FRCEM is a crucial step when working towards either CCT or CESR in Emergency Medicine.
International Medical Graduates (IMGs) from any country in the world can sit some FRCEM examinations, provided certain eligibility criteria are met. For overseas doctors attaining FRCEM is not a route to GMC registration and you are better suited to the MRCEM pathway. These are summarised below along with a broad look at the following topics:
What is FRCEM?
FRCEM Route
Eligibility for overseas doctors
FRCEM Primary Examination
FRCEM Intermediate Certificate
FRCEM Final Examination
As an overseas candidate where can I take the exam and how much will it cost me?
How do I apply?
How to prepare and what resources are available
Passed? What next?
What is FRCEM?
Fellowship of the Royal College is awarded to candidates who pass three examination components.
There have been a few changes to the MRCEM and FRCEM examination structure over the last few years, as such there are currently two routes to an accreditation in Emergency Medicine, both leading to RCEM Membership.
These two routes are:
Membership of the Royal College of Emergency Medicine (MRCEM)
Fellowship of the Royal College of Emergency Medicine (FRCEM)
As of August 2018, applicants beginning the process will be able to sit one set of exams leading to the award of Fellowship of the Royal College of Emergency Medicine (FRCEM).
FRCEM is one of several routes an overseas emergency medicine doctor can take full GMC registration. Read our blogs on acceptable postgraduate qualifications and PLAB if you are unsure what route to take.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCEM or FRCEM would be the best route to take.
Understand the MRCEM pathway in this article above.
FRCEM Examination route:
The Fellowship Examinations consists of the following components:
FRCEM Primary Examination
one, three-hour written paper
FRCEM Intermediate Certificate
Short Answer Question Paper (SAQ)
Situations Judgement Paper (SJP)
FRCEM Final Examination
Critical Appraisal (Short Answer Question Paper)
Quality Improvement Project (QIP)
Clinical Short Answer Question Paper
Objective Structured Clinical Examination (OSCE)
Eligibility for overseas doctors:
FRCEM Primary:
To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
FRCEM Intermediate:
To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme and have passed FRCEM Primary Examination after 1st August 2016.
You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012.
FRCEM Final Examination:
To be eligible you must have FRCEM Primary and FRCEM Intermediate Certificate, attained after 1st August 2016. However, the requirements make it incredibly dififcult to attain outside of the UK - so you are best advised to attain MRCEM, work in the UK and then work towards FRCEM whilst practicing in the NHS.
The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the FRCEM examinations. Remember, you will need to have a pass of 7.5 average in all areas of IELTS to complete your GMC registration.
FRCEM Primary Examination:
The FRCEM Primary Examination is mapped to the Emergency Medicine 2015 Curriculum. More detailed information is provided in the RCEM Basic Sciences Curriculum (June 2010).
The exam consists of one 3-hour paper of 180 single best answer questions (SBAQs) so you must choose one best answer from a choice of five feasible answers.
The paper will examine all the domains of knowledge in the Basic Sciences Curriculum including:
Anatomy
Physiology
Pathology
Microbiology
Pharmacology
Evidence Based Medicine
FRCEM Intermediate Certificate:
FRCEM Intermediate Certificate is comprised of two papers:
Short Answer Question paper (SAQ):
A single 3-hour paper of 60 questions, each worth 3 marks.
Unlike single best answer questions (SBAQs) you will not have the advantage of having a list of options to choose from. Instead you will have to compose your answer independently.
The blueprint for the FRCEM intermediate is as follows:
Curriculum Category
Questions
Common Competences
7
Clinical Presentations – Core Major & Acute Presentations
18
Anaesthetic Competences CT1&2
4
ICM within ACCS
2
Acute Presentations – Additional Adult ST3
6
Paediatric Presentations – Makor & Acute Presentations
11
Practical Procedures (ACCS)
12
Total
60
Situational Judgement Paper (SJP):
A two-hour paper of 120 single best answer questions.
This written paper is designed to test your ability to understand & respond appropriately to real world clinical situations, assessing you against the Common Competencies in the Emergency Medicine Training Curriculum 2015.
FRCEM Final Examination:
From August 2018 the FRCEM Final consists of the following components:
FRCEM Critical Appraisal (Short Answer Question Paper)
FRCEM Quality Improvement Project (QIP)
FRCEM Final Clinical Short Answer Question Paper
FRCEM OSCE
Each component tests individual skill sets and as such may be sat independently.
FRCEM Critical Appraisal:
A 90-minute Short Answer Question Paper.
FRCEM Quality Improvement Project (QIP):
This replaced the CTR from 1st August 2016.
The QIP is a written submission that should be completed whilst working in Emergency Medicine at a level above ST3 or SHO. It should focus on quality improvement in Emergency Medicine, and may focus on either adult or paediatric Emergency Medicine.
Any candidates who have not been awarded FRCEM by 31st July 2018, irrespective of any previous passes in CTR, are required to pass the new FRCEM QIP.
Clinical Short Answer Question paper (SAQ):
The SAQ is a 3-hour paper consisting of 60, 3-mark questions.
A summarised blueprint for the FRCEM Final SAQ is as follows. A fuller version can be found on the RCEM website here.
HST Major and Acute Presentations
25 questions
Additional Paediatric Practical Procedures
3 questions
Practical Procedures (HST)
11 questions
Ultrasound
3 questions
Clinical Presentations - Core Major & Acute Presentations
6 questions
Common Competencies
2 questions
Anaesthetic Competences CT1&2
1 question
ICM within ACCS
1 question
Acute Presentations - Additional Adult ST3
2 questions
Paediatric Presentations - Major & Acute Presentations
3 questions
Practical Procedures (ACCS)
3 questions
FRCEM Final OSCE:
The exam is set in a practical setting and tests your ability to apply knowledge & experience directly to patients – rather than reciting learned knowledge.
The exam consists of 16, 8-minute stations with one minute provided in between stations for reading time.
As with many other final stages to Royal College exams – FRCEM Final OSCE will make use of manikins or actors and you will be observed by an examiner after being presented with a clinical case to assess. Examiners will not engage with you – only observe and mark.
A brief summary of the curriculum for OSCE is found below:
Stations
Curriculum
1
Core Acute
2a
Resuscitation
2b
3
Core Major
4
Common Competencies
5
Common Competences
6
Anaesthetic Competences
7a
Paediatric Resuscitation
7b
8
Paediatric Acute
9
Paediatric Major
10
HST Major
11
HST and Adult Acute
12
Practical Skills
13
Paediatric Practical Skills
14
Non-technical Skills
As an overseas candidate where can I take the exam and how much will it cost me?
Examination and application dates are regularly updated by the Royal College and can be found here.
Please remember, applications made outside the application period will not be accepted.
Examination
Location
Fees
FRCEM Primary
Short Answer Question Paper
UK
£310
Iceland, Malaysia, Oman, India
£390
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
FRCEM Intermediate Cert.
(SJP)
UK
£200
Kuala Lumpur
£200
FRCEM Final
Clinical SAQ
UK
£300
FRCEM Final
Critical Appraisal SAQ
UK
£240
FRCEM Final
QIP
N/A
£150
FRCEM Final
OSCE
London
£420
How can I apply?
All applications are made online and links to all application forms and windows are available here. It is worth noting, the application can take some time to complete so it is always advisable to apply well in advance of the deadlines.
Please remember, applications submitted after the application period will not be accepted.
How do I prepare for each exam and what resources are available?
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.
Curriculum:
Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.
We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Information Packs:
These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day:
FRCEM Primary
FRCEM Intermediate
FRCEM Final Examination
SAQ Blueprint:
The blueprint for the new Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
SJP Blueprint:
A blueprint of the new Intermediate SJP exam can be found on page 11 FRCEM Intermediate examination pack, downloaded from the RCEM website here.
Sample questions:
Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below:
Primary – sample questions
Intermediate Certificate – sample SJP questions
Final – successful QIP
Reducing referral rates of paediatric patients to plastic surgery
Management of fractured neck of femurs in the ED
Final – unsuccessful QIP
Critical Appraisal Questions – Advice to Candidates
Critical Appraisal – Most Frequently Offered Answers
Glossary of Terms:
The royal college uses many terms that may cause confusion, so take plenty time to understand the terms and definitions used in this guide. Candidates are expected to be rigorous in their use of these terms.
Glossary of terms used in RCEM exams.
Examination Report:
The Royal College recently began to publish reports on the performance of those sitting FRCEM examinations. Below is the first report published and helps to break down results for those in training and those out of training.
2018 Examination report.
Online resources:
There are lots of resources online, such as videos on YouTube, FRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.
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 blog: IMG Connects Top Tips for exam preparation.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Should I take a course to prepare for the OSCE?
Whilst it is not essential to take a course when preparing for the MRCEM or FRCEM OSCE - there is no doubt it will help your preparations both technically and mentally, and should be considered an investment towards your future career plans. Have a read of our blog on recommended MRCEM courses for Emergency Medicine doctors.
Passed? What next?
First of all, congratulations! After you have passed all parts of FRCEM, you will be on a firm path towards attaining your Specialist Registration in Emergency Medicine. FRCEM is not a route for GMC registration as doctors will already be in the UK, however those attaining MRCEM can do so from outside the UK, and use MRCEM as a route to GMC registration.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
NHS Hospitals across the UK are offering specialty doctor job plans in Psychiatry with the opportunity for programmed CESR support, giving psychiatrists the chance to quickly work towards Specialist Registration.
For experienced IMGs, this is a new and relatively quick route to your first consultant post in Psychiatry.
By taking up a service level job as an SAS Doctor with CESR support as part of the job plan, many overseas psychiatrists are securing a great start to their career in the NHS that is suited to their senior level experience, whilst taking the time to acclimatize to the NHS and their Trust.
CESR Programmes for Specialty Doctors
By taking such posts in the NHS, you can join diverse, dynamic and inspiring groups of specialty doctors and acting consultants all on the way to achieving Specialist Registration as part of a tailored programme. You can read more about CESR for psychiatrists here.
In offering such job opportunities, Trusts will provide a supportive environment with protected time to fulfill all the requirements of the CESR application in Psychiatry and its sub-specialties, gaining career-enhancing experiences as you do.
Acting up, dedicated peer groups, coaching & mentoring, scheduled learning and study time are some of the benefits that you could receive in one of these roles.
In such roles you will typically receive hands on support from consultant colleagues and exposure to a wide range of experience to specifically aid competency achievement for your CESR application in relation to the Specialty Specific Guidance (SSG) for your sub-specialty.
In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience.
Some Mental Health Trusts will also provide the following as part of their CESR programme:
A number of Supported Professional Activity (SPAs) sessions per week
Tailored experience to your CESR portfolio
Regular clinical supervision
A CESR mentor
Involvement in academic programmes and medical student teaching
Support in gaining research competencies
SAS Tutor support
CESR / SAS support forums and meetings
Finding SAS Roles with CESR Support
If you are an overseas doctor looking for a Specialty Doctor job with the chance to work towards your Certificate of Eligibility for Specialist Registration (CESR) in Psychiatry, speak to the IMG Connect team to discuss if this is a suitable route for you.
We have opportunities across the UK for international psychiatrists to take advantage of the CESR programme.
You can also send your CV to info@imgconnect.co.uk or register here. It takes less than 30 seconds to register!
IMG Jobs
Search and find live Psychiatry jobs in the NHS with CESR support
IMG Resources Library
Browse our library for more useful articles on NHS jobs in psychiatry, salaries for doctors in the UK and postgraduate qualifications for psychiatrists and much more!
Connect with us
Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.
For access to a community of like-minded psychiatry IMGs and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
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 NHS is estimated as the 4th biggest employer in the world, employing more than 1.7million...
Despite the scale of the NHS labour force, it still does not have enough staff to meet demand. In this article we will explore the reasons why International Medical Graduates (IMGs) want to work in the NHS, the demand for more staff across the UK in every aspect of UK Healthcare, and some of the reasons working in the NHS can be beneficial for you.
'The United Kingdom (and the NHS) has been, and remains, a popular place to work for doctors and other members of the medical profession'
In the UK, as well as across the globe, it has been well documented that demands on health services have been increasing year-on-year since the millennium. Advances in technology and medicine, wider ranges of healthcare, and an ageing population all play their part. It can also be said that improved practices, safer staffing numbers and planning strategies have also contributed to increasing demand.
Shortfalls in staff, leading to greater demand for overseas practitioners
Over the past few decades shortfalls in NHS Staff across the UK have increased in part due to the slowing growth in training sufficient numbers of staff. When domestic supply slows, the NHS looks to International Recruitment. Current figures estimate that roughly 13 – 15% of hospital and community staff are recorded as having non-British nationality.
The NHS is one of the most efficient, most egalitarian and most comprehensive public health services in the world.
Unemployment levels in the UK are at an all-time high, yet despite this there are many areas of high jobs demand. According to the UK Bureau Visa Department, the UK is experiencing severe shortages in 3 main skill areas which are: engineering, healthcare and art & entertainment. So, for International Medical Graduates (IMGs) looking to build a long-term career, with good salaries, they need look no further than the UK and the NHS.
Strengths within NHS attract overseas doctors
The strengths of the NHS, such as training, quality and ethos, continues to attract many overseas doctors. Many choose to work in the NHS because of the attractive salaries and benefits. But the work offers much more: the chance to enhance your clinical experience as part of a team of 1.7 million NHS employees, many of whom have come to the UK from across the globe. All of whom are proud to work for the NHS, and care passionately about its growth and development.
The NHS is committed to offering learning and development opportunities for all employees. No matter where you start within the NHS, you will have access to the highest quality training and be given every chance to progress within the organisation and to develop unique skills.
The NHS doesn’t stand still, there’s always more to learn. With a progressive and forward-thinking plan, there is always new equipment, new procedures; there’s always something to keep you progressing in your career in the UK, or for your return to your home country to enhance practice.
There's a growing market for international health practitioners to work in the UK, and demand is very high. With a professional health qualification and an IMG Connect consultant you can pick a lot of the UK in which to work.
Senior NHS figures have told IMG Connect that recruitment has to be approached in line with changes to the way health and care services are delivered and in demand. That means a much more sophisticated approach to understanding where professionals will be needed, at least in the medium to long term.
With that in mind, IMG Connect offers an opportunity for some fresh thinking on the process of recruiting international doctors to UK Healthcare. A comprehensive Recruitment, Relocation and Retention service for permanent doctors only, helping to considerably reduce costs and time to hire.
NHS directors increasingly demand a significant focus on aligning values and fit and after care, in order to build a fully complimented and sustainable workforce to meet demands.
With the level of demand for healthcare continuing to rise, the need for overseas staff will continue to increase.
Put simply, the NHS is reliant on IMGs who want to start a career in a progressive, welcoming and rewarding environment.
If you are a client, we would be delighted to discuss your staffing requirements and develop a bespoke solution and hiring plan. Taking time to understand your Trust and the type of doctor that will thrive in your culture, IMG Connect looks to form successful working partnerships that continue beyond the initial placement.
If you are an IMG, we offer a personalised recruitment & relocation service to any International Medical Graduate looking to find work in the UK. IMG Connect can help you start and progress your career, with advice and guidance on every aspect of planning, finding the right job, navigating legislation and relocating. This service can be summarised into four key areas of support and guidance:
Exams, registration and Medical Qualifications
Job search & interview preparation
UK Visa & Immigration
Relocation, aftercare & ongoing career support
IMG Jobs
Search and find live NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Get in touch using the buttons above (and below) to discuss doctor 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:
For overseas psychiatrists looking to register with the GMC and find a psychiatry job in the NHS, one option is to complete the Membership of the Royal College of Psychiatrists examinations - MRCPsych. Here we will take a detailed look at the MRCPsych exams, fees and centres.
International Medical Graduates (IMGs) from any country in the world can sit the MRCPsych examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is MRCPsych?
What is the exam content and format?
Eligibility for overseas doctors
Assessment Portfolio
Sponsorship Requirements
How do I apply?
How much will it cost me?
Where can I sit the exams?
How can I prepare for the MRCPsych examinations
Passed? What next?
The Royal College of Psychiatrists is the professional body responsible for the specialty of Psychiatry throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.
What is MRCPsych?
The MRCPsych examinations are the central component of training for psychiatrists in the UK and the examinations are designed to test your knowledge of basic medical sciences as well as the clinical skills required for diagnosis and management within psychiatry.
For international doctors, MRCPsych is one of the two main routes IMGs can take to full GMC registration - you can find a range of articles covering these routes in our resource library here: Royal College or PLAB route.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCPsych would be the best route to take.
Overseas doctors must be registered with a recognised medical board in their country of residence and should have undertaken 3 years of training and MRCPsych (UK) is a prerequisite to anyone wishing to go on to a specialist training post as a physician in the UK
What is the exam content and format?
The MRCPsych examinations consist of two written papers (Paper A + Paper B) and one clinical examination (CASC).
Typically, a UK Psychiatrist would sit Paper A from FY2. Candidates will then progress through MRCPsych examinations from CT1 – CT3, before going on to specially training for CCT.
Paper A – The scientific and theoretical basis of psychiatry – 3 hours
This is a written paper, worth 150 marks and comprising 150 questions made up of approximately two thirds multiple choice questions (MCQ) and one third extended matching item questions (EMI).
It covers the following sections of the syllabus:
Paper A is now taken online.
Paper B - Critical review and the clinical topics in psychiatry – 3 hours
This is a written paper, worth 150 marks and comprising 150 questions made up of approximately one third covering critical review and two thirds covering clinical topics.
It covers the following sections of the syllabus:
Paper B is now taken online.
CASC - Clinical Assessment of Skills and Competencies
The CASC is based on a format that is similar to OSCEs. Specifically, the examination consists of two circuits which must be completed on the same day.
In total, the circuit includes 16 stations, made up of:
five stations on history taking, including risk assessment
five stations on examination, including physical and mental state
six stations on patient management
Stations consist of several elements with instructions provided to all candidates, marked against the examiners construct.
These have a standardised format with elements in common between stations of a similar type. Find out more here.
The CASC exam is taken in person.
Eligibility for overseas doctors
The MRCPsych examinations can be taken by both:
Doctors from the EU, who are working overseas
Non-Eu doctors who are working overseas
Each examination has different criteria, to complete the full MRCPsych, an overseas doctor must be registered with a recognised medical board in their country of residence and complete the Assessment Portfolio for Overseas Candidates demonstrating that they have complete 3 years of equivalent training.
Furthermore, prior to taking CASC, overseas candidates must demonstrate competencies in Psychotherapy AND Child & Adolescent Psychiatry or Learning Disability.
For each part of the exam the Royal College suggest the following eligibility criteria:
MRCPsych Paper A
You are eligible for Paper A if you are a fully registered medical practitioner.
MRCPsych Paper B
It is a recommended to have at least 12 months experience in psychiatry before taking this examination.
Clinical Assessment of Skills and Competencies (CASC):
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC
AND
You have a pass in both Paper A and B
AND
You can demonstrate you have sponsorship in place. Sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.
In addition, overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Assessment Portfolio for Overseas Candidates:
As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC.
In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans:
be observed interviewing patients in ward rounds for specified reasons
be observed interviewing patients in out-patient or community settings or other contexts for specified reasons
be assessed via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
be assessed formally in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
Sponsorship requirements
International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC examination and your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
Acceptable sponsors are:
College Tutor
Training Programme Director
Educational Supervisor
Head of School
Director of Medical Education (or equivalent)
Head of Department of Psychiatry
Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
How do I apply?
To apply you will need to complete an online application form. It takes about 15 – 20 minutes. You can sit Paper A and B in any order. You will be required to enter contact details and training history, including your medical registration.
Payment is made by credit/debit card.
If applying for the CASC, you will also need to provide the contact details of your sponsor.
It is important to note that the online form for Paper A, B and CASC will only be available during the published application dates and must be submitted before the closing date and time. Applications submitted after, will not be accepted.
How much will it cost me?
Candidate
Paper A
Paper B
CASC
PMPT Trainees and Affiliates (UK & Ireland Centres)
£496
£446
£1,024
Non-PMPT Trainees and Affiliates (UK & Ireland Centres)
£550
£495
£1,137
Where and when can I sit the examinations?
The good news is that changes have been made in response to the COVID-19 pandemic, and Paper A and B can be taken online, making it much easier for IMGs to complete the MRCPsych examinations and work towards their GMC registration in a normal time frame. To maintain the integrity fo the CASC exam, delivery will be in-person only from September 2023.
You can sit the examination from your home country with details on submissions and preparation for an online exam available on the Royal College website.
For up-to-date information on application and exam dates, please see the Royal College website here.
How do I prepare for the MRCPsych examinations?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and 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:
Syllabus:
We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams.
Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry
Current critical review syllabus:
For Paper B candidates will need to ensure that they make optimal use of the MRCPsych Paper B Critical review Evidence Based Practice Syllabic Content.
Sample Papers:
These will help you prepare and polish your exam techniques and are a good idea to regularly benchmark your knowledge against the syllabus. In addition sample questions will help you work quickly on the day, you will already know what to expect. Please note: you may be required to be a member to access these.
Paper A sample questions
Paper B sample questions
Marking schemes (Paper A and B):
Candidates pass or fail the written papers based on their performance, and not how well you perform against other candidates. As such, it is a good idea to understand how the exam is worked, so you can maximise your exam skills, giving you the best chance of a pass.
Marking schemes can be found here.
Marking scheme (CASC):
A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
Written papers marksheet example:
Again, this is a useful tool to help you familiarise yourself with the exam format and improve your test skills. An example marksheet can be found here.
CASC examination guide:
The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos:
Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint:
This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.
Passed? What's next?
First of all, congratulations! After you have passed all parts of MRCPsych 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.
Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.
For access to a community of like-minded psychiatry IMGs and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
The first exam in the FRCPath Histopathology series...
Overseas histopathologists may have questions about the best ways to prepare for the FRCPath Part 1 exam. With so many resources available online, but many of them geared towards UK trainees, it can be difficult to know what is best suited to you as an international candidate.
In this blog we have compiled some of the best resources and guidance for FRCPath Part 1 aspirants. We will also quickly cover some of the recent changes to the exam regarding its delivery and availability in response to the COVID-19 pandemic.
Here we’ll take a closer look into these and other important questions through the following topics:
What is FRCPath Part 1?
How do I get started with my preparation?
What resources are available online?
How has COVID-19 affected the exam?
#IMG Tips
I’ve passed FRCPath Part 1, what’s next?
Skip ahead to the relevant section if you know what you’re looking for.
FRCPath Part 1
FRCPath Histopathology Part 1 is the first exam in the two-part examination series, administered by the Royal College of Pathologists. The content of the exam can be broken down into three sections:
The three-hour exam is designed to assess candidates’ overall knowledge and understanding of histopathology or cytopathology, including the full range of autopsy practices undertaken in a district general hospital in the UK and the basic science underpinning pathology, including molecular biology.
For an in-depth guide to the FRCPath Part 1 exam, or for a breakdown of the full FRCPath Histopathology exam suite, visit our IMG resources library.
Please note that only full FRCPath satisfies the GMC’s postgraduate requirements for overseas doctors.
How to get started with preparation for FRCPath Part 1
The best way for IMGs to begin their exam preparation is with the Royal College website and resources. The FRCPath Histopathology exams are based on the Curriculum for Specialty Training in Histopathology and as a rule, this should always be the starting point for your revision. This will ensure you are focusing on the exam material that will feature in your exam – knowing the curriculum is key! You can find this on the Royal College website here.
Royal College resources include:
Regulations and guidelines – before applying for FRCPath exams, the College recommends you read both the general and specialty-specific regulations and guidelines, found below:
General Regulations and Guidelines
Histopathology Regulations and Guidelines
FAQs - There is also a Frequently Asked Questions (FAQs) document which the Royal College has compiled to help applicants who have questions about online examinations. You can read this here.
Other helpful resources include:
Oxbridge Medica - FRCPath Part 1 Revision Course
This is a 4-day, exam-oriented online revision course. The course includes live-streamed lectures across four days and covers all the major topics of the examination syllabus. The speakers have knowledge of the Royal College exam - some of them are examiners, and all are experienced teachers. The course can be found here.
Duration
4 days
Cost
£300 (£75 deposit)
Next start date
TBC
Pathology Online Hub - FRCPath Part 1 Orientation Course
This is a preparatory course aimed at overseas candidates. The course includes an introduction to the exam, including a mock exam with a detailed discussion of answers and exam tips. The course can be found here.
Duration
1 day
Cost
£40
Next start date
TBC
Pathology Online Hub - FRCPath Part 1 Comprehensive Course
This is a preparatory course aimed at non-UK candidates, including particularly basic and extended questions on the UK system. The course covers topics which are unique to the UK system and includes a one-hour practice mock similar to the exam format and a detailed discussion of the answers with feedback. The course can be found here.
Duration
1 day
Cost
£45
Next start date
TBC
Reading materials
There is no set reading list or official course for FRCPath Part 1 in Histopathology, however the following books come highly recommended by IMGs who have passed the Part 1 exam:
Practical Applications in Histopathology, Cytopathology & Autopsy – Dr Limci Gupta (£78)
FRCPath, Part 1: Examination Preparation Guide – S. Steele (£22.18)
Sternberg's Diagnostic Surgical Pathology Review - Pier Luigi Di Patre, Darryl Carter (£91.95)
Wheater’s Functional Histology – Barbara Young, Phil Woodford, Geraldine O’Dowd (£44.95)
Robbins and Cotran Atlas of Pathology - Edward Klatt (+/- £45)
(Designed to complement Robbins and Cotran Pathologic Basis of Disease, 8th Edition and Robbins Basic Pathology, 8th Edition)
How have the exams been affected by COVID-19?
In response to the challenges of the COVID-19 pandemic, the Royal College of Pathologists has migrated the FRCPath Part 1 exam online.
Candidates all over the world are now able to take the exam from their home countries. This development allows the College to continue to offer the FRCPath Part 1 exam to both UK trainees and overseas pathologists, with minimal disruptions to the exam schedule.
For full details about the online FRCPath Part 1 exam, please see our blog here.
#IMG Tips
Prepare early – getting your revision going as soon as possible will help you avoid those last-minute cramming sessions and increase your chances of passing first time.
Speak to your colleagues and peers – there are so many study materials to choose from - who better to ask for recommendations than histopathologists who have been through the process or are going through it with you?
Familiarise yourself with the curriculum – we cannot stress this enough! Every country’s qualification and practice differ, so being well-versed in the curriculum is the first step on your path to success in the exam.
Prepare for the online format in advance – make sure to fully complete your IT checks well in advance to avoid tech issues on the day (and save yourself an unnecessary headache).
Find a support network – a great way to do this is to join IMG Histopathologists, an online pathology community of UK and NHS histopathology aspirants and dedicated histopathology recruiters. You’ll find advice, guidance and updates about all things histopathology for IMGs. Join the conversation here.
I’ve passed the FRCPath Part 1 exam, what’s next?
Great stuff! This is a massive achievement, and you deserve to treat yourself after all your hard work. With a pass in hand, it's time to look ahead to FRCPath Part 2. For more information on the final exam in the examination series, take a look at our blog where we explore the FRCPath Part 2, including how to sit the final exam, fees and preparation and results.
Head to our IMG library for more useful articles on the FRCPath exams, GMC registration and qualifications you need to help you find your dream job in the NHS.
For regular news and updates, follow IMG Connect on social media using the links below:
With IMG Connect you can search and apply for roles in the NHS, including posts relating to COVID-19. We can offer you the latest advice on each opportunity to work in the best performing NHS hospitals in the UK.
The NHS is looking for motivated internationally qualified pulmonologists to be a part of its dedicated workforce and join some of the best performing, largest and most successful Trusts in the UK. For experienced pulmonologists, CESR is supported in the majority of vacancies.
NHS Jobs in Respiratory Medicine, offering CESR support and career growth
At IMG Connect we are delighted to be able to offer opportunities for motivated, ambitious respiratory medicine specialists (Consultants, Registrars, Clinical Fellows and Registrars) to join Respiratory Medicine services based up and down the country.
Each appointment will be a member of a Respiratory multidisciplinary team providing high quality care, which are constantly seeking to improve and refine their service. Our NHS clients always have the ambition to continue to deliver an international standard service.
Our NHS clients can accommodate your skill set and professional interests. In some roles, the appointee will participate in both General Medical and Respiratory and will be responsible for the continuing care of patients admitted as emergencies. Sub-specialty clinical and academic interests are always encouraged.
For consultant paleontologists, there are opportunities to work in major teaching hospitals, and all respiratory specialists will also be expected to contribute to undergraduate and postgraduate education. The development of relevant research interests is also encouraged, and opportunities will be enhanced by education and career development departments.
For Specialty Doctors and Consultants in respiratory medicine, CESR is a great option to gain an internationally recognised qualification, allowing you to take on a permanent consultant job in the NHS.
What’s life like in an NHS Respiratory Department?
Respiratory medicine in the NHS is typically a hospital-based specialty. Hospital wards are busy and varied, a third of all acute medical admissions to hospital are the result of respiratory problems. Some Respiratory physicians choose to practice general medicine, and others maintain a focus on acute respiratory medicine.
Respiratory physicians in the NHS will work closely with colleagues in the hospital’s intensive care unit (ICU), as well as across all other specialties. Assessing patients in outpatients’ clinics is an important part of NHS jobs. There are two types of clinic: general respiratory clinics and specialist clinics. Respiratory physicians also run lung function laboratories in NHS hospitals and some respiratory units specialise in areas such as lung transplant, sleep-related medical problems or cystic fibrosis.
Specialist respiratory clinics in the NHS deal with a range of problems including:
cancer
tuberculosis, or TB (a bacterial lung disease)
cystic fibrosis (an inherited condition that causes a sticky section that can affect the airways often causing infection)
interstitial lung disease (scarring of the lung tissue between and supporting the air sacs)
chronic cough
sleep disorders relating to breathing, eg obstructive sleep apnoea
pulmonary vascular disorders (affecting the blood circulation of the lungs)
With such a broad range of job plans and career directions available, the NHS is an excellent place for pulmonologists to secure a job and grow their career in respiratory medicine, whilst working in internationally recognised institutions.
To receive the latest news and updates, including the Royal Colleges, GMC registration and the NHS, follow us on social media and join the conversation.
Attaining Membership of the Royal College of Emergency Medicine or MRCEM is required to attain GMC Registration and start your Emergency Medicine career in the NHS.
International Medical Graduates (IMGs) from any country in the world can sit the MRCEM examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is MRCEM?
MRCEM Route
Eligibility for overseas doctors
Where can I take the exams & how much will they cost me?
How do I apply?
How to prepare and what resources are available
Should I take an MRCEM course?
Passed? What next?
What is the Royal College of Emergency Medicine?
The Royal College of Emergency Medicine is the professional body responsible for the specialty of Emergency 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 in the UK.
What is MRCEM?
Membership of the Royal College is awarded to candidates who pass three examination components.
There have been a few changes to the MRCEM and FRCEM examination structure over the last few years, as such there are currently two routes to an accreditation in Emergency Medicine, both leading to RCEM Membership.
These two routes are:
Membership of the Royal College of Emergency Medicine (MRCEM)
Fellowship of the Royal College of Emergency Medicine (FRCEM)
MRCEM & FRCEM are one several routes an overseas emergency medicine doctor can take full GMC registration. Read our blogs on acceptable postgraduate qualifications and PLAB if you are unsure what route to take.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCEM or FRCEM would be the best route to take.
Please note, applicants that pass a specific combination of MRCEM and FRCEM examinations can still be awarded Membership of the Royal College by Examination (MRCEM). This would still satisfy postgraduate requirements for GMC registration.
MRCEM Examination route:
The alternative route, Membership by Examination (MRCEM), is offered to candidates who have passed all the following components:
FRCEM Primary or (MRCEM Part A)
One written paper, three-hours total
FRCEM Intermediate SAQ (replaces MRCEM Part B)
Short Answer Question paper - 3 hour paper comprised of 60, 3-mark questions
MRCEM OSCE
Practical examination setting with 18, seven-minute stations
Eligibility for MRCEM Examinations:
Eligibility for FRCEM Primary:
To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
Eligibility for FRCEM Intermediate:
To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme and have passed FRCEM Primary Examination after 1st August 2016.
You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012.
Eligibility for MRCEM OSCE:
To be eligible to enter the MRCEM OSCE (Part C) you must meet the following requirements:
Hold a medical qualification approved by the GMC and
Have completed the UK Foundation Programme of equivalent (electronic evidence required at point of application) and
Have passed the FRCEM Primary examination after 1st August 2016 or
Have passed the MRCEM Part A examination after 1st August 2012 and prior to 31st July 2016 and
Have passed the FRCEM Intermediate SAQ after 1st August 2016 or
Have passed the MRCEM Part B examination after 1st August 2012 and prior to 31 July 2016 and
Have 36 months experience including 6 months experience in Emergency Medicine at a level above Foundation Year 1 (post full registration)
Where can I take the exams & how much will they cost me?
Examination and application dates are regularly updated by the Royal College and can be found here.
Please remember, applications made outside of the application period will not be accepted.
Examination
Location
Fees
FRCEM Primary
Short Answer Question Paper
UK
£310
Iceland, Malaysia, Oman, India
£390
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
MRCEM
OSCE
UK
£450
India
£450
How can I apply?
All applications are made online and links to all application forms and windows are available here. It is worth noting, the application can take some time to complete, so it is always advisable to apply well in advance of the deadlines.
Please remember, applications submitted after the application period will not be accepted.
How do I prepare for each exam and what resources are available?
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.
Curriculum:
Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.
We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Information Packs:
These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day:
FRCEM Primary
FRCEM Intermediate
MRCEM OSCE
SAQ Blueprint:
The blueprint for the new Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
Sample questions:
Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below:
Primary – sample questions
Intermediate - Sample SAQs are included in the Information Pack
Glossary of Terms:
The royal college uses many terms that may cause confusion, so take plenty time to understand the terms and definitions used in this guide. Candidates are expected to be rigorous in their use of these terms.
Glossary of terms used in RCEM exams.
Examination Report:
The Royal College recently began to publish reports on the performance of those sitting FRCEM examinations. Below is the first report published and helps to break down results for those in training and those out of training.
2018 Examination report.
Online resources:
There are lots of resources online, such as videos on YouTube, FRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.
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 blog: IMG Connects Top Tips for exam preparation.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Should I take a course to prepare for the OSCE?
Whilst it is not essential to take a course when preparing for the MRCEM or FRCEM OSCEs - there is no doubt it will help your preparations both technically and mentally, and should be considered an investment towards your future career plans. Have a read of our blog on recommended MRCEM courses for Emergency Medicine doctors.
Passed? What next?
First of all, congratulations! After you have passed all parts of FRCEM or MRCEM 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
Search and find live emergency medicine NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding, CESR, a typical doctor salary in the UK and the most suitable NHS job & hospital locations for you.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
The Occupational English Test (OET) medicine version is specifically designed for healthcare professionals.
The exam tests your ability in reading, writing, speaking and listening and it is used by overseas doctors to demonstrate their ability to communicate effectively in English to support their application to register and practice medicine in the UK.
For doctors who prefer OET, compared to IELTS, the good news is that OET is now accepted by both the GMC and the UK Home Office - meaning that only one test now required for both UK registration and visa purposes
As an IMG coming to work in the UK, there are different scenarios in which you’ll need to provide a pass in an English test. In this article, we outline the key facts about OET, including the following topics:
What is the OET?
Content and structure
Listening
Reading
Writing
Speaking
What scores do I need?
Does time matter?
When and where can I sit the test?
How can I prepare?
What resources are available online for each subtest?
Passed? What next?
CLICK HERE & REGISTER FOR 10-20% DISCOUNT ON ENGLISH LANGUAGE COURSES
What is the OET?
The OET tests communication in English with an emphasis in medical and healthcare professional settings.
It is recognised by the General Medical Council (GMC), and is fast becoming a common choice to prove a candidate’s ability to communicate in a healthcare environment, such as the NHS.
As an overseas doctor you must select and sit the medicine version of the test, this is the only one accepted by the GMC for the purposes of registration for a license to practice.
Content and structure:
The OET tests your ability in four areas of English language communication:
Reading (45 minutes)
Writing (60 minutes)
Speaking (45 minutes)
Listening (20 minutes)
Listening:
This section consists of three parts and tests a candidate’s ability to understand a range of materials, such as lectures or consultations.
Part A – consultation extracts (5 minutes each)
You will listen to two recorded patient consultations and will be assessed on identifying specific information. You will also complete the healthcare professionals’ notes using the information that you have heard during the consultation.
Part B – Short extract of workplace discussion (1 minute each)
Here, you are tested on your ability to identify detail, understand conversation, meaning and reasons or purpose contained in the discussion. You will hear 6 short extracts and answer multiple-choice questions on each. Example extracts could be a consultation dialogue, team meetings or professional handovers.
Part C – presentation extracts (5 minutes each)
This tests your ability to follow a recorded healthcare related presentation or interview. You will listen to two extracts covering different topics and will then answer 6 multiple choice questions on each extract.
What does the listening sub-test assess?
The listening sub-test assesses your ability to identify specific information and details, to understand conversations, reasons for comments and the opinions of the speakers.
Reading:
In this section you are expected to demonstrate your ability to read and understand texts related to healthcare. This sub-test consists of three parts.
Part A – expeditious reading task (15 minutes)
This tests your ability to quickly and efficiently locate specific information from short texts. The texts will all relate to the same topic, and you will answer 20 questions in total.
Part B and C (45 minutes)
Part B consists of 6 short text extracts from a healthcare setting, sourced from the workplace. It assesses your ability to identify detail, understand context, main points and overall gist of a text. Example texts are hospital policies or guidelines, manuals, instruction guides, internal communications between staff.
Answers are multiple-choice, and you will be asked three questions per text.
Part C consists of two texts on topics of interest to healthcare professionals. Each text is 800 words in total. Here you will be tested on your ability to identify detailed meaning and opinion. Each text has eight multiple choice questions.
What does the Reading sub-test assess?
Each reading sub-test assesses different skills:
Part A, to read quickly, skim and scan across a variety of texts, in order to identify specific information.
Top tip, familiarise yourself with the conventions of medical texts, the structures, presentation of both numerical and textual content.
Part B, to understand detail and main points.
Top tip for Part B is to excel at identifying ideas or points within paragraphs, or sentences.
Part C, to understand meaning and opinion presented to you. This covers a longer text.
Top tip, the focus here is to understand the wider context, from sentence to paragraph level.
Writing:
This tests your ability to communicate effectively in a healthcare context, such a writing a referral letter. You will be given one task with a healthcare focus relating to the usual demands in the medical workplace.
The task is to write a letter, usually a referral. However, this can on occasion be a letter of discharge or advice for a patient. You will be provided with some materials to assist with context, and information to use in your writing.
How is the writing assessed?
overall execution and completion
use of the correct and most suitable language
overall comprehension and use of the materials provided
grammar, punctuation & spelling
cohesion, presentation, structure and layout
Top tip, reading more will considerably improve your writing skills.
Speaking:
This section tests your ability to communicate effectively in a role-play based on a typical healthcare scenario. Each role-play takes about five minutes each.
The test will start with an introduction and short warm up conversation. Then the role-play will begin one-by-one and you have three minutes to prepare for each.
How is the speaking assessed?
intelligibility (pronunciation)
appropriate use of language
relationship building
understanding and incorporating the patient’s language
providing structure
information gathering
information giving
What scores do I need?
For the GMC to accept your Occupational English Test (OET) certificate you will need to score a grade B or above in each test area.
These scores must be achieved in the same test, and this must be your most recent sitting of the OET.
Remember, for the GMC to accept your OET certificate, you must take the medicine version of the test.
Does time matter?
Each sub-test is timed, and you will need to practice how to give each section the right amount of time. You will have to be efficient and work quickly, dedicating the right amount of time to each question and text.
When and where can I sit the test?
You can sit the OET in test venues around the world and they offer the tests 14 times per year. To find out if there is a test venue that suits you take a look at the official website.
How can I prepare?
OET can be challenging. So, make sure you are as prepared as possible before sitting the exam.
OET involves learning a wide range of healthcare related and profession specific language.
To get the right score, this must be at an advanced level.
CLICK HERE & REGISTER FOR 10-20% DISCOUNT ON ENGLISH LANGUAGE COURSES
You don’t need to pay take a course. However, it is highly advisable to attend a course, and/or language classes, successful IMGs have advised that this helped them improve their standards in all areas of the test, including improved general levels of English.
Most overseas doctors advise that they improved by attending specific OET courses, and this also helps you to get used to the test format and timings.
We strongly recommend that you start preparing for the exams as far in advance as you possibly can.
Establish your level of English, and work out what areas you will need to focus on. Identify your weaknesses, set goals for yourself and plan a revision timetable.
What resources are available online for each subtest?
Listening online resources:
A good start would be to watch and listen to extracts online, here are a few options:
BBC Factual Podcasts
BBC Health Matters
OET Listening Subtests
Reading online resources:
Read short, medium and long extracts online.
Why not try the following resources:
British Medical Journal
ABC health newsletter
OET Reading sub-test
Writing online resources:
To improve writing skills, we recommend reading and writing! Read short, medium and long extracts online. Write short extracts, re-write articles and write on your own journal.
Why not try the following resources:
British Medical Journal
Free Medical Journals
OET Writing sub-test
Speaking online resources:
To improve speaking skills, we recommend speaking! Speak with colleagues and friends in English as much as you can. You can also record yourself reading aloud or speaking and then play back your recording, assessing yourself.
Why not try the following resources:
British Medical Journal
Free Medical Journals
OET Sample Test Video
We have also created a useful blog series on Exam Tips and Revision Guidance, which includes tips for studying at home.
Passed? What next?
If you have your OET in place you are in a prime position to apply and interview for jobs.
IMG Jobs
Search and find live NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.
Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below:
Here we look at finding an NHS doctor job in emergency medicine and why you should choose a career in the NHS.
We will explore the growing demand for Emergency Medicine specialists, offering guidance on how to find the right job suited to your own professional preferences, discussing how to research work in the NHS ER, criteria for GMC registration, (MRCEM, FRCEM & IELTS exemption) as well as some useful resources to get you started.
Growth in Emergency Medicine means that the NHS will rely on recruiting more overseas emergency medicine specialists in order to meet growing demand to fill jobs across the country. Emergency care departments and the doctors who work within them are the foundations of the NHS. Staff working in EDs in the UK deliver high quality patient care for all patients presenting with minor or critical life-threatening and life-changing conditions.
We hope that you too will consider working in some of the best ERs in the world across the NHS.
First steps towards your new job in the NHS:
A stable workforce within the ED departments across the UK is crucial, as such at IMG Connect we have developed a specialist approach to Emergency Medicine recruitment.
Responding to staffing challenges within EDs in the NHS, we have created a dedicated department for Emergency medicine specialists, where you will work with a dedicated consultant who makes it their responsibility to know your chosen field inside and out.
We have taken steps to ensure that IMG Connect and NHS organisations collectively work to help recruit and retain the very best specialists, ensuring a large enough workforce with the right skills, behaviours and values to deliver care in our EDs.
No matter what stage you are at in the process of relocating to the UK, you can speak with a specialist consultant in Emergency medicine, who will work with you to establish the areas that we can offer the most effective support for you.
Why choose to work in Emergency Medicine in the UK?
The Emergency Department is where the public know to come when they need help, they value the service and in return you have the privilege of helping people when they are most in need. Here are a few of the reasons to work in Emergency Medicine in the NHS:
You work with the full range of illness and injury, in all types of patients.
The ED department in the UK means that you will see the ‘best bits’ of all the specialties.
There are no long ward rounds.
Flexible working exists in all departments, giving you the chance to have a better quality of life. Don’t believe the myths!
Flexible working as a consultant is the most flexible in the NHS.
Flexible sessional working allows for a more family friendly environment.
The Emergency Department is the front door of the Hospital and the ‘shopwindow’ of the NHS.
Staff morale is high, despite working in a challenging environment.
You will work as part of a team - with a shared team spirit and camaraderie
You will have access to excellent opportunities to develop a special interest in almost any subspecialty or area of interest.
Career progression and stability is always available
Access to CESR and the specialist register is widespread, and hospitals are highly supportive to overseas doctors to make sure that this progression happens
Recognised subspecialties and niche personal interests are encouraged
Consultant vacancies have increased making this specialism more and more of a attractive career choice in EM
EM is an excellent career choice for those looking for flexibility and balance.
Do some research:
Don’t just take our word for it, we advise that you do some research online to explore the various opportunities and experiences that await you in the Emergency Department in the NHS.
There are many free resources available to help you explore what it is like to work in an ED in the UK, here are a few that we think will be useful:
The Royal College of Emergency Medicine
Paediatric Emergency Medicine UK
Emergency Medicine Trainees’ Association (EMTA)
Forum for Associate Specialist and Staff Grade Doctors in Emergency Medicine (FASSGEM)
The Royal College of Emergency Medicine (Careers)
The Royal College of Emergency Medicine (Training)
Health Careers
Don’t forget, we are always here to answer any questions you may have and offer our support in any way we can.
Find out what jobs are available:
There has been significant investment in the UK geared towards growing the number of ED trust doctors, SHOs, specialty doctors and consultants over recent years. There are many ways to get access to these jobs, including online via NHS jobs, through networks of doctors, and through an agency, such as IMG Connect.
You can search jobs and apply for Emergency Medicne jobs here.
Working with an IMG Connect specialist in Emergency Medicine you will receive access to the widest possible range of current and future vacancies in the UK. Better still, your consultant will spend time getting to know you personally, understanding both your personal and professional relocation needs.
A key benefit in terms of working with a specialist is that they will be able to give you an honest assessment of each job, including but not exclusive to, advice on the following: the hospital, standards and CQC reports, working in the ED, the local area, cost of living, housing, quality of life, job expectations and career progression. Advice that is designed to ensure you can settle into life in the UK and focus on your career in the NHS.
Speak to a consultant today to discuss your career options in the NHS and get the widest access to jobs and advice.
Get the right qualifications:
All Emergency Medicine doctors looking to secure a job and work in the UK, whether you are from inside or outside of Europe, will need to satisfy certain criteria to fully register with the Emergency Medical Council (GMC) before beginning their journey in the NHS.
If you qualified as a doctor outside the EEA, then you will have to demonstrate that both your medical knowledge & skills and English Language capabilities meet the level required to practice safely in the UK.
In addition, you will need to apply for a visa from the UK Home Office.
Take a look at our articles on each qualification:
English Language Testing
Evidence of Knowledge & Skills
PLAB
MRCEM
FRCEM
Tier 2 Visas
Full GMC Registration
English language exemption:
Many trusts or hospitals will be able to offer English Language test exemption for overseas doctors in emergency medicine specifically. This is a process that can be used when an ER needs to meet demand for doctors quickly.
Not every hospital will accept IELTS exemption, so relying on this process means that the number of available posts could be reduced slightly. That said, a great number of our NHS partners are able to offer this exemption, to establish what this could mean for you, our best advice is to speak to an IMG Consultant to discuss further.
In summary, Emergency Medicine in the NHS has developed into one of the most exciting and rewarding careers, offering great opportunity for career progression through the specialist training programme or CESR. It attracts individuals who thrive on challenge and variety and can offer professional development in areas of personal interest.
Working with an IMG Consultant specialist in Emergency Medicine will give you access to the best advice and job opportunities. As well as helping you to make decisions about the hospitals you wish to work in, they will also ensure you and your family relocate and settle into your new life in the UK.
IMG Jobs
Search and find live emergency medicine NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists
Get in Touch
Get in touch using the buttons above (and below) to discuss emergency medicine job opportunities in the NHS, including discussions regarding, CESR, a typical doctor salary in the UK and the most suitable NHS job & hospital locations for you.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
As an NHS employee, you will pay Income Tax and National Insurance on your wages through the PAYE system.
Overseas doctors will have tax and national insurance automatically deducted from their monthly salary. How much deducted depends on how much you earn.
PAYE stands for Pay As You Earn.
Some income is tax-free. You can earn a certain amount of income each year, called your Personal Allowance, before you need to pay any Income Tax.
The personal allowance is a fixed amount set against your gross income.
In all four UK countries, the Personal Allowance is set at £12,500 (tax-free income). It is worth noting that if you earn more than £125,000 you will not receive a personal allowance.
The Personal Allowance will also be set at £12,500 for 2020/21.
Any pay above the personal allowance is then taxed according to your salary and pension.
Tax bands in England, Wales & Northern Ireland
Band
Taxable income
Tax rate
Personal Allowance
Up to £12,500
0%
Basic rate
£12,501 to £50,000
20%
Higher rate
£50,001 to £150,000
40%
Additional rate
over £150,000
45%
How much you pay is fixed as a percentage according to a band system. In Scotland the tax bands vary from those set in England, Wales and Northern Ireland, see below:
Tax bands in Scotland
Band
Taxable income
Scottish tax rate
Personal Allowance
Up to £12,500
0%
Starter rate
£12,501 to £14,549
19%
Basic rate
£14,550 to £24,944
20%
Intermediate rate
£24,945 to £43,430
21%
Higher rate
£43,431 to £150,000
41%
Top rate
over £150,000
46%
You can check that you are paying the right amounts using this online government tool. This will allow you to check the following your Personal Allowance and tax code are accurate. As well as helping you to understand how much tax you’ve paid in the current tax year and how much you’re likely to pay for the rest of the year. Your NHS employer will set your salary, and you will be automatically set up to pay your pension, tax and national insurance. However, at IMG Connect we think that it’s important to check you have the right tax code and are paying the right amount.
Can I make any more savings?
You will get tax relief on your pension payments. The NHS pension scheme is an attractive one, with very few schemes in the UK even coming close to this benefit. Find out more about your NHS benefits here.
Getting started
For more information on NHS doctor benefits and pay arrangements in the UK, take a look at our IMG Resources library.
In this article we look at the guidance on dermatology evidence required for CESR applications...
Much evidence must be submitted, and you will only get a full picture of what you specifically require once you've spoken with the GMC and Royal College of Physicians. However, here we broadly discuss the evidence required to submit a complete application for entry onto the specialist register with a certificate of eligibility for specialist registration in dermatology.
What is CESR in Dermatology in the NHS?
As a Dermatology specialist, attaining CESR will mean you are qualified to practice at consultant level in the NHS in Dermatology.
Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP to attain CESR in Dermatology?
No, whilst it is always a benefit to attain MRCP and you may have already attained MRCP as by ways of registering with the GMC, you do not require MRCP to attain CESR in Dermatology.
Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP (UK).
What is the indicative period of training for a CCT in Dermatology?
The indicative period of training for CCT in Dermatology is four years full-time training and it is highly unlikely that a CESR applicant with limited experience, applying directly from outside the UK, could achieve these competencies in less time.
Experienced dermatologists who take a consultant position in the NHS, with support of their department, can attain CESR in much less time with the right focus and clarity on what they need to sign off.
What is the CCT training pathway?
The structure of the CCT training programme is:
2 years in Core Medical Training OR
Acute Care Common Stem (ACCS) OR
LEVEL 1 PAEDIATRICS (ST1-3)
How does IMT fit into this? CMT no longer exists as of Aug 2019.
Followed by:
4 years training in Dermatology
Therefore, CESR applicants need to demonstrate they have achieved the competencies in both of these areas.
Where experience has not provided adequate experience in the diagnosis and ongoing inpatient management of patients with a broad range of general medical problems, this will need to be completed to a level equivalent to the experience gained in Core Medical Training before the specialist curriculum may be followed.
For complete details refer to the Dermatology Curriculum documentation.
Submitting Evidence
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Dermatology Curriculum documentation.
If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it.
As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC.
You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
Names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for senior Dermatologists looking to work as NHS Consultants in Dermatology.