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.
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Here we take a closer look at the routes available to overseas consultants & experienced doctors who wish to join the GMC’s Specialist Register.
IMGs from any country in the world can apply for Specialist Registration, provided certain eligibility criteria are met, though there are different routes available based on a doctor’s qualifications and training.
To shed some light on the routes to Specialist Registration, we've put together a short article to explain further, including the following topics:
What is Specialist Registration?
What are the different types of Specialist Registration?
Am I eligible?
How do I apply for Specialist Registration and what evidence will I need?
What are the benefits of Specialist Registration?
Are other senior NHS posts available without Specialist Registration?
How much does Specialist Registration cost?
#IMG Tips
Skip ahead to the relevant section if you know what you’re looking for.
Specialist Registration
All doctors who wish to work as permanent consultants in the UK must show evidence of skills, knowledge and experience in order to apply for Specialist Registration. This registration in any specialty means you can be appointed to a substantive consultant post within the NHS.
Specialist Registration is additional to full registration with the GMC.
The 3 Types of Specialist Registration
There are three types of certificates issued by the GMC, and the type of certificate you will receive at the end of your training defines which training route you are on.
The Certificate of Completion of Training (CCT)
The CCT is the route to specialist registration for doctors who have completed a GMC-approved, specialty training programme through the relevant Royal College.
To be eligible for CCT, an applicant’s entire training (including any core years) must have taken place within UK-approved training posts. Please see our blog on career pathways for a UK doctor in training.
The Certificate of Eligibility for Specialist Registration - Combined Programme (CESR (CP))
CESR(CP) is a simplified route for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK.
Doctors on the CESR(CP) route count a combination of approved training and previous experience in non-approved posts (overseas) towards their training time.
The Certificate of Eligibility for Specialist Registration (CESR)
CESR is the route to specialist registration for doctors who have not completed a GMC-approved specialty training programme – doctors who have trained outside of the UK, Switzerland, and the EEA.
These doctors apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK.
Doctors who have completed their specialist training in the EEA or Switzerland are eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ).
For an in-depth guide to CESR, take a look at our blog for overseas doctors here.
Eligibility
Eligibility for Specialist Registration depends on your nationality, qualification and experience.
To meet the minimum eligibility requirements to apply you must have either:
A specialist qualification in the specialty you’re applying in
OR
At least six months continuous specialist training in the specialty you’re applying in
You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.
In your application you must show that you meet the requirements of the CCT curriculum in your specialty.
The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience.
Applications and Evidence for Specialist Registration
CCT and CESR-CP
Once you have been issued with your Outcome 6 has been issued, you must complete and return the relevant CCT/ CESR(CP) notification to your Royal College along with the following documents:
Copies of any ARCPs that are not on your ePortfolio
ARCPS/evidence of successful progression for any LAT/FTTA/SHO posts counting towards your training (this applies to doctors who were appointed above ST1 only)
You will also need to complete an online GMC form. The link to this form will be emailed to you by the GMC and you should contact your Royal College if you do not receive it.
The GMC has created a guide for each CCT specialty with the relevant royal college or faculty. You can see this here.
CESR
You will need to apply to the GMC, who will then send your application to the Royal College for evaluation. The application process for CESR can be lengthy and potentially stressful, so it is important that you read the GMC’s general guidance and specialty-specific guidance before starting to put together an application.
You will need to provide a portfolio of evidence demonstrating that your specialist training or qualifications are equivalent to the award of a CCT in your specialism in the UK. This information is available for each specialty and Royal College on the GMC website here.
If you apply for an NHS post which provides CESR support, your hospital should assist you in this process.
Once the GMC has sent you a letter informing you that your application is complete and has been sent to your Royal College for assessment, the College is not permitted to discuss your case with you until the GMC has sent you a letter informing you of the decision.
Benefits of Specialist Registration
Specialist registration allows doctors to take up permanent or substantive consultant positions. Without CCT, CESR or CESR-CP, a doctor may only take a Trust locum or fixed-term consultant posts.
Fixed-term and locum posts offer of course offer less stability than permanent consultant posts and require extension.
It is a legal requirement before taking a substantive, honorary or permanent NHS consultant post in the UK that doctors have their names entered on the GMC's Specialist Register.
Senior Positions in the NHS
It is important to note that you can apply for more senior roles such as a specialty doctor (SAS), specialist grade or a locum consultant (locum consultants are not required to be on the Specialist Register).
This way, you will have better pay and roles and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these jobs you can collect evidence of your competences.
These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.
Cost
All doctors applying for Specialist Registration must pay a fee. The fees for 2021 are as follows:
CCT - £439
CESR-CP - £439
CESR - £1,676
#IMG Tips
Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.
Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.
Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.
Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
Ask an IMG Connect recruitment specialist about NHS posts with CESR support, these are not always advertised by a Trust, but we can help you to find a role which aligns well with your career goals in the NHS.
Most IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR or CESR-CP route. Take a look at our in-depth CESR overview for more information on how to apply and what to expect. If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Respiratory Medicine with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Respiratory Medicine in the NHS?
As a respiratory medicine or pulmonary specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Respiratory Medicine. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP to attain CESR in Respiratory Medicine?
No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Respiratory Medicine. Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP (UK).
What is the indicative period of training for a CCT in Respiratory Medicine?
The indicative period of training for CCT in Respiratory Medicine is six years full-time training and it is highly unlikely that a CESR applicant could achieve these competencies required in less time.
The structure of the CCT training programme is:
2 years in Core Medical Training or Acute Care Common Stem (ACCS)
How does IMT fit into this? CMT no longer exists as of Aug 2019.
4 years training in Respiratory Medicine
Applicants need to demonstrate that they have achieved the competencies in both of these areas. For complete details have a read through the Respiratory Medicine Curriculum documentation.
Submitting Evidence
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Respiratory Medicine Curriculum documentation. If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
Summary
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for senior Respiratory doctors looking to work as NHS Consultants in Respiratory Medicine.
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Search and find live NHS doctor jobs in the UK
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Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & hospital locations for you.
Here we look briefly at the CESR route available to overseas consultants and exerienced senior doctors who wish to secure a job in the NHS and relocate to the UK.
Many IMGs have recently asked if they would be eligible for the CESR route to Specialist registration. International Medical Graduates (IMGs) from any country in the world can apply for CESR, provided certain eligibility criteria are met.
To help answer this question we have put together a short article to explain further, including the following topics:
What is CESR?
What is the Equivalence process?
Who is the CESR for? Who can apply?
What does the CESR route involve?
Are there other senior NHS positions available?
Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK
What are the achieved standards?
How can I prepare my evidence for CESR applications?
What if my application is not successful?
CESR is suitable for those who have already been practising overseas for many years.
What is CESR?
The CESR is for doctors who wish to join the GMC (General Medical Council) Specialist Register, and whose specialist training, qualifications or experience was partly or completely acquired outside an approved CCT (Certificate of Completion of Training) programme in the UK.
It is equivalent to a CCT and certifies that the recipient has all the competences defined in the CCT curriculum, known as specialist registration.
What is the Equivalence process?
Equivalence describes the process of assessing an overseas applicant’s training and experience against the current training programme requirements, in order to gain a Certificate of Eligibility for Specialist Registration (CESR) for the Specialist Register held by the General Medical Council.
The process involves submitting a written body of evidence to the GMC of:
training and/or competence
skills and knowledge
Each Royal College will assess the application against the relevant Curriculum before providing a recommendation to the GMC, who will then make a decision.
Please note that Equivalence procedures are the responsibility of the GMC.
Applications are made through their Certification Department and initial enquiries should be directed there.
Who is the CESR for? Who can apply?
If you have training, qualifications and experience in a CCT specialty but have gained these partly or completely outside an approved CCT training programme (for example, you have trained outside the UK or EEA), you may apply for a CESR in a CCT specialty.
What does the CESR route involve?
In a nutshell, you will need to compile a portfolio of evidence to prove you have achieved the equivalent skills and experience of a doctor who has completed a full GMC-approved training programme.
You can collect this evidence prospectively through non-training jobs.
Is it the right route for me? Yes, if…
You have already completed specialty training back home
If you have already completed Specialty Training, then you’re unlikely to want to repeat it.
You haven’t completed training, but you have too much experience in your specialty to apply for training posts.
In both scenarios, even if you are willing, you may be overqualified to apply for training.
Doctors who have complete specialist training overseas or via a non-CCT pathway may be eligible for entry without further training. You can check using the guidelines below:
GMC CESR Guidance
Specialty Specific Guidance
You will need to demonstrate all specialty learning outcomes specified in the relevant CCT curriculum.
Are there other senior NHS positions available?
It is important to note that you can apply for more senior roles such as a SAS doctor, specialty doctor or a locum consultant (locum consultants are not required to be on the Specialist Register).
This way you will have better pay and the roles and responsibilities are more appropriate to your level of experience compared to a junior trainee. While working in these jobs you can collect evidence of your competences.
This is also a quicker route to the UK than the CESR route, which can take a substantial amount of time.
Legal requirement before taking a substantive, honorary or fixed term NHS consultant post in the UK:
It is a legal requirement that doctors must have their names entered on the General Medical Council's (GMC's) Specialist Register before taking up substantive NHS consultant posts in the UK.
What are the achieved standards?
To apply you will need to have either a specialist qualification or have undertaken a period of specialist training (not less than 6 months anywhere in the world).
Your application is measured against the GMC standard.
The GMC break down the standard into four domains mirroring the headings of Good Medical Practice.
The GMC recommend that you allocate the evidence you provide with your application in the following way:
Domain 1: Knowledge, Skills and Performance - 75%
Domain 2: Safety and Quality - 20%
Domain 3: Communication, Partnership and Teamwork - 5% (combined for
both domains 3 & 4)
Domain 4: Maintaining Trust - 5% (combined for both domains 3 & 4)
The full list of evidence needed for each specialty is provided here.
How can I prepare my evidence for CESR applications?
As CESR applications are currently a completely paper-based process it is important to think about the evidence you present. You should:
Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.
Make sure that your evidence is current and of the highest possible quality.
Always note any curriculum changes – you will be assessed against the most recent one
Ensure that the evidence you collect demonstrates your competence across the whole of the curriculum, not just your sub-specialty.
Throughout your application you should refer to the Specialty Specific Guidance in your specialty (or the most relevant if applying in a non-CCT specialty).
You should also refer to the relevant CCT curriculum in your specialty; as this is the standard that all CCT applicants will be measured against.
Look thoroughly at the GMC guidance available and get advice on your application from the GMC before you apply.
Remember to refer to the relevant CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.
The GMC has strict guidelines for presenting evidence, including verification, anonymising and translating documents. We strongly advise all IMGs to take a look here and familiarise themselves with the criteria.
What if my application is not successful?
Following an unsuccessful application, you can apply for a review within 12 months of receiving your decision from the GMC. You can apply for a review of the GMC’s decision on the grounds that:
You now have additional evidence to submit that addresses the areas of your application in which you were previously unsuccessful
You believe that there has been a procedural error or unfairness in the processing of your original application.
Please refer to the GMC guidance for further information on applying for a review.
IMG Jobs
Search and find live NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK, CESR and the most suitable hospital locations for you.
In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Haematology with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Haematology in the NHS?
As a Haematologist, attaining CESR will mean you are qualified to practice at consultant level in Haematology in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP or FRCPath in Haematology to attain CESR in Haematology?
No, but whilst it is always a benefit to attain MRCP, or FRCPath, or both (you may have already attained either of these by ways of registering with the GMC) you do not require MRCP or FRCPath in Haematology to attain CESR.
Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK) and FRCPath in Haematology.
What is the indicative period of training for a CCT in Haematology?
The indicative period of training for a CCT in Haematology is seven years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time.
This training consists of the following:
2 years in Core Medical Training OR
Acute Care Common Stem (ACCS) OR
AND
Five years training in Haematology
Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas. For a complete list of competencies refer to the Haematology Curriculum documentation.
Submitting Evidence:
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Haematology Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Haematologists looking to work as NHS Consultants in Haematology.
IMG Jobs
Search and find live NHS Pathlology jobs offering CESR in the UK
IMG Resources
Read more useful articles on finding an CESR, NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable hospital locations for you.
As an IMG, what documents should you submit for your CESR application in Geriatric Medicine?
In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Geriatrics or Elderly Care Medicine with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Geriatric Medicine in the NHS?
As a Geriatrician, attaining CESR will mean you are qualified to practice independently as a Geriatrics consultant in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP to attain a CESR in Geriatric Medicine?
No, but whilst it is always a benefit to attain MRCP you do not require it to attain CESR in Geriatric Medicine, though you may have already attained this depending on which route you have taken for GMC registration.
Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK).
What is the indicative period of training for a CCT in Geriatrics?
The indicative period of training for a CCT in Geriatric Medicine is seven years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time.
This training consists of the following:
2 years in Core Medical Training OR
Acute Care Common Stem (ACCS) OR
AND
Five years training in Geriatrics
Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas.
For a complete list of competencies refer to the Geriatric Medicine Curriculum documentation.
Submitting Evidence:
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Geriatric Medicine Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Geriatricians looking to work as NHS Consultants in Geriatrics.
Getting started
Many geriatric medicine IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route.
If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Sources
https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration
https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr
https://www.gmc-uk.org/-/media/documents/sat---ssg---geriatric-medicine-2010--amended-2016----dc2302_pdf-48455396.pdf
In this article we provide guidance on evidence to be supplied for an application onto the Specialist Register for Emergency Medicine, with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Emergency Medicine in the NHS?
As an Emergency Medicine doctor, attaining CESR will mean you are qualified to practice independently as an Emergency Medicine consultant in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCEM to attain a CESR in Emergency Medicine?
Yes, Emergency Medicine is one of the few specialisms where there are no GMC-accepted equivalents to MRCEM. Any doctor wishing to attain Specialist Registration via the CCT route will attain FRCEM in addition.
What is the indicative period of training for a CCT in Emergency Medicine?
The indicative period of training for a CCT in Emergency Medicine is six years and it is very unlikely that an applicant would achieve the competencies required for a CCT in a shorter period of time.
The evidence you collect for your CESR application should reflect this period of training, which consists of:
Two years in the Acute Care Common Stem (covering areas of Emergency Medicine, Anaesthetics, Intensive Care Medicine and Acute Medicine)
Four years of training in Emergency Medicine (covering areas of Paediatric EM, EM and EM ultrasound)
CESR applicants will need to demonstrate they have achieved the competences in each of these areas.
The EM ultrasound competences (EMUS) can be shown by completing the triggered assessments outlined in the EM curriculum (level 1 or equivalent).
The assessments forms for Core Ultrasound can be found in the RCEM EMUS booklet (Appendix 2).
The first three years of training make up Core Specialty Training, the final years of training are known as Higher Specialty Training.
For complete details please refer to the Emergency Medicine Curriculum documentation.
Submitting Evidence
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Emergency Medicine Curriculum.
If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC.
You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
Names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Emergency Medicine doctors looking to work as NHS Consultants in Emergency Medicine.
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Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding, CESR, a typical doctor salary in the UK and the most suitable NHS job & hospital locations for you.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Hospitals across the UK are offering specialty doctor job plans with opportunity for CESR programmed support, giving doctors the chance to quickly work towards specialist registration.
For experienced IMGs this is a new and quick route to your first Consultant post. By taking up a service level job as a Specialty Doctor with CESR support as part of the job plan many IMGs are securing a great start to their future career in the NHS that is suited to their senior level experience.
If you are an overseas doctor looking for a Specialty Doctor job with the chance to work towards your Certificate of Eligibility for Specialist Registration (CESR), speak to the IMG Connect team to discuss if this is a suitable route for you. We have opportunities across the UK for doctors to take advantage of the CESR programme.
You can also send your CV to info@imgconnect.co.uk or register here. It takes 30 seconds to register!
By taking such posts in NHS trusts and hospitals you can join diverse, dynamic and inspiring groups of specialty doctors and acting Consultants all on the way to achieving their CESR as part of a tailored programme. In offering such job opportunities, hospitals will provide a supportive environment with protected time to fulfill all the requirements of the CESR application, gaining career-enhancing experiences as you do.
Acting up, dedicated peer groups, coaching & mentoring, scheduled learning and study time are some of the benefits that you could receive.
In such roles you will typically receive hands on support from consultant colleague and exposure to a wide range of experience to specifically aid competency achievement for your CESR application.
In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience.
Some hospitals will also provide the following as part of the CESR programme:
Supported Professional Activity (SPAs) sessions per week
Tailored experience to your CESR portfolio
Regular clinical supervision
A CESR mentor
Involvement in academic programme and medical student teaching
Support in gaining research competencies
SAS Tutor support
CESR / SAS support forums and meetings
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One of the main reasons that overseas doctors want to work in the Emergency Medicine departments across the UK, is the excellent opportunity for access to training such as the Specialist Training Programme, career progression, including CESR, and sub-specialty development.
This short article provides useful information on the training and development available, how to access the training, the best route to becoming a consultant in the UK with entry to the specialist register, no matter what stage of your training.
Emergency Medicine Training, leading to CCT
We start with an overview of the Emergency Medicine Training in the NHS. Trainees may enter the emergency medicine training programme via:
The EM (Emergency Medicine) core training programme at ST1. This is a three-year core training programme (starting from ST1 and ending at ST3).
For the first two years, trainees will spend 6 months in EM, Intensive Care Medicine, Anaesthetics and Acute Medicine. This is followed by a further year in trauma and paediatric EM.
The start of specialty training (ST4-6) subject to having achieved the necessary competences required for completion of ST3.
Once ST6 is completed, then a doctor will be added to the specialist register for medicine and hold the title of CCT. This means that they can apply for and practice at a consultant level in the NHS.
CESR
For senior Emergency Medicine doctors (experienced specialty doctors, consultants and heads of departments) there is also the option of CESR. You can apply directly for CESR from overseas, or secure a post in the NHS with CESR support and complete your application in the UK. This is a good option for those wanting to take up their first role in the NHS as a specialty doctor (leading to consultant) or as a locum consultant.
Applying from abroad can be lengthy, and it is certainly not the quickest route towards specialist registration. Most IMGs prefer to secure a post with CESR support, so speak to your IMG Consultant to learn more about the best route to the UK for senior doctors seeking consultant jobs in Emergency Medicine.
Most senior Emergency Medicine job vacancies advertised will offer support with CESR, access to training and career progression, and senior managers will encourage you to develop your own professional interests.
Emergency medicine departments in the NHS are particularly supportive of doctors seeking to develop both personally and professionally. To find out what jobs are on offer take a look here.
If you think that a Specialty Doctor post with CESR support is suited to you, or if you are a consultant or head of department, then you can find out more information here.
For further advice on how to secure the right job for you in the NHS, take a look at our the following article.
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Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to see what Emergency Medicine job opportunities there are for you, including access to CESR support, Core and Specialty training.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Here we take a quick look at the CESR route for overseas experienced specialty doctors & consultants hoping to find a senior doctor job in the NHS and qualify for the Certificate of Eligibility for Specialist Registration (CESR).
Many IMGs have recently asked if they would be eligible for the CESR route to Specialist registration. International Medical Graduates (IMGs) from any country in the world can apply for CESR, provided certain eligibility criteria are met.
To help answer this question we have put together a short article to explain further, including the following topics:
What is CESR?
How does CESR work?
Am I eligible?
I am eligible, what next?
Applications for CESR requires a lot of preparation and can seem quite daunting. This is the first in a series of articles aimed at helping doctors planning to engage in this process.
What is CESR?
The Certificate of Eligibility for Specialist Registration (CESR) is the process by which doctors who have not trained in an approved programme can demonstrate their knowledge, skills and experience are equivalent to that of the relevant CCT curriculum to join the GP or specialist registers.
How does CESR work?
The CESR is awarded by the GMC and applications are made directly to them.
The Royal College then assesses the evidence an applicant has submitted to the GMC.
The assessment is to assure the GMC that the applicant has gained the equivalent level of competence as a trainee (i.e. ST6) making application for CCT via the ARCP process (Annual Review of Competency Progression).
This means that the CESR applicant must demonstrate competence against all Intended Learning Outcomes in the curriculum of the specialty of their choice via the written evidence submitted.
Are you eligible?
There are different ways to apply for registration with a licence to practise in the UK. It depends on your nationality, qualification and experience.
To meet the minimum eligibility requirements to apply you must have either:
a specialist qualification in the specialty you’re applying in
OR
at least six months continuous specialist training in the specialty you’re applying in.
You’ll need to provide evidence of how you’re eligible as part of your application. This could be a copy of your qualification or evidence of your employment.
In your application you must show that you meet the requirements of the CCT curriculum in your specialty.
The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience.
In most circumstances we can say that evidence must:
come from higher training equivalent
be less than 5years old
demonstrate higher level experience
map to the curriculum
be represented clearly
be current
be primary evidence
You can check the approved Royal College curricula for all 65 specialities and sub specialties here.
I am eligible, what happens next?
As an IMG, it is highly likely that you haven’t complete a UK based approved training programme but could be eligible for Specialist Registration via the CESR route. Take a look at our in-depth CESR overview for more information on how to apply and what to expect.
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Most overseas radiologists coming to the UK want to attain their CESR in Radiology.
In this article we look at the specialty specific guidance on evidence required for entry onto the Specialist Register for Clinical Radiology. This is entry to the specialist registration with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Clinical Radiology in the NHS?
As a Clinical Radiology specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Clinical Radiology. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need FRCR to attain CESR in Clinical Radiology?
Not necessarily. Whilst it is a benefit to attain FRCR, and you may have already attained MRCP or FRCR as your route to GMC registration, you do not necessarily require FRCR to attain CESR in Clinical Radiology. Any doctor wishing to attain Specialist Registration via the CCT route must attain FRCR.
What is the indicative period of training for a CCT in Clinical Radiology?
The indicative period of training for a CCT in Clinical Radiology is five years it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. This training consists of the following:
3 years in Core Training AND
2 years in Higher Training
During Higher Training, competence is expected to be achieved at Level 1 or Level 2 which indicates the greater degree of expertise to be achieved by those intending to practice in one or more special interest areas. CESR applicants must demonstrate that they have achieved the competencies in each of these areas.
You should refer to the Clinical Radiology Curriculum documentation before you make your application to ensure that you can demonstrate the required competencies.
Submitting Evidence:
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier). It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
Please note you will also need to submit translations of any documents that are not in English and you must ensure the translations you submit meet the GMC translation requirements.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Clinical Radiology Curriculum. If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
Types of Evidence:
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Key Evidence Requirements – advice from the FRCR’s Equivalence Committee:
Evidence must demonstrate that you have achieved ALL the requirements and competencies as set down in the relevant CCT curriculum.
Where you have worked in a specialised area for a substantial period of time, evidence will be required to the following effect:
That at one stage in your career you achieved the requirements and competencies of the relevant specialty curriculum
These skills have been maintained within the last five years
Your current specialised practice allows you to meet all of the domains above
You must submit evidence to demonstrate that you can practise competently and independently across the breadth of the CCT curriculum
Key Evidence Requirements – Summarised:
In summary you are expected to demonstrate competence across the core requirements of the radiology specific content of the curriculum:
breast, cardiac, emergency radiology, gastro-intestinal, general and non-vascular intervention, head and neck, moledcular imaging, musculoskeletal, neuroradiology, oncological, paediatric imaging, radionuclide radiology, thoracic, uro-gynaecological and vascular radiology, in the relevant technique-based areas (plain film including mammography, CT, US, MRI, nonvascular interventional procedures, fluoroscopy)
You are also expected to demonstrate the equivalent Level 1 and/or Level 2 competencies required for Higher training, in one or more areas of special interests.
Key Documents to submit with your application:
Take a look at the GMC’s SGPC – SSG document to affirm the information above and to understand the key documents recommended by the Royal College of Radiology’s Equivalence Committee.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC. You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Radiologists looking to work as NHS Consultants in Clinical Radiology.
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Here we will look closely at the application for CESR in acute and general medicine.
In particular, we will explore the specialty specific guidance on providing evidence for an application for entry onto the Specialist Register for Acute Internal Medicine or Acute Medicine with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Acute Internal Medicine in the NHS?
As an Acute Medicine specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Acute Medicine. Have a read through our CESR articles found in the IMG Resources library to understand a little more.
Do I need MRCP to attain CESR in Acute Medicine?
No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Acute Internal Medicine.
Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK).
What is the indicative period of training for a CCT in Acute Internal Medicine?
The indicative period of training for a CCT in Acute Internal Medicine is six years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time.
This training consists of the following:
2 years in Core Medical Training OR
Acute Care Common Stem (ACCS) OR
AND
Four years training in Acute Internal Medicine
Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas.
For a complete list of competencies refer to the Acute Internal Medicine Curriculum documentation.
Submitting Evidence
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Acute Internal Medicine Curriculum.
If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it.
As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC.
You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
Names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Acute Medicine doctors looking to work as NHS Consultants in Acute Medicine.
IMG Jobs
Search and find live NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Get in touch using the buttons above (and below) to discuss acute & general medicine job opportunities in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & hospital locations for you.
Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below: