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last updated:18/01/2022 @ 2:00 pm
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FAQs: CESR entry to the Specialist Register

Find answers to frequently asked questions about CESR entry to the GMC Specialist Register.

Why is there a CESR route/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.  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 CESR route 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 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 competencies.

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 competencies of core training (medicine, surgery or other suitable specialties 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, 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.  (The Person Specification for specialty training indicates which fields are acceptable, but for CESR candidates other clinical specialties may also be considered).   You will need to provide evidence that competencies have been achieved without necessarily having had to pass postgraduate exams.  You can submit your evidence to FOM for consideration before preparing to gather evidence for a 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 D Occ 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 RSAs, to offer advice to those interested in pursuing a CESR 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 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, as it is for specialty trainees,  while the FOM logbook (in the Training Handbook) is an alternative. 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 document for OM, which can be found on the GMC and FOM websites, and the document list on the CESR section of the FOM website give indications of what is required, although the OP supervising or mentoring you will also be able to guide you.  The various pages on CESR on the GMC website should also be consulted.

What curriculum will I need to follow
The current version of the FOM specialty training curriculum, just as for specialty training.

Will I need to undertake WBAs/SLEs
Yes.  These will need to be in the same format as for specialty training. The FOM website gives 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
Yes.  You will need to pass the exams which enable you to obtain the FOM’s Dip Occ Med and AFOM qualifications (similar to or identical to the MFOM Part 1 and Part 2 exams, respectively).

What if I have taken the Irish MFOM exams?
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.  As you will need to demonstrate that you have met all of the same competencies as a trainee working towards a CCT, you will have to meet the research competencies in the same ways.  You may undertake a dissertation ‘for purpose’ unless you have already done an MSc on a suitable subject.  The FOM website gives information about dissertations.

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 towards CESR 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 will still need to 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 CESR advisory group.  In addition, the SOM has a CESR support group.

What happens if I do not complete my “training” for CESR?
This will not affect your employment and you may be able to resume training 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 not more than five years old at the time you make an application for CESR).

Where can I find more information about CESR
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 working towards obtaining a CESR and strongly recommends that you attend one of these days (anyone supervising or mentoring you is also welcome to attend if they wish).