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:

CESR applicant training day - 21 March 2018

If you are considering entering the Specialist Register through CESR, you'll benefit from this event.

Structured training sessions from paediatric CESR assessors and the GMC Specialist Applications Team will show how to best present evidence from prior training or practice for a successful application and avoid the extra cost of reviews. Bookings are now open. 

Find out more and book, or contact equivalence@rcpch.ac.uk for further details. 

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 or EEA, 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 child health and safeguarding children. 

Sub-speciality paediatricians

Doctors who have undertaken training outside the UK towards a qualification in a sub-speciality of paediatrics may be eligible to 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.

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:

  • 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. 

  • 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. Please note that the new curriculum will apply to CESRs  commenced from 1 August 2018.

  • RCPCH guidance for applicants (PDF, 46KB, 2 pages) summarises the evidence and other information needed to complete a successful CESR application.

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. (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, applicants 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 6-month placement in a given field, such as community paediatrics or neonatal medicine, before submitting a review. Applications are evaluated on evidence of competence, so this is 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 contact Ben Harper in the Certification team at RCPCH to discuss the most appropriate route to obtaining certification, at equivalence@rcpch.ac.uk or on 020 7092 6145.