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Certificate of Eligibility for Specialist Registration (CESR) & Combined Programme (CESR-CP)

Certificate of Eligibility for Specialist Registration (CESR)

CESR Evaluators required

Are you interested in this very important role which involves ensuring that Emergency Departments are led by consultants who have all the necessary competences? Are you a Member, Fellow or Associate Fellow of RCEM who is currently practising in EM in the NHS and is informed about the latest EM curriculum?

We currently need evaluators from all over the UK.

If you’re interested in applying, please download the Job Description and send a copy of your CV along with a cover letter about why you wish to be an evaluator and what you think you can bring to the panel to Daniah Ahmed.

Information for doctors who wish to apply for UK Specialist Registration

It is a legal requirement for doctors to have their names entered on the General Medical Council’s (GMC’s) Specialist Register before taking up a substantive, honorary or fixed term NHS consultant post in the UK. Most doctors achieve this by completing a UK training programme resulting in the award of a Certificate of Completion of Training. However specialists who have not undergone a UK training programme are now able to apply for evaluation of their specialist training, qualifications, experience and knowledge to determine whether it is equivalent to the UK CCT.

Entry criteria

You may apply for assessment in the specialty of Emergency Medicine if you have had a period of training or a qualification in Accident & Emergency Medicine/Emergency Medicine wherever obtained. You must be able to demonstrate that your qualifications, training, experience and knowledge are equivalent to that of a UK consultant in the NHS.

How to apply for a Certificate of Eligibility for Specialist Registration (CESR)

Applications are made directly to the General Medical Council (GMC) under Article 14 of the General Medical Practice and Specialist Medical Evaluation Training and Qualifications Order 2003. You will find an application pack and guidance notes on the GMC website.

Specialty Specific Guidance and GMC Generic Guidance

The Specialty Specific Guidance 2015 version informs applicants of the criteria against which all applications will be evaluated.

The new 2021 curriculum SSG is now available: Specialty Specific Guidance 2021.


Applicants will be expected to meet the skills and knowledge outlined in the Royal College of Emergency Medicine’s current curriculum. Please note that there is a new curriculum planned which is likely to be approved in Spring of 2020, and implemented for trainees in August 2021. Further information regarding submission of CESR applications against the new curriculum will be provided here in due course.

CESR colleagues will be at varying stages of collecting evidence and preparing their CESR applications for submission to the GMC. To help with colleagues following this route to specialist registration the College has agreed with the GMC that until August 2022 CESR applicants can choose to submit on 2015 or 2021 curriculum, depending on their experience and body of evidence. After August 2022, all CESR applicants will be required to demonstrate equivalence against the 2021 curriculum.

FAQs will also be provided on this current site to help support planning for transition in due course. The RCEM CESR group will also provide further clarification to those planning CESR application.

Common reasons for unsuccessful CESR applications

Applicants often fail due to insufficient evidence of current competences in the allied (Core) specialties of Acute Medicine, Intensive Care Medicine and Anaesthetics. In addition to submitting detailed logbooks, and workplace-based assessments as set out in the curriculum, it is expected that the applicant will have spent a period of time of at least three months (WTE) in each of Anaesthetics and Intensive Care Medicine. A period of time in Acute Medicine is desirable although these competences may be achieved in the Emergency Department. Experience in a Paediatric Emergency Department is recommended, but Paediatric EM competences may be achieved in a General ED with sufficient exposure to paediatric patients. Primary evidence of all competences should have been obtained within five years of submission of the application.

Note that applicants who have not completed FRCEM rarely provide sufficient equivalent evidence of having knowledge of the breadth and depth of the curriculum in order to succeed on a first CESR application.

Other frequent areas of shortfall include Advanced Life Support Courses (ALS, ATLS and APLS or recognised equivalents) not being in date, and lack of evidence to demonstrate completion of an audit cycle. Evidence for audit can include audit reports, presentation slides, publications and any guidelines produced as a result of the audit.

Note to doctors applying for specialist registration through the General System route

Doctors applying under the general system of assessment will essentially have their training evaluated; this involves a comparison of the curriculum for their specialist qualification to the current CCT curriculum in the UK in the speciality they are applying in. For CESR, a doctor’s current competence is assessed against the full breadth of the UK CCT curriculum of the specialty they are applying in. These two routes are very similar. However, for general system applications, evaluators place less importance upon demonstration of current competence (within the last five years) unless they are addressing gaps identified between the curricula from their practice.

The College would stress, however, that the curricula of most European countries are different to that of the UK to the extent that it is highly unlikely that an application will be acceptable without supporting evidence. We would strongly encourage potential General System applicants to come to one of the RCEM CESR Applicants Training Days to discuss their cases with the panel before applying.


Contact GMC for information about the application process at

Contact Daniah Ahmed, CESR Officer at the Royal College of Emergency Medicine –

Fellowship Exam

Those preparing to apply for a CESR and who meet the experience/training requirements may be eligible to sit the Fellowship exam. It is highly recommended that applicants obtain FRCEM; equivalent evidence for knowledge of the breadth and depth of the curriculum needs to be extremely robust, and therefore it is rare for those without the qualification to succeed in obtaining CESR on a first application. Please email for clarification regarding eligibility for FRCEM. The application form, details about the exam and regulations are available on the Exams/FRCEM page of this website.

ePortfolio for non-trainees

The RCEM ePortfolio is available for non-trainees.


The College has an eLearning resource, RCEMLearning, content of which has been mapped to the curriculum. For access information, please

CESR-CP (Combined Programme)

Some trainees who have been appointed to GMC-approved training programmes are able to have some of their non-approved training and experience recognised and enter at a level higher than CT/ST1. These trainees will be training towards CESR-CP rather than CCT. More information about the Combined Programme can be found on the GMC’s website.

From August 2014 the GMC requires that it be notified at the start of their training of all trainees wishing to have previous non-GMC-approved training recognised – for instance training towards CESR-CP. The trainee’s LETB/deanery will contact the College with the entry level. The LETB will then make an application to the GMC to approve the trainee’s enrolment and confirm eligibility to apply for a CESR via a CP application upon successful completion of their training. The GMC will write to the trainee, as well as their LETB and college, confirming that the trainee is working to the award of a CESR via a CP application, and provide a unique number, to be used by the college when making notifications and recommendations for the award of a CESR (CP). The College will then write to the trainee confirming enrolment with the TSC and an expected end of training (CESR(CP)) date.

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