CESR in Histopathology

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 Histopathology.

An introduction to CESR in the CCT specialty of Histopathology

Following completion of their Integrated Cellular Pathology Training, which lasts for 2.5 years, those pursuing a career in Histopathology will complete a further 2.5 years of higher speciality training. Upon their successful completion of training, they are awarded a Certificate of Completion of Training (CCT) in the specialty of Histopathology. 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 Histopathology, 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 within the last five years, however, small amounts of older evidence may support an application if it’s highly relevant to Histopathology practise (for example, robust evidence of basic autopsy training older than five years will be accepted as a CCT trainee does not need to maintain this).

Evidence from over eight years prior to your application (other than qualifications and evidence of career history) will be discounted so this should not be submitted.

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 Histopathology.

The Histopathology curriculum developed by the Royal College of Pathologists is divided into 11 capabilities in practice (CiPs). Each CiP has a set of descriptors associated with that activity or task and applicants must demonstrate that they are capable of unsupervised practice in all 11 CiPs.

Capabilities in Practice (CiPs)

The following 11 Capabilities in Practice (CiPs) describe the professional tasks or work within the scope of Histopathology. Applicants must demonstrate that they are capable of unsupervised practice in all 11 CiPs:

  • CiP 1 – Able to function effectively within healthcare and other organisational and management systems to deliver consistent highquality patient care.
  • CiP 2 – Able to work within ethical and legal frameworks across all aspects of 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 – Maintains patient safety at the forefront of clinical working. Can utilise quality improvement activity realistically within the constraints of the role.
  • CiP 5 – Able to contribute to and support research.
  • CiP 6 – Behaves as an educator in the context of the role and promotes educational culture.
  • CiP 7 – Able to self-appraise, learn and adapt.
  • CiP 8 – Able to demonstrate leadership and management within the laboratory setting for the benefit of patient care.
  • CiP 9 – Able to use laboratory and other services effectively in the investigation, diagnosis, and management of patients, relatives, and the deceased.
  • CiP 10 – Able to manage and contribute to a multidisciplinary team effectively.
  • CiP 11 – Able to take, manage and interpret pathological specimens accurately and safely, mindful of risks to self and others.
For further information about the CiPs, please carefully read the CESR Specific Guidance in Histopathology.

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 Histopathology:

  • Primary medical qualification (PMQ)
  • Specialist medical qualification(s)
  • Recent specialist training
  • CV
  • Employment letters
  • Job descriptions
  • Logbooks
  • Case histories
  • Appraisals and assessments
  • ARCPs and training assessments
  • 360˚and multi-source feedback
  • Management and leadership experience
  • CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences
  • Membership of professional bodies and organisations
  • Audits undertaken by applicant
  • Reflective diaries
  • Service Improvement and clinical governance meetings
  • Health and safety
  • Letters from colleagues
  • Teaching timetables
  • Lectures
  • Feedback or evaluation forms from those taught
  • Attendance at teaching or appraisal courses
  • Participation in assessment or appraisal and appointments processes
  • Working in multidisciplinary teams
  • Service Improvement and clinical governance meetings
  • Management and leadership experience
  • Data protection certification
  • Research papers, grants, patent designs
  • Publications within specialty field
  • Presentations, poster presentations
For explanations of exactly what is required for the evidence types mentioned above, please carefully read the CESR Specific Guidance in Histopathology.

Unsuccessful applications or poor evidence

The Royal College advise that unsuccessful applications from doctors in the specialty of Histopathology are often submitted with inadequate or poor evidence in these areas:

  • No evidence of Fellowship of the Royal College of Pathologists (FRCPath) by examination or equivalent robust evidence of knowledge of the breadth and depth of the curriculum.
  • No evidence of experience or exposure to paediatric and neuropathology.
  • No evidence of competence in Autopsies equivalent to the curriculum. Applicants need to demonstrate evidence of performing 40 adult autopsies.
  • No evidence of competence in Gynae Cytology equivalent to the curriculum.

It is 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, 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 Histopathologists 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 Histopathology 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 Histopathology 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.