Applying through CESR · 1 –submission of application 2 –evaluation by College/Faculty ......

Applying through CESR

5th November 2018

Mr Amit Kochhar, SASC UK Chairman for BMADr Sujesh Bansal, Consultant Anaesthetist & CESR Champion

Applying for CESR

Today we will consider:• Why are you applying?

• Is CESR the route for you?

• CESR portfolio introduction

• What’s stopping you?

• Changes in 2018-2019

Applying for CESR

Introductions

Tell us your:

• Name

• Specialty

• Why are you considering CESR application

• Application stage

CESR – Who can apply?

• Training meet the requirements of a CCT programme in one of the standard CCT specialties.

• Training or qualifications were obtained outside

the UK and which are not in one of the standard

CCT specialties

• “a level of knowledge and skill consistent with practice as a consultant in the National Health

Service”

Standards

• Specialist qualification or specialist training in the CCT specialty, in which they apply.

• Specialist training must be a continuous period of at least six months in the applicants CCT specialty

• a specialist qualification in a programme of specialist postgraduate education or training in any medical specialty

CESR – Application Process

• Four stages:

1 – submission of application

2 – evaluation by College/Faculty

3 – decision by GMC

4 - review / appeals

Application Stage 1

• Online

– CV

– Referees

– Professional experience

– List of evidence

– Fee (CESR £1600, Review £695)

• Focus on

– Application

– Supporting evidence

– Structured reports from referees

• Certification advisor

– Evidence review

– Authenticated, validated, anonymised

– Referral to RCs

Application Stage 1

CESR – Application stage 2

• Evaluating the application

– Application is forwarded to the relevant Royal College or Faculty for an assessment (training, qualifications & experiences)

– Documentary evidence in application assessed against standards of the relevant CCT curriculum or a new consultant in NHS

– Submit a recommendation to GMC


• GMC decision

– GMC panel considers the totality of the application including the applicants documentation, the structured reports from their referees the recommendation from the relevant Royal College/ Faculty before issuing the final decision.

– If necessary, GMC will take further advice from certification panel


• If your application is successful, GMC will send you a “certificate of eligibility for specialist registration” (CESR) and a letter about entering your name on the GMC Specialist Register.


• If GMC decides that the evidence you provide does not support approval, may require you to undertake further training or assessment to meet the required standards.

• GMC not responsible for organising, managing or financing that training or assessment

Referees

• At least 5 (Suggested 6)– Current medical director / clinical director– Current supervising colleague [or senior

colleague in same speciality]• Knowledge of last five years of experience• Within 3 years of retirement- At least 2 from doctors in your specialty or related

specialty: must be able to comment from direct observation

- If you have undertaken training, 1 report should be from your TPD, Ed-Sup or regional advisor

CESR – Application – stage 4

• Should you disagree with the decision of GMC, you may request a review within 3 months of receiving your decision letter

• You also have a statutory right of appeal against decisions of the GMC, including the decision resulting from a request to review your application. Such applications must be made within 3 months of the date of the decision letter or the outcome on the review application.

How your application will be considered

• Each application is considered on its own individual merit

• GMC will consider the totality of a doctors career if, for example, they can demonstrate breadth and depth of knowledge and skills and we are satisfied that your skills and knowledge remain up to date.

• Your documentary evidence will be assessed against the standards of the CCT in your specialty.

Applying for CESR

Filling your portfolioWhat documents can be used to demonstrate all the relevant competencies?

Applying for CESR

GMC: some basic guidanceEvaluation standardAn application in a CCT specialty must demonstrate that you meet the requirements of the CCT curriculum in place at the time of your application.http://www.gmc-uk.org

http://www.gmc-uk.org/

Applying for CESR

GMC: some basic guidanceMinimum requirements for CCT specialtiesTo be eligible to apply you must have either a specialist medical qualification or at least six months continuous specialist training in the specialty you are applying in.

http://www.gmc-uk.org


Applying for CESR

GMC: some basic guidanceThe size of your applicationIt will help us to deal with your application more quickly if you make sure that you send us only evidence that is directly relevant.

Our guidance on compiling your evidence will help you to decide what is relevant and what is not. We recommend that you read it carefully.

Evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, we would usually expect to see between 800 and 1000 pages of evidencehttp://www.gmc-uk.org


Example framework: Portfolio guidance

Applying for CESRPreparing your Application Portfolio

• Standard requirements

• Qualifications

• Assessments and appraisals

• Logbooks

• Details of posts & duties

• Research, publications & presentations

• CPD and CME

• Teaching & Training

• Audit

• Safety

• Communication

• Partnership & Teamwork

• Honesty & Integrity

• Patient Relationships

GMC application divider pack

4 Domains - 13 Sections - 52 Items• Qualifications

• Assessments and appraisals

• Logbooks


• Research, publications & presentations

• CPD and CME

• Teaching & Training

• Audit

• Safety & Quality

• Communication

• Partnership & Teamwork

• Honesty & Integrity

• Patient Relationships

Domain 1 (75%)

Domain 2 (20%)

Domain 3&4 (5%)

Applying for CESR

Filling your portfolio

Exercise

• Break into 2 groups

• Agree a scribe/speaker

• What documents would you include in your portfolio to demonstrate your competencies in this area?

• Leadership & Management


• Do you foresee any difficulties obtaining them?

Validation

• Every thing that is related to training & experience

• Medical (Educational)supervisors who can confirm it is true and accurate record

• Name

• Designation

• Signature

• Date

• Hospital stamp

• Incorrectly validated or authenticated evidence is NOT accepted

Changes from 28th March 2018re. validation

• From 27 March doctors applying for entry on the GP or Specialist Register through the equivalence route will no longer need all their evidence to be validated by stamping and signing.

• Doctors will be required to identify a verifier for each institution where they gained experience, and which they are providing evidence for.

• We’ll then contact the verifier for further information as they have seen the original source of the evidence.

Authentication

• Specialist postgraduate medical qualification(s) and any other relevant qualifications

• Body that issued the certificate

• Solicitor

• Must be accompanied by validated copies of the curriculum and/or syllabus for that qualification

Structured Referee reports

• 6 Referees

• Royal colleges - Triangulate your primary evidence and Verify

• work, training and experience

• Personal attributes , skills and competencies

• First referee should be your current Medical/Clinical director

• Base hospital......

Knowledge, Skills and performance

• Primary medical qualification (PMQ)

• Specialist medical qualification(s) • Must relate to the specialty

• provide a validated copy of your curriculum or syllabus

• Colleges evaluate where the curriculum covers areas of the CCT curriculum

• Specialist registration outside the UK

• Honours and prizes

• Other relevant qualifications and certificates • degrees or diplomas in relevant areas such as management,

business, IT, communication, education or law


• Appraisals and assessments

• RITAs, ARCPs and training assessments

• 360˚ and multi-source feedback

• Awards and discretionary points letters

• Participation in assessment, appraisal and appointments process

• Personal development plans (PDP)

• Logbooks, records of daily clinical practice and portfolios


• Case histories

• Referral letters discussing patient handling

• Patient lists

• Departmental (or trust) workload statistics and annual caseload statistics

• Rotas, timetables and job plans

• Courses relevant to curriculum –ALS,ATLS


• Details of posts and duties (including both training and experience posts)

• Employment letters and contracts of employment

• Job descriptions

• Job plans

• Research, publications and presentations • Research papers, grants, patent designs

• Publications within specialty field

• Presentations, poster presentations


• CPD and CME • CPD record certificates

• Internal/External

• Membership of professional bodies and organisations

• how membership is achieved (evaluation, examination, is membership restricted or open to all)


• Teaching and training • Teaching timetables

• Lectures

• Feedback or evaluation forms from those taught

• Thank you letters

• Attendance at teaching or appraisal courses

• Participation in assessment or appraisal and appointments processes

Domain 2 – Safety and quality

• Clinical Governance activities• Audits undertaken by applicant

• Reflective diaries

• Service Improvement projects

• Incident reports

• Health and safety • Declaration of health on your application form

• Attendance at appropriate course(ANTT)

• Involvement in infection control

• Logbook information on infections

• Audit on infections and subsequent changes in activity.

Domain 3 – Communication, partnership and teamwork

• Communication - Colleagues • letters from colleagues (Testimonials)

• letters of correspondence between you and your colleagues (Referral letters)

• management – including organising staff rotas

• presentations

• Copies of appraisals or references written for colleagues

• Communication - Patients • thank you letters and cards from patients

• complaints and responses to complaints

• 360° feedback.

Partnership and teamwork

• Working in multidisciplinary teams • Minutes of meetings demonstrating your attendance

and participation in the meeting (MDT,RCA,HLI)

• Involvement in governance projects

• Management and leadership experience • Rota management

• Service evaluation projects

• Chairing meetings and leading projects

Domain 4 – Maintaining trust

• Honesty and integrity • The declarations on your application form • statements from your referees • Appraisal forms • having no restrictions on your registration • Certificate of Good Standing (overseas based doctors

• Equality and human rights • evidence of attendance at relevant courses • feedback from patients and colleagues • statements from your referees • Testimonials.

• Data protection • attendance at relevant courses • your application and evidence being appropriately

anonymised

Domain 4 – Maintaining trust

• Relationships with patients • Testimonials and letters from colleagues

• Thank you letters, cards from colleagues and patients

• Complaints and responses to complaints

• Feedback from patients

Don’t forget

• Authenticate• Qualifications

• Validate - Form

• Anonymised individuals names wherever applicable

• Importance of data protection

• You need to substantiate whatever you put in with evidence

Applying for CESR

Evidencing Non-Clinical skillsLeadership ManagementCommunicationTeamworkTeaching & TrainingAuditSafetyHonesty & integrity, etc

Applying for CESR

NW Deanery – Medical Leadership ProjectLeadership development tools:

http://www.nwpgmd.nhs.uk/medical-leadership/leadership-development-tools

• Project based discussion

• Time management

• Chairing a meeting

• Presentation skills

• Audit based discussion

http://www.nwpgmd.nhs.uk/medical-leadership/leadership-development-tools

Appeal

• You can choose between:

– A written appeal

– An oral appeal

• Appeals are handled by the Appeals team, who are not involved in making decisions relating to entry to the Specialist or GP register.

• Within 28 days

Review• Additional relevant documents

• Completed top-up training as per letter

• Errors in evaluation

• Within 1 year

Reapplication• With additional training

• Additional evidences

• Keep up with changes in the curriculum

• Within 3 years


GMC – Common errors• At stage 1 (GMC receive your application)

- the applicant does not fulfill the minimum requirements for application (namely, they do not have an acceptable primary medical qualification or they do not have specialist training or a specialist medical qualification in the specialty)

- the applicant has not provided enough referees


GMC – Common errors• At stage 2 (GMC quest further evidence)- the applicant does not provide additional evidence- evidence is not authenticated, validated or anonymised

appropriately- translations of documents are not supplied- the applicant has not sought the permission of each

referee before nominating them- referees do not respond to requests for structured

reports- referees provide a structured report without enough

information (we will not seek a replacement structured report)

Do’s

• Make sure evidence is well organised

• Look at the website of the college/faculty your specialty

• Make sure the specific guidance on key pieces of evidence for your specialty is followed

• Provide evidence across the breadth of your specialty

• Demonstrate two way communication with colleagues and patients in your evidence.

Do’s

• Read the relevant specialty curriculum before finalising your evidence

• Try and gain a good understanding of the assessment process used in the UK for your specialty

• Consider UK evidence formats

• Act on any suggestions that the GMC make in their initial checklist.

•

Don’t

• Submit an application until the majority of evidence has been obtained

• Submit duplicate evidence

• Assume that reports, references and testimonials on your level of ability will be sufficient for your application to be successful

• Submit unnecessary evidence

Don’t

• Rely heavily on evidence that’s over five years old

• Forget to check our website for updates to curricula, specialty specific guidance and guidance on the application process

• Submit certificates for expired courses in your evidence

• Be disheartened when the GMC ask for additional evidence

Common problems

• Submitting evidence that is not appropriately validated.

• Including patient details in documentation (not anonymised.)

• Not responding or ignoring the advice given by GMC Certification Advisors.

Failed applications

• Incomplete

• Not enough referees

• Structured reports incomplete

GMC Developments

GMC survey 2009

• over 40% of associate specialists

• over 25% of staff grade doctors

wished to become a consultant through Article 14 / CESR


GMC – Recommendations approved on 27/09/12• Recommendation 1: Doctors must already hold a full

registration and a license to practice, and have practiced as in the UK as a licensed doctor for at least 12 months within the previous 3 years, before applying for CESR / CEGPR

• Recommendation 2: In principle tests of specialist knowledge should be a mandatory element of the new model for evaluating equivalence applications


GMC – Recommendations • Recommendation 3: Successful application for a CESR/CEGPR

should require an evaluation of performance in practice in the relevant specialty in the UK against prescribed competencies

• Recommendation 4: Relevant statutory regulations should be amended to enable CESR/CEGPR applicants to undergo evaluation of their performance in practice in training environments


GMC – Recommendations • Recommendation 5: The documentary evidence of

knowledge and experience should concentrate on those areas of the curriculum that have not been addressed by the applicant through the other elements of the evaluation model

• Recommendation 6: The new evaluation model should also replace the current paper based applications for academic and research CESRs

Applying for CESR

Resources available• Online course at http://vlc.nwpgmd.nhs.uk

Under Careers - “Applying for CESR”

• CESR Champions

CESR workshops and one to one coaching

• Career Champions

• Local SAS Trust Lead initiatives

• GMC / BMA workshops and helpsheets

• CPD allowance

http://vlc.nwpgmd.nhs.uk/

Applying through CESR

5th November 2018

Mr Amit Kochhar, SASC UK Chairman for BMADr Sujesh Bansal, Consultant Anaesthetist & CESR Champion

Applying through CESR · 1 –submission of application 2 –evaluation by College/Faculty ......

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