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CESR in Clinical Radiology

CESR stands for Certificate of Eligibility for Specialist Registration. Doctors who haven’t completed a GMC-approved programme to obtain their CCT, but can evidence that their specialist training, qualifications and experience are equivalent to what is acceptable for CCT in the UK, can apply to join the GMC Specialist Register via the CESR pathway.

This article has been created to assist doctors who are applying for entry onto the GMC Specialist Register with a CESR in Clinical Radiology.


An introduction to CESR in the CCT specialty of Clinical Radiology

Clinical radiology trainees in the UK will complete about five years of specialty training. Upon their successful completion of training, they are awarded a Certificate of Completion of Training (CCT) in the specialty of Clinical radiology. This allows them entry to the GMC specialist register. 

To be awarded this CESR, you will need to submit a range of evidence to demonstrate that your specialty training, qualifications and experience taken together are equivalent to the CCT in Clinical radiology, as set out in the specialty training curriculum.

Upon successful completion of a CESR application, you will receive entry to the GMC specialist register.


Eligibility criteria

To be eligible to apply under this route, you must have either (1) a specialist qualification in the specialty you apply in or (2) at least six months of continuous specialist training in the specialty you apply in.


How much evidence is required?

Most CESR applications contain around 800-1000 pages of evidence.


How recent should the evidence be?

Your CESR application must demonstrate that you have acquired the relevant competencies across the breadth of the curriculum
and/or demonstrated maintenance of those competencies within the last five years.

It’s advised that evidence of skills or experience more than five years old should not be submitted, as typically it does not demonstrate that the competencies have been recently maintained.


Which evidence is required?

You will need to demonstrate that your specialist training, qualifications and experience are equivalent to a doctor who has successfully completed training according to the CCT curriculum for Clinical radiology.

The curriculum is structured around 12 learning outcomes called “Capabilities in Practice” (CiPs). Your evidence must cover the knowledge, skills and qualifications to demonstrate the required CiPs in all areas of the Clinical radiology CCT curriculum.


Capabilities in Practice (CiPs)

The 12 Capabilities in Practice (CiPs) listed below describe the professional capabilities of a consultant clinical radiologist, to which you must demonstrate equivalence. Each CiP has a definition and descriptors about the range of skills and behaviours that your evidence should demonstrate.

  • CiP 1 – Demonstrate the professional values and behaviours expected of all doctors as outlined in Good Medical Practice.
  • CiP 2 – Successfully function within the health service and healthcare systems in the UK.
  • CiP 3 – Engage in reflection, clinical governance and quality improvement processes to ensure good practice.
  • CiP 4 – Engage in evidence-based practice and safeguard data, including imaging data.
  • CiP 5 – Act as a clinical teacher and supervisor.
  • CiP 6 – Work well within a variety of different teams, communicating effectively with colleagues and demonstrating the skills required to lead a team.
  • CiP 7 – Appropriately select and tailor imaging to patient context and the clinical question(s).
  • CiP 8 – Provide timely, accurate and clinically useful reports on imaging studies.
  • CiP 9 – Appropriately manage imaging examination lists/procedures according to clinical need and professional expertise.
  • CiP 10 – Evaluate image quality and utilise the knowledge of imaging sciences to optimise image quality.
  • CiP 11 – Safely manage the imaging and image-guided intervention needed to support emergency care.
  • CiP 12 – Effectively contribute a clinical/imaging opinion to a multidisciplinary (MDT) meeting.
For further information about the CiPs, please carefully read the Specialty Curriculum and CESR Specific Guidance in Clinical Radiology.

Evidence Types

The types of evidence listed below will be required to demonstrate that your specialty training, qualifications and experience are equivalent to the CCT in Clinical Radiology:

  • Primary medical qualification (PMQ)
  • Specialist medical qualification(s)
  • Recent specialist training
  • CV
  • Employment letters
  • Job descriptions
  • Multisource feedback
  • Patient feedback
  • Appraisal
  • Complaints and significant incidents
  • Courses and CPD activity relevant to this CiP Multidisciplinary team (MDT) meeting activity
  • Participation in other meetings involving direct patient care (minutes etc.)
  • Participation in developing guidelines, standard operating procedures etc.
  • Complaints and significant incidents
  • Clinical governance activity
  • Reflective activity
  • Safety and quality activity
  • Audit and quality improvement projects
  • Management and leadership activity
  • Research activity
  • Patient consent forms
  • Good Clinical Practice (GCP) certification and/or other research/ethics courses or qualifications
  • Notes from journal clubs
  • Relevant meeting participation (ethics meetings etc.)
  • Teaching activity
  • Evidence of assessments on others (WpBAs etc.)
  • Workplace-based Assessments (WpBAs)
  • Multidisciplinary team (MDT) meeting activity
  • Clinical correspondence
  • Evidence of assessments on others (WpBAs etc.)
  • Radiology reports
  • Workload statistics
  • Patient feedback
  • Patient consent forms
  • Relevant meeting participation (clinical governance activity)
  • On-call rotas/weekly activity rotas
  • Workplace based Assessments (WpBAs)
  • Participation in morbidity and mortality or other relevant meetings
For explanations of exactly what is required for the evidence types mentioned above, please carefully read the CESR Specific Guidance in Clinical Radiology.

Inadequate Evidence

Annex C of the Specialty Specific Guidance outlines key documents for a successful application. Information about the evidence types required is detailed in Annex A and Annex B, however, it is also advised that you read Annex C to help you ensure that inadequate evidence isn’t submitted.


Can I apply for CESR without having worked in the NHS?

If you haven’t worked in the NHS then it can be very difficult to make a successful CESR application. This is because key features of training and practice in the NHS are not always covered in the same way outside it. For example, MDT meetings, appraisal, multisource feedback and patient feedback, safety, and quality activity especially in clinical audit and quality improvement projects and other areas.

The vast majority of international Radiologists will complete their CESR applications from within the UK, having taken up employment with an NHS organisation. If you’re considering making a CESR application and are currently, or have recently, been practising in an environment that is not comparable to practice in an NHS clinical radiology department (including teleradiology, for example), then you might find it useful to consolidate your experience in the UK beforehand.

Doctors Relocate works alongside NHS organisations across the UK that can support CESR applicants. To further discuss how we could assist you, please contact us.


This article has been created to assist doctors who are applying for entry onto the GMC Specialist Register with a CESR in Clinical Radiology only. We do not offer any CESR advice, nor can we comment or assist with any individual application. If you have a query regarding the specialty-specific guidance, then please contact the RCR.