CESR in Haematology

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 Haematology.

An introduction to CESR in the CCT specialty of Haematology

The indicative period of training for a CCT in Haematology is seven years. When a UK trainee has completed their training satisfactorily, they will be eligible for a CCT and can be recommended to the GMC for inclusion on the specialist register. At this stage, they will be regarded as capable of unsupervised practice and eligible for appointment as an NHS consultant.

To be awarded a CESR in Haematology, 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 Haematology 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.

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 Haematology.

The Haematology curriculum is divided into 13 capabilities in practice (CiPs). Each CiP has a set of descriptors associated with that activity or task and applicants must demonstrate the required CiPs in all areas of the curriculum.

Capabilities in Practice (CiPs)

The first 6 Capabilities in Practice (CiPs) are generic and shared across all physician specialties:

  • CiP 1 – Able to function successfully within NHS organisational and management systems.
  • CiP 2 – Able to deal with ethical and legal issues related to clinical practice.
  • CiP 3 – Communicates effectively and is able to share decision-making, while maintaining appropriate situational awareness, professional behaviour and professional judgement.
  • CiP 4 – Is focussed on patient safety and delivers effective quality improvement in patient care.
  • CiP 5 – Carries out research and manages data appropriately.
  • CiP 6 – Acts as a clinical teacher and clinical supervisor.

The remaining 7 CiPs describe the clinical tasks or activities essential to the Haematology practice.

  • CiP 7 – Providing a comprehensive haematology laboratory service, including investigation, reporting and blood transfusion.
  • CiP 8 – Providing safe clinical advice to colleagues on the interpretation of haematology laboratory results, blood transfusion practice and haematological disorders.
  • CiP 9 – Managing patients with suspected or known haematological disorders in the outpatient setting.
  • CiP 10 – Managing patients in an ambulatory/ day unit environment including specialist haematological treatments.
  • CiP 11 – Managing inpatients with haematological conditions and provide continuity of care to haematological inpatients.
  • CiP 12 – Managing acute haematological emergencies in all environments.
  • CiP 13 – Managing end-of-life and palliative care skills.
For further information about the CiPs, please carefully read the CESR Specific Guidance in Haematology.

Suggested Evidence

Information about the suggested evidence that you should use to demonstrate your key capabilities in the different CiPs can be found between pages 10 – 39 of the CESR-specific guidance in Haematology.

Tips for a successful CESR application in Haematology

Most CESR applications will fail because inadequate or poor evidence of current capabilities – covering the entire curriculum – is provided. As such, it’s recommended that:

  • Prior to submitting your CESR in Haematology application, you review the current CCT curriculum in conjunction with the CESR-specific guidance in Haematology.
  • You provide evidence of your current capabilities in all areas of the curriculum.
  • You ensure that your evidence is clearly linked to the CiPs and is presented in a clear, logical manner.
  • You ensure you have evidence demonstrating core medical knowledge and application of this knowledge in practice to the level of two years of Internal Medicine stage 1 training. To demonstrate core internal medical capabilities, applicants need to provide MRCP (UK) or equivalent and evidence showing the application of core skills including outpatient capability. This evidence could include supervised learning events (SLEs) and workplace based assessments (WPBAs) including multi-source feedback (MSF).
  • You ensure that your referees can provide detailed support for your key skills across all (or most) areas of the curriculum and understand the requirements for specialist training and registration in Haematology in the UK.
  • You can provide evidence of managing a broad range of patients (as seen daily by Haematology doctors in the UK) and of your clinical capability across the range of experience, ages and settings.
  • You ensure that your evidence demonstrates that you are entrusted to act at consultant level across all of the specialty CiPs.

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 Haematologists 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 Haematology 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 Haematology 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.