Routes to registration

There are four main routes to specialist registration in the UK. These pathways, and the certificates they result in, are outlined below:

Route 1:


Certificate Issued:

Certificate of Completion of Training (CCT)

Eligibility Requirements:


This is for doctors who complete their specialist psychiatric training in GMC-approved training posts.

For trainees that complete both Core and Higher psychiatry training in the UK.

Route 2:

The Combined Programme

Certificate Issued:

Certificate of Completion of Training

Eligibility Requirements:


This is for those who have completed part of their training in GMC-approved training posts and some outside of approved training posts, typically either international training that isn’t recognised by the GMC or working as a Specialist or Associate Specialist doctor to obtain competencies. 

Route 3:


Certificate Issued:

Certificate of Eligibility for Specialist Registration (CESR)

Eligibility Requirements:


This is the equivalence process for those who have not completed GMC-approved training where doctors use their current psychiatric practice (the last 5-6 years) to evidence each competency outlined in the relevant specialty curriculum.
Route 4:

Relevant European Qualification - Specialist

Certificate Issued:

No certificate issued

Eligibility Requirements:


For doctors who hold a relevant specialist European Qualification which meets the current GMC criteria for recognition

Brexit's impact on psychiatry training

As of 28 May 2021, the GMC have announced the full impact of the UK leaving the EU on certification for trainees within psychiatry. UK postgraduate medical education is no longer bound by the EU directive, 'Professional qualifications in practice' and as a result there is no longer a mandated minimum training duration to be completed.

All psychiatric trainees, whether they enter ST4 through successful completion of Core training or via the Combined Programme route, will be eligible for CCT upon completion of their higher training.

This is not able to be applied retrospectively to before the UK's departure from the EU on 1 January 2021.

What this means for those previously issued with CESR via the Combined Programme

The recent change cannot be issued retrospectively so if you were issued a CESR through the Combined Programme before 1 January 2021 you cannot be issued with a CCT unless you meet the requirements below:

  • Those previously issued with a CESR at the end of their CESR CP programme may be eligible to have it reviewed and be issued with a CCT.
  • If you have qualified in either Child and Adolescent or General psychiatry, you will need to have been in GMC-approved UK training for a minimum of four years (WTE) and be able to provide evidence of this.
  • For all other specialties with no minimum training time requirement, you would need to provide evidence of your time in UK training and that you left a GMC-approved UK training programme ready for consultant practice.

The GMC website has information on how to apply for a retrospective granting of a CCT for doctors granted a CESR through the combined programme.

What this means for MTIs

  • Medical Training Initiative posts are not required to be undertaken in GMC approved UK training posts and MTI doctors and trusts are required not to complete a formal documented ARCP process.
  • This means that MTI posts are not eligible to count towards a CCT.

Advice for SAS doctors

The experience and circumstance of SAS doctors is not universal and the best course of action for specialist registration within psychiatry is very dependent on the specific doctor. We understand that the individual circumstances, of each doctor, are not always compatible with re-entering into training.

To ascertain what your best course of action should be we would advise you to:

  • speak with your local School of Psychiatry for a clear understanding of training and the options within it
  • speak with a CESR mentor in your trust (if you have one)
  • speak with any known colleagues who are undergoing or have undergone the CESR process.

We would also advise you to contact the CESR & Training department at the College who are happy to talk through your circumstances and your options in relation to those circumstances. It is our aim to maintain a lack of bias between all routes to consultancy and to offer clear and concise advice relevant to your specific situation.

Contacts for clarification

Current trainees or prospective trainees (incl. of MTIs and SAS doctors) should email for clarification around their CCT eligibility or potential eligibility.

Those already on the specialist register should email the GMC at to directly to discuss their eligibility.