If taking this option, pathologists can then take up training or a more senior post once they have established themselves in the NHS. Take a look through our comprehensive guides on PLAB. Fellowship of Royal College of Pathologists Royal College Qualification of FRCPath: Attaining a Royal College qualification is a preferred path for doctors who have already chosen their field of specialism i.e. pathology. For senior pathologists taking this route, they will gain access to more senior, well-paid jobs in the specialism of their choice. The Royal College of Pathologists is the Professional Body that regulates the specialism of Pathology in the UK, and Membership of the Royal College of Pathologists (FRCPath) is the full qualification attainable by examination. For overseas doctors, attaining FRCPath will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior roles in UK Pathology. Take a look at our complete guides on Fellowship of the Royal College of Pathologists as per your sub-specialty to understand more. GMC recognised or equivalent qualifications Some overseas qualifications and licensing exams are recognised by the GMC and accepted for registration purposes. This is to say these qualifications or licensing exams are considered as meeting the same standards as the Royal College qualifications.   To find out if your qualification is accepted by the GMC, take a look at our blog: Overseas accepted postgraduate qualifications. English Language Testing  Both EEA and non-EEA histopathologists, regardless of experience, and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. This can be done by passing either the International English Language Testing System (IELTS) or the Occupational English Test (OET). Detailed guides to these tests can be found below:  IELTS – a guide for overseas doctors OET – a guide for overseas doctors Experience in English-speaking countries  For doctors who have at least two years of their most current experience in an English-speaking country, you can use a reference from your current employer or employers over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.  Certificate of Good Standing  All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.   The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. You can find out which medical regulatory authority to contact via the GMC website here.  Please note that each certificate is only valid for three months from the date it's signed and must be valid when we approve your application.  If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.  GMC Registration  Once you’ve completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:  English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).  AND  Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.   AND  (EEA pathologists) Sufficient skill and knowledge – as an EEA pathologist, this would either be your recognised EEA qualification.  OR  (Non-EEA pathologists) Sufficient skill and knowledge – as a non-EEA pathologist, this would either be PLAB, FRCPath or a GMC-approved qualification.  To understand the registration process more fully, read our blog on GMC registration for overseas doctors here.  Visas  If you or your family are from the EU, Switzerland, Norway, Iceland or Liechtenstein and started living in the UK by 31 December 2020, you may be able to apply to the free EU Settlement Scheme. Otherwise, you will need to apply for a visa from the UK Home Office.  A Tier 2 visa is the document given to a skilled worker by the UK Home Office following a job offer from a UK employer with a valid Tier 2 Sponsorship License. The list of valid Tier 2 Sponsors can be found here.  Understand Tier 2 visas and Certificates of Sponsorship in depth by taking a look at our article: Tier 2 Visa - how do I apply and what's the process? Wondering whether you can relocate with your family? Take a look at our blog on the Tier 2 dependent visa below: Tier 2 Dependent visa - Can I bring my family with me to the UK? For pathologists looking to come to the UK to work in the NHS, GMC registration and specialist registration is a crucial part of the process. Therefore, it’s important to put together a good application to present to the GMC, and IMG Connect are here to help with this. Whether it’s deciding the best options for demonstrating your skills and knowledge in histopathology, or sourcing the best English Language courses and resources, take advantage of the benefits of having a pathology recruitment specialist working with you and proving you with the best guidance and support to fit your career needs.  For regular news and updates on the Royal College and all things pathology, follow IMG Connect on social media using the links below:              

IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.  Here we explore specialist registration in psychiatry for overseas consultant psychiatrists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) in more detail, 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 psychiatrist? Do I have to complete CESR before I can work in the UK? Do I need MRCPsych for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in psychiatry? 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 specialty means that you can be appointed to a substantive (permanent) consultant position in the NHS. All psychiatrists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to apply for Specialist Registration.   For psychiatrists, 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 psychiatrist 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 which training route you followed.  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.   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.  Psychiatry Positions in the NHS without CESR  It is important to note that you can apply for more senior psychiatry 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 psychiatry curriculum.  These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  MRCPsych for Specialist Registration  Whilst it is always beneficial to complete MRCPsych, overseas doctors looking to join the Specialist Register do not necessarily need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the CCT curriculum is the MRCPsych exam, so passing these exams confirms the attainment of the competencies of the Core Curriculum.  MRCPsych is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  However, if CESR applicants have not successfully completed these exams, they must provide alternative evidence that demonstrates equivalent knowledge to psychiatrists who have passed the MRCPsych exams.  Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.  CESR Equivalence Process  Equivalence describes the process of assessing an overseas applicant’s training and experience against the current psychiatry 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 Psychiatrists 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 Psychiatry  Skills & Experience: The evidence provided for a CESR application in psychiatry must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the General Psychiatry Curriculum, and the Advanced Module in the sub-specialty you are applying in. 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 800-1200 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 psychiatrists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.  How long does is the application process for CESR in Psychiatry?  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 psychiatrists, 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 psychiatry 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 psychiatrists.  #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 psychiatry curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Psychiatry 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 psychiatry posts with CESR support. These are not always advertised by a Trust, but we can help you to find a role which aligns well with your career goals in the NHS.  Join the IMG Psychiatrists community – as well as support on Royal College exams, our online community of international psychiatrists and dedicated psychiatry recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.  Getting started  Many psychiatry 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 psychiatry 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.   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 histopathology job market in the UK is fantastic. Vacancies for histopathologists coming from outside of the UK can be found in a variety of ways, and it can be a little confusing navigating the minefield that is GMC registration, a job search and considering what steps you need to take when relocating to the UK. Working with IMG Connect will give you easy access to vacancies for trained histopathologist, though remember your job opportunities will vary depending on what qualifications you hold, and how advanced your GMC registration is.  The IMG Connect job search is a dedicated online recruitment service for overseas doctors looking to secure a job in the NHS.  Save time and get expert advice based on your preferences  Performing a job search online can take up a lot of your time, so at IMG Connect we are here to do the time-consuming work for you. Upon registering, you will have a dedicated consultant whose role is to find jobs that match your skills, and apply for NHS jobs on your behalf.  You can receive jobs updates by E-mail to view new posts to suit your job search every day. Create a profile – it takes 30 seconds It really is that easy, so why not take advantage of our resources, time and energy to find you the right job in the NHS suited to your preferences. By providing us with some key details we can quickly assess which jobs are best suited to your preferences, and even email you job alerts for new exciting roles which we think will interest you! We understand you, and our clients When looking for a pathology job in the NHS, it can be hard to try to find out key information before applying, such as: What specialty specific training or development will be avialable to you?  Can the trust support CESR applicants and is their CESR programme established enough for my needs?  What is the job plan and how much time will I spend my time?  What is it like to work and live there? How does a histopathology department operate in the NHS? What salary will I get paid, and can I earn extra through additional duties or private work? It can be tricky to get all the answers you want before applying online, so we spend our time getting to know both our clients and you, finding out as much key information as possible to help you to make the right decisions. Including details on the pathology department, hospital & trust, as well as an overview of what it is like to live in the area, including housing and the cost of living, as well as access to schools for your children, childcare and finding work for spouses.  Making an impact We will also provide you with top tips on CV writing, job applications and interviews, ensuring that your application and interview makes the most impact with our NHS clients.  Making it personal  Once registered, you can quickly search and apply for NHS jobs using our job search, and take advantage of many useful articles written to support you through your journey to the UK. In addition, when you sign up to 'job alerts' we will automatically email you each time a relevant Pathology vacancy comes available that you may be interested in. Once logged in, you can also save job details and make applications.  By registering with IMG Connect, you will: Have a dedicated consultant who understands your preferences and will do the time-consuming job searches and applications for you. Find your ideal NHS position amongst thousands of unadvertised vacancies - from consultant to middle grade Be the first to hear about new vacancies – registering with IMG Connect means that your CV will gain priority with our NHS clients, and will professionally represented by international recruitment experts. To help you find a job in the NHS simply follow these easy steps: Register with IMG Connect Fill in the 'Personal details' section. Arrange a chat with your dedicated IMG Consultant  Sign up to receive 'job alerts’  Search our live pathology jobs Searching for pathology jobs in the NHS could not be easier If you want to find out more about the many different pathology jobs available within the NHS - it only takes a minute to register with IMG Connect and receive expert advice and representation. We have helped many overseas pathologists into consultant, specialty doctor, registrar, clinical fellow and staff grade NHS roles, whilst offering expert guidance to many more IMGs on NHS doctor pay, royal college qualifications and English language testing. We’d be happy to help you!

CESR acts as a route to applying for substantive (permanent) consultant jobs for doctors who have not followed a specialty training programme in the United Kingdom. In a nutshell it is the option available to doctors practicing as consultants from overseas who wish to gain specialist registration in the UK. Some doctors choose to apply from overseas, others work with IMG Connect to secure a job in the NHS geared at helping them gain entry to the specialist register once in the UK.  If you are working as a consultant in your home country and are eligible for specialist registration in the UK, then as an overseas doctor (IMG) you have a couple of options. Here we focus on applying for CESR from abroad as well as the alternative route, applying for a Specialty Doctor or Fixed Term Consultant job in the UK before applying for CESR with support of your NHS employer.  Both routes lead to gaining CESR and entry to the Specialist Registration, meaning that you can work as a substantive consultant in the NHS. Both take hard work, preparation, evidence gathering, time and dedication. Both options have the same end goal, specialist registration.  It is important to say that no matter how you choose to apply, the CESR process involves submitting a large volume of evidence to demonstrate that you have the equivalent experience, skills and competencies as a doctor who has taken the specialty training route in the UK. Whether applying from overseas or not, some doctors are asked to complete additional experiences to meet this strict standard. Because of this, the process can be lengthy.  Applying for CESR from overseas  This is a great option for Consultants who are not constrained by time and have an understanding department that will support the additional gathering of evidence. The GMC reckons that it takes between 6 – 9 months between submitting your application and receiving a decision. At IMG Connect our experience tells us that is takes a similar amount of time to gather the evidence prior to submitting. In addition, you must have completed the evidence in the first place in real workplace and clinical scenarios. This can take twice as much time as preparing and submitting. Put simply, the process can be time-consuming and laborious.  Add to this the issue of completing and gathering evidence against the CESR application from overseas. It can prove challenging to ensure that you have completed the full complement of competencies for CESR applications. This can result in the GMC asking for further evidence, adding more time to the process. You may have to identify gaps in your learning and then resolve them. It is not all bad though, this is good practice and will benefit you in the long run.  Applying for a specialty doctor job and/or fixed term consultant post before applying for CESR For doctors who are keen to secure entry to the Specialist register quickly, and work in the UK as soon as possible, then taking up a Specialty Doctor role with CESR programme, or a Fixed Term Consultant post with CESR programme/support is a good option. Many NHS hospitals or trusts in the UK will offer access to support, clinical experience and study or preparation time for CESR. This is often built into the weekly job plan, but in some circumstances, this may be arranged informally. Either way, this is a good way for overseas consultants to quickly gather the right evidence for their application with the support of their peers, senior colleagues and NHS employer. This can shorten the time spent on the application overall. If this sounds like the best option for you, it is wise to start gathering and signing off evidence in your current consultant post. That way you will already have some or most of the required evidence for CESR in place, allowing you to quickly focus on any elements that are missing once in the UK and working in the NHS Secure a job in the NHS with CESR  Securing a job as a Specialty Doctor with CESR programme, or a job as a Fixed Term Consultant with CESR programme/ support, gives you instant exposure to the UK system, NHS experience and a great start to your career in the NHS.  To discuss whether applying for CESR from overseas or securing a job as a Specialty Doctor or Fixed term consultant with CESR programme is the right route for you towards specialist registration, speak with an IMG Connect consultant, register or send your CV.   IMG Jobs  Search and find live NHS doctor jobs in the UK 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 Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.

One of the main reasons that overseas doctors want to work in the Emergency Medicine departments across the UK, is the excellent opportunity for access to training such as the Specialist Training Programme, career progression, including CESR, and sub-specialty development.  This short article provides useful information on the training and development available, how to access the training, the best route to becoming a consultant in the UK with entry to the specialist register, no matter what stage of your training. Emergency Medicine Training, leading to CCT We start with an overview of the Emergency Medicine Training in the NHS. Trainees may enter the emergency medicine training programme via: The EM (Emergency Medicine) core training programme at ST1. This is a three-year core training programme (starting from ST1 and ending at ST3).  For the first two years, trainees will spend 6 months in EM, Intensive Care Medicine, Anaesthetics and Acute Medicine. This is followed by a further year in trauma and paediatric EM.  The start of specialty training (ST4-6) subject to having achieved the necessary competences required for completion of ST3.  Once ST6 is completed, then a doctor will be added to the specialist register for medicine and hold the title of CCT. This means that they can apply for and practice at a consultant level in the NHS.  CESR For senior Emergency Medicine doctors (experienced specialty doctors, consultants and heads of departments) there is also the option of CESR. You can apply directly for CESR from overseas, or secure a post in the NHS with CESR support and complete your application in the UK. This is a good option for those wanting to take up their first role in the NHS as a specialty doctor (leading to consultant) or as a locum consultant. Applying from abroad can be lengthy, and it is certainly not the quickest route towards specialist registration. Most IMGs prefer to secure a post with CESR support, so speak to your IMG Consultant to learn more about the best route to the UK for senior doctors seeking consultant jobs in Emergency Medicine. Most senior Emergency Medicine job vacancies advertised will offer support with CESR, access to training and career progression, and senior managers will encourage you to develop your own professional interests. Emergency medicine departments in the NHS are particularly supportive of doctors seeking to develop both personally and professionally. To find out what jobs are on offer take a look here.  If you think that a Specialty Doctor post with CESR support is suited to you, or if you are a consultant or head of department, then you can find out more information here.  For further advice on how to secure the right job for you in the NHS, take a look at our the following article. IMG Jobs  Search and find live emergency medicine NHS doctor jobs in the UK IMG Resources Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to see what Emergency Medicine job opportunities there are for you, including access to CESR support, Core and Specialty training.  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.              

GMC Registration is a complex process. For histopathologists who’ve qualified outside the EEA region there are two main pathways to consider – FRCPath and PLAB. Whilst these are the most common routes to GMC registration, this is not an exahaustive list. There are other options such as Royal College sponsorship and GMC-approved qualifications or licensing exams, and you can read more about these here. Here we will give a summary of both of the main routes and briefly consider their benefits.  PLAB for GMC Registration FRCPath for GMC Registration Which is better for me as an overseas pathologist, PLAB or FRCPath? #IMG Tips How do I get started? Professional & Linguistics Assessment Board (PLAB)  The first and most popular route with most junior doctors is PLAB.  PLAB is a two-part exam (one written one practical), and which assesses whether you are at least as capable as a doctor starting the second year of their Foundation Programme Training and can therefore work safely as an SHO in the NHS.  The GMC have created a video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.  FRCPath - UK Postgraduate Qualification  The UK postgraduate qualification for histopathology – FRCPath Histopathology - is the most popular and recommended route for overseas doctors who have completed a training or residency programme, and will be looking for senior pathology positions in the NHS.   By completing both parts of the FRCPath you are awarded Fellowship of the Royal College of Pathologists. The Royal College of Pathologists is the professional body that regulates the pathology specialties in the UK. Take a look at our IMG Resources library for complete guides on FRCPath for histopathology to learn more.  PLAB vs FRCPath  Both are legitimate routes and will allow you to register with the GMC and work in the UK. To decide which route is best for you, you’ll need to consider the benefits of each and how they align with your priorities and needs in moving to the UK.    Seniority of Positions in the NHS  Histopathology is a consultant led specialty in the UK, and it would be difficult for an overseas pathologist to obtain a more senior post without FRCPath, or extensive experience from a similar, English speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.   Time   PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.  FRCPath has two stages and can take anywhere between 18-30 months to prepare from start to finish.   Cost   FRCPath costs just under £1,930 and whilst the Part 2 exam is an in-person exam, the Part 1 exam can be taken online. You can read about the changes to the FRCPath 1 delivery here.  PLAB costs £1,189, and both exams are sat in person. PLAB 1 can be taken in the UK or several overseas centres, which you can find here. PLAB 2 must be taken in the UK.   For both FRCPath Part 2 and PLAB 2, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.   It’s important to note that these costs can rise if re-sits of the exams are necessary.  Summary  PLAB, as an exam which assesses a doctor’s ability to work safely in the UK, does not demonstrate ability in histopathology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine.  Additionally, PLAB can facilitate GMC registration much faster than other routes – so if you feel you can attain an offer of employment in the UK with your overseas experience only – but GMC registration is the one thing standing in your way – PLAB may be a good option for you.   FRCPath involves two more difficult examinations and takes more time to prepare for. Attaining FRCPath in Histopathology will allow you to jumpstart your career in the UK, you’ll most likely be able to take a consultant role. You would not need PLAB or Core Training in addition to FRCPath.   Additionally, histopathology in the UK is also a consultant-led specialism, and FRCPath demonstrates competency to practice unsupervised as a consultant.   #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. 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 news and updates about all things histopathology for IMGs. Join the conversation here.  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 FRCPath exams, registrations and qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.   Or if you have any questions on PLAB or Postgraduate qualifications, feel free to get in touch with our histopathology consultants here. For regular news and updates, follow IMG Connect on social media using the links below.             

In this article we provide guidance on evidence to be supplied for an application onto the Specialist Register for Emergency Medicine, with a Certificate of Eligibility for Specialist Registration or CESR. What is CESR in Emergency Medicine in the NHS? As an Emergency Medicine doctor, attaining CESR will mean you are qualified to practice independently as an Emergency Medicine consultant in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more. Do I need MRCEM to attain a CESR in Emergency Medicine? Yes, Emergency Medicine is one of the few specialisms where there are no GMC-accepted equivalents to MRCEM. Any doctor wishing to attain Specialist Registration via the CCT route will attain FRCEM in addition.  What is the indicative period of training for a CCT in Emergency Medicine? The indicative period of training for a CCT in Emergency Medicine is six years and it is very unlikely that an applicant would achieve the competencies required for a CCT in a shorter period of time.  The evidence you collect for your CESR application should reflect this period of training, which consists of: Two years in the Acute Care Common Stem (covering areas of Emergency Medicine, Anaesthetics, Intensive Care Medicine and Acute Medicine) Four years of training in Emergency Medicine (covering areas of Paediatric EM, EM and EM ultrasound) CESR applicants will need to demonstrate they have achieved the competences in each of these areas.  The EM ultrasound competences (EMUS) can be shown by completing the triggered assessments outlined in the EM curriculum (level 1 or equivalent). The assessments forms for Core Ultrasound can be found in the RCEM EMUS booklet (Appendix 2).  The first three years of training make up Core Specialty Training, the final years of training are known as Higher Specialty Training.  For complete details please refer to the Emergency Medicine Curriculum documentation. Submitting Evidence Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Emergency Medicine Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC.  You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: Names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers In Summary: If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Emergency Medicine doctors looking to work as NHS Consultants in Emergency Medicine. IMG Jobs  Search and find live emergency medicine NHS doctor jobs in the UK IMG Resources Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding, CESR, a typical doctor salary in the UK and the most suitable NHS job & hospital locations for you. 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.              

In this article we look at the guidance on dermatology evidence required for CESR applications... Much evidence must be submitted, and you will only get a full picture of what you specifically require once you've spoken with the GMC and Royal College of Physicians. However, here we broadly discuss the evidence required to submit a complete application for entry onto the specialist register with a certificate of eligibility for specialist registration in dermatology. What is CESR in Dermatology in the NHS? As a Dermatology specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Dermatology. Have a read through our CESR articles found in the IMG Library to understand a little more. Do I need MRCP to attain CESR in Dermatology? No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Dermatology. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP (UK).  What is the indicative period of training for a CCT in Dermatology? The indicative period of training for CCT in Dermatology is four years full-time training and it is highly unlikely that a CESR applicant with limited experience, applying directly from outside the UK, could achieve these competencies in less time. Experienced dermatologists who take a consultant position in the NHS, with support of their department, can attain CESR in much less time with the right focus and clarity on what they need to sign off.  What is the CCT training pathway? The structure of the CCT training programme is: 2 years in Core Medical Training OR  Acute Care Common Stem (ACCS) OR LEVEL 1 PAEDIATRICS (ST1-3)  How does IMT fit into this? CMT no longer exists as of Aug 2019. Followed by: 4 years training in Dermatology Therefore, CESR applicants need to demonstrate they have achieved the competencies in both of these areas. Where experience has not provided adequate experience in the diagnosis and ongoing inpatient management of patients with a broad range of general medical problems, this will need to be completed to a level equivalent to the experience gained in Core Medical Training before the specialist curriculum may be followed.  For complete details refer to the Dermatology Curriculum documentation. Submitting Evidence Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Dermatology Curriculum documentation. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it.  As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC.  You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: Names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers In Summary: If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for senior Dermatologists looking to work as NHS Consultants in Dermatology.

CESR acts as a route to applying for substantive (permanent) consultant jobs in Emergency Medicine for doctors who have not followed a specialty training programme in the United Kingdom. In a nutshell it is the option available to emergency medicine doctors practicing as consultants, or at a senior level from overseas who wish to gain specialist registration in the UK. Some doctors choose to apply from overseas, others work with IMG Connect to secure a job in the NHS geared at helping them gain entry to the specialist register once in the UK.  If you are working as an Emergency Medicine consultant, or at a senior level in your home country and are eligible for specialist registration in the UK, then as an overseas doctor (IMG) you have a couple of options. Here we focus on applying for CESR from abroad as well as the alternative route, applying for a Specialty Doctor or Fixed Term Consultant job in the UK before applying for CESR with support of your NHS employer.  Both routes lead to gaining CESR and entry to the Specialist Register, meaning that you can work as a substantive consultant in the NHS. Both take hard work, preparation, evidence gathering, time and dedication. Both options have the same end goal, specialist registration.  It is important to say that no matter how you choose to apply, the CESR process involves submitting a large volume of evidence to demonstrate that you have the equivalent experience, skills and competencies as a doctor who has taken the specialty training route in the UK. Whether applying from overseas or not, some doctors are asked to complete additional experiences to meet this strict standard. Because of this, the process can be lengthy.  Applying for CESR from overseas  This is a great option for emergency medicine consultants who are not constrained by time and have an understanding department that will support the additional gathering of evidence. The GMC reckons that it takes between 6 – 9 months between submitting your application and receiving a decision. At IMG Connect our experience tells us that is takes a similar amount of time to gather the evidence prior to submitting. In addition, you must have completed the evidence in the first place in real workplace and clinical scenarios. This can take twice as much time as preparing and submitting. Put simply, the process can be time consuming and laborious.  Add to this the issue of completing and gathering evidence against the CESR application from overseas. It can prove challenging to ensure that you have completed the full complement of competencies for CESR applications. This can result in the GMC asking for further evidence, adding more time to the process. You may have to identify gaps in your learning and then resolve them. It is not all bad though, this is good practice and will benefit you in the long run.  Applying for a specialty doctor job and/or fixed term consultant post before applying for CESR For senior emergency medicine doctors who are keen to secure entry to the Specialist Register quickly, and work in the UK as soon as possible, then taking up a Specialty Doctor role with CESR programme, or a Fixed Term Consultant post with CESR programme/support is a good option. Many NHS hospitals or trusts in the UK will offer access to support, clinical experience and study or preparation time for CESR. This is often built into the weekly job plan, but in some circumstances, this may be arranged informally. Either way, this is a good way for senior emergency medicine doctors to quickly gather the right evidence for their application with the support of their peers, senior colleagues and NHS employer. This can shorten the time spent on the application overall. If this sounds like the best option for you, it is wise to start gathering and signing off evidence in your current consultant post. That way you will already have some or most of the required evidence for CESR in place, allowing you to quickly focus on any elements that are missing once in the UK and working in the NHS Find an emergency medicine job in the NHS with CESR Securing a job as a Specialty Doctor with CESR programme attached, or a job as a Fixed Term Consultant with CESR programme/support attached, gives you instant exposure to the UK system, NHS experience and a great start to your career in the NHS.  To discuss whether applying for CESR from overseas or securing a job as a Specialty Doctor or Fixed term consultant with CESR programme is the right route for you towards specialist registration, speak with an IMG Connect consultant, register or send your CV.  IMG Jobs  Search and find live emergency medicine NHS doctor jobs in the UK IMG Resources Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you. 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.              

Here we take a closer look at the Medical Training Initiative (MTI), a placement scheme for more junior overseas doctors to come to the UK to receive training and development within the NHS.   To be eligible for an MTI post, certain criteria must be met. These are summarised below along with a broad look the following:  What is the Medical Training Initiative? What training will I receive through the MTI? Am I eligible for an MTI post? What does the application process for the MTI involve? What are the advantages and disadvantages of the MTI? Do I need a visa for the MTI? How can I use the MTI for GMC registration? How much will I be paid throughout the MTI? What is the full process for MTI? I’ve completed the MTI, what’s next? Skip ahead to the relevant section if you know what you’re looking for.   The Medical Training Initiative  The Medical Training Initiative, or MTI, is a training programme that provides junior doctors from all over the world the opportunity to gain clinical training and development in the UK for a maximum of 24 months.  The MTI as a training scheme is mutually beneficial for both junior doctors and the NHS, in that doctors from several countries and specialisms around the world can work and train in the UK, gaining knowledge and experience which they can take back to their home country, while giving NHS Trusts a high-quality, longer-term alternative for unfilled training vacancies and rota gaps.  Training  The training provided through the MTI scheme will vary between programmes; however, it will typically follow the CCT curriculum (Certificate of Completion of Training). The level of training will be highly dependent on the doctor’s interests, competence and the training available within the placement hospital.  At the beginning of each placement, doctors are allocated an Educational Supervisor who will help to set the doctor’s specific training objectives to meet over the 24 months of the placement.  Eligibility The MTI has been designed specifically with junior doctors in mind, therefore sponsorship will not be offered to consultants, specialty doctors or for locum-appointed service posts (LAS).   The criteria also differ among MTI programmes, so eligibility criteria should be checked directly with the Royal College before applying. However, the general elements of eligibility include the following:  Country requirements - priority is given to doctors from countries classified as low income or lower middle income by the World Bank. Doctors from outside of these countries may also apply, but there may be a long wait time and no guarantee of acceptance.  Evidence of skills and knowledge – the requirements for evidence of skills and knowledge vary based on the MTI programme, but the potential requirements for evidence of skills and knowledge include:  PLAB exams  Part 1 of relevant Royal College exam e.g. MRCP  Specialist qualifications from your home country  Evidence of English language skills - almost all MTI programs accept what test is approved by the GMC, meaning either of the IELTS or OET can be used for MTI.  Sufficient clinical experience - most MTI programmes will require a minimum of three years' experience, including one year of internship and one year in the relevant specialty.  Active medical practice - candidates must have been actively practicing clinically for at least three out of the last five years including the past 12 months before the application as well as throughout the application process.  The Application Process There are two ways to join the MTI programme:  Apply for an MTI-match programme – certain specialisms have programmes which match doctors to a job. For these, you apply for the relevant programme, providing the necessary documentation. If your application is successful, you will be allocated a suitable job, which can take up to 12 months.  Find an NHS job before applying for the MTI – in cases where specialties do not have an established match programme, candidates are required to apply directly for an NHS post. Once the candidate has been accepted for the role, they can then apply for the MTI scheme through the relevant Royal College. If you would like to know more about finding NHS posts for the MTI scheme, you can get in touch with us here.  Specialties may use either, or a combination of these two methods, so we suggest visiting the Royal College and searching for their information on the MTI scheme.  The availability of MTI posts will vary between each Royal College, as certain specialties are more consultant-led, meaning there are fewer training posts for junior doctors. Once again, we suggest finding out more from the relevant Royal College. Advantages and Disadvantages of the MTI Scheme  Advantages  Training – MTI doctors will receive training and development support in their clinical, communication and leadership skills, as well as supervision by a consultant. You will also have the opportunity to create a training plan with the support of an Educational Supervisor.  Reduced cost – for posts that accept specialist qualifications from the applicant’s home country, the associated costs are lower as you will not have to pay for the PLAB or Royal College exams which can be costly, especially where retakes are needed  Alternative to PLAB and the Royal College – As some posts accept a candidate’s specialist qualifications from overseas, this allows you to bypass the Royal College and PLAB exams (N.B. if you have passed both parts of PLAB or ever failed either of the exams, you are not eligible for MTI)  Diploma of UK Medical Practice - If you complete an MTI post that is at least 12 months long, with the Royal College of Physicians (RCP) or the Royal College of Paediatrics and Child Health (RCPCH), you can apply for the DipUKMP, a professional diploma which can be used as part of the portfolio of evidence required for specialist registration (CESR or CESR-CP). Disadvantages  Not all posts are paid - Some MTI posts require you to secure funding for your training, for example through scholarships or funding from an organisation in your home country, such as a government agency or university (N.B. personal funds cannot be used).  Junior posts – More senior doctors wanting to take this route to the UK will receive a lower salary and more junior role than if taking the postgraduate route.  British citizenship or ILR - For doctors who wish to make a permanent move to the UK, the 12-24 months spent in the UK on the MTI scheme will not count towards the 5-year requirement for British citizenship or indefinite leave to remain (ILR).  Return to home country – at the end of the 24-month period, MTI doctors are legally required to leave the UK and return to their home country.  MTI Posts Offer Tier 5 Visas  MTI candidates require a Tier 5 visa to travel to the UK. Applications for the visa can only be made after receiving the Certificate of Sponsorship.   Applications for Tier 5 visas must be made from your home country (or the country you work in), but never from the UK.   The visa must only be used for travel to the UK at the beginning of the placement and will activate after your arrival, lasting for exactly two years from your arrival date.   Please note that Tier 5 visas cannot be extended.  GMC Registration  All doctors practicing in the UK MUST be registered with the GMC. For MTI candidates, registration is typically supported by the Royal College, but some NHS Trusts also have the right to register MTI doctors.  English Language Testing  As always with GMC registration, candidates will also need to provide evidence of English language skills. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below:  IELTS – a guide for overseas doctors OET – a guide for overseas doctors Pay Received for MTI Posts  MTI posts are either paid, or candidates are required to secure funding for their placement as detailed above.  Where the placements are paid, the salary received by the MTI doctor corresponds to trainees at a similar level in the UK. All trainees can expect to commence their MTI training at an equivalent salary to ST3 level.  Some hospitals may take prior international experience into account while others do not. This is at the discretion of the hospital and not the Royal College. Hospitals can also decide whether to employ MTI doctors under the 2002 or 2016 junior doctor contract, which have slightly different pay scales.  Therefore, it's best to verify as early as possible where your placement will be paid, whether your prior experience will be taken into account, and under what pay scale you will be paid.  Steps through MTI   We’ve detailed the general processes involved in MTI below, from a candidate’s initial application for a post, to their final interview with the Royal College after gaining GMC registration:     I’ve completed the MTI, what’s next?  Ordinarily, on completion of the MTI scheme, doctors return to their home country with the training and experience they gained from working in the NHS.  Some doctors may want to remain in the UK after completing the MTI for a number of reasons. This can be done if the doctor finds another NHS post, in which case, they may be able to switch from the Tier 5 visa to the Tier 2 Health and Care Worker visa. For more information on the Health and Care Worker Visa, please see here.  If you want to find another NHS post after completing the MTI, applying for your first NHS job follows the same process as any other doctor. You will need to consider what job it is you would like to obtain and what location in the UK you would prefer to relocate to. For guidance on jobs in your specialty in the UK, please see our IMG Resources library.  Once you are ready to start the application process you can get in touch with us – IMG Connect can offer you expert advice and representation throughout the recruitment and relocation process.  For regular news and updates on the Royal Colleges, GMC registration and working in the NHS, follow us on social media and join the conversation below:              

Are you a psychiatrist looking for your next career move? Get access to the latest psychiatry jobs, whether you're a consultant, resident trainee, specialty doctor or SHO. Through IMG Connect you can receive the very latest psychiatry jobs straight to your inbox, create your own account and job preference email alerts with just a couple of clicks.  IMG Connect specialises in a huge variety of psychiatry vacancies, including jobs in child & adolescent, general adult, old age, perinatal, learning disabilities or intellectual disabilities, eating disorders, addictions and forensic psychiatry. You will find a range of jobs covering inpatient, outpatient and other community services.  Review & apply for the latest Psychiatry & Psychiatrist Jobs - with a range of new jobs added every week, you will find jobs that match your skills, career goals and location preferences in the UK. Register now to receive NHS jobs by e-mail to view new posts to suit your job search.  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.              

As an IMG, what documents should you submit for your CESR application in Geriatric Medicine? In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Geriatrics or Elderly Care Medicine with a Certificate of Eligibility for Specialist Registration or CESR. What is CESR in Geriatric Medicine in the NHS? As a Geriatrician, attaining CESR will mean you are qualified to practice independently as a Geriatrics consultant in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more. Do I need MRCP to attain a CESR in Geriatric Medicine? No, but whilst it is always a benefit to attain MRCP you do not require it to attain CESR in Geriatric Medicine, though you may have already attained this depending on which route you have taken for GMC registration. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK).  What is the indicative period of training for a CCT in Geriatrics? The indicative period of training for a CCT in Geriatric Medicine is seven years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. This training consists of the following: 2 years in Core Medical Training OR  Acute Care Common Stem (ACCS) OR AND  Five years training in Geriatrics Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas.  For a complete list of competencies refer to the Geriatric Medicine Curriculum documentation. Submitting Evidence: Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Geriatric Medicine Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers In Summary: If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Geriatricians looking to work as NHS Consultants in Geriatrics. Getting started  Many geriatric medicine 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.  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:               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---geriatric-medicine-2010--amended-2016----dc2302_pdf-48455396.pdf

Experienced overseas Emergency Medicine trust doctors, or consultants who have completed specialist training, can apply for specialty doctor posts in the NHS with CESR programmes included in the job plan.  So, if you are committed, motivated and enthusiastic in embracing the CESR application once in the UK, this could be the best route towards gaining entry to the specialist register. Many trusts are piloting such projects, which will support you via a CESR programme tailored to your needs. Specialist Register for Emergency Medicine All consultants (other than a locum consultant appointments) must be on the specialist register of the General Medical Council (GMC). To be eligible to apply for specialist registration with the GMC, doctors must have successfully completed a GMC-approved training programme leading to CCT, or applied for a certificate confirming Eligibility for Specialist Registration (CESR). Doctors who have not completed a full GMC-approved training programme and wish to have their training, qualifications and experience assessed for eligibility for entry onto the specialist register must make an application under The General and Specialist Medical Practice Order for a CESR. Working with IMG Connect & our NHS Clients Working with our NHS clients, we are offering CESR Specialty doctor roles, with the opportunity of being mentored by CESR Consultants to guide you in your application toward CESR and to participate in a job plan that is tailored to your needs. Such CESR programmes are locally developed and targeted for both International Doctors coming to work in the NHS and non-trainees wanting to apply for a CESR in Emergency Medicine. As an Emergency Medicine doctor your CESR programme will include dedicated one-to-one mentoring and a course mapped on the GMC domains for successful completion of your application.  Benefits of the CESR programme Such Specialty doctor vacancies will give you the benefit of support on your journey to achieving consultant status, give you the opportunity to adapt to working in the NHS, and help you to further your career at the most senior level.  Furthermore, job plans will typically provide you with a dedicated mentor for CESR applicants by Emergency Medicine CESR Consultants who will take you through the application process. In some circumstances practical experience will be delivered via simulation and workshops where you are at the centre of the learning experience. Most NHS trusts have experienced Emergency Medicine CESR consultants who will be available to give you support, mentorship and coaching. The post are intended to provide the emergency medicine clinician with the support and training required to successfully complete all aspects of the CESR process and attain specialist registration, allowing you to take a substantive emergency medicine post and work as a consultant in the NHS.  IMG Jobs  Search and find live emergency medicine NHS doctor jobs in the UK IMG Resources Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you. 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.              

In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Respiratory Medicine with a Certificate of Eligibility for Specialist Registration or CESR. What is CESR in Respiratory Medicine in the NHS? As a respiratory medicine or pulmonary specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Respiratory Medicine. Have a read through our CESR articles found in the IMG Library to understand a little more. Do I need MRCP to attain CESR in Respiratory Medicine? No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Respiratory Medicine. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP (UK).  What is the indicative period of training for a CCT in Respiratory Medicine? The indicative period of training for CCT in Respiratory Medicine is six years full-time training and it is highly unlikely that a CESR applicant could achieve these competencies required in less time. The structure of the CCT training programme is: 2 years in Core Medical Training or Acute Care Common Stem (ACCS) How does IMT fit into this? CMT no longer exists as of Aug 2019. 4 years training in Respiratory Medicine Applicants need to demonstrate that they have achieved the competencies in both of these areas. For complete details have a read through the Respiratory Medicine Curriculum documentation. Submitting Evidence Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Respiratory Medicine Curriculum documentation. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers Summary If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for senior Respiratory doctors looking to work as NHS Consultants in Respiratory Medicine. IMG Jobs  Search and find live NHS doctor jobs in the UK 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 Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & hospital locations for you.

Here we will look closely at the application for CESR in acute and general medicine. In particular, we will explore the specialty specific guidance on providing evidence for an application for entry onto the Specialist Register for Acute Internal Medicine or Acute Medicine with a Certificate of Eligibility for Specialist Registration or CESR. What is CESR in Acute Internal Medicine in the NHS? As an Acute Medicine specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Acute Medicine. Have a read through our CESR articles found in the IMG Resources library to understand a little more. Do I need MRCP to attain CESR in Acute Medicine? No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Acute Internal Medicine. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK).  What is the indicative period of training for a CCT in Acute Internal Medicine? The indicative period of training for a CCT in Acute Internal Medicine is six years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. This training consists of the following: 2 years in Core Medical Training OR  Acute Care Common Stem (ACCS) OR AND  Four years training in Acute Internal Medicine Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas.  For a complete list of competencies refer to the Acute Internal Medicine Curriculum documentation. Submitting Evidence Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Acute Internal Medicine Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it.  As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC.  You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: Names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers In Summary: If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Acute Medicine doctors looking to work as NHS Consultants in Acute Medicine. IMG Jobs  Search and find live NHS doctor jobs in the UK 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 acute & general medicine job opportunities in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & 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:             

In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Haematology with a Certificate of Eligibility for Specialist Registration or CESR. What is CESR in Haematology in the NHS? As a Haematologist, attaining CESR will mean you are qualified to practice at consultant level in Haematology in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more. Do I need MRCP or FRCPath in Haematology to attain CESR in Haematology? No, but whilst it is always a benefit to attain MRCP, or FRCPath, or both (you may have already attained either of these by ways of registering with the GMC) you do not require MRCP or FRCPath in Haematology to attain CESR. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK) and FRCPath in Haematology.  What is the indicative period of training for a CCT in Haematology? The indicative period of training for a CCT in Haematology is seven years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. This training consists of the following: 2 years in Core Medical Training OR  Acute Care Common Stem (ACCS) OR AND  Five years training in Haematology Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas. For a complete list of competencies refer to the Haematology Curriculum documentation. Submitting Evidence: Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Haematology Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers In Summary: If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Haematologists looking to work as NHS Consultants in Haematology. IMG Jobs  Search and find live NHS Pathlology jobs offering CESR in the UK IMG Resources Read more useful articles on finding an CESR, NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!   Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable hospital locations for you.

Most overseas radiologists coming to the UK want to attain their CESR in Radiology. In this article we look at the specialty specific guidance on evidence required for entry onto the Specialist Register for Clinical Radiology. This is entry to the specialist registration with a Certificate of Eligibility for Specialist Registration or CESR. What is CESR in Clinical Radiology in the NHS? As a Clinical Radiology specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Clinical Radiology. Have a read through our CESR articles found in the IMG Library to understand a little more. Do I need FRCR to attain CESR in Clinical Radiology? Not necessarily. Whilst it is a benefit to attain FRCR, and you may have already attained MRCP or FRCR as your route to GMC registration, you do not necessarily require FRCR to attain CESR in Clinical Radiology. Any doctor wishing to attain Specialist Registration via the CCT route must attain FRCR. What is the indicative period of training for a CCT in Clinical Radiology? The indicative period of training for a CCT in Clinical Radiology is five years it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. This training consists of the following: 3 years in Core Training AND  2 years in Higher Training During Higher Training, competence is expected to be achieved at Level 1 or Level 2 which indicates the greater degree of expertise to be achieved by those intending to practice in one or more special interest areas. CESR applicants must demonstrate that they have achieved the competencies in each of these areas. You should refer to the Clinical Radiology Curriculum documentation before you make your application to ensure that you can demonstrate the required competencies. Submitting Evidence: Do not submit original documents – this is very important. 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). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence. Please note you will also need to submit translations of any documents that are not in English and you must ensure the translations you submit meet the GMC translation requirements. How much evidence should you submit? The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence. The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Clinical Radiology Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail. If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.  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 – make sure you are reading the latest version on the GMC website – here. It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.  Types of Evidence: The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below: Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area. Key Evidence Requirements – advice from the FRCR’s Equivalence Committee: Evidence must demonstrate that you have achieved ALL the requirements and competencies as set down in the relevant CCT curriculum.  Where you have worked in a specialised area for a substantial period of time, evidence will be required to the following effect: That at one stage in your career you achieved the requirements and competencies of the relevant specialty curriculum These skills have been maintained within the last five years Your current specialised practice allows you to meet all of the domains above  You must submit evidence to demonstrate that you can practise competently and independently across the breadth of the CCT curriculum Key Evidence Requirements – Summarised: In summary you are expected to demonstrate competence across the core requirements of the radiology specific content of the curriculum:  breast, cardiac, emergency radiology, gastro-intestinal, general and non-vascular intervention, head and neck, moledcular imaging, musculoskeletal, neuroradiology, oncological, paediatric imaging, radionuclide radiology, thoracic, uro-gynaecological and vascular radiology, in the relevant technique-based areas (plain film including mammography, CT, US, MRI, nonvascular interventional procedures, fluoroscopy) You are also expected to demonstrate the equivalent Level 1 and/or Level 2 competencies required for Higher training, in one or more areas of special interests. Key Documents to submit with your application: Take a look at the GMC’s SGPC – SSG document to affirm the information above and to understand the key documents recommended by the Royal College of Radiology’s Equivalence Committee. Make sure to anonymise your evidence: It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following: All patient identifying details Details of patients’ relatives Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes: names (first and last) addresses  contact details such as phone numbers or email addresses NHS numbers & other individual patient numbers GMC numbers In Summary: If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Radiologists looking to work as NHS Consultants in Clinical Radiology. IMG Jobs  Search and find live NHS radiology jobs in the UK IMG Resources In our IMG Resources library you can 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 radiology job opportunities in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.

Hospitals across the UK are offering specialty doctor job plans with opportunity for CESR programmed support, giving doctors the chance to quickly work towards specialist registration.  For experienced IMGs this is a new and quick route to your first Consultant post. By taking up a service level job as a Specialty Doctor with CESR support as part of the job plan many IMGs are securing a great start to their future career in the NHS that is suited to their senior level experience.  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), speak to the IMG Connect team to discuss if this is a suitable route for you. We have opportunities across the UK for doctors to take advantage of the CESR programme. You can also send your CV to info@imgconnect.co.uk or register here. It takes 30 seconds to register!  By taking such posts in NHS trusts and hospitals you can join diverse, dynamic and inspiring groups of specialty doctors and acting Consultants all on the way to achieving their CESR as part of a tailored programme. In offering such job opportunities, hospitals will provide a supportive environment with protected time to fulfill all the requirements of the CESR application, 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 such roles you will typically receive hands on support from consultant colleague and exposure to a wide range of experience to specifically aid competency achievement for your CESR application.  In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience. Some hospitals will also provide the following as part of the CESR programme:   Supported Professional Activity (SPAs) sessions per week  Tailored experience to your CESR portfolio Regular clinical supervision  A CESR mentor  Involvement in academic programme and medical student teaching  Support in gaining research competencies  SAS Tutor support CESR / SAS support forums and meetings IMG Jobs  Search and find live NHS doctor jobs in the UK with CESR 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 Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG consultant to discuss the CESR job vacancies in the NHS and start your journey towards specialist registration and your first consultant post in the NHS.  To receive the latest news and updates, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

Here we take a quick look at the CESR route for overseas experienced specialty doctors & consultants hoping to find a senior doctor job in the NHS and qualify for the Certificate of Eligibility for Specialist Registration (CESR). Many IMGs have recently asked if they would be eligible for the CESR route to Specialist registration. International Medical Graduates (IMGs) from any country in the world can apply for CESR, provided certain eligibility criteria are met. To help answer this question we have put together a short article to explain further, including the following topics:  What is CESR? How does CESR work? Am I eligible? I am eligible, what next? Applications for CESR requires a lot of preparation and can seem quite daunting. This is the first in a series of articles aimed at helping doctors planning to engage in this process. What is CESR?  The Certificate of Eligibility for Specialist Registration (CESR) is the process by which doctors who have not trained in an approved programme can demonstrate their knowledge, skills and experience are equivalent to that of the relevant CCT curriculum to join the GP or specialist registers.  How does CESR work?  The CESR is awarded by the GMC and applications are made directly to them. The Royal College then assesses the evidence an applicant has submitted to the GMC.  The assessment is to assure the GMC that the applicant has gained the equivalent level of competence as a trainee (i.e. ST6) making application for CCT via the ARCP process (Annual Review of Competency Progression). This means that the CESR applicant must demonstrate competence against all Intended Learning Outcomes in the curriculum of the specialty of their choice via the written evidence submitted. Are you eligible?  There are different ways to apply for registration with a licence to practise in the UK. It depends on your nationality, qualification and experience.  To meet the minimum eligibility requirements to apply you must have either: a specialist qualification in the specialty you’re applying in  OR at least six months continuous specialist training in the specialty you’re applying in. You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.  In your application you must show that you meet the requirements of the CCT curriculum in your specialty.  The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience.  In most circumstances we can say that evidence must:  come from higher training equivalent  be less than 5years old demonstrate higher level experience  map to the curriculum be represented clearly be current be primary evidence You can check the approved Royal College curricula for all 65 specialities and sub specialties here.  I am eligible, what happens next?  As an IMG, it is highly likely that you haven’t complete a UK based approved training programme but could be eligible for Specialist Registration via the CESR route. Take a look at our in-depth CESR overview for more information on how to apply and what to expect.   IMG Jobs  Search and find live NHS doctor jobs in the UK 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 Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.             

Here we look briefly at the CESR route available to overseas consultants and exerienced senior doctors who wish to secure a job in the NHS and relocate to the UK. Many IMGs have recently asked if they would be eligible for the CESR route to Specialist registration. International Medical Graduates (IMGs) from any country in the world can apply for CESR, provided certain eligibility criteria are met. To help answer this question we have put together a short article to explain further, including the following topics:  What is CESR? What is the Equivalence process? Who is the CESR for? Who can apply? What does the CESR route involve? Are there other senior NHS positions available? Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK What are the achieved standards? How can I prepare my evidence for CESR applications? What if my application is not successful?  CESR is suitable for those who have already been practising overseas for many years.  What is CESR?  The CESR is for doctors who wish to join the GMC (General Medical Council) Specialist Register, and whose specialist training, qualifications or experience was partly or completely acquired outside an approved CCT (Certificate of Completion of Training) programme in the UK. It is equivalent to a CCT and certifies that the recipient has all the competences defined in the CCT curriculum, known as specialist registration.  What is the Equivalence process? Equivalence describes the process of assessing an overseas applicant’s training and experience against the current training programme requirements, in order to gain a Certificate of Eligibility for Specialist Registration (CESR) for the Specialist Register held by the General Medical Council. The process involves submitting a written body of evidence to the GMC of: training and/or competence skills and knowledge Each Royal College will assess the 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. Who is the CESR for? Who can apply?  If you have training, qualifications and experience in a CCT specialty but have gained these partly or completely outside an approved CCT training programme (for example, you have trained outside the UK or EEA), you may apply for a CESR in a CCT specialty. What does the CESR route involve?  In a nutshell, you will need to compile a portfolio of evidence to prove you have achieved the equivalent skills and experience of a doctor who has completed a full GMC-approved training programme.  You can collect this evidence prospectively through non-training jobs. Is it the right route for me? Yes, if… You have already completed specialty training back home If you have already completed Specialty Training, then you’re unlikely to want to repeat it.  You haven’t completed training, but you have too much experience in your specialty to apply for training posts.  In both scenarios, even if you are willing, you may be overqualified to apply for training. Doctors who have complete specialist training overseas or via a non-CCT pathway may be eligible for entry without further training. You can check using the guidelines below:  GMC CESR Guidance Specialty Specific Guidance You will need to demonstrate all specialty learning outcomes specified in the relevant CCT curriculum. Are there other senior NHS positions available? It is important to note that you can apply for more senior roles such as a SAS doctor, specialty doctor or a locum consultant (locum consultants are not required to be on the Specialist Register).  This way you will have better pay and the roles and responsibilities are more appropriate to your level of experience compared to a junior trainee. While working in these jobs you can collect evidence of your competences.  This is also a quicker route to the UK than the CESR route, which can take a substantial amount of time.  Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK:  It is a legal requirement that doctors must have their names entered on the General Medical Council's (GMC's) Specialist Register before taking up substantive NHS consultant posts in the UK.  What are the achieved standards?  To apply you will need to have either a specialist qualification or have undertaken a period of specialist training (not less than 6 months anywhere in the world). Your application is measured against the GMC standard.  The GMC break down the standard into four domains mirroring the headings of Good Medical Practice.  The GMC recommend that you allocate the evidence you provide with your application in the following way: Domain 1: Knowledge, Skills and Performance - 75% Domain 2: Safety and Quality - 20% Domain 3: Communication, Partnership and Teamwork - 5% (combined for both domains 3 & 4) Domain 4: Maintaining Trust - 5% (combined for both domains 3 & 4) The full list of evidence needed for each specialty is provided here. How can I prepare my evidence for CESR applications?  As CESR applications are currently a completely paper-based process it is important to think about the evidence you present. You should: Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application. Make sure that your evidence is current and of the highest possible quality. Always note any curriculum changes – you will be assessed against the most recent one  Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.   Throughout your application you should refer to the Specialty Specific Guidance in your specialty (or the most relevant if applying in a non-CCT specialty).  You should also refer to the relevant CCT curriculum in your specialty; as this is the standard that all CCT applicants will be measured against. Look thoroughly at the GMC guidance available and get advice on your application from the GMC before you apply. Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.     The GMC has strict guidelines for presenting evidence, including verification, anonymising and translating documents. We strongly advise all IMGs to take a look here and familiarise themselves with the criteria. What if my application is not successful?  Following an unsuccessful application, you can apply for a review within 12 months of receiving your decision from the GMC. You can apply for a review of the GMC’s decision on the grounds that:  You now have additional evidence to submit that addresses the areas of your application in which you were previously unsuccessful  You believe that there has been a procedural error or unfairness in the processing of your original application.  Please refer to the GMC guidance for further information on applying for a review.  IMG Jobs  Search and find live NHS doctor jobs in the UK 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 Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK, CESR and the most suitable hospital locations for you.

The NHS offers extensive training schemes and career development for all of its doctors, and such programmes are recognised as a gold standard across the medical world.  Training in the NHS is always in keeping with advances in medical sciences and the progressive landscape of the medical profession, including the more complex ailments of a growing and ageing population. The NHS frequently updates and develops its training programmes, making them attractive to UK graduates and doctors, as well as overseas doctors seeking the very best training.  In this article we will cover the following topics:  The NHS Training Pathway Graduation to Foundation Training Specialty Training Programmes Different types of Specialty Training programmes Completion of Specialty Training Programme Should I apply for a training or service post? As an IMG, can I get onto the specialist register? How do I secure a service post? Skip ahead to the relevant section if you know what you're looking for. The NHS Training Pathway Many IMGs looking to move to the UK (particularly more junior doctors) will be keen to enter into UK Specialty Training at some point, and as such it is important to understand the UK training pathway from start to finish in order to map your NHS career effectively. Furthermore, greater understanding of the NHS structure and training offered to doctors in the UK will help an IMG to understand at what grade they can likely enter the system and the salary most appropriate for them.  The NHS Training Pathway describes the journey from medical school to completion of specialist training and is the path most commonly followed by UK trainees. Graduation to Foundation Training After graduating from a medical school, doctors gain provisional registration with the GMC allowing them to enter the Foundation Programme - a two-year work-based training programme. Upon completion of the first year (FY1 or F1) doctors will gain full registration with the GMC and can apply for further study and training in a specialised area – known as Core or Specialty Training, depending on the specialty. Specialty Training Programmes Completion of the Foundation Programme allows doctors to apply for Specialty Training in an area of medicine or general practice. There are 60 different specialties to choose from.  A doctor entering year one of Specialty Training is known as an ST1 or CT1 doctor. Specialty Training programmes can take between three and eight years depending on the specialism chosen. Doctors can pass through the training quicker depending on how fast they achieve their competencies.  Sometimes doctors do not complete the training pathways in the indicated time for a variety of reasons and it can take between 1 - 4 years longer than indicated in the curricula.  Types of Specialty Training Programmes There are two different structures for Specialty Training programmes, and these vary between specialties. Run-through Training Programmes For these training programmes, you only have to apply once at the beginning of the programme. This is because you are recruited for the full duration of Specialty Training. These training programme can last from approximately three years for general practice, to five or seven for other specialties such as histopathology. Uncoupled Specialty Training Programmes These programmes are split into Core Training and Higher Specialty Training. Core Training lasts for either two or three years and once complete, allows you to apply for Higher Specialty Training, which can take from three to five years.  Overall, Specialty Training programmes can take anywhere from 5 – 8 years in their entirety, depending on your medical specialty, for example 6 years for psychiatry. Doctors are known as ST1-3 or CT1-3 during their Core Training and ST4+ level during Higher Specialty Training programmes. Higher Specialty Training programmes are very competitive, and completion of a UK Core Training programme does not guarantee a Higher Specialty Training post.   Completion of Specialty Training Programme Upon successful completion of either a run-through or coupled training programme, doctors are awarded a Certificate of Completion of Training (CCT). At this point doctors are able to make an application for Specialist Registration (or GP Registration) and are able to take up permanent consultant posts. Training Positions vs Service Posts As above, competition for places on training programmes within the NHS is very high. As such, we advise that IMGs who are interested in entering core or specialty training in the NHS first obtain a service post for 1 – 2 years. Following this contract, you can apply for a training post, for which you will be given priority. Not only will this approach give you the best chance of securing excellent training and career progression opportunities in the NHS, it will also give you the chance to settle in to the UK and the NHS system, and help you understand the training post that will suit you the most.  Service posts also offer very competitive rates, so whilst you are getting to know the NHS and settling into life in the UK, you can also ensure that you are financially rewarded.  Specialist Registration for IMGs IMGs that enter the UK training programmes later on and have not completed the full programme can still get on the specialist register via the CESR-CP route (Certificate of Eligibility for Specialist Registration via a Combined Programme) Check to see if you're eligible for CESR-CP via the GMC website or read through our detailed blog through our IMG Resources library. Secure a Trust Doctor Post (with the view to securing a training post at a later date) You can apply for Trust Doctor or Service Role online via the NHS Jobs website.  However, working with IMG Connect can offer more jobs than are available online with the added benefit of an IMG Consultant speaking directly with services on your behalf to expedite the process and negotiate the best doctor salary for you. Getting started Read more useful articles on finding an NHS trust doctor job, training pathways, doctor salaries in the UK, relocation and much more!   Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once as an IMG new to the UK. For the latest news and updates, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation: