Understanding the status of your qualifications when registering with the GMC is critical to finding the best registration route for you and streamlining your journey to the UK and working in the NHS.   The breadth of global postgraduate oncology qualifications can confuse overseas oncologists as to the status of their qualifications in the UK. This blog aims to simplify subject, covering the following topics:   How do I register with the GMC as a European specialist? EEA Countries GMC-accepted EEA Primary Medical Qualifications (PMQ) GMC-accepted EEA Specialist Qualifications I am on the Specialist Register - what type of post can I be offered? Skip ahead to the relevant section if you know what you’re looking for.  GMC Registration for European Specialists When applying for GMC registration, all doctors must provide evidence of sufficient skills and knowledge. For oncologists from certain European countries (those within the European Economic Area or EEA), there is a group of relevant European qualifications which are accepted as sufficient evidence of skills and knowledge to practise in the UK.  These are Primary Medical Qualifications and European Specialist qualifications which provide eligibility for Full and Specialist Registration respectively.  European Economic Area (EEA) Countries These are the countries from which a relevant European qualification would be accepted by the GMC*:  Austria  Germany  Netherlands  Belgium  Greece  Norway  Bulgaria  Hungary  Poland  Croatia  Iceland  Portugal  Cyprus  Ireland  Romania  Czech Republic  Italy  Slovakia  Denmark  Latvia  Slovenia  Estonia  Lithuania  Spain  Finland  Luxembourg  Sweden  France  Malta  Switzerland  *When determining the eligibility of your EEA qualification, it is important to check the given dates and evidence required by the GMC for acceptance.  EEA Primary Medical Qualifications If your primary medical qualification was awarded by a medical school in an EEA country, it may be a relevant European qualification. Oncologists with an EEA PMQ are eligible for full GMC registration with licence to practise.  You can find out whether your PMQ is eligible and what qualifications and evidence you need to send to the GMC to support your application here or by selecting your country from the table above.  EEA Specialist Qualifications If your specialist qualification was awarded after the completion of an EEA training programme, it may also be a relevant European qualification. Oncologists with an EEA specialist qualification are eligible for direct entry to the GMC’s Specialist Register.  You can find out whether your European Specialist Qualification is eligible by searching for oncology within this list and checking whether your country’s evidence is accepted (if your country’s field is blank for oncology, your qualification would not be accepted for Specialist Registration).  You can then check what qualifications and evidence you need to send to the GMC to support your application here or by selecting your country from the table above.  NHS Posts for European Oncologists on the Specialist Register The NHS post you would be eligible for as a European oncologist would be dependent on your level of experience with your postgraduate qualifications taken into account.  If you are on the Specialist Register for clinical or medical oncology, you are eligible fo substantive consultant positions in the NHS - meaning you can be offered a permanent consultant contract to work in the NHS. Without GMC Specialist Registration, you can still work as a locum consultant on a fixed-term contract, and attain Specialist Registration via the CESR Portfolio Pathway. Oncology Consultants are in high demand in the UK, and thus command competitive rates of pay.   As a Consultant Oncologist, the pay you will earn can be broken down as follows:  Basic salary for 40 hours per week or 10 PAs (programmed activities)  Pay for additional hours worked  37% premium for night hours worked  Weekend allowance for hours worked  On-call allowance  There are also other wage premiums that may be offered.  You can find the latest pay scales for NHS Consultants across the UK here.   Please use these pay scales as a guide, but bear in mind that you may be eligible for a different rate of pay than stated, based on experience and/or demand. It is therefore worth checking what you may be entitled to with your IMG Consultant.  Sources https://www.gmc-uk.org/registration-and-licensing/join-the-register/eea-countries   IMG Connect are here to help We hope this helps to clear up any doubts around registering to work in the UK as an EEA oncologist and securing an NHS post.  Get in touch with our oncology team if you have any further questions regarding EEA entry to the NHS, CESR or oncology in the NHS more broadly.              

This article delves into the specific guidance on GMC applications for entry onto the UK Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for clinical oncologists.  We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:  What is CESR and who is it for? Do overseas oncologists need FRCR (Oncology) for CESR? What is the CESR equivalence process? What evidence is required for a CESR in clinical oncology? Where will I find this evidence? How do I submit a CESR application? How long does it take to complete? How much does CESR cost? How long does it take to receive a decision? Do I have to complete CESR before I can work in the UK? #IMG Tips Skip ahead to the relevant section if you know what you’re looking for.  An Introduction to CESR CESR, or the Certificate of Eligibility for Specialist Registration, is the route to specialist registration for doctors who have not completed a GMC-approved training programme, but can demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of the CCT in the UK.   CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a clinical or radiation oncologist, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.  Oncologists must prove to the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question.   In order to be eligible for CESR, doctors should have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist experience or knowledge as a clinical oncologist within a non-training post.  Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced oncologists will secure a post in the UK, and work towards CESR whilst in post.   FRCR (Oncology) for Specialist Registration Whilst it is always beneficial to complete FRCR (Oncology), particularly for doctors who have trained outside the UK or an EEA country, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the Clinical Oncology curriculum is the FRCR exams, so passing these exams confirms the attainment of the competencies of the core curriculum.  FRCR (Oncology) is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  Similarly, UK trainees would have completed MRCP (UK) before beginning their clinical oncology training, which is also not required for oncologists going through the CESR route.  However, CESR applicants who have not successfully completed these exams must provide alternative evidence that demonstrates equivalent knowledge to oncologists who have passed the FRCR (Oncology) exams and the appropriate level of non-oncology expertise and that you can appropriately manage the acutely unwell patient.  Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside the evidence presented.  You can read more about the evidence required in the specialty specific guidance here.  The CESR Equivalence Process Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current clinical oncology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence; AND  skills and knowledge  The Royal College of Radiologists will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Clinical Oncology Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the clinical oncology curriculum. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of Evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:    Domain 1 – Knowledge, skills and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  Gathering Evidence for a CESR Application Domain 1 – Knowledge, skills and performance  Qualifications  Primary Medical Qualification (PMQ)  Specialist medical qualification(s)  Curriculum or syllabus (if undertaken outside the UK)  Specialist registration outside the UK  Honours and prizes  Other relevant qualifications  Assessments and appraisals Appraisals and assessments  RITAs, ARCPs and training assessments  360˚ and multi-source feedback  Awards and discretionary points letters  Personal development plans (PDP)  Logbooks, records of daily clinical practice and portfolios Logbooks  Consolidation, cumulative data sheets, summary lists and annual caseload statistics  Medical reports  Case histories  Referral letters discussing patient handling  Patient lists  Departmental (or trust) workload statistics and annual caseload statistics  Rotas, timetables and job plans  Courses relevant to curriculum  Portfolios (electronic or revalidation)  Details of posts and duties (including both training and experience posts) Employment letters and contracts of employment  Job descriptions  Job plans  Research, publications and presentations Research papers, grants, patent designs  Publications within specialty field  Presentations, poster presentations  CPD and CME CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences  CPD registration points from UK Medical Royal College (or equivalent body overseas)  Membership of professional bodies and organisations  Teaching timetables  Lectures  Feedback or evaluation forms from those taught  Letters from colleagues  Attendance at teaching or appraisal courses  Participation in assessment or appraisal and appointments processes  Domain 2 – Safety and quality  Participation in audit, service improvement Audits undertaken by applicant  Reflective diaries  Service improvement and clinical governance meetings  Safety Health and safety  Domains 3 - Communication, partnership and teamwork  Communication  Colleagues  Patients  Partnership and teamwork Working in multidisciplinary teams  Management and leadership experience  Chairing meetings and leading projects  Domain 4 – Maintaining trust  Acting with honesty and integrity Honest and integrity  Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)  Data protection  Relationships with patients Testimonials and letters from colleagues  Thank you letters, cards from colleagues and patients  Complaints and responses to complaints  For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for clinical oncology.  Validating Evidence   Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.   All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.  Application Submission All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.  Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.  Your electronic evidence can be in any of the following formats:  .doc  .pdf  .ppt  .xls  Formats outside of these are unlikely to be accepted.  The Online Application You will be required to complete the following sections once you begin your application:  Specialty details  Qualification details and professional experience  Details of your referees  Registration and licensing history  Evidence summary  Details of your verifiers  Final declaration and payment  Additional Evidence  Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:   What evidence they’ve accepted   What evidence they’re unable to accept (including the reasons for this)   Advice and guidance on how your application could be strengthened   You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).  For further information about the online application process, see the GMC’s User Guide.  How long does it take to complete? As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in clinical oncology is seven years (not including Foundation Training), so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior clinical or radiation oncologists.  Cost of CESR Applications All oncologists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,727.  For CESR-CP and CCT, the cost is £452.  How long does it take to receive a decision? The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  Clinical Oncology Jobs in the NHS without CESR Overseas doctors do not require CESR to work in the UK.  There are also roles for more senior oncologists such as a specialty doctor (SAS), specialist grade or acting consultant, where you will likely receive better pay and responsibilities that are more appropriate to your level of experience. While working in these positions, you can also collect evidence of your competences, particularly those specific to the UK clinical oncology curriculum.  Across the UK there are several NHS Trusts with well-established CESR programmes of support for oncology who have taken up a fixed term post with the view to completing CESR.   These positions also facilitate a faster route to working in UK and attaining Specialist Registration when compared to making an application for CESR from overseas, which can take an additional amount of time, depending on the country in which you completed your training.  #IMG Tips Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.   Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.   Ensure that the evidence you collect demonstrates your competence across the whole of the Clinical Oncology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Clinical Oncology CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress.  Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).  Ask an IMG Connect recruitment specialist about NHS oncology posts with CESR support. These are not always advertised by a Trust, but we can help you find a role which aligns well with your career goals in the NHS.  Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncology CESR aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology, including guidance on CESR applications, completely free to all doctors. You can access our IMG Oncologists community here. Sources https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration   https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr  https://www.gmc-uk.org/-/media/documents/sat---ssg---clinical-oncology---dc3556_pdf-48456770.pdf   https://www.rcr.ac.uk/sites/default/files/clinical_oncology_curriculum_2021.pdf   Getting started Many senior IMG oncologists looking to develop their careers through Specialist Registration with the GMC may be eligible via the CESR route, and attaining CESR can be a long but very rewarding process. Look at our introduction to CESR for clinical oncologists for a full overview.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS.              

In this article, we’ll be taking a closer look at the specific guidance on NHS applications for entry onto the Specialist Register through the Certificate of Eligibility for Specialist Registration (CESR) for medical oncologists.  We’ll cover the eligibility criteria, application process, and most importantly the required evidence, along with some other topics, summarised in the headings below:  What is CESR and who is it for? Do overseas oncologists need MRCP for CESR? What is the CESR equivalence process? What evidence is required for a CESR in medical oncology? Where will I find this evidence? How do I submit a CESR application? How long does it take to complete? How much does CESR cost? How long does it take to receive a decision? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  An Introduction to CESR CESR, or the Certificate of Eligibility for Specialist Registration, is the route to specialist registration for doctors who have not completed a GMC-approved training programme, but can demonstrate that their specialist training, qualifications and experience are equivalent to the requirements for the award of the CCT in the UK.   CESR holders can be appointed to substantive (or permanent) consultant positions in the NHS. As a medical oncologist, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.  Oncologists must prove to the GMC that their specialist training or specialist qualifications, when considered together, are equivalent to a CCT in the specialty in question.   In order to be eligible for CESR, doctors should have undertaken a minimum of 6 months training or obtained a specialist qualification and acquired specialist medical experience or knowledge as a medical oncologist within a non-training post.  Overseas doctors do not require CESR before moving to the UK to work in the NHS. Often, experienced oncologists will secure a post in the UK, and work towards CESR whilst in post.   MRCP for Specialist Registration Whilst it is always beneficial to complete MRCP (UK), particularly for doctors who have trained outside the UK or the EEA, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the Medical Oncology curriculum is the MRCP (UK) exams, so passing these exams confirms the attainment of the competencies of the core curriculum.  MRCP (UK) is only a requirement for doctors looking to attain Specialist Registration via the CCT or CESR-CP route.  The structure of medical oncology training in the UK is an indicative two years in Core Medical Training or Acute Care Common Stem (ACCS), followed by an indicative four years of training in Medical Oncology. Therefore, applicants need to demonstrate the appropriate level of acute medicine expertise as well as competencies in medical oncology.  You can read more about the evidence required in the specialty specific guidance here.  CESR Equivalence Process Equivalence refers to the process of assessing an overseas applicant’s training and experience against the current medical oncology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence; AND  skills and knowledge  The Royal College of Physicians will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Medical Oncology Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Medical Oncology curriculum. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit & Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of Evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 – Knowledge, skills and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  Gathering Evidence for a CESR Application Domain 1 – Knowledge, skills and performance  Qualifications  Primary Medical Qualification (PMQ)  Specialist medical qualification(s)  Curriculum or syllabus (if undertaken outside the UK)  Specialist registration outside the UK  Honours and prizes  Other relevant qualifications  Assessments and appraisals Appraisals and assessments  RITAs, ARCPs and training assessments  360˚ and multi-source feedback  Awards and discretionary points letters  Personal development plans (PDP)  Logbooks, records of daily clinical practice and portfolios Logbooks  Consolidation, cumulative data sheets, summary lists and annual caseload statistics  Medical reports  Case histories  Referral letters discussing patient handling  Patient lists  Departmental (or trust) workload statistics and annual caseload statistics  Rotas, timetables and job plans  Courses relevant to curriculum  Portfolios (electronic or revalidation)  Details of posts and duties (including both training and experience posts) Employment letters and contracts of employment  Job descriptions  Job plans  Research, publications and presentations Research papers, grants, patent designs  Publications within specialty field  Presentations, poster presentations  CPD and CME CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences  CPD registration points from UK Medical Royal College (or equivalent body overseas)  Membership of professional bodies and organisations  Teaching timetables  Lectures  Feedback or evaluation forms from those taught  Letters from colleagues  Attendance at teaching or appraisal courses  Participation in assessment or appraisal and appointments processes  Domain 2 – Safety and quality Participation in audit, service improvement Audits undertaken by applicant  Reflective diaries  Service improvement and clinical governance meetings  Safety Health and safety  Domains 3 - Communication, partnership and teamwork Communication Colleagues  Patients  Partnership and teamwork Working in multidisciplinary teams  Management and leadership experience  Chairing meetings and leading projects  Domain 4 – Maintaining trust  Acting with honesty and integrity Honest and integrity  Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)  Data protection  Relationships with patients Testimonials and letters from colleagues  Thank you letters, cards from colleagues and patients  Complaints and responses to complaints  For more guidance on the different types of evidence, see the specialty specific guidance from the GMC for medical oncology.  Validating Evidence Original documents which are on headed paper with a hospital stamp and original signatures do not need additional validation.   All photocopied evidence should contain a hospital stamp on every page of each document, the validator’s name (printed and in full), job title (printed and in full) and original signature.  Application Submission All CESR applications are submitted online via GMC Online and if you have not already created an account, you can find a guide on how to do so here.  Electronic evidence is required for each of the different evidence sections of the CESR application. Once started, the online application remains open for 12 months, meaning that it can be used as a portfolio to gather evidence against each of the different sections.  Your electronic evidence can be in any of the following formats:  .doc  .pdf  .ppt  .xls  Formats outside of these are unlikely to be accepted.  The Online Application You will be required to complete the following sections once you begin your application:  Specialty details  Qualification details and professional experience  Details of your referees  Registration and licensing history  Evidence summary  Details of your verifiers  Final declaration and payment  Additional Evidence  Once an Adviser on the Specialist Applications Team has reviewed your initial evidence, they will provide you with information on:   What evidence they’ve accepted   What evidence they’re unable to accept (including the reasons for this)   Advice and guidance on how your application could be strengthened   You’ll have up to 60 days to provide additional documentary evidence in support of your application (30 days if you’ve submitted a Review application).  For further information about the online application process, see the GMC’s User Guide.  How long does it take to complete? As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in medical oncology is six years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior oncologists.  Cost of CESR Applications All oncologists applying for Specialist Registration must pay a fee. For CESR, this fee is £1,727.  For CESR-CP and CCT, the cost is £452.  How long does it take to receive a decision? The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  #IMG Tips Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.   Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.   Ensure that the evidence you collect demonstrates your competence across the whole of the Medical Oncology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Medical Oncology CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress.  Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).  Ask an IMG Connect recruitment specialist about NHS oncology posts with CESR support. These are not always advertised by a Trust, but we can help you find a role which aligns well with your career goals in the NHS.  Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded MRCP aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors. You can access our IMG Oncologists community here. Sources https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration   https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr  https://www.gmc-uk.org/-/media/documents/sat---ssg---medical-oncology---dc2310_pdf-48455474.pdf  Getting started  Attaining Specialist Registration through the CESR pathway can be a long but very rewarding process. Look at our introduction to CESR for medical oncologists for a full overview.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:              

Here we take a closer look at the Medical Training Initiative (MTI) for international doctors practicing medicine and its sub-specialties.  Whilst the MTI describes a UK-wide placement scheme for junior overseas doctors, the processes involved vary between specialties.   This blog focuses on the MTI scheme as administered by the RCP, and the particular of this are summarised below along with a broad look the following:  What is the Medical Training Initiative? What is the RCP and what support does it provide throughout my training? Am I eligible for an MTI post? Are there any additional requirements for the RCP? How can I use the MTI for GMC registration? What does the application process for the MTI through the RCP involve? How am I supported in obtaining a visa? I’m coming to the end of the MTI, what’s next? Skip ahead to the relevant section if you know what you’re looking for.   The Medical Training Initiative The Medical Training Initiative, or MTI, is a training programme that provides junior doctors from all over the world the opportunity to gain clinical training and development in the UK for a maximum of 24 months.  The MTI as a training scheme is mutually beneficial for both junior doctors and the NHS, in that doctors from several countries and specialisms around the world can work and train in the UK, gaining knowledge and experience which they can take back to their home country, while giving NHS Trusts a high-quality, longer-term alternative for unfilled training vacancies and rota gaps.  Royal College of Physicians (RCP) The Royal College of Physicians is the professional body that regulates medicine specialties in the UK, and Membership of the Royal College of Physicians (MRCP) is the full qualification attainable by examination.  Take a look at IMG Resources library for complete guides on MRCP to learn more.  There are several ways you will be supported by the RCP as listed below:  Induction – all MTI candidates are expected to attend an induction at the RCP. The induction is held on a quarterly basis  Free ePortfolio access – this is an electronic portfolio to log all your assessments and training whilst in the UK  Free RCP associate membership – this is for the first year and discounted rate for the second year and comes with a number of benefits  Annual symposium – this is a clinical conference for all RCP MTIs held once a year  Diploma in UK Medical Practice – participants are required to carefully document their training using the ePortfolio system, complete a range of continuing medical education sessions, and submit a written reflection piece at the end of their placement  RCP certificate - at the end of training there is an RCP certificate available to all candidates  Support for any issues that you might encounter relating to your training  Eligibility The MTI has been designed specifically with junior doctors in mind, therefore sponsorship will not be offered to consultants, specialty doctors or for locum-appointed service posts (LAS).   The eligibility criteria differ among MTI programmes, but for the RCP, eligibility includes the following:  Country Requirements - Priority is given to doctors from countries classified as low income or lower middle income by the World Bank and priority countries as described by the Department for International Development. Doctors from outside these countries may also apply, but there may be a long wait time and no guarantee of acceptance.  Primary Medical Qualification: You must hold a recognised PMQ by the GMC and verified by Educational Commission for Foreign Medical Graduates (ECFMG)  Have a Postgraduate Medical Qualification: This can be MRCP Part 1, MD or other higher degree in medicine or a medical subspecialty  Skills & Competencies: You must possess the skills, competencies and understanding of medicine at least equivalent to a UK graduate at the end of their core medical training.  Clinical Experience: You must have 3 years post-qualification experience, including 1 year's internship and at least 1 year in the specialty in which you intend to train while in the UK  Active Medical Practice: Candidates must have been actively practicing clinically for at least three out of the last five years including the past 12 months before the application as well as throughout the application process (the GMC does not consider clinical observerships as clinical practice).  Please note, the RCP cannot sponsor doctors who have failed the Professional and Linguistic Assessments Board (PLAB) test.  Additional Requirements Before you can make an application for the MTI scheme through the RCP, the following criteria must be satisfied:  Verification of PMQ – your primary medical qualification must be independently verified by the ECFMG via their EPIC service.  Complete an English Language test – the test must have been completed within two years of application for GMC registration.  Find an NHS job before applying for the MTI – you are required to apply directly for an NHS post and should have already been formally offered the role before contacting the RCP. The hospitals should also be in support of your intention to seek sponsorship for the post.   Obtain funding - you should already have funding for your post from either a scholarship, official funding, or a salary. The funding should be equivalent to a UK salary for the level of work being undertaken and must last for the duration of the post. The RCP will not sponsor applicants who are self-funded.  Certificate of Good Standing - you must be able to provide a certificate of good standing (CGS) from the regulatory body in the countries where you have practised in the last 5 years. The CGS should be no older than 3 months when submitted.  GMC Registration All doctors practicing in the UK must be registered with the GMC. For MTI candidates, registration is typically supported by the Royal College, but some NHS Trusts also have the right to register MTI doctors.  English Language Testing – candidates will also need to provide evidence of English language skills. This can be done by passing either IELTS with overall score of 7.5 and 7.0 in all categories or OET with minimum grade B in all categories. Further information on these tests can be found below:  IELTS – a guide for overseas doctors  OET – a guide for overseas doctors  Application Process Once you fulfill all the eligibility criteria and additional requirements laid out by the RCP, you must complete the initial and professional postgraduate experience (PPE) forms and email these along with your CV to mti@rcplondon.ac.uk.  Once your CV, initial form and PPE forms have been received, the RCP will contact the supervising consultant in the UK and confirm the details of your post. You will then be sent an application pack. You should complete the application form and send it to the RCP with all of the following documents:  sponsor form (forms will be provided by the RCP) – must be completed by your consultant or head of department in your home country  two reference forms (forms will be provided by the RCP)  copy of your passport  copy of your IELTS/OET certificate or details of exemption  copies of your medical qualifications  translations of your medical qualifications if they are not in English  letter from the dean of the medical school from which you graduated  copy of certificate of good standing  letter from the UK hospital confirming your appointment  evidence of funding for the post  your statement agreeing to the level of funding which you have received from any of the sources listed  initial fee of £125  We’ve detailed the general processes involved in MTI applications through the RCP below, from a candidate securing an NHS post, to their eligibility to work in the UK after gaining GMC registration and securing a visa.  Tier 5 Visa for MTI The MTI scheme falls under the Tier 5 government authorised exchange visa. This visa must only be used for travel to the UK at the beginning of the placement and will activate after your arrival, lasting for exactly 24 months from your arrival date.  For a Tier 5 MTI visa, the RCP needs to provide evidence regarding your post to the Academy of Medical Royal Colleges (AoMRC - the official visa sponsor) once the GMC has approved your application in order to get your Tier 5 Certificate of Sponsorship (CoS) issued.   Once your Tier 5 CoS has been issued it is your responsibility to apply for the Tier 5 visa via https://www.gov.uk/browse/visas-immigration/work-visas. Applications for Tier 5 visas must be made in your home country (or the country you work in), but never from within the UK.  You can also apply to the AoMRC for Tier 5 dependent visas for your spouse and children, although this is not guaranteed, and you should read the UKVI requirements on this well in advance.  Please note that Tier 5 visas cannot be extended.  Sources  https://www.rcplondon.ac.uk/education-practice/advice/medical-training-initiative-resources-applicants  https://www.rcplondon.ac.uk/education-practice/advice/medical-training-initiative   https://www.rcplondon.ac.uk/file/19236/download  https://www.rcplondon.ac.uk/file/23841/download   https://www.rcplondon.ac.uk/file/4534/download?token=QyAzDCP8   What are my options after I complete the MTI? Ordinarily, on completion of the MTI scheme, doctors return to their home country with the training and experience they gained from working in the NHS.  Some doctors may want to remain in the UK after completing the MTI for a number of reasons. This can be done if the doctor finds another NHS post, in which case, they may be able to switch from the Tier 5 visa to the Tier 2 Health and Care Worker visa.  If you want to find another NHS post after completing the MTI, you would follow the same process as any other doctor. You will need to consider what job it is you would like to obtain and what location in the UK you would prefer to relocate to.  For guidance on NHS jobs in your specialty, please see our live jobs or get in touch with us to learn more about your options in the NHS. For regular news and updates on the Royal Colleges, GMC registration and working in the NHS, follow us on social media and join the conversation:              

Exam places for MRCP PACES have been hard to secure in some countries. This increase in demand has continued through to 2023, so what can you do to maximise your chances of securing an examination place?  The Royal College of Physicians has advised that they are working to grow capacity internationally. However, this will not have an immediate impact on the number of spots available across the world.  With so many overseas doctors missing out on a spot, we have put together some of the main discussion points to help you to broaden your chances of sitting the exam as soon as possible.  All applications submitted during the application period will be treated equally, with spaces being allocated using a random lottery model. Some spaces are reserved for local trainees and some priority can be given for applicants near the end of their eligibility periods.  So, to maximise your chance of success, we suggest that not only do you apply to your closest PACES exam centre, but also to 3 more centres that you are able to travel to.  Apply to more centres Why should I apply for more centres? More applications equals more chance of securing a place. They way that it works is that if you are not successful with your 1st preference (most local centre), then you will be considered for a space in your 2nd choice centre, and so on until you secure a spot.  Of course, this means that you must be willing to travel to sit the exam. This can be costly, especially if you have to travel to a different country, flights and hotels are not cheap! As such, we suggest taking some time to carefully choose the locations that will not only have the possibility of a spare place, but where your costs will be kept to a minimum.  Candidates will be notified on the outcome of their application within 2 weeks from the closing date, giving you time to plan your travel if necessary.  Whilst this advice does not guarantee a place to sit the exam, it will increase your chances.  If you are not sure what to do, or have any other questions regarding the PACES exam, get in touch with an IMG Connect specialist. Take a look at our IMG library for more information regarding postgraduate exams & PACES 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 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:             

PACES is the final exam in the MRCP UK examination series. Attaining full MRCP UK will facilitate registration with the GMC for overseas doctors, allowing you to secure a job in one of the many medical specialties in the NHS, depending on your experience and specialisation. In this article we will consider the following:  What is PACES? Am I eligible to sit MRCP PACES? What is the content and format?  How is PACES marked?  As an overseas candidate where can I take the exam? When should I take PACES? How can I prepare for the exam?  Passed? What next?  What is PACES? The Practical Assessment of Clinical Examination Skills (PACES) is designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialist training (ST3). The exam sets rigorous standards to ensures trainees are competent across a wide range of skills and are ready to provide high-quality care to patients. Am I eligible to sit MRCP PACES? You must have passed the Part 1 written examination within the last seven years before taking PACES. The Royal College strongly advises trainees to apply after competing two years practical experience and Part 2 of the examination. What is the content and format?  PACES is based on a format that is similar to OSCEs, a practical assessment in a clinical setting. There are five clinical stations with either patients with a given condition, or trained stand-ins (surrogates).  The exam is sat over a half-day and assesses seven core skills over five stations. IMGs can expect eight patient encounters assessed independently by a total of ten examiners (two at each station).  The seven core skills: Physical examination – demonstrate correct, thorough, systematic, appropriate and professional technique of physical examination. Identify physical signs – identifying physical signs correctly. Clinical communication – elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough and professional manner. Differential Diagnosis – create a sensible, clinically assessed differential diagnosis for a patient. Clinical Judgment – select an appropriate management plan for a patient or clinical situation. Select appropriate investigations or treatments for a patient that the candidate has clinically assessed. Managing patients concerns – seeks, detect, acknowledge and address patients or relatives concerns, confirming their understanding and demonstrate empathy. Maintain patient welfare – treat a patient or relative respectfully and sensitively in a manner that ensures their comfort, safety and dignity. The PACES Carousel: The Carousel consists of five stations, each assessed by two independent examiners. Candidates start at any of the five stations, moving round the carousel at 20-minute intervals, until completed. A five-minute period between each station is given.  Candidates are marked on clinical skills at each encounter in the examination. An encounter is when a candidate has an interaction with a patient or a surrogate. Stations 2 and 4 involve one encounter, whereas stations 1, 3 and 5 have two encounters.  How is PACES marked?  PACES is marked on seven skills, A-G, these are:  Skill A: Physical examination (stations 1, 3 and 5) Skill B: Identifying physical signs (stations 1, 3 and 5) Skill C: Clinical communication (stations 2, 4 and 5) Skill D: Differential diagnosis (stations 1, 2, 3 and 5) Skill E: Clinical judgement (all stations) Skill F: Managing patients’ concerns (all stations) Skill G: Maintaining patient welfare (all stations) Skill B, identifying physical signs, is often considered the most challenging skill to pass. As an overseas candidate, where and when can I take the exam? It is a little more complicated than Part 1 or 2 exams and exam slots are often in short supply. Whilst the Royal College is working hard to increase the number of spaces, it is not always possible to offer a place to all applicants. Priority is given to those candidates who are near the end of their stage 2 eligibility period. A full list of examination dates can be found here, please note these are subject to change. Examination centres are subject to change, so for up-to-date information, please see the Royal College website here. The examination is run at clinical centres across the UK (England, Scotland, Wales and Northern Ireland); these vary from diet to diet. When should I take PACES? Royal College performance data provides some food for thought when considering when to apply for PACES. The data suggests: Wait at least 36 months after graduation before applying. Those taking the exam before this period were less likely to pass. 24-36 months post-graduation – 50% pass rate 36-48 months after graduation – 77% Candidates that had already passed part 1 & 2 written examinations were significantly more likely to pass PACES at first attempt. How can I prepare for the exam?  With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:  Curriculum: Applicants are tested on a range of common and important disorders in General Medicine as set out in the Joint Royal Colleges Specialty Training Curriculum for Core Medical Training. We recommend getting to know the curriculum as early as possible, using it as a road map for your study plan.  It is recommended that to give yourself the best chance, you gain clinical experience involving care of emergency patients, adults and children.We advise you to regularly invite senior colleagues to observe and provide feedback on your clinical assessments, so you will be comfortable with the PACES format and give you confidence in approaching and examining patients with examiners present. PACES station 4 examiner guidance examples: This useful guide contains examples of the types of statements found in the examiner guidance section of station 4 scenarios.  This will help you to understand what the examiner is looking for.  PACES sample scenarios: These will provide you with the most accurate and relevant scenarios to prepare you for the real thing. Sample scenarios cover Station 2, 4 & 5 (‘history taking’, ‘communication skills and ethics’ and ‘clinical consultations’ respectively. Most of these have been previously used in a recent exam, but please note that during the exam you will only receive the section marked ‘information for the candidate’. Videos on what to expect on the day: These helpful videos will give you a true reflection of what to expect on the day of the exam, easing some of the pressure and ensuring you can focus on the task at hand.  PACES candidate video: Whilst there are lots of useful videos online that are easy to find, the PACES candidate video contains important information about the exam, and practical examples of how the exam will run.  Candidate guide notes: these guidenotes created by the Royal College help IMGs to understand what to expect on the day, from your arrival to the completion of the test.  It can also be useful to understand how IMGs have failed the exam in the past, as this will give you the best chance to pass first time. The ‘how I failed PACES’ guide provides tips to help you to identify where you might be going wrong, along with practical advice to help you to improve.  For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses - take a look at our blogs on exam tips and preparation.  Passed? What next?  First of all, congratulations! After you have passed all parts of MRCP (UK) you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.  IMG Jobs Specialise in gastroenterology, respiratory, neurology, dermatology, geriatrics or any other areas within specialist medicine? Search and find live specialist medicine NHS doctor jobs in the UK. General & Acute medicine? Search for live vacancies here. 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 specialist medicine job opportunities in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable 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:             

Doctors from any country can apply for Specialist Registration in the UK, provided they meet certain eligibility criteria, though there are different routes available based on the doctor’s training and qualifications.  In this blog we’ll be exploring Specialist Registration in medical oncology for overseas medical oncologists more closely. We’ll look at all aspects of Specialist Registration, focusing more closely on the Certificate of Eligibility for Specialist Registration (CESR), including the application process, costs, and eligibility criteria, along with some other topics, summarised in the headings below:  What is Specialist Registration? What route is best for me as an overseas oncologist? Do I have to complete CESR before I can work in the UK? Do I need MRCP (UK) for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in medical oncology? How much does CESR cost? How long is the CESR application process? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  Specialist Registration  Holding Specialist Registration in any CCT specialty means that you can be appointed to a substantive (or permanent) consultant position in the NHS. All medical oncologists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience equivalent to a CCT in order to apply for Specialist Registration.   For oncologists, attaining specialist registration will mean you are qualified to practice independently as a medical oncology consultant in the NHS.   Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a medical oncologist in the UK.  Routes to Specialist Registration  There are three types of certificates issued by the GMC for Specialist Registration, and the type of certificate you receive depends on the training route you followed.  CCT for UK-trained Oncologists  For doctors who have completed a GMC-approved training programme, an application must be made to the GMC for a CCT in their specialty within 12 months of their completion date in order to qualify. After this point, they will be required to use the CESR route to apply directly to the GMC if they wish to attain Specialist Registration.  CCT for EEA-trained Oncologists  Doctors who have trained outside the UK or Switzerland, but within an EEA country, will be awarded CCT (Certificate of Completion of Training) after a successful specialist registration application. Specialist Certifications from across the EU are deemed as equivalent by the GMC, and therefore a straightforward application can be made. You can read more about this in the Specialist Registration section under your country on the GMC website here.  CESR-CP for Oncologists who have complete part of a GMC-approved training programme  CESR(CP) is a simplified route to Specialist Registration for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK.  CESR for Overseas Oncologists  For overseas doctors who have completed their full training outside a GMC-approved training programme, CESR is the route they will usually take towards attaining Specialist Registration. This route does not require further training, rather the submission of an application.   You can read a detailed breakdown of Specialist Registration in the UK in our IMG Resources library.  Medical Oncology Positions in the NHS without CESR  It is important to note that you can apply for senior oncology roles in the NHS, such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register.  Similarly, CESR is not required by overseas doctors before moving to the UK to work in the NHS.  In these senior NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. Within these positions, you can collect evidence of your competences, particularly those specific to the UK medical oncology curriculum.  These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  Get in touch with us to find out more about senior positions in the NHS with CESR support.  MRCP (UK) for Specialist Registration  Whilst it is always beneficial to complete MRCP (UK), particularly for doctors who have trained outside of the UK or an EEA country, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the Medical Oncology curriculum are the MRCP (UK) exams, so passing these exams confirms the attainment of the competencies of the core curriculum.  MRCP (UK) is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  The structure of the programme is an indicative two years in Core Medical Training or Acute Care Common Stem (ACCS), followed by an indicative four years of training in Medical Oncology. Therefore, applicants need to demonstrate the appropriate level of acute medicine expertise as well as competencies in medical oncology.  You can read more about the evidence required in the specialty specific guidance here.  CESR Equivalence Process  Equivalence describes the process of assessing an overseas applicant’s training and experience against the current medical oncology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence  skills and knowledge  The Royal College of Physicians will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Medical Oncology  Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the Medical Oncology Curriculum. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your medical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 – Knowledge, skills, and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership, and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  CESR Application Cost  All oncologists applying for Specialist Registration must pay a fee. As of 1st April 2022, for CESR, this fee is £1,727. For CESR-CP and CCT, the cost is £452.  How long does it take to complete an application for CESR in Medical Oncology?  The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in medical oncology is six years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior oncologists.  #IMG Tips  Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.   Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.   Ensure that the evidence you collect demonstrates your competence across the whole of the Medical Oncology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Medical Oncology CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress.  Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).  Ask an IMG Connect recruitment specialist about NHS oncology posts with CESR support. These are not always advertised by a Trust, but we can help you find a role which aligns well with your career goals in the NHS.  Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded MRCP aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors. You can access our IMG Oncologists community here. Sources  https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration   https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr  https://www.gmc-uk.org/-/media/documents/sat---ssg---medical-oncology---dc2310_pdf-48455474.pdf   Getting started  Many oncology IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route. Take a look at our guide to CESR applications for medical oncology for more information on how to apply and what to expect.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:              

As there is no hard and fast rule for what position you will have after gaining a UK qualification, it is important for IMGs to understand the posts that are available to you after completing FRCR (Oncology).  FRCR (Oncology) is a highly beneficial qualification to achieve, but it does not guarantee you a consultant position in the NHS.  This can be a confusing area for overseas clinical and radiation oncologists, but this blog aims to de-mystify the subject. This article will explain the following topics:  What is FRCR (Oncology) and how does it fit into the UK training programme? What grade will IMGs, new to the NHS, be offered with FRCR (Oncology)? Can I take a permanent consultant post if I have FRCR (Oncology)? CESR opportunities for clinical oncologists in the NHS Skip ahead to the relevant section if you know what you’re looking for.  FRCR (Oncology) within the UK Oncology Training Programme Fellowship of the Royal College of Radiologists (Oncology) or FRCR (Oncology) is the postgraduate qualification awarded by the Royal College of Radiologists, the body responsible for the specialties of clinical oncology and clinical radiology throughout the UK.   FRCR (Oncology) is a three-part exam which is a necessary part of the training programme of clinical oncologists in the UK.   For trainees who have chosen to pursue clinical oncology, FRCR (Oncology) Part 1 or CO1 must be passed by the end of ST4.  Clinical oncology trainees will then sit Final FRCR (Oncology), also known as Part 2A and 2B or CO2A and CO2B, usually from ST6 to ST7.   These final exams are important in that they assess a trainee’s knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.  Any UK-trained clinical oncologist applying for a CCT in order to work as a substantive consultant must have completed full FRCR (Oncology).  As shown above, UK trainees will also have completed MRCP (UK), although this is not required for overseas clinical oncologists.  Positions for Doctors new to the NHS with FRCR (Oncology) As an IMG with full FRCR (Oncology), you will be eligible for consultant grade positions in the UK.   You are not guaranteed a consultant position, particularly if you do not have previous consultant position in your home country, but you will certainly be able to attain more senior positions in the NHS, such as a specialty doctor (SAS) or specialist grade.  Consultant positions are the most senior in the UK, and thus the highest paid position for doctors within the NHS pay system.  For further information on how NHS pay scales work for consultants, please see our detailed article here.  Of course, this is assuming that you have also completed the other necessary components to make you eligible for GMC registration.  Alongside your postgraduate qualification, you will need to have passed an English Language Test (either IELTS or OET).   Additionally, you must obtain a Certificate of Good Standing, and submit this to the GMC. Upon the receipt of these three components, you will receive full GMC registration.  Permanent Consultant Posts with FRCR (Oncology) To take up a permanent consultant position in the NHS, you would need to have Specialist Registration. Specialist Registration (more specifically CESR for most overseas doctors) allows you to take up permanent or substantive consultant roles in the NHS.  The type of consultant position you would be eligible for with FRCR (Oncology) is a locum consultant post.  Firstly, we should clarify the meaning of the term ‘locum consultant’ in the UK. The NHS has two types of locums - Trust locums and Agency locums.   If you are an IMG with full registration, but you are not on the Specialist Register, you are only able to take on consultant positions as a trust locum, but no permanent positions.  Trust locums are hired on a fixed-term contract and are able to better acclimatize themselves to the NHS system, whilst receiving the support and guidance to work towards consultant positions and CESR.  Please note, you can only work as an agency locum if you have a British passport.  CESR Opportunities in the NHS  CESR or the Certificate of Eligibility for Specialist Registration is a route of entry to the Specialist Register for those doctors who have not followed a GMC-approved training programme.  You can read more about CESR in Clinical Oncology through our IMG Resources library here.  IMG Connect are able to help you to secure senior roles such as specialty doctor (SAS), specialist grade or locum consultant in Trusts that offer CESR support.  In these roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. These Trusts have a lot of experience in supporting overseas doctors to progress their careers through CESR.  You can collect evidence of your competences, particularly those specific to the UK Clinical Oncology curriculum and those you may not be able to achieve outside the UK.  These positions also facilitate a faster route to the UK than applying directly through the CESR route, which can take a substantial amount of time.  Get in touch with us to find out more about senior positions in the NHS with CESR support.  Getting started  We hope this blog has been helpful in clarifying your questions about securing senior posts in the NHS with FRCR (Oncology). If you have any further questions regarding the postgraduate exams, CESR or Oncology in the NHS - feel free to contact us directly.  Join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncologists and dedicated oncology recruiters. In this group you will find tailored support for oncology IMGs, including access to our NHS and CESR webinars, completely free to all doctors. You can access our IMG Oncologists community here. Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.               

Overseas doctors from any country in the world can apply for Specialist Registration in the UK, provided certain eligibility criteria are met, though there are different routes available based on the doctor’s qualifications and training.  In this blog we’ll be exploring Specialist Registration in clinical oncology for overseas clinical or radiation oncologists more closely. We’ll look at all aspects of Specialist Registration, focusing more closely on the Certificate of Eligibility for Specialist Registration (CESR), including the application process, costs, and eligibility criteria, along with some other topics, summarised in the headings below:  What is Specialist Registration? What route to Specialist Registration is best for me as an overseas oncologist? Do I have to complete CESR before I can work in the UK? Do I need FRCR (Oncology) for Specialist Registration? What is the CESR equivalence process? What evidence do I need to submit for a CESR in clinical oncology? How much does CESR cost? How long is the CESR application process? #IMG Tips How do I get started? Skip ahead to the relevant section if you know what you’re looking for.  Specialist Registration  Specialist Registration in any CCT specialty means that you can be appointed to a substantive (or permanent) consultant position in the NHS. All clinical oncologists who wish to take permanent consultant roles in the UK must show evidence of skills, knowledge, and experience equivalent to a CCT in order to apply for Specialist Registration.   For clinical oncologists, attaining specialist registration will mean you are qualified to practice independently as a consultant in the NHS.   Specialist Registration is additional to full registration with the GMC and is therefore not required to practice as a clinical oncologist in the UK.  Routes to Specialist Registration  There are three types of certificates issued by the GMC for Specialist Registration, and the type of certificate you receive depends on the training route you followed.  CCT for UK-trained Oncologists  For doctors who have completed a GMC-approved training programme, an application must be made to the GMC for a CCT in their specialty within 12 months of their completion date in order to qualify. After this point, they will be required to use the CESR route to apply directly to the GMC if they wish to attain Specialist Registration.  CCT for EEA-trained Oncologists  Doctors who have trained outside the UK or Switzerland, but within an EEA country, will be awarded CCT (Certificate of Completion of Training) after a successful specialist registration application. Specialist Certifications from across the EU are deemed as equivalent by the GMC, and therefore a straightforward application can be made. You can read more about this in the Specialist Registration section under your country on the GMC website here.  CESR-CP for doctors who have completed only part of a GMC-approved training programme CESR(CP) is a simplified route to Specialist Registration for doctors who joined their specialty training programme after ST1, and therefore do not meet the requirement of 4 years duration in GMC-approved training on completion, as they began their training overseas and completed it in the UK.  CESR for Overseas Oncologists  For overseas doctors who have completed their full training outside of a GMC-approved training programme, CESR is the route they will usually take towards attaining Specialist Registration. This route does not require further training, rather the submission of an application.   Clinical Oncology Positions in the NHS without CESR  It is important to note that you can apply for more senior oncology roles such as a specialty doctor (SAS), specialist grade or a locum consultant without being on the Specialist Register.  Similarly, overseas doctors do not require CESR before moving to the UK to work in the NHS.  In these NHS roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. While working in these positions, you can collect evidence of your competences, particularly those specific to the UK clinical oncology curriculum.  These positions also facilitate a faster route to the UK than the CESR route, which can take a substantial amount of time.  Get in touch with us to find out more about senior positions in the NHS with CESR support.  FRCR (Oncology) for Specialist Registration  Whilst it is always beneficial to complete FRCR (Oncology), particularly for doctors who have trained outside the UK or an EEA country, overseas doctors looking to join the Specialist Register do not need to have completed the Royal College postgraduate exams.  The standard test of knowledge in the Clinical Oncology curriculum are the FRCR (Oncology) exams, so passing these exams confirms the attainment of the competencies of the core curriculum.  FRCR (Oncology) is only a requirement for doctors looking to attain Specialist Registration via the CCT route.  Similarly, UK trainees would have completed MRCP (UK) before beginning their clinical oncology training, which is also not required for oncologists going through the CESR route.  However, CESR applicants who have not successfully completed these exams must provide alternative evidence that demonstrates equivalent knowledge to oncologists who have passed the FRCR (Oncology) exams and the appropriate level of non-oncology expertise and that you can appropriately manage the acutely unwell patient.  Even if the competencies covered by the exam require something that someone in your position would not routinely undertake (in your sub-specialty for example), you must still provide evidence of it – as the evaluators will not make assumptions outside of the evidence presented.  You can read more about the evidence required in the specialty specific guidance here.  CESR Equivalence Process  Equivalence describes the process of assessing an overseas applicant’s training and experience against the current clinical oncology training programme requirements, in order to be awarded CESR.  The equivalence process involves submitting a written body of evidence to the GMC, consisting of:  training and/or competence  skills and knowledge  The Royal College of Radiologists will assess each application against the relevant curriculum before providing a recommendation to the GMC, who will then make a decision.  Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.  Evidence Requirements for CESR in Clinical Oncology  Skills & Experience: The evidence provided for a CESR application in oncology must cover the knowledge, skills, and qualifications to demonstrate the required competencies in all areas of the Clinical Oncology Curriculum. If evidence is missing from any area of the curriculum, the application will fail.  Primary Evidence: To demonstrate that you can do what is required by the curriculum, you need to submit primary evidence of your clinical practice which shows how you work on a day-to-day basis: letters, reports, assessments etc. References, retrospective case summaries, and reflective notes can all be used in a CESR application, but by themselves they are not sufficient.  Audit and Governance: You are required to submit evidence of your active leadership in audit, including evidence that you have completed at least one audit cycle  Currency of evidence: Your evaluators will be looking for evidence of current competency, generally defined as within the last five years. If you have completed training before this point, it is crucial that you provide evidence of maintaining competency across the whole area of the curriculum.   The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – you can find this on the GMC website here.  As a general guide, the GMC usually expects to see about 800 - 1000 pages of evidence, divided into four different domains, reflecting those of Good Medical Practice. The GMC recommends that you apportion the evidence provided as shown below:  Domain 1 – Knowledge, skills, and performance  Domain 2 – Safety and quality  Domain 3 – Communication, partnership, and teamwork  Domain 4 – Maintaining trust  Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.  The full list of evidence required for each domain can be found on the GMC website here.  The Cost of CESR Applications  All oncologists applying for Specialist Registration must pay a fee. As of 1st April 2022, for CESR, this fee is £1,727. For CESR-CP and CCT, the cost is £452.  How long does it take to complete an application for CESR in Clinical Oncology?  The GMC estimate that it can take between six and eight months to receive a decision, from the date you submit your CESR application.  As there is a substantial amount of evidence to gather for a CESR application, the process of preparing all the necessary documentation and applying for CESR can take even longer than this, and a typical candidate will usually set out to complete this within 1 – 3 years.  It is worth noting that more senior oncologists, such as consultants, are more likely to have achieved all the competences outlined in the curriculum.  The indicative period of training for a CCT in clinical oncology is seven years, so it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time. Therefore, CESR is not suitable for more junior oncologists.  #IMG Tips  Research/think about the types of evidence you will need and begin to gather your evidence well in advance of making your application.   Gather evidence prospectively – this is much easier than retrospectively trying to pull together the evidence under additional pressures.  Make sure that your evidence is of the highest possible quality and is current – you will be assessed against the most recent curriculum.   Ensure that the evidence you collect demonstrates your competence across the whole of the Clinical Oncology curriculum, not just your sub-specialty.     Remember to refer to the most up-to-date Clinical Oncology CCT Curriculum and Specialty Specific Guidance for the evidence requirements in your specialty.   Create a CESR ‘to-do list’ with sections under the GMC’s 4 domain headings – organise your evidence directly into these sections to manage your progress.  Do not submit original documents – all your copies, other than qualifications you’re getting authenticated must be accompanied by a pro formas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).  Ask an IMG Connect recruitment specialist about NHS oncology posts with CESR support. These are not always advertised by a Trust, but we can help you find a role which aligns well with your career goals in the NHS.  Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncology CESR aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology, including guidance on CESR applications, completely free to all doctors. You can access our IMG Oncologists community here. Sources  https://www.rcr.ac.uk/clinical-oncology/careers-and-recruitment/specialist-registration-cesr  https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr  https://www.gmc-uk.org/-/media/documents/sat---ssg---clinical-oncology---dc3556_pdf-48456770.pdf  Getting started  Many oncology IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route. Take a look at our guide to CESR applications for oncology for more information on how to apply and what to expect.  If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.   Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:              

The Medical Oncology SCE is a postgraduate qualification delivered by the Royal College of Physicians as a higher specialist qualification for medical oncologists. It is one of 11 SCEs offered by the Royal College and offers physicians a postgraduate qualification which demonstrates achievement of a high standard (equivalent to UK specialist trainees) to prospective employers.  Here we take a closer look at the MRCP (UK) Medical Oncology Specialty Certificate Examination for doctors who have chosen to specialise in medical oncology. We cover the exam content, fees and eligibility, summarised below along with a broad look at the following topics:  What is the medical oncology SCE? Where does the SCE fit into my oncology training? What is the structure of the SCE? How do I apply for the exams and what do they cost? Where can I sit the exams as an overseas medical oncologist? How should I prepare for the exams as an IMG? I’ve passed? What’s next? Skip ahead to the relevant section if you know what you're looking for.  MRCP (UK) Medical Oncology SCE The Royal College of Physicians is the professional body responsible for the specialty of medicine throughout the UK.   The medical oncology specialty certificate exams are administered as a compulsory component of assessment for Certificate of Completion of Training (CCT) in medical oncology for all UK trainees.   The purpose of an SCE is to:  ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants  complement workplace-based assessments  provide a rigorous national assessment to establish public confidence  offer a challenge similar to sub-specialty certification examination in North America  For in-depth information on each of the MRCP exams, see our IMG Resources library here.  Medical Oncology SCE as Part of Training in Oncology As the MRCP exams are taken during the Internal Medicine Training years (CT1-CT3), an SCE allows medical oncologists to demonstrate that they are able to practice independently.  The SCE has no official entry requirements (both for UK and overseas candidates), however, UK trainees would normally take the SCE in their penultimate year of higher specialty training (ST5).  To find out more about the medical oncology training pathway in the UK, see our blog on this topic here. Exam Structure The SCE assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum:  Topic  Number of questions  Breast cancer  14  Colorectal and anal cancer  14  Lung and thoracic cancer  14  Carcinoma of unknown origin  7  Ovarian cancer  7  Germ cell tumours  7  Oesophagogastric cancer  6  Lymphoma  3  Uterine cancer  3  Hepatobiliary cancer  5  Skin cancer  5  Sarcoma  5  Leukaemia  1  Prostate cancer  3  Urothelial cancer  3  Cervical cancer  3  Head and neck cancer  2  CNS cancer  2  Renal cell cancer  3  Endocrine cancer  2  Scientific basis of malignancy  18  Professional skills  14  Acute oncology  20  Clinical research, ethics and economics  8  Systemic anticancer therapy  18  Supportive therapies and palliative care  10  Standard operating procedures  3  Total  200    All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.  Medical Oncology SCE Applications SCEs are held once a year and applications are made online through My MRCP(UK) account, within the Upcoming Exams section of the Royal College website.   The application process is as follows:  Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)  Request a preferred test country and city  Pay applicable examination fee  Application is confirmed via an automatically generated email  Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.  The Royal College has created a helpful video guide on SCE applications which you can watch here.  Cost  The cost of the MRCP exams are as follows:  UK centres: £665  International centres: £833  Exam Centres UK Centres  Candidates choosing to sit the exam in the UK must contact Pearson VUE to book their test. There are up to 137 test centres throughout the UK for each SCE, and the Royal College advise that candidates should book their exam as early as possible to secure their preferred test centre, as bookings operate on a first come, first served basis.  International Centres  Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. MRCP (UK) will pass this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the date of the examination. If the exam is not available in a requested location, candidates will be offered a choice of the nearest available test centres.  Please note, international candidates should not book their own test centre with Pearson VUE, and attempting to do so may delay a candidate's application.  The full list of international SCE test centres can be found here.  Preparation and resources for the Medical Oncology SCE With lots of resources available online, it can be difficult for IMGs to know where to start with their preparation and revision. This list should provide a good starting point for any international medical oncologists preparing to sit the SCE:  Curriculum - Applicants are tested on a range of common and important disorders in Medical Oncology as set out in the Joint Royal Colleges Specialty Training Curriculum for Core Medical Training. We recommend getting to know the curriculum as early as possible and using it as a roadmap for your study.   Guidelines - These resources are helpful for supplementing your knowledge:  British Journal of Cancer 2009 March 100 (5) 684–692 Jones et al. – guidelines for Herceptin modification  British Thoracic Society (BTS) - pleural disease guidelines  International Prognostic Index score for non-Hodgkin's lymphoma  National Comprehensive Cancer Network (NCCN) - guidelines for follicular lymphoma  NHS Cancer Screening – guidelines for bowel and other cancers  Books  Candidates can find information on genetics and some basic science in the Oxford Desk Reference of Oncology 2011.  Sample questions It is a good idea to regularly benchmark your knowledge by testing your knowledge and progress throughout your preparation using example questions from the current exam syllabus. You can find these here.  For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connect's Top Tips for exam preparation.  IMG Oncologists Join the online community - join the IMG Oncologists Facebook group for access to a community of like-minded oncology SCE aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors. You can access our IMG Oncologists community here. I’ve passed? What’s next? First, congratulations - this is a fantastic achievement! Armed with your MRCP and medical oncology SCE qualifications, you can apply for a full GMC registration with a license to practice. Once the GMC has approved your application, you can work as a doctor in the UK. Nice one!   Don’t hesitate to get in touch with an IMG oncology recruitment specialist to discuss GMC registration, oncology positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.  To receive the latest news and updates on all things oncology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.              

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

Overseas medical oncologists looking to register with the GMC through the postgraduate qualification route will need to attain Membership of the Royal College of Physicians (MRCP UK).  Here we take a closer look at the MRCP (UK) examinations for doctors who have chosen their specialism in medical oncology, including a breakdown of each exam, fees and eligibility.   International Medical Graduates (IMGs) from any country in the world can sit the MRCP examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:  What is MRCP (UK)? Where does MRCP fit into my oncology training? How are the MRCP exams structured? Eligibility for overseas doctors How do I apply for the exams and what do they cost? Where can I sit the exams as an overseas medical oncologist? How should I prepare for the exams as an IMG? I’ve passed, what’s next? Skip ahead to the relevant section if you know what you're looking for.  What is MRCP(UK)?  The Royal College of Physicians is the professional body responsible for the specialty of medicine throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.  As medical oncology comes under the umbrella of medicine, the postgraduate exams for medical oncologists are set and delivered by the Royal College of Physicians. For clinical oncologists, the Royal College of Radiologists are the overseeing body for training and exams. You can learn more about the clinical oncology postgraduate route here.  The MRCP examinations assess a candidate’s knowledge of basic medical sciences, as well as clinical skills required for the diagnosis and management of disease. The exams are designed to test both applied basic science and principles of medicine to the level of a UK trainee with two to three years postgraduate experience.  Therefore, completion of MRCP will allow you to work in the UK from ST3 level upward, with seniority beyond ST3 level dependent on experience.  MRCP (as a postgraduate qualification) is one of the two main routes an overseas doctor can take to gain full GMC registration, the other being the PLAB route. For in-depth information on each of the MRCP exams, see our IMG Resources library here.  MRCP as Part of Training in Oncology  Full MRCP (UK) is a requirement for all oncologists wishing to go on to a specialty training post in the UK. For doctors who wish to find more senior roles in the NHS which are reflective of their current practice and experience, IMG Connect advise that MRCP (UK) would be the best route to take to GMC registration.  MRCP (UK) Exams Structure  The MRCP exam has three parts as outlined below:   MRCP (UK) Part 1  The first exam in the MRCP exam suite tests a sample of medical knowledge skills and behavior are specified in the UK specialty training curriculum for core medical training / internal medicine training.   The first examine that MRCP suite is designed to assess the candidate's knowledge and understanding of the clinical silences relevant to medical practice and of common or important disorders to a level appropriate for entry to specialist training.  The examination has a two-paper format - each paper is 3 hours long and contains 100 multiple choice questions in a ‘best of five’ format. The paper both tests core knowledge and comprehension as well as a candidate's ability to interpret information and solve clinical problems.  Each question has five options: one correct answer and four alternatives to the correct answer.  The exam is also designed to help prepare candidates for the more challenging Part 2 written and PACES exam.  Specialty  Number of questions  Cardiology  14  Clinical Pharmacology and Therapeutics  15  Clinical sciences  25  Dermatology  8  Endocrinology, diabetes and metabolic medicine  14  Gastroenterology and Hepatology  14  Geriatric medicine  8  Haematology  14  Infectious diseases  14  Neurology  14  Oncology  5  Medical ophthalmology  4  Palliative medicine and end of life care  4  Psychiatry  9  Renal medicine  14  Respiratory medicine  14  Rheumatology  14  Total  200    For more detailed information on the content of the exam, see the Royal College website here.  MRCP (UK) Part 2  The second exam in the exam suite builds on the knowledge assessed in Part 1 and again tests the acquisition of a representative sample of medical knowledge skills and behavior.  The questions will usually have a clinical scenario, may include the results of investigations and may be illustrated with images such as clinical photographs, pathology slides, inheritance trees ECGs, X-rays, CT and MR scans and echocardiograms.  Questions are asked about the diagnosis investigation management and prognosis of patients using multiple choice questions in a ‘best of five’ format.  Specialty  Number of questions  Cardiology  19  Clinical Pharmacology and Therapeutics  18  Dermatology  9  Endocrinology, diabetes and metabolic medicine  19  Gastroenterology and Hepatology  19  Geriatric medicine  9  Haematology  9  Infectious diseases  19  Medical ophthalmology  3  Neurology  17  Oncology, Palliative medicine & end-of-life care  9  Psychiatry  3  Renal medicine  19  Respiratory medicine  19  Rheumatology  9  Total  200    For more detailed information on the content of the exam, see the Royal College website here.  MRCP (UK) PACES  The MRCP (UK) Practical Assessment of Clinical Examination Skills (PACES) assesses a candidate’s ability to carry out essential clinical skills.  There are five clinical stations where there are either patients with a given condition, or trained stand-ins (surrogates). At each station, there are two independent examiners who will observe and evaluate the candidates' performance.   PACES Carousel  For more detailed information on the content of the exam, see the Royal College website here.  Eligibility for Overseas Medical Oncologists  Part 1  To be eligible for MRCP (UK) Part 1, you must have a GMC recognised Primary Medical Qualification and a minimum of 12 months postgraduate experience in medical employment.  Part 2 & PACES   To be eligible for MRCP (UK) Part 2 & PACES, you must have passed Part 1 within the last seven years.  Please note, whilst it is not essential to successfully complete Part 2 to sit PACES, the Royal College strongly advises you to do so, as pass-rates are much lower for those who sit PACES before passing Part 2.  Applications  Applications for all MRCP exams are made online through My MRCP(UK) account, via the Royal College website. You will need to create an account and submit evidence of your primary medical qualification, then make a payment online to confirm your application.  The cost of the MRCP exams are as follows:  Candidate  Part 1  Part 2  PACES  UK  £460 £460  £657  International  £616  £616 £1,202    Exam Centres  The MRCP exams are held 4 times a year and can be sat in several locations around the world, including the UK, Manama, Dhaka, Cairo, Accra, Hong Kong, Reykjavik, Chennai, Hyderabad, Kerala, Kolkata, Mumbai, New Delhi, Erbil, Amman, Nairobi, Kuwait City, Kuala Lumpur, Malta, Kathmandu, Muscat, Karachi, Lahore, Doha, Jeddah, Riyadh, Singapore, Sri Lanka, Khartoum, Abu Dhabi, Dubai, New Jersey, Barbados, Jamaica, Trinidad and Harare.  Please note that the number of sittings for each exam varies between countries – you can find the full list of cities and dates here.  The Part 1 and Part 2 exams are held online in the UK for candidates within the UK and Republic of Ireland.  During the COVID-19 pandemic, there is limited availability of spaces for the PACES exam, and whilst every effort will be made to provide as many places as possible, if the number of applications for the exam exceeds the places available, candidates in UK training will be prioritised.  Preparation and Resources  With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. These include:  Curriculum: Applicants are tested on a range of common and important disorders in General Medicine as set out in the Joint Royal Colleges’ Specialty Training Curriculum for Core Medical Training. We recommend getting to know the curriculum as early as possible and using it as a roadmap for your study.   Sample questions for Part 1 & Part 2: It is a good idea to regularly benchmark your knowledge by testing yourself using example questions from the current exam syllabus provided by the Royal College see below:  Part 1  Part 2  PACES scenarios: To familiarise yourself with the format of the PACES exam, take a look at sample scenarios from the stations. You can find these here.  IMG Oncologists Join the IMG Oncologists Facebook group for access to a community of like-minded MRCP aspirants and dedicated oncology recruiters. In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors. You can access our IMG Oncologists community here. For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connects Top Tips for exam preparation.  For more information on the MRCP exams including structure, preparation, dates and a content drill down, see the blogs we’ve written on each part of the examination suite:  MRCP (UK) Part 1  MRCP (UK) Part 2  MRCP (UK) PACES  I’ve passed, what’s next?  First of all, congratulations! This is a massive achievement and you deserve to put your feet up after all that hard work. With full MRCP, you can now apply for a full GMC registration with a license to practice (once you’ve passed an English language exam). Once the GMC has approved your application, you can work as a doctor in the UK. Nice one!  Get in touch  Don’t hesitate to contact an IMG oncology recruitment specialist to discuss GMC registration, oncology positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.  For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below: