Certificate of Eligibility for Specialist Registration (CESR)

The CESR is for doctors who wish to join the GMC (General Medical Council) Specialist Register, and whose specialist training, qualifications or experience was partly or completely acquired outside of an approved CCT (Certificate of Completion of Training) programme.

It is equivalent to a CCT and certifies that the recipient has all the competences defined in the CCT curriculum.
Last modified
21 January 2020

Who can apply for a CESR?


If you have training, qualifications and experience in paediatrics but have gained these partly or completely outside of an approved CCT training programme (for example, you have trained outside the UK or EEA, moved abroad or taken a career break), you may apply for a CESR in a CCT specialty, listing your specialty as paediatrics.

You will need to demonstrate all specialty learning outcomes specified in the CCT curriculum, including clinical capabilities in acute general paediatrics, neonatal medicine, community child health and safeguarding children.

Paediatric sub-specialties 

Specialist Registration in a sub-specialty is only possible if you have undertaken training outside the UK towards a qualification in a sub-specialty of paediatrics, through CESR in a non-CCT specialty. You would be listed on the Specialist Register in your chosen sub-specialty only, as your sub-specialty training is not equivalent to a full CCT programme.

You will need to demonstrate capabilities consistent with practice as a consultant in the NHS.

Please consult the list of GMC-approved sub-specialties in paediatrics to see which may be certified by this route.

Researchers and academics

If you have not followed conventional specialist training and work outside of clinical practice, but have focused on a specific area of research and made a significant contribution to your academic field, you may apply for a CESR in academic and research medicine.

You will need to demonstrate your contribution to your academic field and that you have achieved the knowledge and skill consistent with that of 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 for certification.

Applicants will need to consult the following pages below:

  • 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 non-CCT CESR applicants should also consult it for examples of evidence
  • approved curricula in paediatrics and sub-specialties show the full range of specilist learning outcomes expected of a doctor attaining either a CCT in paediatrics or a paediatric sub-specialty, and thus for a successful CESR applicant

How to apply

Apply online on the GMC website. You will need to supplement your application with supporting evidence and structured reports from four nominated referees.

The application process includes a guide - please read this carefully. CESR applications are often unsuccessful because applicants do not submit sufficient, recent evidence (ie within the past five years) to cover the full breadth of the CCT curriculum or relevant sub-specialty.

Evidence overview

For different routes:

  • CESR in a CCT specialty - Ensure you can provide primary evidence of your specialist learning outcomes in your 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 - Submit primary evidence that particularly addresses the specialist learning outcomes expected within your sub-specialty syllabus. Such applications may not require evidence to the same standard for all other capabilities outside of their sub-specialty. Nevertheless, you should address all learning outcomes required in the application, to the standard defined in the syllabus of your chosen sub-specialty.
  • CESR in academic and research medicine - Submit primary evidence that particularly addresses the capabilities expected within your area of research. Nevertheless, you should address all capabilities 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. (Academic applicants may not require this level of certification.)
  • Child protection - Up-to-date, level three child protection training within the last three to five years, with primary evidence of experience, eg 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 or 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 capabilities 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 your application be unsuccessful, you have 12 months to submit a review application. The College’s evaluation will specify what further evidence would be required for a successful review. Reviews are evaluated only on the points not previously approved.

If there is insufficient evidence of recent clinical experience, the College will typically recommend the applicant take a six month placement in a given field, such as community paediatrics or neonatal medicine, before submitting a review. Applications are evaluated on evidence of learning outcomes, so this period of time is indicative only as sufficient time to obtain enough new evidence. 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 the Training Services team at RCPCH to discuss the most appropriate route to obtaining certification, at equivalence@rcpch.ac.uk or on 020 7092 6000.