These frequently asked questions deal with common issues faced by SAS doctors and provide background on how Portfolio Pathway works and what is expected of applicants.
Who is the Portfolio Pathway for?
It is for doctors who wish to gain Specialist Registration but have not completed a full training programme in the UK and do not have a relevant training qualification from the European Economic Area.
What are the options in Portfolio Pathway?
Portfolio Pathway in a CCT (Certificate of Completion of Training) specialty: for registration in a specialty with a complete training curriculum approved by the General Medical Council (GMC), ie paediatrics
Portfolio Pathway in a non-CCT specialty: for registration in a specialty without a complete training curriculum approved by the GMC. This includes all paediatric sub-specialties, as well as paediatric specialties without an approved training programme
Portfolio Pathway Academic or Research: for doctors who need specialist registration to pursue research with only minimal clinical practice
Who is eligible to apply?
Applicants must either have a specialty training qualification or have trained for at least six months towards such a qualification.
For Portfolio Pathway in a CCT specialty: this training can be in any specialty anywhere in the world, including the UK
For Portfolio Pathway in a non-CCT specialty: this training must be in a non-GMC approved specialty and must have been taken outside the UK
Why are the non-CCT eligibility criteria restrictive?
The eligibility requirements to apply for Specialist Registration are defined in legislation.
It is not possible under this legislation for the GMC to accept UK-based training for non-CCT specialty applications, nor is it possible to accept training outside the UK for a non-CCT specialty application if the training was in a GMC-approved specialty (eg paediatrics).
Can these criteria be changed?
The GMC has previously reviewed possible changes to the specialist registration process and has found that eligibility criteria can only be legally resolved through a revision of the existing legislation. This would be a long-term project, potentially involving multiple parliamentary bodies.
Why can doctors from overseas compete for roles which UK doctors can’t get?
The GMC itself doesn’t have any control over which non-CCT specialty doctors may wish to apply in. Applicants may apply for Portfolio Pathway in whatever specialty is permitted under the legislation, which the applicant believes to be the most appropriate based on their experience and their acquired evidence. The GMC’s role is to support applicants and ensure a robust and thorough evaluation based on the evidence provided.
Competition cannot factor into how a Portfolio Pathway application is evaluated: this is an employment issue for potential employers to consider. All doctors must be on the Specialist Register to apply for consultant posts, regardless of specialty, so competition for roles does not privilege doctors on the basis of where they trained. The ultimate test of whether a clinician gets a consultant post is an AAC (Advisory Appointments Committee) panel, so this also needs to be considered.
Does this mean the standards for overseas-based doctors are different from those for UK-based doctors?
No. All applicants need to submit evidence that demonstrates knowledge, skills and experience across the full breadth and scope of practice in that specialty, both for generic and clinical learning outcomes. Evidence from anywhere in the world can be accepted for evaluation but will be evaluated against the standard expected of a consultant working in the UK health services.
What alternatives are there for doctors who want non-CCT registration but are not eligible to apply?
In this situation, doctors are expected to apply for Specialist Registration in paediatrics. This may likely involve taking placements or duties in aspects of the general paediatrics curriculum to attain the higher-level learning outcomes outside of the applicant’s usual practice.
It may be possible to take part of a sub-specialty training programme offered outside the UK or achieve such a training qualification in less than six months. As eligibility is determined by the GMC, applicants should contact the GMC in advance to find out if this would be acceptable.
There may be some overseas training qualifications which can be achieved by remote work in the UK, but the GMC has indicated that they have no plans to accept qualifications gained remotely for this purpose.
Does eligibility to apply guarantee success?
The success of an application depends upon its supporting evidence. Training will only be directly relevant to the application evidence if it has taken place within the last five years (working time equivalent, or WTE), ie is recent enough to be considered a current indicator of knowledge, skills and experience. The same standards of evidence will apply for experience from training.
Does the type of Specialist Registration restrict the consultant roles that can be applied for?
Once on the Specialist Register, a doctor may apply for consultant roles in any specialty or sub-specialty, regardless of the specialty on their Register entry. Employers will appoint on the basis of the applicant’s work history and experience.
What is the standard being evaluated? Is the Core curriculum assessed?
We evaluate evidence against the standard expected of a consultant in any of the UK health services in that area of practice. Your evidence will show knowledge, skills and experience that reflect the higher-level learning outcomes commensurate with this standard.
The higher-level learning outcomes are defined in a way that broadly reflects the learning outcomes in Progress+, including some core learning outcomes.
How do I get evidence for clinical capabilities in paediatrics when my employment is entirely within a sub-specialty area?
Doctors preparing for Portfolio Pathway in paediatrics will sometimes need to achieve or refresh their knowledge, skills and experience in areas of practice outside their special interest.
To do this, it may require the doctor working with their employer to get posts or duties that give them the required exposure and experience. These can be full placements, secondments or clinics, as applicants are evaluated on the quality of evidence and not time served in specific roles.
How do the evaluation standards differ for CCT and non-CCT applications?
All applications need evidence for both specialty and generic higher level learning outcomes. These outcomes are reflected in the learning outcomes in Progress+. Non-CCT applicants can refer to the specialty learning outcomes from the relevant sub-specialty syllabus, while CCT applicants will refer to the specialty learning outcomes in general paediatrics.
Generic higher level learning outcomes are largely the same for all applicants, with some minor changes for certain sub-specialties, for example experience in child protection cases.
All applicants must have current certification in advanced paediatric life support and level 3 child protection training.
What about applications in a non-CCT specialty that doesn’t have a sub-specialty syllabus?
The GMC will contact RCPCH with potential applications in a non-CCT specialty without an approved syllabus to determine whether that area of practice is appropriate for a consultant role in the UK.
RCPCH will ask the closest relevant College Specialty Advisory Committee (CSAC) for guidance on whether the application would be viable when applying standards for evaluation, and to give an assessment of the evidence if such an application is accepted and submitted for evaluation.
Who evaluates Portfolio Pathway evidence?
The GMC currently evaluates all applications in paediatrics. This is due to availability of assessors and ensuring we meet the legal deadlines.
The GMC does have associates who can evaluate some paediatric sub-specialties, but whenever possible non-CCT applications will continue to be evaluated by RCPCH, using members of the relevant CSAC.
If an application is rejected by a CSAC, will this be reviewed by anyone else?
Each application evaluated by a CSAC is reviewed by RCPCH before submitting its recommendation to the GMC. This is to ensure that consistency of standards is applied both with regard to standards of knowledge, skills and experience, and to standards of evidence. The RCPCH Training & Quality Board oversees CSACs and may comment on an evaluation as needed.
How many times can an applicant resubmit an application?
If an application is rejected, the applicant can submit a Review application within 12 months of the decision or submit an appeal within 28 days. The Review requires the applicant to submit evidence that addresses the recommendations made in the initial evaluation to show that all expected knowledge, skills and experience have been met.
Most applicants are successful on a Review application. If a Review application is rejected, the applicant can appeal the decision within 28 days or submit a new, full application again. The new application will be evaluated without reference to the previous application, so full evidence for all higher-level learning outcomes must be submitted.
There is no limit on the number of applications an individual doctor can make.
How long does the application process take?
This can vary for each application but it usually takes six to twelve months. Typically, it takes three to six months from starting an application to having it ready for evaluation – this includes verifying and reviewing evidence with the GMC to ensure that all areas are covered. There may be some processing time after this before the GMC can forward the application to assessors.
Once the GMC sends the application for evaluation, it has three months to issue a decision to the applicant.
Further information
Details on how to apply for Portfolio Pathway, with guidance and common questions about preparing applications, is on our Portfolio Pathway web page.