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- CAREER SUPPORT >
- Career Progression

Specialist register / CESR - what are my options in the NHS?
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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Specialty Doctor posts with CESR support - your new route to specialist registration in the UK
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 inthe NHS taht 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 fulfil all the requirements of the CESR application, gaining career-enhancing experiences as you do.
Acting up, dedicated peer groups, coaching & mentoring, scheduled learning and study time are some of the benefits that you could receive.
In such roles you will typically receive hands on support from consultant colleague and exposure to a wide range of experience to specifically aid competency achievement for your CESR application.
In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience.
Some hospitals will also provide the following as part of the CESR programme:
Supported Professional Activity (SPAs) sessions per week
Tailored experience to your CESR portfolio
Regular clinical supervision
A CESR mentor
Involvement in academic programme and medical student teaching
Support in gaining research competencies
SAS Tutor support
CESR / SAS support forums and meetings
IMG Jobs
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Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG consultant to discuss the CESR job vacancies in the NHS and start your journey towards specialist registration and your first consultant post in the NHS.

Training, development and career progression in Emergency Medicine
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 speciality 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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Career Pathway for a UK Doctor in Training
The NHS offers extensive training schemes and career development for all of its doctors, and such programmes are recognised as a gold standard across the medical world.
Training in the NHS is always in keeping with advances in medical sciences and the progressive landscape of the medical profession, including the more complex ailments of a growing and ageing population. The NHS frequently updates and develops its training programmes, making them attractive to UK graduates and doctors, as well as overseas doctors seeking the very best training.
In this article we will cover the following topics:
Why is it important for IMGs to understand the NHS Training Pathway?
The NHS Training Pathway
From Graduation to Foundation Training
Specialty Training Programmes
Different types of Specialty Training programmes
Uncoupled specialty training programmes
Run-through Training Programmes
Completion of Specialty Training Programme
Should I apply for a training or service post?
As an IMG can I get onto the specialist register?
How do I secure a service post? With the view to securing training at a later date.
Why is it important for IMGs to understand the NHS Training Pathway?
Most IMGs looking to move to the UK will be keen to enter into UK Specialty Training at some point, and as such it is important to understand the UK training pathway from start to finish in order to map your NHS career effectively.
Furthermore, greater understanding of the NHS structure and training offered to doctors in the UK will help an IMG to understand at what grade they can likely enter the system.
The NHS Training Pathway
The NHS Training Pathway is the term given to the journey from medical school to completion of GP or specialist training and is the path most commonly followed by UK trainees.
From Graduation to Foundation Training
Upon graduation from a medical school, doctors gain provisional registration with the GMC allowing them to enter the Foundation Programme - a two-year work-based training programme.
Upon completion of the first year (FY1) doctors will gain full registration with the GMC and can apply for further study and training in a specialised area – known as Specialty Training.
Specialty Training Programmes
Completion of the Foundation Programme allows doctors to apply for Specialty Training in an area of medicine or general practice. There are 60 different specialties to choose from.
A doctor entering year one of Specialty Training is known as an ST1 doctor.
Specialty Training programmes can take between three and eight years depending on the specialism chosen. Doctors can pass through the training quicker depending on how fast they achieve their competencies.
However, rarely do doctors complete the training pathways in the indicated time for a variety of reasons. On average the training takes between 1 - 4 years longer than indicated in the curricula.
Different types of Specialty Training Programmes
There are a number of different types of Specialty Training programmes, which are different for each specialty.
Uncoupled Specialty Training Programmes
These programmes split into Core Training and Higher Specialty Training.
Core Training lasts for either two or three years and once complete, allows you to apply for Higher Specialty Training, which can take between 3 – 5 years.
Overall, Specialty Training programmes can take between 5 – 8 years in their entirety, depending on your medical specialty.
Doctors will be known as ST1-3 during their Core Training and ST4-6/7/8 level during Higher Specialty Training programmes.
Higher Specialty Training programmes are very competitive, and completion of Core Training does not guarantee a Higher Specialty Training post.
It is worth noting that in August 2019 the core medical training programme will be replaced by the Internal Medicine Training Programme, described as ‘a new training model designed to equip doctors with skills and confidence to lead on the care of patients in general ward and acute care settings’.
Run-through Training Programmes
For these training programmes you only have to apply once, at the beginning of the programme, as you are recruited for the full duration of Specialty Training.
They can last from approximately three years for general practice, to five or seven for other specialties.
Completion of Specialty Training Programme
Upon successful completion of either a run-through or coupled training programme doctors are awarded a Certificate of Completion of Training (CCT).
At this point doctors are entered onto the specialist register (or GP Register) and are recognised as a consultant.
Should I apply for a training or service post?
As above, competition for places on training posts within the NHS is highly competitive. As such for IMGs interested in securing a place on a training post in the NHS, we advise that IMGs obtain a service post for 1 – 2 years.
Following this contract you can apply for a training post, for which you will be given priority. Not only will this approach give you the best chance of securing excellent training and career progression opportunities in the NHS, it will also give you the chance to settle in to the UK, get to know your trust better, and help you understand the training post that will suit you the most.
Service posts also offer very competitive rates, so whilst you are getting to know the NHS and settling into life in the UK, you can also ensure that you are financially rewarded.
As an IMG can I get onto the specialist register?
IMGs that enter the UK training programmes later on and have not completed the full programme can still get on the specialist register via the CESR route (Certificate of Eligibility for Specialist Registration)
Check to see if you're eligible via the GMC website or read through our overview on CESR and eligibility for CESR.
How do I secure work as a trust doctor? With the view to securing a training post at a later date.
You can apply for Trust doctor or service roles online via the NHS Jobs website.
However, working with IMG Connect can offer more jobs than are available online with the added benefit of an IMG Consultant speaking directly with services on your behalf to expedite the process and negotiate the best doctor salary for you.
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.