Recognised qualifications, endless potential
For European-qualified anatomical pathologists, transitioning to the NHS is now smoother than ever. Recognition of specialist qualifications from EEA countries means that most anatomical pathologists can register with the GMC and work as histopathology consultants in the UK. However, it’s not just about recognition; understanding the NHS’s unique approach to pathology can make a significant difference for those making the move.
This series explores the evolution of NHS pathology services, beginning with the Carter Review, which catalysed key changes in UK histopathology. We’ll dive into the practical impact on subspecialisation, digital pathology, and NHS networks, mapping how these changes could shape your NHS experience.
The Carter Review - a catalyst for modernising NHS pathology
In 2008, the UK government commissioned the Carter Review, a significant report aimed at transforming pathology services in the NHS. Led by Lord Carter of Coles, the review highlighted areas for improvement, pushing for efficient, cost-effective, and patient-centred pathology services. For European pathologists joining the NHS, understanding these reforms provides valuable context for today’s NHS setup.
Here’s a look at the key reforms and why they matter:
Centralisation of Pathology Services - centralising pathology services into regional labs, instead of maintaining many smaller units, was one of the Carter Review's foundational recommendations. This shift aimed to reduce duplicate work, improve quality control, and facilitate better investment in advanced equipment for enhanced diagnostic capabilities.
Emphasis on Digital Pathology - digital pathology was a major focus and something most pathologists get excited about! Digital platforms streamline histopathology workflows, enabling faster reporting, reducing storage needs, and allowing for easier peer reviews. The UK is currently one of the most digitally developed pathology systems in Europe—a potential game-changer for those accustomed to more traditional setups.
Standardised Processes and Reporting - the Carter Review recommended standardised protocols to ensure uniformity across NHS services. With a more consistent approach to diagnostics, patients receive equitable care, regardless of which hospital they attend, and what laboratory their biopsy gets sent to. This also aligns with the Royal College’s points-based system which is designed to support system-wide adoption of best practices. You can read more about the RCPath Points based-system here.
Optimising Workforce Efficiency - the review recognized the importance of a balanced, efficient workforce, advocating for an increased role for biomedical scientists (BMS) to relieve histopathologists, allowing them to focus on complex cases. This support system is crucial in reducing diagnostic backlogs and improving patient outcomes.
Building Clinical Networks for Subspecialisation - recognising the benefits of subspecialisation, the review encouraged collaboration across clinical networks. With centralised hubs, referrals to subspecialist pathologists are more efficient, improving access to expert diagnostics, especially for rare or complex cases.
The Modern NHS - so what can a European (EEA) pathologist expect?
In the years following the Carter Review, the NHS has made strides toward a more digital, centralised, and specialised pathology landscape. While some regions are more advanced in implementing these changes, the NHS’s commitment to modernisation is clear. For European pathologists, this means:
A digitalised workspace - NHS laboratories now offer state-of-the-art digital infrastructure, providing opportunities for remote working, enhanced workflows, and digital archiving.
Opportunities for subspecialisation - pathologists can increasingly specialise in one, two, or three specific organ systems or pathology subspecialties, supported by an efficient referral network not just in their laboratory, but in their regional (and national) network.
Job security and flexible working conditions - with high demand and ongoing recruitment needs, NHS consultants enjoy secure employment with the flexibility to work from home as digital systems continue to advance.
Competitive compensation - recent updates to NHS consultant pay scales have increased earning potential, making the NHS an attractive option for European-trained histopathologists. Here you can find the NHS pay circulars, and here we discuss their comparison with other European healthcare systems, focusing on the consultant pay in particular. With pay in the NHS now far higher than many other European countries, its a great moment to take that step upwards into the NHS and UK pathology sector.
Joining the Digital NHS Landscape
If you’re a European pathologist interested in joining the NHS, now is the time to explore your options. The UK welcomes EEA-qualified pathologists to contribute to a healthcare system embracing innovation and collaboration. If you're curious about GMC registration or how your experience could translate to NHS practice, reach out to IMG Connect to discover how you can step into a modernised, supportive, and specialised NHS environment. Alternatively, you can read through our Route to the UK blog for Pathologists blog published on our IMG Library.
Whether you’re ready to make the move or just starting to explore the possibilities, the NHS offers a promising, high salaried, digitally integrated, and patient-centred future for European-trained anatomical pathologists
Are you an NHS or overseas-trained doctor looking to boost your main income? You’re not alone! Many doctors employed in the UK turn to the private sector for extra work at some point, and those considering Jersey as a future employer will be pleased to know it is an excellent place to do just that.
With about 30% of Jersey’s population covered by private healthcare insurance, the demand for private services is on the rise. This makes now the perfect time to consider relocating to Jersey, where you can balance public sector responsibilities with exciting opportunities in a growing private healthcare market. Whether you’re looking to enhance your career or simply increase your earnings, Jersey has a lot to offer.
Throughout this blog we will be looking into:
Health and Community Service’s (HCS) Private Patients Services Strategy
Benefits of Working in Jersey’s Private Sector
Career Growth Opportunities for IMGs in Jersey’s Private Healthcare
How to move from NHS to private
Health and Community Service’s (HCS) Private Patients Services Strategy
Since the pandemic, Jersey’s private patient revenues took a hit, but things are looking up. In 2023, private patients contributed £12.2 million to Health & Community Services (HCS), about 5% of its total budget. Now, with the launch of the Private Patients Services Strategy, HCS aims to double that figure to over £24 million.
This growth presents exciting opportunities for consultants and specialists, allowing for enhanced career and skill development alongside the main bulk of their work in public sector.
Having choices in healthcare provision not only brings comfort but can also benefits the entire system. Supporting the option to go private enhances care delivery for both clinicians and patients in Jersey. It’s an exciting time to be part of this evolving landscape!
Jersey’s Private Patients Services Strategy: A Vision for 2024-2028
Jersey has unveiled its Private Patients Services Strategy for 2024-2028, aiming to elevate private healthcare on the island over the next five years. Here’s a snapshot of the key goals:
Attracting Top Talent: The strategy seeks to draw in highly-skilled consultants and specialists from the UK and EEA region, enriching and diversifying Jersey's healthcare expertise.
Expanding Service Options: By broadening the range of private healthcare services, patients will have more tailored choices to meet their specific needs.
Boosting Revenue for Community Benefit: The goal is to double private patient income to over £24 million by 2028, contributing to the overall healthcare system and benefiting all islanders. Think of the potential for your fledgling private practice!
Supporting Healthcare Professionals: The plan emphasises collaboration with doctors. The HCS private patients’ leadership team will work closely with consultants to develop and grow services, backed by government support through stakeholder engagement, giving you the guidance and security to take this big step!
This strategy promises exciting advancements for both healthcare professionals and the community.
Benefits of Working in Jersey’s Private Sector
Thinking about making the switch from public to private healthcare? Here are some compelling reasons:
Career Advancement: The private sector offers numerous opportunities for leadership roles, business partnerships, and even the chance to establish your own practice. For those looking for the next step in their career, this would be great for the portfolio!
Better Work-Life Balance: Generally, Jersey’s healthcare workers report lower burnout rates compared to those in the NHS. This may mean you have more time available to supplement your public sector work, with your private sector work, and not just at the expense of your personal time and sanity!
Support from HCS: The HCS private patients leadership team collaborates with medical consultants to help them develop and enhance commercial services, ensuring mutual benefits for everyone involved.
Government Backing: If you’re interested in the private medical sector, substantial government support is available, whether you want to open your own practice or become a partner, through the
Improving Public Health: By easing the demand for state care, you can help reduce waiting lists, allowing patients to receive timely care and avoid worsening conditions.
Career Growth Opportunities for IMGs in Jersey’s Private Healthcare
Leadership and Business Roles: IMGs can pursue leadership positions, form partnerships, or launch their own practices in Jersey’s expanding private healthcare market.
Specialisation and Niche Services: The opportunity to specialise in areas like cosmetic surgery or oncology allows IMGs to introduce unique treatments and thrive in a patient-focused environment.
Starting a Private Practice: As previously stated, IMGs receive support from Jersey’s Health & Community Services (HCS) for business planning, marketing, and regulations, ensuring a smooth transition to private practice, as well as financial incentives from the government to help start things up.
Networking and Collaboration: Joining a network of specialists offers opportunities for collaboration and knowledge exchange, enhancing career advancement.
Leading Service Expansion: IMGs can take on leadership roles in developing and expanding innovative healthcare services as the sector grows.
Active Role in the Private Patients Strategy: Contributing to Jersey’s Private Patients Services Strategy allows IMGs to help shape the future of private healthcare.
Enhanced Professional Recognition: Working in Jersey’s high-standard private healthcare system helps IMGs build recognition locally and internationally, creating future opportunities worldwide.
How to move from NHS to private in 10 steps
Understand Jersey’s Healthcare System: Jersey has its own independent healthcare system. Consultants often work in private practices or a hybrid model with Jersey General Hospital, where many patients pay for services directly or through insurance.
Research Private Hospitals and Clinics: Key private providers include Lido Medical Centre and Clinique Pinel. Explore opportunities at Jersey General Hospital, which may offer private consulting roles.
Jersey License to Practice: Ensure you’re licensed to practice in Jersey by registering with the Jersey Care Commission, which regulates healthcare professionals on the island.
Private Practice Setup: If starting your own practice, register it with Jersey's Government and secure medical indemnity insurance. Build relationships with private insurers like Bupa and AXA PPP.
Finding Job Opportunities: Jersey has a demand for specialists in fields like orthopaedics and cardiology. Check job listings at Jersey General Hospital and private clinics.
Building a Patient Base: Success in private practice relies on referrals from local GPs and maintaining a strong professional reputation. Consider marketing yourself through websites and local directories.
Work Flexibility: Many consultants work in both public and private sectors. Decide if you want to focus solely on private care or split your time.
Finances and Earnings: Private consultants can earn significantly more than NHS counterparts, but consider Jersey’s higher cost of living when planning your finances.
Housing and Relocation: Understand local housing rules, as competition for rentals can be high. Your employer might assist with relocation.
Legal and Tax Considerations: Familiarise yourself with Jersey’s tax laws, which differ from the UK. Private earnings must be declared to the Jersey tax authorities.
Wrapping Up!
To transition from an NHS role to Jersey private healthcare as a consultant or specialist, you must:
Familiarise yourself with Jersey's healthcare system and private sector.
Obtain the necessary medical licenses and register with the Jersey Care Commission.
Explore employment or business opportunities at private clinics, Jersey General Hospital, or set up your own practice whole researching all opportunities.
Establish a patient base, including networking with local GPs and insurers.
Understand the financial and legal implications of practicing privately in Jersey.
Considering a career move to Jersey’s healthcare system? Many UK-trained medical consultants have likely been approached by recruitment agencies regarding job opportunities in Jersey. Whether you’re an IMG doctor, a European-qualified specialist, or an established NHS consultant with a CCT, Jersey might be a career destination that you don’t know much about beyond a few myths and legends. In this article, we’ll explore the key aspects of working as a doctor in Jersey’s healthcare system. Whether you’re an IMG or a UK trainee, we hope to provide you with a clearer perspective on whether Jersey could be an exciting next step in your career.
A Small Island with Big Opportunities!
Whilst not technically being part of the UK, Jersey, the farthest of the Channel Islands from mainland Britain, offers a unique blend of professional opportunities and an enviable lifestyle. It's size may not be impressive, but its healthcare system certainly is. Here’s a snapshot of what you need to know about working in Jersey’s healthcare system, with some notable comparisons to the NHS.
Like most things in Jersey, its healthcare system is robust, well-financed, and highly respected. Whilst still being part of the UK, Jersey operates independently of the NHS, meaning it has its own health service structure, policies, and funding.
Jersey also has a thriving private healthcare sector, with an estimated 30% of the population who have private healthcare insurance, providing another avenue for professionals seeking diverse career opportunities. Working in private healthcare in Jersey allows for a more individualised patient care experience, often with access to state-of-the-art facilities and even more flexibility in clinical practices. Whether in public or private settings, the healthcare landscape here is designed to cater to both professionals and patients.
If you are relocating from the NHS, you may find the transition smooth. Luckily, many of the clinical standards, training, and governance procedures mirror the NHS, so your qualifications will be seamlessly transferable.
Some Key Differences from the NHS:
Smaller Scale, Personal Touch: Jersey’s healthcare system is compact, bringing with it certain advantages. A petit population means fewer patients to manage, so there’s often more time to dedicate to each case, fostering a closer doctor-patient relationship. You’ll be part of a smaller team, which can offer a more personalised, collaborative working environment in Jersey have been expanding compared to larger NHS trusts.
Focus on Mental Health: Mental health services, with a strong focus on community-based care. As a mental health professional, you'll find a commitment to delivering integrated care in both hospital and community settings, providing you with diverse experiences and opportunities for specialisation in your preferred area of practice.
Work-Life Balance: The island’s healthcare system is known for offering a better work-life balance. While NHS roles can often involve long hours and on-call obligations, Jersey’s healthcare professionals frequently report lower levels of burnout. The island’s slower pace of life, along with the stunning beaches and outdoor lifestyle, means you can recharge more effectively during your time off.
Pay and Benefits: Salaries for healthcare professionals in Jersey are competitive and often higher than those offered in mainland UK, as well as other parts of Europe. You can find the Jersey pay scales in full here, whilst we have simplified the pay scales, for your ease, here.
Competitive Tax Rates: And you may’ve heard, but there’s also no VAT in Jersey, which means you can see your earnings go much further. While the cost of living, particularly housing, can be higher, this is often offset by the attractive salary packages and tax rates (a maximum of 20%).
Pensions: When comparing to the NHS’s robust pension schemes, you will see the key differences within the tax environment and contribution rates. This makes Jersey particularly attractive for high-earning specialists or consultants due to the potential to save more into their pensions without hitting the same tax barriers that UK practitioner must adhere to.
Shorter Waiting Lists = More Flexibility: As much as we cherish the NHS, there’s no secret to the pressures it faces day-to-day. Jersey’s healthcare system is not as stretched, where you’ll see waiting times for patients are significantly shorter, and as a clinician you have more flexibility to make important decisions without the same level of resource constraints.
Licensing and Registration
One of the most important steps when making the move is ensuring your qualifications are recognised in Jersey. Most UK-trained doctors and mental health professionals will find this straightforward, but you’ll need to register with the General Medical Council (GMC) or, as a mental health practitioner, the Health and Care Professions Council (HCPC) and obtain a licence to practice in Jersey. The process is akin to the NHS, and guidance is readily available to help you through it on the GMC website.
If you are coming from abroad, the process is similar to what is required for practicing in the UK. You'll need to comply with the following:
Obtain a GMC registration: If you're not already registered, you'll need to meet the GMC's requirements, which may involve providing proof of qualifications, passing relevant exams (such as the PLAB), and demonstrating your English language competence. This process includes psychiatrists, where they will also be required to
Obtain a licence to practice: In addition to being registered, you'll need an active licence to practice. Jersey operates under the same framework, so an active GMC licence is essential.
Visa and work permits: If you're moving from outside the UK or the European Economic Area (EEA), you’ll also need to ensure you have the correct visa and work permits to live and work in Jersey. Employers often assist with this process.
Specialist Registration: As a specialist doctor practicing in Jersey, you will also need to be listed on the GMC's Specialist Register. This requires demonstrating your specialty training, typically through certification of completion of training (CCT) in psychiatry or equivalent qualifications from your home country.
For mental health and care professionals, if you're a psychologist or physiotherapist for example, you would need to register with the relevant UK bodies such as the HCPC, depending on your profession.
Professional Development
The state of Jersey is committed to professional development and getting the most out of its residents, whereby they provide access to a variety of training programmes to enhance your career and opening doors to progression. As previously mentioned, the island has strong ties with UK institutions, and you'll often find that continued professional development follows similar frameworks to the NHS, meaning you won't miss out on growth opportunities!
Perks of the Job
Relocating to Jersey means more than just a new job—it’s a new lifestyle. The island is known for its uniquely stunning landscapes, mild climate and strong sense of community. With its breathtaking beaches, outdoor sports amenities, and short commutes, you’ll enjoy a much calmer, more relaxed pace of life. And with quick travel links to the UK, France and the rest of Europe, you’ll never feel too far from home or adventure. [CS2]
Housing and Relocation Support
It’s worth noting that Jersey has a controlled housing market, and your residential status will determine where you can live. However, many healthcare roles come with relocation support, including assistance with accommodation. Whether you're moving from mainland Britain or further afield, Jersey’s healthcare employers are well known for their generosity with assisted relocation packages, aiming to ensure as smooth
as possible transition.
So, Why Jersey?
Career advancement: Jersey’s healthcare system offers varied and rewarding career opportunities, with less bureaucracy and more flexibility than the NHS.
Competitive salary: Higher wages, lower tax rates, and no VAT make your money go further.
Improved work-life balance: Enjoy shorter commutes, less stress, and a lifestyle focused on health and wellbeing, leaving you full of (Jersey) beans!
Seamless transition: Familiar standards and processes make it easy for NHS and EEA professionals to adapt.
Relocating to Jersey offers the chance to make a real difference. It gives you the exclusive opportunity to progress in a uniquely vibrant healthcare system while enjoying a high quality of life. If you're ready for your next career move, Jersey’s healthcare community is waiting to welcome you!
The NHS offers extensive training schemes and career development for all of its doctors, and such programmes are recognised as a gold standard across the medical world.
Training in the NHS is always in keeping with advances in medical sciences and the progressive landscape of the medical profession, including the more complex ailments of a growing and ageing population. The NHS frequently updates and develops its training programmes, making them attractive to UK graduates and doctors, as well as overseas doctors seeking the very best training.
In this article we will cover the following topics:
The NHS Training Pathway
Graduation to Foundation Training
Specialty Training Programmes
Different types of Specialty Training programmes
Completion of Specialty Training Programme
Should I apply for a training or service post?
As an IMG, can I get onto the specialist register?
How do I secure a service post?
Skip ahead to the relevant section if you know what you're looking for.
The NHS Training Pathway
Many IMGs looking to move to the UK (particularly more junior doctors) will be keen to enter into UK Specialty Training at some point, and as such it is important to understand the UK training pathway from start to finish in order to map your NHS career effectively.
Furthermore, greater understanding of the NHS structure and training offered to doctors in the UK will help an IMG to understand at what grade they can likely enter the system and the salary most appropriate for them.
The NHS Training Pathway describes the journey from medical school to completion of specialist training and is the path most commonly followed by UK trainees.
Graduation to Foundation Training
After graduating from a medical school, doctors gain provisional registration with the GMC allowing them to enter the Foundation Programme - a two-year work-based training programme.
Upon completion of the first year (FY1 or F1) doctors will gain full registration with the GMC and can apply for further study and training in a specialised area – known as Core or Specialty Training, depending on the specialty.
Specialty Training Programmes
Completion of the Foundation Programme allows doctors to apply for Specialty Training in an area of medicine or general practice. There are 60 different specialties to choose from.
A doctor entering year one of Specialty Training is known as an ST1 or CT1 doctor.
Specialty Training programmes can take between three and eight years depending on the specialism chosen.
Doctors can pass through the training quicker depending on how fast they achieve their competencies.
Sometimes doctors do not complete the training pathways in the indicated time for a variety of reasons and it can take between 1 - 4 years longer than indicated in the curricula.
Types of Specialty Training Programmes
There are two different structures for Specialty Training programmes, and these vary between specialties.
Run-through Training Programmes
For these training programmes, you only have to apply once at the beginning of the programme. This is because you are recruited for the full duration of Specialty Training.
These training programme can last from approximately three years for general practice, to five or seven for other specialties such as histopathology.
Uncoupled Specialty Training Programmes
These programmes are split into Core Training and Higher Specialty Training.
Core Training lasts for either two or three years and once complete, allows you to apply for Higher Specialty Training, which can take from three to five years.
Overall, Specialty Training programmes can take anywhere from 5 – 8 years in their entirety, depending on your medical specialty, for example 6 years for psychiatry.
Doctors are known as ST1-3 or CT1-3 during their Core Training and ST4+ level during Higher Specialty Training programmes.
Higher Specialty Training programmes are very competitive, and completion of a UK Core Training programme does not guarantee a Higher Specialty Training post.
Completion of Specialty Training Programme
Upon successful completion of either a run-through or coupled training programme, doctors are awarded a Certificate of Completion of Training (CCT).
At this point doctors are able to make an application for Specialist Registration (or GP Registration) and are able to take up permanent consultant posts.
Training Positions vs Service Posts
As above, competition for places on training programmes within the NHS is very high. As such, we advise that IMGs who are interested in entering core or specialty training in the NHS first obtain a service post for 1 – 2 years.
Following this contract, you can apply for a training post, for which you will be given priority. Not only will this approach give you the best chance of securing excellent training and career progression opportunities in the NHS, it will also give you the chance to settle in to the UK and the NHS system, and help you understand the training post that will suit you the most.
Service posts also offer very competitive rates, so whilst you are getting to know the NHS and settling into life in the UK, you can also ensure that you are financially rewarded.
Specialist Registration for IMGs
IMGs that enter the UK training programmes later on and have not completed the full programme can still get on the specialist register via the CESR-CP route (Certificate of Eligibility for Specialist Registration via a Combined Programme)
Check to see if you're eligible for CESR-CP via the GMC website or read through our detailed blog through our IMG Resources library.
Secure a Trust Doctor Post (with the view to securing a training post at a later date)
You can apply for Trust Doctor or Service Role online via the NHS Jobs website.
However, working with IMG Connect can offer more jobs than are available online with the added benefit of an IMG Consultant speaking directly with services on your behalf to expedite the process and negotiate the best doctor salary for you.
Getting started
Read more useful articles on finding an NHS trust doctor job, training pathways, doctor salaries in the UK, relocation and much more!
Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once as an IMG new to the UK.
For the latest news and updates, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation:
As there is no hard and fast rule for what position you will have after gaining a UK qualification, it is important for IMGs to understand the posts that are available to you after completing FRCR (Oncology).
FRCR (Oncology) is a highly beneficial qualification to achieve, but it does not guarantee you a consultant position in the NHS.
This can be a confusing area for overseas clinical and radiation oncologists, but this blog aims to de-mystify the subject. This article will explain the following topics:
What is FRCR (Oncology) and how does it fit into the UK training programme?
What grade will IMGs, new to the NHS, be offered with FRCR (Oncology)?
Can I take a permanent consultant post if I have FRCR (Oncology)?
CESR opportunities for clinical oncologists in the NHS
Skip ahead to the relevant section if you know what you’re looking for.
FRCR (Oncology) within the UK Oncology Training Programme
Fellowship of the Royal College of Radiologists (Oncology) or FRCR (Oncology) is the postgraduate qualification awarded by the Royal College of Radiologists, the body responsible for the specialties of clinical oncology and clinical radiology throughout the UK.
FRCR (Oncology) is a three-part exam which is a necessary part of the training programme of clinical oncologists in the UK.
For trainees who have chosen to pursue clinical oncology, FRCR (Oncology) Part 1 or CO1 must be passed by the end of ST4.
Clinical oncology trainees will then sit Final FRCR (Oncology), also known as Part 2A and 2B or CO2A and CO2B, usually from ST6 to ST7.
These final exams are important in that they assess a trainee’s knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.
Any UK-trained clinical oncologist applying for a CCT in order to work as a substantive consultant must have completed full FRCR (Oncology).
As shown above, UK trainees will also have completed MRCP (UK), although this is not required for overseas clinical oncologists.
Positions for Doctors new to the NHS with FRCR (Oncology)
As an IMG with full FRCR (Oncology), you will be eligible for consultant grade positions in the UK.
You are not guaranteed a consultant position, particularly if you do not have previous consultant position in your home country, but you will certainly be able to attain more senior positions in the NHS, such as a specialty doctor (SAS) or specialist grade.
Consultant positions are the most senior in the UK, and thus the highest paid position for doctors within the NHS pay system.
For further information on how NHS pay scales work for consultants, please see our detailed article here.
Of course, this is assuming that you have also completed the other necessary components to make you eligible for GMC registration.
Alongside your postgraduate qualification, you will need to have passed an English Language Test (either IELTS or OET).
Additionally, you must obtain a Certificate of Good Standing, and submit this to the GMC. Upon the receipt of these three components, you will receive full GMC registration.
Permanent Consultant Posts with FRCR (Oncology)
To take up a permanent consultant position in the NHS, you would need to have Specialist Registration. Specialist Registration (more specifically CESR for most overseas doctors) allows you to take up permanent or substantive consultant roles in the NHS.
The type of consultant position you would be eligible for with FRCR (Oncology) is a locum consultant post.
Firstly, we should clarify the meaning of the term ‘locum consultant’ in the UK. The NHS has two types of locums - Trust locums and Agency locums.
If you are an IMG with full registration, but you are not on the Specialist Register, you are only able to take on consultant positions as a trust locum, but no permanent positions.
Trust locums are hired on a fixed-term contract and are able to better acclimatize themselves to the NHS system, whilst receiving the support and guidance to work towards consultant positions and CESR.
Please note, you can only work as an agency locum if you have a British passport.
CESR Opportunities in the NHS
CESR or the Certificate of Eligibility for Specialist Registration is a route of entry to the Specialist Register for those doctors who have not followed a GMC-approved training programme.
You can read more about CESR in Clinical Oncology through our IMG Resources library here.
IMG Connect are able to help you to secure senior roles such as specialty doctor (SAS), specialist grade or locum consultant in Trusts that offer CESR support.
In these roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. These Trusts have a lot of experience in supporting overseas doctors to progress their careers through CESR.
You can collect evidence of your competences, particularly those specific to the UK Clinical Oncology curriculum and those you may not be able to achieve outside the UK.
These positions also facilitate a faster route to the UK than applying directly through the CESR route, which can take a substantial amount of time.
Get in touch with us to find out more about senior positions in the NHS with CESR support.
Getting started
We hope this blog has been helpful in clarifying your questions about securing senior posts in the NHS with FRCR (Oncology). If you have any further questions regarding the postgraduate exams, CESR or Oncology in the NHS - feel free to contact us directly.
Join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncologists and dedicated oncology recruiters.
In this group you will find tailored support for oncology IMGs, including access to our NHS and CESR webinars, completely free to all doctors.
You can access our IMG Oncologists community here.
Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.
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.
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:
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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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.
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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.