Career Support

CESR in General Psychiatry

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 General Psychiatry.


An introduction to CESR in the CCT specialty of General Psychiatry

Following completion of their Core Psychiatric training, which lasts for around three years, those pursuing a career in General Psychiatry will complete a further three years of General Psychiatry training. Upon their successful completion of training, they are awarded a Certificate of Completion of Training (CCT) in the speciality of General Psychiatry. This allows them entry to the GMC specialist register. 

To be awarded a CESR in General Psychiatry, 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 General Psychiatry, 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?

Evidence of your competencies should be recent and from within the last five years. Evidence over five years old will hold less weight, as it typically doesn’t demonstrate that the competencies have been recently maintained.


Is MRCPsych required to apply for CESR in General Psychiatry?

No, the MRCPsych qualification is not compulsory for a CESR application. If you do not hold MRCPsych you will, however, need to provide evidence of learning/knowledge covering the range of the topics covered in the MRCPsych examination, as well as demonstrating that you have met all the competencies of the curriculum for Core Psychiatry Training in addition to those of the General Psychiatry curriculum.


A breakdown of the evidence 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 General Psychiatry.

Your evidence should be divided into four different domains. It’s recommended that you apportion the evidence you provide with your application as shown below:

  • Domain one (Knowledge, skills and performance): 75%
  • Domain two (Safety and quality): 20%
  • Domains three (Communication, partnership and teamwork) and four (Maintaining trust): 5%

You will not be able to compensate for shortfalls in your evidence of training and experience in a particular area of the curriculum by providing extra evidence in other areas.

Information about the suggested evidence types that you should use to demonstrate your capabilities in each of the domains can be found in CESR-specific guidance in General Psychiatry.

Unsuccessful applications

CESR applications in the CCT speciality of General Psychiatry which are unsuccessful, are usually unsuccessful because:

  • Applicants need to have either passed the MRCPsych exam or provide alternative evidence that demonstrates equivalent knowledge to someone who has passed the exam.
  • Applicants need to demonstrate that they have achieved all the competencies of both the Core Curriculum and the Advanced Module in the speciality they are applying in.
  • The evaluators need to see for themselves that the applicant can do what is required by the curriculum, meaning primary evidence of the applicant’s clinical practice which shows how they work on a day-to-day basis needs to be submitted.
  • Applicants need to submit evidence of their active leadership in audit, including evidence that they have completed at least one audit cycle.
  • Applicants need to evidence their current competency, which is generally defined as from within the last five years. If an applicant has completed training before this point, it’s crucial that they provide evidence of maintaining competency across the whole area of the curriculum.
It’s strongly recommended that you closely match your experiences against the current curriculum and provide evidence of equivalence across all areas.

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, multi-source feedback and patient feedback, safety, and quality activity especially in clinical audit and quality improvement projects and other areas.

The vast majority of international Psychiatrists 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 Psychiatry department, 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 General Psychiatry 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 speciality-specific guidance, then please contact the GMC.