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
- Evidence is > 5 years old
- Evidence is from core training – must be higher training equivalent
- Not demonstrating higher level experience in psychological therapies
- Evidence does not demonstrate full biopsychosocial assessments, formulation, differential diagnosis and care plan
- Not demonstrating range of evidence across all psychiatric conditions, range of social\cultural backgrounds & all settings\ages
10 top tips
- Map evidence to all aspects of the curriculum
- Present evidence clearly showing which curriculum ILO it satisfies
- Check and check again
- Take advice from GMC, RCPsych and others about your application
- Primary evidence is essential
- Must be current and ST6 equivalent
- WPBAs are important but not sufficient by themselves
- Use reflective notes to triangulate evidence
- Gather evidence from your daily work as you go along
- Validate at the time
Look at the curriculum thoroughly - Victoria Thomas
If I'd looked at the curriculum in sufficient detail, I could have provided all of the evidence the first time round!
I graduated from Newcastle University and completed all of my postgraduate jobs in the UK. I passed each of the MRCPsych exams at my first attempt, however was unsuccessful in gaining a higher training post in CAMHS. I then took a staff grade/specialty doctor post, and, as I was settled in this role, I decided not to pursue further training.
I never planned to apply for CESR, but after a number of years I realised that I would like to have something formal to demonstrate the experience that I had had in my specialty. Most of my clinical experience had been in an inpatient setting, however I had also done two brief community posts and felt that I had gained sufficiently broad experience to attempt the CESR application.
There were no formal support mechanisms in place for this in my Trust, however I sought advice from a colleague who was also going through the process, and from our SAS Tutor, who had achieved CESR herself. I attended a course arranged by the Royal College of Psychiatrists, and it was useful to hear from other doctors who had been successful and hear from them how they had tackled it.
I started by looking at the GMC application form and taking note of each section and subsection. I then looked back retrospectively to find documents, reports, clinical letters etc relevant to each section. I found this fairly straightforward as I had mostly worked in one Trust, so could easily access electronic records and speak to colleagues to gather evidence.
I was fortunate that my clinical supervisor at the time was also the clinical director, and was very supportive in helping me gather the evidence and also in validating well over 1000 pieces of paper! There was a requirement to provide case histories – some of these I compiled specifically for the application, some were amended and anonymised assessment reports etc.
I was not successful in my first attempt. The feedback I received was extremely comprehensive, and I was given very detailed guidance on what I should provide if I wished to request a review of my application. From this I learnt that I should have paid more attention to the detail of the curriculum, rather than focussing on how to fill up each section on the application form.
If I’d looked at the curriculum in sufficient detail, I could have provided all of this evidence first time round, and saved myself the time and expense of the review! I was also asked specifically for workplace-based assessments relating to the outcomes for which I had not provided sufficient evidence. I had not included any of these first time round, so now recommend to colleagues considering this process that they do request colleagues to complete these and submit them with their evidence.
Where there were areas that I found difficult to provide evidence for, for example where I was unable to locate old reports, I found it helpful to include testimonial letters from colleagues who supervised me or were involved in cases with me. I was able to use SPA time to gain additional more up to date experience in different clinical areas where necessary.
From the date I made the decision to start the process to receiving the email to say I had finally been successful, was just under two years. I used most of my annual leave over this time to come into work and gather information, anonymise reports, write up case histories etc. The process overall was not difficult, just extremely time-consuming and expensive – but well worthwhile!