Doctors who haven’t completed a GMC approved programme of training but can show they have knowledge, skills and experience equivalent to the approved curriculum for your specialty may be able to apply for a Certificate of Eligibility for Specialist Registration (CESR)
The CESR application is made to the GMC and any queries about general application matters including legislation, forms, documentation, process and fees should be referred to the GMC. The GMC website contains a wealth of information and guidance about submitting a CESR application.
The JRCPTB and its Specialist Advisory Committees (SACs) have produced advice for CESR applicants in the physicianly specialties. This includes:
- Specialty specific guidance relevant to the applicant’s specialty
- Advice on the type of evidence that the application may be required to submit as part of their CESR application
Changes to the curricula and implications on CESR applications
As a result of drivers for change such as the Shape of Training review, a new model of physician training was developed to meet future healthcare needs of patients. Internal Medicine Training (IMT) stage 1 forms the first three years of post-foundation training, replacing Core Medical Training (CMT). For the main specialties supporting acute medical care - identified as group 1 specialties - an indicative 12 months of further Internal Medicine (IM stage 2) will be integrated flexibly with specialty training in a dual training programme. This model enhances training in internal medicine to prepare doctors for the challenge of managing acutely unwell medical patients, who may also have complex presentations based around chronic disease and comorbidities.
In addition, the GMC introduced new standards for the development and design of postgraduate medical curricula in 2017 which required new curricula describing generic, shared and specialty-specific outcomes. Curricula must also be mapped to the GMC's generic professional capabilities framework which sets out the essential generic capabilities needed for safe, effective and high quality medical care in the UK.
Group 1 specialties
New curricula for group 1 specialties include generic, specialty and clinical internal medicine learning outcomes known as capabilities in practice (CiPs). Applicants via the CESR route will need to demonstrate all capabilities as described in the curriculum. By demonstrating these capabilities a successful applicant will be awarded an additional CESR in internal medicine.
There is a separate curriculum for General Internal Medicine (to be renamed Internal Medicine) and it will be possible for an applicant to apply for a CESR in GIM/IM.
Group 2 specialties
Group 2 specialties will not dual train in internal medicine and the curricula do not include the internal medicine capabilities.
Transition period for CESR applications
The JRCPTB and the GMC has agreed a transition policy for CESR applicants to reflect the significance of the changes to the curricula for many of the physician curricula. This will allow applicants to apply against the previous curriculum for a transition period beyond publication of the new curricula. The transition period considers the notice CESR applicants will be given of the new curricula requirements and the significance of the curricular changes. This will range from two to three years following publication of the curricula, depending on the degree of change to the specialty curriculum. The previous curriculum will be retired on the deadline date.
The transition period and deadline for each specialty are given below.
|Group 1 specialties||Transition period||Transition deadline|
|Acute Internal Medicine||2 years||31 July 2023|
|Cardiology||3 years||30 Oct 2024|
|Clinical Pharmacology and Therapeutics||2 years||31 Jan 2024|
|Endocrinology and Diabetes Mellitus||2 years||31 Oct 2023|
|Gastroenterology and Hepatology||2 years||31 Oct 2023|
|Genitourinary Medicine||3 years||31 July 2024|
|Geriatric Medicine||2 years||31 Aug 2023|
|Infectious Diseases||2 years||31 May 2023|
|Neurology||3 years||31 Aug 2024|
|Palliative Medicine||3 years||30 Oct 2024|
|Renal Medicine||2 years||31 Oct 2023|
|Respiratory Medicine||2 years||31 Oct 2023|
|Rheumatology||3 years||31 Aug 2024|
|Stroke Medicine||2 years||31 Aug 2023|
|Tropical Medicine||2 years||31 May 2023|
|Group 2 specialties||Transition period||Transition deadline|
|Allergy (Allergy and Clinical Immunology)||3 years||31 July 2024|
|Audio vestibular Medicine||2 years||30 June 2023|
|Aviation and Space Medicine||2 years||31 Jan 2024|
|Clinical Genetics||2 years||30 June 2023|
|Clinical Neurophysiology||2 years||30 June 2023|
|Dermatology||2 years||30 June 2023|
|Haematology||2 years||30 June 2023|
|Immunology (Allergy, Clinical and Laboratory Immunology)||3 years||31 July 2024|
|Infectious Diseases||2 years||30 June 2023|
|Medical Oncology||2 years||30 June 2023|
|Medical Ophthalmology||2 years||30 June 2023|
|Nuclear Medicine||2 years||30 June 2023|
|Paediatric Cardiology||2 years||30 June 2023|
|Pharmaceutical Medicine||2 years||30 June 2023|
|Rehabilitation Medicine||2 years||31 May 2023|
|Sport and Exercise Medicine||2 years||31 May 2023|
|Tropical Medicine||2 years||31 May 2023|