Since November last year, the General Medical Council has implemented its new Portfolio Pathway system to replace the Certificate of Eligibility for Specialist Registration (CESR). In this article, College Training Manager Jenny Maginley explains these changes.

Doctors must have their names entered on the General Medical Council's (GMC) Specialist Register before taking up substantive, honorary or fixed-term NHS consultant posts in the UK.

Until 29 November 2023, the Certificate of Eligibility for Specialist Registration (CESR) was the route to specialist registration for doctors who had not completed a GMC-approved programme but who were able to demonstrate that their specialist training, qualifications and experience gained anywhere in the world were equivalent to the requirements for the award of the Certificate of Completion of Training (CCT).

Since 30 November 2023, the legislation has changed. It now requires applicants to demonstrate that they have the knowledge, skills and experience required for practising as an eligible specialist in the UK. Doctors are no longer required to demonstrate equivalence to the respective CCT curriculum but must instead demonstrate how they meet the high-level outcomes, known as Capabilities in Practice (CiPs). The GMC has, therefore, renamed the CESR pathway as the Portfolio Pathway. As with the CESR process, applicants will continue to apply directly to the GMC, which then passes the applications to the College for evaluation.

The Portfolio Pathway gives applicants more flexibility to submit evidence that demonstrates capability, rather than mirroring exactly the evidence that a CCT trainee would accumulate.

In preparation for this change, we have worked with the GMC and consulted the College Specialty Training Committees to develop new specialty-specific guidance (SSG) for all the 7 relevant pathology specialties.

The new SSG sets out the evidence that doctors will need to provide to apply in their specialty. In particular, evidence from the last 10 years will now be accepted. However, a small amount of older evidence can also be considered, where it provides a more complete account of the breadth of practice, training, experience and achievement of the curriculum outcomes.

An important point to note is that the FRCPath or an equally robust specialist postgraduate examination will be the best way to demonstrate knowledge. The College is unable to define what alternative evidence would be acceptable from doctors who have not passed the FRCPath or similar examination.

For applicants in medical microbiology and medical virology, experience and qualifications gained in another specialty (e.g. MRCP (UK)) could be used to provide evidence of knowledge and skills in support of continuity of care for inpatients and outpatients with suspected or proven infection. However, experience and such qualifications in another specialty are not essential, since the scope of their medical microbiology or virology practice may provide sufficient evidence towards this CiP.

In addition to the SSGs, a template has been produced to allow Portfolio Pathway applicants to map their evidence to the relevant curriculum CiPs and describe how they meet them. This also allows the assessors to clearly understand how applicants intended the evidence submitted to be used.

These documents and further information can now be found on the College's website.

We advise doctors considering a Portfolio Pathway application to contact the Training team ([email protected]) at the College for advice, before applying to the GMC.

We have seen a large increase in the number of CESR applications recently. This trend is set to continue for some time. By mid-February this year, we evaluated 12 CESR applications, having evaluated 38 applications in 2023 and 14 applications in 2022.

Applications submitted before 30 November 2023 will be assessed against the requirements and specialty guidance that were in place at the time of submission.

We are planning webinars for both current and new Portfolio Pathway assessors, as well as for future Portfolio Pathway applicants. All webinars will be recorded and available on the College website in due course.

The College is always looking to recruit assessors and welcomes applications from consultants, who meet the role description specification. The College’s Portfolio Pathway assessors play a vital role in helping us uphold the highest standards for entry to the Specialist Register for our pathology specialties.

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