Certificate of Eligibility for Specialist Registration (CESR)
Doctors must have their names entered on the General Medical Council's (GMC's) Specialist Register before taking up substantive, honorary or fixed term NHS consultant posts in the UK.
CESR allows doctors who have not completed a UK specialist training programme and have a combination of qualifications and/or training and experience gained anywhere in the world to be evaluated as part of an application for entry to the GMC Specialist Register.
You make your application directly to the GMC via their specialist registration website.
The JCST has provided JCST CESR Guidance for Applicants which gives details of how to apply and also provides relevant links to the GMC website.
The standard you will be assessed against is ‘equivalent to a CCT in the specialty in question’ (The Post-graduate Medical Education and Training Order of Council 2010). This means that you need to demonstrate equivalence to the curriculum current at the time of application. Not only must you demonstrate that you have gained the competencies, but you must also demonstrate that you are currently maintaining those competencies across the depth and breadth of the curriculum.
The GMC as of 17 November 2020 has published the new surgical curricula that will be implemented for surgical training from August 2021. From now onwards you will be offered a choice about whether you want to have your CESR application assessed against the new 2021 curriculum or the ‘current’ curriculum. Both versions of the CCT curriculum can be found on the GMC website.
It is very important that you refer to the Specialty Specific Guidance in your specialty. This is the GMC document that sets out how to provide the evidence for your application. There are versions for both curricula. If you are applying under the current curricula you should also refer to the Certification Guidelines in your specialty. If you are applying under the 2021 curricula this information has been incorporated into the curriculum in section 5.4 Completion of training in your specialty.
About the 2021 Curricula
The GMC designed its new standards for postgraduate medical curricula Excellence by Design and its framework for Generic Professional Capabilities, published in May 2017, to help postgraduate medical training programmes re-focus trainee assessment away from an exhaustive list of individual competencies, towards fewer broad capabilities required to practice safely as a day-one consultant.
As a result, the 2021 surgical curricula are outcomes-based, meaning that trainees will be assessed against the fundamental capabilities required of consultants in the working week. These include the general skills which all doctors need to have (the GMC’s Generic Professional Capabilities (GPCs) as well as those needed to carry out all the specific day to day tasks undertaken by a consultant surgeon. JCST has called these Capabilities in Practice (CiPs).
There are five CiPs which are shared between all surgical specialties:
CiP 1 Manages an out-patient clinic
CiP 2 Manages the unselected emergency take
CiP 3 Manages ward rounds and the on-going care of in-patients
CiP 4 Manages an operating list
CiP 5 Manages multi-disciplinary working
Some specialties also have specialty specific CiPs. Full details are in the curricula
A new assessment tool has been developed to assess the CiPs and GPCs. This assessment tool is called the Multiple Consultant Report (MCR). The MCR allows assessment of performance relative to the level required of a Day 1 consultant in each CiP and the GPCs. The MCR is an assessment based in the workplace using observations gathered over an extended period of time. For trainees, this is the entire duration of a placement. For CESR applicants we would expect observations to be over a similar time frame. The MCR for CESR would be like the final MCR for a trainee and should be a summative assessment. The MCR should cover a period of at least 6 months prior to making the CESR application. Applicants should bear this in mind when they first begin to gather their evidence for CESR. The MCR for CESR must be prospective.
MCR Guidance for CESR (documentation):
The MCR for trainees is available via ISCP but for CESR you should use the following version on the JCST website MCR form for CESR. Also available on the JCST website is:
Example Completed Multiple Consultant (MCR) form
A YouTube video of a webinar about CESR under the 2021 Curriculum which took place on 08 November 2021.
FAQs arising from the Webinar