FAQs: CESR entry to the Specialist Register via the Portfolio Pathway
Find answers to frequently asked questions about the Portfolio Pathway and entry to the GMC Specialist Register via the Portfolio Pathway.
Why is there a Portfolio Pathway?
Some doctors may have chosen not to undertake formal training to gain a CCT, while others may have wanted to do so and been unable to, but still wish to attain specialist status. The alternative is to work for and apply to GMC for a CESR via the Portfolio Pathway. Some may aim to obtain a CESR from the time they commence work in the specialty, although it can be attempted at any time after that. The Portfolio Pathway enables you to work towards specialist registration at any time after you enter the specialty without undergoing a full formal training programme.
How long can I take before applying for a CESR?
The minimum is generally considered to be four years’ WTE work in Occupational Medicine (OM), as for specialty training, but there will be no maximum period of time or deadline for the achievement of all capabilities.
Do I need any postgraduate diplomas before entry?
No. It is not essential to have obtained any postgraduate diplomas before entering this pathway, although if you have not obtained any, you will need to be able to demonstrate the achievement of the capabilities of core training in any recognised specialty or general practice in an equivalent way.
What qualifying criteria will I need to meet before entering this pathway?
If you wish to proceed towards applying for a CESR via the Portfolio Pathway, you will still need to have completed, as a minimum, both Foundation Years and at least two years in a range of fields of medicine by way of core training. You will need to provide evidence that capabilities have been achieved without having had to pass postgraduate exams. You can submit your evidence to FOM for consideration before preparing to gather evidence for a Portfolio Pathway/CESR application later.
Will I need to apply to NSOH and obtain a training number?
No. Neither is required in order to follow this pathway.
What if I do not meet the criteria for entering this pathway?
You would not be able to obtain a CESR, but will still be able to work in OM and obtain the DOcc Med. (You may also be able to obtain the AFOM if you meet the criteria to enter that examination).
Do I have to obtain a GMC-approved training post?
No. Any post you work in will not require GMC approval.
Will I need to be supervised?
This is strongly recommended, preferably by a more senior occupational physician (OP) (with at least the MFOM qualification) acting in the same way as an Educational Supervisor does for a specialty trainee. He or she will ideally be trained in order to undertake this role. If you have someone acting for you in this capacity, you can inform FOM of this. At the very least, you should have a senior OP to mentor you. They may or may not work for the same organisation as you, but you are recommended to interact regularly with them and you will need the assistance of an OP in at least one organisation you work for who is able to observe your work directly (and who may then act as a referee when you apply for a CESR).
How will I know if the work I am doing will assist me in gathering the necessary evidence?
FOM is encouraging senior OPs, such as Regional Specialty Advisers (RSAs), to offer advice to those interested in pursuing the Portfolio Pathway about the opportunities for gathering evidence in the course of their work and how this might be gained, if necessary, from various sources. FOM would also encourage employers of OPs (those who are in formal employment) who wish to apply for a CESR via the Portfolio Pathway in due course to confirm their support for them in writing to FOM.
How will I collect and maintain evidence?
The Faculty of Occupational Medicine (FOM) e-portfolio is available for this purpose for a certain number of Portfolio Pathway candidates, as it is for specialty trainees, although other organised means of storing documents electronically would also be suitable. It is recommended that you collect and keep evidence as you go along.
What kind of evidence will I need to collect and how much?
The Specialty Specific Guidance (SSG) documents for OM (one for the 2017 curriculum, one for the 2022 curriculum), which can be found on the GMC and FOM websites, give indications of what is required, although the OP supervising or mentoring you will also be able to guide you. The various Portfolio Pathway pages on the GMC website should also be consulted.
What curriculum will I need to follow?
You may be able to choose to follow either the 2017 or 2022 curriculum, according to eligibility criteria, similarly to the situation for trainees (see elsewhere on FOM website).
Will I need to undertake WBAs/SLEs?
Yes. These will need to be in the same format as for specialty training. The FOM website and SSG give information about how these are to be done, in what numbers per year (if you are working full time) and the forms to be used.
Will I need to pass exams?
FOM expects that you will take and pass the exams which enable you to obtain the FOM’s DOcc Med and AFOM qualifications (similar to or identical to the MFOM Part 1 and Part 2 exams, respectively). The SSG should be consulted.
What if I have taken the Irish MFOM exams?
You will need to have taken the FOM’s Diploma in Occupational Medicine Examinations (or equivalent). However, if you have passed the Irish MFOM exams and have not taken the FOM’s AFOM exams, you will not need to do so. The FOM Council considered this question and concluded that the Irish exams were considered equivalent to the AFOM ones. This position may be subject to periodic review.
Will I need to do research?
Yes. If you have previously undertaken research and have gained a degree in a topic or subject related to medicine (not necessarily Occupational Medicine) or in a related scientific discipline, no matter how long ago this was, you will not need to undertake any further research. Otherwise, you are still able (and welcome) to write a dissertation and if you have obtained a University degree as a result, this too will be acceptable. For all other items of research (including dissertations not submitted for a degree), written evidence that they have met the required standard will need to be provided in a CESR application. This can be obtained from your Educational Supervisor, if you have one, or by submitting your research to FOM for approval. You will need to have attended an FOM PP Coaching Day to access the FOM service. If you do, your evidence will be passed by FOM staff to one of a panel of assessors who will consider it and provide a written outcome.
Will I have to have ARCPs?
No. You will not have to attend any formal reviews with NSOH or any LETB. An appraisal process you already participate in may incorporate an assessment of your progress towards an application for CESR if the appraiser is willing to carry it out. If you obtain advice on your progress along the Portfolio Pathway in your appraisal, you can notify FOM about the outcome – that either you are proceeding satisfactorily or that specific actions will be needed to get you “back on track” (FOM will not need to know what those are).
Can I work towards a CESR if working less than full time?
Yes, if your employer(s) agree(s). You should still have worked at least four years WTE in OM before you apply for a CESR.
Where will I be able to obtain advice and support once I have commenced?
This will be primarily available from your supervisor, but can also be obtained from your nearest RSA and from the FOM Portfolio Pathway Group. In addition, the SOM has a Portfolio Pathway support group. Both FOM and SOM also have Portfolio Pathway representatives whom you can approach with questions or to offer feedback on your experience.
Is it possible to obtain advice about the quality of examples of my evidence if it is difficult to do so otherwise?
Yes. FOM has set up an assessment panel for this purpose and you can approach FOM in order to obtain this advice. This service is provided voluntarily by FOM and is intended for Portfolio Pathway candidates who are not able to gain access to regular supervision or guidance from senior colleagues. You will need to have attended an FOM Coaching Day to access the service. Your evidence will be passed by FOM staff to one of a panel of assessors who will consider it and provide advice. The advice you receive can be used to guide your evidence gathering or refine the quality of it and can be discussed with any senior colleague who advises you. It is recommended that you reflect on it. Any indication you receive that your evidence is considered to be of satisfactory quality will not, however, be binding on the evaluation of your CESR application – the evaluators will consider it independently. Only individual examples of evidence, rather than substantial amounts, will be considered. Evidence relating to research or complaints is excluded from this service. Any evidence you submit will be processed in accordance with FOM’s data protection policies.
What happens if I cannot complete the collection of all the evidence needed for a CESR application?
This will not affect your employment and you may be able to resume this later if you choose, with what you have previously done being able to count towards your application for a CESR if you choose to make one. (Please note, however, that GMC indicate that they expect to see evidence which is mostly from the last six years of your practice at the time you make an application for CESR).
Where can I find more information about the Portfolio Pathway?
There is additional information on the FOM and GMC websites. You can also make enquiries by contacting FOM in person. In addition, FOM holds coaching days annually for those interested in following the Portfolio Pathway and strongly recommends that you attend one of these days (anyone supervising or mentoring you is also welcome to attend if they wish).
