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

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

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

IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.  Here we explore specialist registration in histopathology for overseas consultant pathologists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) specifically, including the application, costs, and eligibility criteria, along with some other topics, summarised in the headings below:  What is Specialist Registration? What route to Specialist Registration is best for me as an overseas pathologist? Do I have to complete CESR before I can work in the UK? Do I need FRCPath for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in histopathology? How much does CESR cost? How long is the CESR application process? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  Specialist Registration  Specialist registration in any specialty means that you can be appointed to a substantive (permanent) consultant position in the NHS. All physicians who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to gain Specialist Registration.   Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a histopathologist in the UK.  Routes to Specialist Registration  There are three types of certificates issued by the GMC for specialist registration across all specialties, and the type of certificate you receive depends on which training route you followed.  For pathologists who have completed their full training outside a GMC-approved training programme, CESR is the route they will usually take towards attaining specialist registration. This route does not require further training, but rather the submission of an application.   Doctors who have trained outside the UK or Switzerland, but within an EEA country, will be awarded CCT (Certificate of Completion of Training) after a successful specialist registration application. Specialist Certifications from across the EU are deemed as equivalent by the GMC, and therefore a straightforward application can be made.   Pathology Positions in the NHS without CESR  It is important to note that you attain more senior histopathology roles in the NHS, such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register.  Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS.  In these NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK histopathology curriculum.  These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  FRCPath for Specialist Registration  Whilst it is always beneficial pathologists to complete FRCPath, overseas doctors looking to join the Specialist Register do not necessarily need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the CCT curriculum are the FRCPath exams, so passing these exams confirms the attainment of the competencies of the Histopathology Curriculum.  FRCPath is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  However, if CESR applicants have not successfully completed these exams, they must provide alternative evidence that demonstrates equivalent knowledge to histopathologists who have passed the FRCPath exams.  Even if the competencies covered by the exams require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.  CESR Equivalence Process  Equivalence describes the process of assessing an overseas applicant’s training and experience against the current histopathology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence  skills and knowledge  The Royal College of Pathologists will assess each application against the relevant Curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Histopathology  Skills & Experience: The evidence provided for a CESR application in histopathology must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the Curriculum for Specialty Training in Histopathology. If evidence is missing from any area of the curriculum, the application may be unsuccessful.  Capabilities in Practice: The Royal College of Pathologists has divided the Training Curriculum into 11 different Capabilities in Practice (CiPs) – each comes along with its own descriptor and guidance on where such CiPs would be evidenced.  Applicants are required to gather evidence by area of competence and attach this under the relevant section of the online application.  Generic CiPs  Able to function effectively within healthcare and other organisational and management systems to deliver consistent high-quality patient care.  Able to work within ethical and legal frameworks across all aspects of clinical practice.  Communicates effectively and is able to share decisionmaking, while maintaining appropriate situational awareness, professional behaviour and professional judgement.  Maintains patient safety at the forefront of clinical working. Can utilise quality improvement activity realistically within the constraints of the role.  Able to contribute to and support research.  Behaves as an educator in the context of the role and promotes educational culture.  Able to self-appraise, learn and adapt.  Histopathology-specific CiPs  Able to demonstrate leadership and management within the laboratory setting for the benefit of patient care.  Able to use laboratory and other services effectively in the investigation, diagnosis, and management of patients, relatives, and the deceased.  Able to manage and contribute to a multidisciplinary team effectively.  Able to take, manage and interpret pathological specimens accurately and safely, mindful of risks to self and others.  Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle. Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800-1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 - Knowledge, skills, and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership, and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  The Cost of CESR Applications  All histopathology applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.  How long does it take to complete a CESR in Histopathology application?  The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior histopathologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in histopathology is five years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior pathologists.  #IMG Tips  Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.   Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.   Ensure that the evidence you collect demonstrates your competence across the whole of the histopathology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Histopathology Specialty Training Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the 11 CiPs headings – organise your evidence directly into these sections to manage your progress.  Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).  Ask an IMG Connect recruitment specialist about NHS histopathology posts with CESR support. These are not always advertised by the Trusts, but we can help you find a role which aligns well with your career goals in the NHS.  Join the IMG Histopathologists community – as well as support on Royal College exams, our online community of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.  Getting started  Many pathology IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route. Take a look at our guide to CESR Applications for Histopathology for more information on how to apply and what to expect.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS histopathology posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:              

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

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

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

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

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

IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.  Here we explore specialist registration in psychiatry for overseas consultant psychiatrists and specialists more closely. We’ll cover the Certificate of Eligibility for Specialist Registration (CESR) in more detail, including the application process, costs, and eligibility criteria, along with some other topics, summarised in the headings below:  What is Specialist Registration? What route to Specialist Registration is best for me as an overseas psychiatrist? Do I have to complete CESR before I can work in the UK? Do I need MRCPsych for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in psychiatry? How much does CESR cost? How long is the CESR application process? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  Specialist Registration  Specialist registration in any specialty means that you can be appointed to a substantive (permanent) consultant position in the NHS. All psychiatrists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience in order to apply for Specialist Registration.   For psychiatrists, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.   Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a psychiatrist in the UK.  Routes to Specialist Registration  There are three types of certificates issued by the GMC for specialist registration, and the type of certificate you receive depends on which training route you followed.  For overseas doctors who have completed their full training outside a GMC-approved training programme, CESR is the route they will usually take towards attaining specialist registration. This route does not require further training, rather the submission of an application.   Doctors who have trained outside the UK or Switzerland, but within an EEA country, will be awarded CCT (Certificate of Completion of Training) after a successful specialist registration application. Specialist Certifications from across the EU are deemed as equivalent by the GMC, and therefore a straightforward application can be made. You can read more about this in the Specialist Registration section under your country on the GMC website here.  Psychiatry Positions in the NHS without CESR  It is important to note that you can apply for more senior psychiatry roles such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register.  Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS.  In these NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK psychiatry curriculum.  These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  MRCPsych for Specialist Registration  Whilst it is always beneficial to complete MRCPsych, overseas doctors looking to join the Specialist Register do not necessarily need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the CCT curriculum is the MRCPsych exam, so passing these exams confirms the attainment of the competencies of the Core Curriculum.  MRCPsych is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  However, if CESR applicants have not successfully completed these exams, they must provide alternative evidence that demonstrates equivalent knowledge to psychiatrists who have passed the MRCPsych exams.  Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.  CESR Equivalence Process  Equivalence describes the process of assessing an overseas applicant’s training and experience against the current psychiatry training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence  skills and knowledge  The Royal College of Psychiatrists will assess each application against the relevant Curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Psychiatry  Skills & Experience: The evidence provided for a CESR application in psychiatry must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the General Psychiatry Curriculum, and the Advanced Module in the sub-specialty you are applying in. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800-1200 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 - Knowledge, skills, and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership, and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  The Cost of CESR Applications  All psychiatrists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,676. For CESR-CP and CCT, the cost is £439.  How long does is the application process for CESR in Psychiatry?  The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior psychiatrists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in psychiatry is six years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior psychiatrists.  #IMG Tips  Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.   Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.   Ensure that the evidence you collect demonstrates your competence across the whole of the psychiatry curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Psychiatry CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress.  Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).  Ask an IMG Connect recruitment specialist about NHS psychiatry posts with CESR support. These are not always advertised by a Trust, but we can help you to find a role which aligns well with your career goals in the NHS.  Join the IMG Psychiatrists community – as well as support on Royal College exams, our online community of international psychiatrists and dedicated psychiatry recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.  Getting started  Many psychiatry IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route. Take a look at our guide to CESR applications for psychiatry for more information on how to apply and what to expect.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

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

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