Certificate of Eligibility for Specialist Registration (CESR)

The CESR is for doctors who wish to join the Specialist Register, whose specialist training, qualifications or experience was partly or completely acquired outside of an approved CCT programme.

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.

On this page:

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Who can apply for a CESR?

General paediatricians

Doctors who have training, qualifications and experience in paediatrics but have gained these partly or completely outside of an approved CCT training programme (e.g. have trained outside the UK, moved abroad, taken a career break) may apply for a CESR in a CCT specialty, listing their specialty as paediatrics.

A CESR in the CCT specialty of paediatrics requires demonstration of competences according to the CCT curriculum, which includes acute general paediatrics, neonatal medicine, community paediatrics and safeguarding children. 

Sub-speciality paediatricians

Doctors who have training, qualifications and experience in a sub-speciality of paediatrics may apply for a CESR in a non-CCT specialty.  Doctors following this route are listed on the Specialist Register in their chosen sub-specialty only, as their sub-specialty training is not equivalent to a full CCT programme.

Qualifications, or at least six months continuous specialist training in the sub-specialty, must have been gained outside the UK. Please consult the list of GMC-approved sub-specialties in paediatrics to see which sub-specialties may be certified by this route.

A CESR in a non-CCT specialty requires demonstration of competences consistent with practice as a consultant in the NHS.

Researchers and academics

Doctors who have not followed conventional specialist training, but have focused on a specific area of narrow research and have made a significant contribution to their academic field may apply for a CESR in academic and research medicine. Applicants must demonstrate their contribution to their academic field and that they have achieved the knowledge and skill consistent with practice as a consultant in the NHS.

Before you apply

All intending CESR applicants are advised first to contact both the RCPCH Certification team and the GMC to discuss the most appropriate route they should take to obtaining certification.

Applicants will need to consult the following pages:

  • FAQs on CESR on the GMC website, for complete details about the CESR and the application process, to ensure that you are applying for the correct certification and are fully informed on what is needed for a successful application.

  • Approved curriculum in paediatrics and sub-specialties shows the full range of competences expected of a doctor attaining either a CCT in paediatrics or a paediatric sub-specialty, and thus for a successful CESR applicant.

  • Specialty guidance checklists are devised to assist in the assessment of the paediatric training standards, in general paediatrics and in sub-specialties, and can be downloaded from the College’s Quality of Training web page.

  • Specialty specific guidance on evidence to be submitted with your application. Use the document listed under ‘Royal College of Paediatrics and Child Health’. This applies particularly to applicants for the CESR in a CCT specialty, but most non-CCT CESR applicants should also consult it for examples of evidence. Applicants for the non-CCT CESR in Community Child Health  should consult the guidance linked immediately below. 

  • Specialty specific guidance (Community Child Health) (PDF, 168KB, 25 pages) on evidence to be submitted with applications for the non-CCT CESR in Community Child Health only.

How to apply

Applications are first made online, through the GMC website. This application will need to be supplemented by supporting evidence and structured reports from six nominated referees.

Evidence overview

All applicants should consult the above information thoroughly when considering making an application. CESR applications are often unsuccessful because applicants have not submitted sufficient, recent evidence (i.e. within the past five years) to cover the full breadth of the CCT curriculum or relevant subspecialty.

CESR in a CCT specialty applicants must ensure they can provide primary evidence of their competences in their training and experience in acute general and community paediatrics, neonatal medicine and safeguarding children. If you have not covered a specific area of the curriculum it is advisable to postpone an application until you have been able to gain this experience.

CESR in a non-CCT specialty applicants will need to submit primary evidence that particularly addresses the competences expected within their sub-specialty. Such applications may not require evidence to the same standard for all other competences outside of their sub-specialty. Nevertheless, applicants should address all competences required in the application, to the standard defined in the curriculum of their chosen sub-specialty.

CESR in academic and research medicine applicants will need to submit primary evidence that particularly addresses the competences expected within their area of research. Nevertheless, applicants should address all competences required in the application, to a standard appropriate to their research. Applicants to this CESR are expected to submit evidence of additional experience related to research and academia.

All applicants are expected to submit the following evidence: 

  • Resuscitation: current, valid APLS certification or equivalent evidence of advanced paediatric and neonatal life support skills. (Non-CCT and academic applicants may not require this level of certification.)

  • Child protection: up-to-date, level 3 child protection training within the last three-five years, with primary evidence of experience, e.g. child protection reports, witness statements, case-based discussions. (Non-CCT and academic applicants may not require evidence of practical experience.)

  • Clinical governance: audit reports written by the applicant, and other evidence of service improvement, risk management projects or other clinical governance activity.

  • Teaching and supervision: teaching presentations, with feedback from attendees. Evidence of attendance at a ‘training the trainers’ course and/or the training or supervision of more junior colleagues. Assessments or feedback for students or colleagues, such as workplace-based assessments, multisource feedback, reference letters or other constructive advice.

  • Management: examples of rota management, meeting/event management, budget management, leading ward rounds, leading audits and service improvement projects, leading on educational or research related activities.

  • Structured reports: the College strongly recommends that all your nominated referees for the structured reports should be fully conversant with the current curriculum and able to provide detailed support for your competence across all or most areas

Application outcomes

All CESR applications are decided on by the GMC, based upon recommendations by the College. Once the College receives an application from the GMC for evaluation, it can take two to three months for the GMC to determine the final outcome.

Unsuccessful applicants

Should an application be unsuccessful, the College’s evaluation will specify what further evidence or training would be required for a successful re-application or review. Resubmissions are evaluated only on the points not previously approved.

Examples of recommended evidence include: evidence of level 3 child protection training or experience, up-to-date certification in APLS or NLS. If further training is required, the College will typically recommend the applicant take a 6-month placement in a given field, such as community paediatrics or neonatal medicine, after which it would expect to find the required competences have been attained. In some circumstances, usually involving acute paediatrics, a 12-month placement may be recommended. It is not the College’s responsibility to provide additional training for CESR applicants. 

Further information

Prospective CESR applicants are advised to contact Ben Harper in the Certification team at RCPCH to discuss the most appropriate route to obtaining certification, at ben.harper@rcpch.ac.uk or on 020 7092 6145.