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:              

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.              

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:             

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 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:              

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.