Hail CESR! The portfolio pathway and how I successfully navigated my way to specialist registration
28 May, 2026
Read Dr Juliette Fowler's personal, practical reflection from on successfully navigating the CESR (Portfolio Pathway) and achieving specialist registration.
I genuinely loved the Portfolio Pathway (PP). It offered a structured, evidence based way to demonstrate my abilities – something exams had never quite captured for me. Instead of waiting for someone else to tell me how I was doing, I had the chance to show it myself.
And with that came opportunities I might never have had in training. Every day became a small treasure hunt:
- Teaching a student? Ask for feedback.
- Chairing a meeting? Use the minutes as evidence.
- Handling a complex case? Document the journey.
Once I started looking, the evidence was everywhere.
Starting from scratch (and a big pile of paper)
The truth? I had absolutely no idea how to begin. I didn’t know anyone who had completed CESR, let alone passed first time. So I started simply: I took a week of study leave, emptied every drawer in my office, and sifted through every piece of paper I could find. Then I did the same digitally – emails, folders, attachments – anything that might become evidence.
It wasn’t glamorous, but it was a start.
The rhythm of hard work (and the gift of protected time)
The process wasn’t linear. I’d have bursts of productivity followed by weeks where work took over and CESR sat untouched. What changed everything was my Clinical Director. They asked what I needed, and the answer was simple: time.
For six months, every Monday afternoon was mine. No calls. No interruptions. Just me and the portfolio. Slowly, something resembling a submission began to take shape.
Organisation: the beating heart of CESR
If CESR has a secret, it’s organisation. I tried countless formats before landing on what worked:
- Listing every Intended Learning Outcome (now Higher Learning Outcome)
- Writing the evidence for each
- Adding page numbers for quick navigation
- Using a traffic light system:
- Green – complete
- Amber – in progress
- Red – not started
That colour coding saved me. On days when motivation dipped, seeing the greens grow gave me the push I needed.
If you’re wondering where to start, begin with the “easy” bits – the time consuming but straightforward documents like job plans, contracts, HR letters confirming exact dates. If you don’t have them, request them early.
Follow the instructions (even if they seem daft!)
At times it is a bit like playing “Simon says” because if the process asks you to do something in a particular way, do it that way! For example, use the GMC format for your CV as requested. Even if you don’t have something to put in a box, still add the section for completeness.
Telling the story behind the evidence
Think about what you want the evaluators to understand. Are you demonstrating your use of the Mental Health Act? Leading a complex patient journey? Showing leadership? Teaching?
To help with this, I created a cover sheet for every case, including:
- Diagnosis
- Contents
- A short summary of what I was illustrating
It guided the evaluators through my thinking – and reminded me what each case was meant to show.
Becoming a PDF ninja
Your technical skills will skyrocket. Mine certainly did. A good PDF editor became my best friend – redacting, merging, rotating pages (yes, they must all face the right way or the admin team will return your application). It sounds trivial, but the detail matters. The more polished your submission, the fewer corrections you’ll face later.
Submission: the start of a new waiting game
Submitting isn’t the end – it’s the beginning of a long, sometimes unpredictable journey. My process, during COVID, was heavily delayed. Admin corrections took time, but every one of them strengthened my application. The Specialist Advisor was supportive, and when the College finally received it, I naively expected a quick decision.
There were delays finding evaluators. The application sat. And then Sarah – the CESR lead in London – picked it up and moved it forward with such kindness and clarity.
The day it all became real
On 2 May 2023, I received the email: successful registration. Passing first time was exhilarating. Every Monday afternoon, every PDF, every colour coded spreadsheet – it was all worth it.
Since then, I’ve joined the CESR Fellowship programme in Grampian, supporting others through the process. Doctors from across Scotland reach out for advice, and it’s a privilege to demystify something that once felt so opaque.
Thinking about CESR? Here’s my advice...
Stop thinking – start doing!
Start with the easy bits and keep going! Even when it feels slow! Don’t lose faith
You will get there.
Dr Juliette Fowler, Consultant in Psychiatry of Old Age