Advice for applicants

Quarterly Blog

July 2018

Tips for successful Certificate of Eligibility for Specialist Registration (CESR) applications

by Dr Liz Fellow-Smith, Vice Chair of the Equivalence Committee

The College recognises that applications for CESR requires a lot of preparation and can seem quite daunting. This is the first in a series of articles aimed at helping doctors planning to engage in this process.

The CESR is awarded by the GMC and applications are made to them. The College assesses the evidence an applicant submits to the GMC. The assessment is to assure the GMC that the applicant has gained the equivalent level of competence as a ST6 trainee making application for CCT via the ARCP process.

The CESR applicant must demonstrate competence against all Intended Learning Outcomes in the curriculum of the specialty of their choice via the written evidence submitted.

The CESR certificate is awarded only on the written evidence provided by the applicant. It is not granted on the basis of references or experience. Clinical contemporaneous primary evidence is the key to a successful application. 

We hope the Top Tips and Common Errors below help you in planning you application... 

5 common errors

  1. Evidence is > 5 years old
  2. Evidence is from core training – must be higher training equivalent
  3. Not demonstrating higher level experience in psychological therapies
  4. Evidence does not demonstrate full biopsychosocial assessments, formulation, differential diagnosis and care plan
  5. Not demonstrating range of evidence across all psychiatric conditions, range of social\cultural backgrounds & all settings\ages

 10 top tips

  1. Map evidence to all aspects of the curriculum 
  2. Present evidence clearly showing which curriculum ILO it satisfies
  3. Check and check again
  4. Take advice from GMC, RCPsych and others about your application
  5. Primary evidence is essential
  6. Must be current and ST6 equivalent
  7. WPBAs are important but not sufficient by themselves
  8. Use reflective notes to triangulate evidence
  9. Gather evidence from your daily work as you go along 
  10. Validate at the time​

Applying for CESR as a locum - Khalid Rauf

I graduated from the University of the Punjab, Pakistan. I completed my Core Training in the approved rotational training scheme of the Royal College of Psychiatrists  in the Republic of Ireland.

I passed my MRCPsych part 1 and the written part of MRCPsych 2, unfortunately failed to get through from one of the PMP's in 2008. Thereafter exam pattern and Curriculum changed – I had no energy to do it all over again!  

I chose the CESR route because the feedback from colleagues and service users clearly reflected that I was ready to take my career to next level. In early 2009 I moved to UK with a clear goal set in my mind to seek Specialist Registration in CAMHS via CESR.

I started working as Locum staff grade in Birmingham CAMHS. A few months into the job I got into the habit of assessing and documenting all the new cases with CESR in mind, and my evidence started to build up gradually.

I continued my day to practice in line with CESR guidance for about 2 years over various locum roles. My immediate supervisors and clinical directors reassured me of their support at every stage.  I sought guidance from my supervisors during weekly supervision and peer group. Finally, after 3 years of perseverance I had collected enough evidence to apply.

I was unsuccessful on first application. I found reapplying was frustrating and I was not as confident as on the first application. The feedback put me off and the only way forward was to do as it says, no short cuts.

I was asked to provide evidence of medico-legal training and to produce evidence in the form of family and criminal court reports. CAMHS forensic seems super special interest and not everyone has a chance to rotate through this sub-specialty, even in training programmes. This was a real challenge for me as I was doing locum work which did not give me an option to stay in one place.

After several locum jobs where I was unable to gain this experience I started new job as a locum consultant. My clinical director was aware of my progress on CESR and reassured me of her support even before I commenced the job. Finally, I got an opportunity to produce family court reports and started to look for opportunity to produce criminal court reports.

Once again, time lapsed and I took a few other Locum posts. I took a new assignment at Shropshire and once again clearly communicated about my professional needs. I was given two criminal cases to compile a report on then re-submitted my application which got through nicely.

The moral of the story is to prove that you have the skills, knowledge and a professional conduct according to the Specialist training curriculum. It really depends on the individual's motivation.

A substantive colleague may find it easier because they don’t have to prove in several jobs that they deserve employer's support in furthering their career as locums may have to. I found my immediate supervisors, colleagues are the best people to support my CESR work.

I would say cover every small bit of guidelines and you will get through first time. I know guidelines do not put enough emphasis on some areas and usually people assume that their evidence is good enough which it may not be! 

In brief, furnish your application at least with two supportive, primary evidences for each ILO. For example, where they asked for evidence A or B or C, I provided A & B to be on the safe side on the reapplication. I wish I had done it on the first go.

I also recommend taking on courses. I did courses on report writing and giving evidence on cross examination as an expert witness which provided weight to my medico-legal training.

Khalid Rauf

Read more to receive further information regarding a career in psychiatry