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​

My advice for applying for CESR - Vijayendra Waykar

CESR is a process to ensure applicants are able to demonstrate ‘equivalence’ to specialist registration in terms of their knowledge, skills and performance. Most applicants produce a bundle of evidence with comprehensive reports and case summaries but still fail to demonstrate the ‘equivalence’ which is a crucial part of the process. 

My advice would be to pair up with at least 2 people who are in the process of applying for specialist registration within the next 1 year. This could be current ST 5 trainees within your trust. Speak to them about how they are collecting evidence for different ILOs (Intended learning Outcomes). For the purpose of CESR you would need roughly similar (probably a bit more) evidence to what ST6 trainees have collected for their final ARCP.

My advice would be to clearly set yourself a time period of 1-2 years and speak to you clinical supervisor and make relevant people in the trust (clinical director, medical director, director of medical education, SAS tutor) aware of your intention. Check how the trust can support you in this process. This could be in the form of agreeing a job plan including activities (Direct Clinical Care and Supporting Professional Activity) which will make it easy for you to collect evidence for your portfolio. 

You could negotiate more allocated time for ‘portfolio work’ in your job plan. Most applicants I know spend a lot of their own time on weekends or annual leave in collecting evidence. I found it easy to collect evidence prospectively during working week.  Keep your log book templates readily available around your desk area and complete them regularly and keep them up-to-date.

Mark out cases which you want to include in the evidence and get it validated from your supervisor. Remember if you collect evidence prospectively you are saving a lot of hassle later on. If possible, have your portfolio reviewed by supervisor once in 3-4 months to check if you are on track. Check with your ST5-6 colleagues/clinical supervisor if you are unsure about a particular competency from the curriculum. 

GMC expects you to separate evidence into 4 GMC domains (Knowledge, skills and performance; Safety and Quality; Communication, Partnership and Teamwork; Maintaining trust). I found useful to distribute ILOs into different GMC domains, and this is included in the curriculum. For example, domain 4 will include ILO 14, 17 and 18. This will keep your evidence organised from the beginning.

I will recommend that you keep your Clinical Director and Medical Director informed about your progress in CESR application and look for any opportunities where you could take up ‘acting up consultant role’ within your specialty. This is not mandatory but will strengthen your application. This could be as short as one session (for example covering consultant ward round) or covering planned 2 weeks’ leave.

Identify a mentor who will support you if you are stuck for whatever reason; clinically or professionally during this process. The CESR process can be frustrating at times as the reward is not immediate. You would have to be focussed and remain motivated. Seek appropriate support from family and friends as appropriate and ensure you have time for recreational work as well.

Vijayendra Waykar

Read more to receive further information regarding a career in psychiatry