CESR / Article 14 in the General Surgery (ONE)

CESR (prev called article 14)

It is a route for Doctors who wish to join the Specialist Register, whose specialist training, qualifications or experience (clinical and non-clinical) was partly or completely acquired outside of an approved CCT programme in the UK. It is equivalent to a CCT and certifies that the recipient has all the competences defined in the CCT curriculum, and so is eligible for admission to the Specialist Register.This can be obtained in CCT Speciality, Non CCT speciality and Academic or Research Medicine. Most of the SAS doctors tend to apply for CCT speciality.

Pre-requisite for CESR in CCT Speciality:

You must have either: a specialist qualification in the specialty you are applying in OR at least six months continuous specialist training in the specialty you are applying in

Pre-requisite for CESR in non-CCT Speciality:

You must have either a specialist medical qualification from outside the UK in any non-CCT specialty OR at least six months continuous specialist training outside the UK in any non-CCT specialty.

Period: GMC normal assesses application and answer within 6 months of submission but you need approximately 2 years of planning:

Important Tips for Applicants:

1.                  Look at Speciality Specific Guidance, if some of the evidence is not available perhaps consider delaying the application.

2.                  Look at Speciality Specific Checklist if available from respective Royal Colleges

3.                  Please check approved speciality and subspecialist curriculum from Royal colleges,  it keeps on changing e.g. The general surgery curriculum was changed in 2013.

4.                  Read guidance on GMC websites. GMC has recently changed the amount of documentation one can submit for CESR. They expect specific documentation.

5.                  Choose your references carefully they need to comment on your clinical competences, at least six referees (from the last 5 years) are required preferably to give eight to ten(from earlier experience).

6.                  Emails are good sources of information about yourself from colleagues and could be used as an evidence.

7.                  Don’t delete any emails which are work related. The positive comments on it about work can be used as evidence.

8.                  Discuss with the collegues in your speciality who had been successfully granted CESR to get guidance for your application.

9.                  Attend CESR seminar, BMA organises this with help of GMC. It will give fair idea about the work you need to do.

10.              Curriculum  is a key. Visit JCST website, look at what is requirement for your speciality (http://www.jcst.org/quality_assurance/cct_guidelines). If you do not meet the criteria delay the application.

11.              Discuss with the trainee in your speciality about his ARCP and requirements for successful completion of ARCP and CCT. You need to have more evidence than a trainee to complete CESR.

12.              You will not be granted CESR if you have not completed exit exam in your speciality. "The successful completion of the Intercollegiate exam  demonstrates your depth and breadth of knowledge is equivalent to the standards required by the  CCT curriculum"

13.              Please re-write your CV from scratch. The application form and CV must correspond,  submitting a CV that does not contain the required information will delay your application and also if you have not submitted all evidence as mentioned on the CV will also delay your application.

14.              Please write page number of each of document when possible printed or write it yourself it is very helpful.

15.              Use lot of polly pocket to store all the evidence.

Validating the evidence.

Original documents which are on headed paper with hospital stamp and original signature e.g. letters do not need validation is submitting original. All photocopied evidence should contain on every page of each document a hospital stamp, validators name (printed and in full), validators job title (printed and in full) and validators original signature. 

If you submitting evidence gathered from Princess of Wales – needs to be validated by somebody from the same hospital.

If a document has multiple pages (for example, a logbook or appraisal), the first page must show the stamp, signature, name and job title as described above. The rest of the document can simply show the stamp and signature. (In such case you case ask your validator to write that “He has verified this page and another …. Pages of this logbook or appraisal document of Mr/Dr XYZ) Make sure logbook or appraisal document has your name on it.

Authencating your evidence

Evidence showing registration with overseas medical regulators or qualifications gained outside the UK have to be authenticated by a solicitor or from the overseas awarding body. (You will still stamp, sign and date)

Confidentiality

Annonymise all patients information, information of colleagues you have assessed or written a reference for. No Name, addresses, NHS numbers, GMC numbers or email address. Gender and Date of Birth is allowed.

Use white eraser ink to anonymise all evidence. Marker pens are not best

GMC take patient and colleague confidentiality very seriously. They can inform Royal College about this and will also omit evidence that is not anonymised. PLEASE CAREFULLY CHECK EVERYWORD OF DOCUMENT YOU HAVE PROVIDED.

EVIDENCE (Suggestions)

Domain 1 Knowledge Skills and performance

1.                  Primary medical qualification, any overseas qualification with overseas syllabus validated by your overseas Head of department or Professor

2.                  UK exams, exit exams

3.                  Logbooks – surgical, Total consolidated experience, year wise experience last 5 years also complete logbook of surgical training (please explain the year of logbook as per CV and mention period and name on each page)

4.                  DOPS and PBA to level 4 for speciality specific and general surgery index procedures (at least 60),  CBD and observation of teaching.

5.                  Courses  - relevant courses in your speciality

a.                  Divided courses as clinical, teaching, managerial

6.                  Conferences

7.                  Research

a.                  Thesis

b.                  Original articles – mandatory to have original article published in your speciality indexed journal

c.                   Other publication like abstracted publications, Letter to editors, technical tips, commentary,

d.                  Presentations – International, National, regional and local

8.                  Teaching, training, assessing and appraising

a.                  Evidence of teaching courses attended

b.                  Feedback – personal and team

c.                   Lectures delivered in various teaching courses

d.                  Organising teaching course

e.                  Assessing juniors – CBD, CEX DOPS

f.                    Appraising colleagues as an appraiser

Domain 2 Safety and Quality

1.                  Audits

a.                  Completed full cycle audit in last 5 years with other one phase audits

b.                  Audit on service delivery, infection control, quality control audits – very helpful

2.                  Participating in various committees in the hospital e.g. MDT, research risk review group or data quality with minutes of meetings.

3.                  Training in infection control, radiation hazard etc

4.                  Upto date personal immunisation

5.                  Lot of evidence from Domain 1 will also be considered for this Domain 2 so please mention also in Domain 2

Domain 3 Communication Partnership and Teamwork

1.                  Structures reports from prev exams

2.                  Assessments used in prec Domains

3.                  Testimonials or old references

4.                  Cancer MDT letters

5.                  Letter to GP, colleague and patients – anonymised

6.                  Letter to you from GP’s, Colleagues and patients – anonymised

7.                  360 degree feedback

8.                  Management diplomas

Domain 4 – Maintaining Trust

1.                  References

2.                  Structured reports, testimonials and assessments

3.                  Complaints

4.                  Compliments – card letter from patients and colleagues

References are key for a successful application

Lot of evidence can be used in more than one Domain so please use it

Triangulate all information properly

if you need more information please email me or send a message and will send or give specific info you need. 

This information is based on the personal experience. I would strongly recommend to use GMC website for all information. please contact me if you need to discuss any thing. There are more practical information I cannot share on the blog.