Portfolio Pathway (formerly CESR) registration

Please note that in providing you with any advice and guidance in respect of your Portfolio Pathway application, we cannot give guarantees or opinions as to the likelihood of your application being successful, nor can any such advice guarantee success in any application.

Doctors must be registered on the GMC’s Specialist Register to take up a substantive (permanent), fixed-term, or honorary NHS consultant post.

If you haven't completed training in the UK or don't have a relevant European qualification (see below), you should apply for a Portfolio Pathway to obtain specialist registration. 

You need to make your Portfolio Pathway application to the GMC.  The GMC has a dedicated online application process for  Portfolio Pathways. To make a Portfolio Pathway application you will need to open a GMC Online account and upload all your evidence electronically as requested in the online application. Anything recorded in Kaizen or in any other ePortfolio won't be transferred into a Portfolio Pathway application.

The GMC will send your completed application to us for specialist evaluation. We make a recommendation to the GMC as to whether or not the application should be approved, but the GMC makes the final decision.

We are happy to assist with queries by email about our specialty-specific guidance.  Please send us a copy of your CV when you email. Please think about structuring your CV in accordance with the GMC's Portfolio Pathway CV advice, and see this article about preparing a medical CV. Your questions may be answered in our advice and documents on this page, so please do have a look at these first.

Queries about the application form, fee, or general application process should be directed by email to the GMC. 

The application form, fees, guidance, and criteria are subject to change; please refer to the General Medical Council's (GMC) website for current information. 

This is the most appropriate route for most applicants and most people apply for a Portfolio Pathway in clinical oncology.  However, clinical oncology training and practice in the UK may differ significantly from training and practice elsewhere, so please read the curriculum and specialty specific guidance carefully to make sure you can meet the standards.

In the UK, clinical oncology trainees complete about five years of specialty training according to the current training curriculum, having obtained the MRCP(UK) to enter training. When they successfully complete training they are awarded a Certificate of Completion of Training (CCT) in the specialty of clinical oncology. The CCT allows them entry to the GMC specialist register. 

To be awarded this Portfolio Pathway, you need to submit a range of evidence to demonstrate that your specialty training, qualifications and experience taken together are equivalent to the CCT in clinical oncology, the requirements for which are set out in our specialty training curriculum. Portfolio Pathway allows you entry to the GMC specialist register.

To be eligible to apply under this route, you must have either a specialist qualification in the specialty you apply in or at least six months of continuous specialist training in the specialty you apply in.  

Please review the following documents:

1. The Specialty Specific Guidance published by the GMC to help you make your application. When getting your evidence together, you can use it as a checklist to make sure you include all the documents we need. 

2. Our FAQs for Portfolio Pathway Applicants which sets out things to note when making your Portfolio Pathway application. 

This route is designed for those who are nationally renowned leaders and are known internationally in their field through their academic or research activity.

Applicants must show that the knowledge and skills they have gained through academic or research work are consistent with practice as a consultant in any of the UK health services.  Successful applications tend to be submitted in very specific areas. This is because it would be difficult to demonstrate academic or research work to the required standard in a broad area such as a CCT specialty. 

This application needs to show two things – that your academic or research work has given you knowledge and skills to the standard of an NHS consultant and that your clinical knowledge, skills and experience of the specialty you have applied in are equivalent to the standards of an NHS consultant.

The range of evidence requested here is different from the other Portfolio Pathway pathways, as you can see in the GMC academic Portfolio Pathway guidance. You will have to provide evidence of your academic or research activities, as well as evidence of your clinical skills in the area in which you apply - the clinical elements are likely to cover the relevant specialty areas of the CCT curriculum. You must check with the GMC as to your eligibility and whether the specialty you intend to apply in is acceptable under this route.  

Please see the GMC's information for doctors about Brexit 

If you have an EEA or Swiss primary and/or specialist medical qualification classed as a "relevant European qualification", you may be able to apply for GMC full and/or specialist registration using those qualifications.  It is the qualification you hold and not your nationality that determines whether you can use these qualifications to obtain registration.

See apply for full with specialist registration with a relevant European qualification 

Please refer to the current SSG for guidance on what evidence is required for each of the CiPs. The following guide will help to clarify what the evaluators are looking for or what an unfamiliar term means. 

For any further assistance, email [email protected]

Clinical audit is designed to improve quality of care and healthcare outcomes by comparison against agreed standards and measuring the success of interventions. Quality Improvement is designed to improve quality of care and healthcare outcomes by trialling interventions, using repeated measures to assess success. For example, a CCT trainee is required to show how they have instigated, collated and presented a piece of work, as well as reflected upon any changes in clinical management as a result of work completed.

Completion of clinical audit and/or Quality Improvement projects is a specific curriculum requirement. You should submit 1-3 clinical audits or quality improvement projects, at least one of which should show completion of the audit cycle either through re-audit or evidence of the implementation of change through Quality Improvement projects – make sure you clearly show how and whether improvements or changes have been made.

The strongest evidence is the report and action plan, any re-audit or changes in practice and a presentation.

Reflection on audit and quality improvement activity should also be submitted.

Letters stating that you have participated in these activities are useful background but will not be sufficient evidence on their own.

• Audit and Quality Improvement projects – Please upload your projects and related evidence in one file per institution. These should be in order of project grouping together everything related to each project (for example, audit proposal, audit, presentation, re-audit, reflection).

A CbD provides an indication of competence in areas such as clinical reasoning, decision-making and application of medical knowledge in relation to patient care. It also serves as a method to document conversations about and presentations of cases.

The CbD should include discussion about a written record (such as written case notes, outpatient letters or discharge summaries).

You can see under each CiP, where relevant, when a CbD is most useful.

You should submit a range of letters and emails to and from referring clinicians; you can also include patient consent forms and other correspondence you consider relevant.

Evidence of your clinical correspondence can support a number of CiPs, including those relating to communication, patient management and clinical competence. You can include evidence relating to correspondence with referring clinicians and/or other professionals (for example, physics, radiographers, clinical radiologists, etc.) alerting them on issues such as missing images, inadequate coverage, recalls and similar safety and quality issues and particularly correspondence relating to emergency/Acute Oncology events, ceiling of care and end of life.

You can see under each CiP the areas where relevant correspondence is most useful.

You should provide minutes of relevant meetings in which you have participated. For example:

• clinical governance meetings
• discrepancy meetings
• department meetings
• MDT meetings (see below)
• Morbidity and mortality (M&M) meetings

Invitations to meetings or agendas for meetings will be given less weight without the minutes or outcome.

Your MDT activity should be uploaded separately but other activity such as relevant meeting attendance and reflection on it can be grouped together and uploaded as one file per institution.

We know that incidents happen and complaints are made; for a Portfolio application, we are interested in how you respond to these. Evidence relating to two examples should be sufficient.

You may include complaints received against you, the department within which you worked or one against a colleague where you have been involved in the resolution. You can provide evidence of your response to any complaint or untoward incident and evidence of reflective activity. If you have raised a concern, you could provide relevant evidence of that. Complaints can be formal or informal.

Please be sure to provide evidence of how the situation was resolved and reflection or any CPD that resulted.

Evidence of participation in courses and learning events relevant to the curriculum is useful supporting evidence in respect of a number of CiPs, particularly in respect of:

• clinical courses to show you are making efforts to maintain good practice
• courses relevant to equality and diversity, consent, data protection/information governance, equal opportunities, ethics, probity, infection control, safety and so on
• teaching
• research
• management and leadership
• communication
• GCP

CPD activity and courses are given less weight if they were completed more than five years ago, so please make sure that you demonstrate such activity from within the last five years. Invitations to meetings or agendas for meetings will be given less weight without the certificate or similar confirmation of participation.

• Courses and CPD activity relevant to the CiP – Please group these together and upload them from the last five years as one file. You can subdivide into sections within the file – for example, you might list ethics and similar courses under CiP 2 and teaching-related courses under CiP 6.

Evidence of relevant activity includes rota management, responsibility for finances/budgets, assessments on others such as WpBAs, relevant courses and qualifications, leading MDTs, chairing other meetings, acting as audit lead or head of department, setting up new services/service mapping, participation in wider trust consultations, protocol or pathway development, or examples where you helped address a service problem or new demand etc.

MDT meeting-related activity may be referred to outside the UK as grand rounds, tumour boards, etc.

You should submit minutes and records of your participation in MDT meetings covering a period of at least six months, with patient histories and any notes.

Include your reflective activity on MDTs, especially on your personal contribution. Evidence of you leading the MDT is also useful.

Workplace-based assessment of your MDT contribution will also be useful through a Case-based Discussion.

A range of on-call rotas covering a period of at least six months will support evidence of your ability to perform in the emergency context as well as support your general activity.

Reflecting on your experience is important to your development as a doctor and in improving the quality of patient care.

We want to see specific examples of your own experiences and how a particular situation has impacted you and what you have learnt, such as:

• How the activity contributed to the development of your knowledge, skills or professional behaviours
• Ways in which your own behaviour may change as a result of reflecting on the event
• What difference this will make to patient safety and quality

If you are unfamiliar with reflective practice, you should read the GMC guidance on reflection to help you understand the principles behind it and how to demonstrate it.

Your evidence should demonstrate reflective activity as a regular feature of your practice, not all completed on one day.

Reflective activity includes notes and diaries, for example, on CPD and learning events, teaching, research, audit and QI activity, discrepancies, complaints and significant events, appraisal and feedback and MDT activity.

• Reflective activity - Your reflection can be included in the file next to the item on which you have reflected – for example, CPD, clinical governance, audit and QI, etc. Or you can include it all in one file in date order called “Reflective activity”.

For example:

• participation in clinical trials
• evidence of literature searches and critical appraisal of research
• participation in journal clubs
• development of guidance and protocols
• publications, posters and abstracts
• applications for research projects
• ethics committee submissions and/or participation
• patient consent forms
• Good Clinical Practice (GCP) certificate or other relevant courses or qualifications
• case-based discussion
• submissions to RTTQA or equivalent, or reflection on RTTQA in service delivery
• research training and/or qualifications

For example:

• participation in a review of patient leaflets
• development of standard operating procedures and protocols
• participation in clinical trials
• relevant publications
• evidence of presentations at audit meetings
• reflective activity
• CPD related to safety and quality

Letters stating that you have participated in these activities are useful supporting evidence but are insufficient evidence on their own.

Evidence may include:

• example presentations (PowerPoint etc.)
• confirmation that you delivered these by way of invitations, timetables etc. or other evidence to show how teaching is delivered
• formal learner feedback
• relevant courses or qualifications in teaching
• assessments of your teaching
• evidence of supervision of others and giving feedback, for example in their management of patients or carrying out practical procedures and/or being a clinical supervisor (for example, through assessments completed in the workplace)

CCT trainees complete a range of assessments in the workplace regularly in each year of their training (see section 4.5.3 of the curriculum for what these are).

We understand that training outside the NHS will not feature these assessments in the same way and, for those who have finished training and are working in non-training jobs, that you will not necessarily undergo similar assessment in your current post.

However, structured, unselected multisource feedback and patient feedback are the most effective way to evidence your communication and team-working skills. Assessments of your MDT, teaching and audit and quality improvement activity are also useful.

WpBAs are not generally expected for clinical activity you have undertaken recently that is confirmed by your planning and prescriptions and other evidence, but, of course, if you have them, please submit them. Assessments such as mini-CEX, DOST or DORPS can be useful if they support a particular range of procedures or a period of additional training you have had, or for a clinical activity in which you participate less regularly. Acute Care Assessments (ACAT) may also help with CiP 8.

If you have completed training within the last five years, you should submit evidence of how you were assessed during your training.

Appraisals or assessments completed retrospectively will not be given as much weight as ones that were completed at the relevant time.

Your application is made directly to the GMC using their dedicated online application process. Please see the GMC website for further information on how to apply.

You compile your Portfolio Pathway application in liaison with the GMC. Once the application is deemed complete by the GMC, it is passed to the College for assessment. Applications are evaluated by the RCR Equivalence Committee and a recommendation is then made to the GMC. 

To be eligible to apply you must have either a specialist qualification in the specialty you apply in or at least six months of continuous specialist training in the specialty you apply in.

Information can be found in both the Specialty Specific Guidance and generic guidance available on the GMC website. You should read this guidance carefully because it defines the type of evidence you should provide to demonstrate their knowledge, skills and experience (KSE) for specialist practice in the UK. 

No. As the RCR officially reviews the applications, we only review them at the point they are submitted to us by the GMC. The RCR can provide advice on the type of evidence required but will not review your application before submission. You are encouraged to read the Specialty Specific Guidance carefully before submitting your application to the GMC. 

It is recommended that you collect and keep evidence as you go along. You will need to open a GMC Online account and upload all your evidence electronically, as requested in the online application. 

The RCR Equivalence Committee reviews applications on behalf of the GMC. Members of the Committee will determine whether you have the knowledge, skills and experience needed for practising as a day one consultant in the UK. If your application is successful, you will be recommended for entry to the Specialist Register.

Before sending the complete application to the RCR for evaluation, the GMC first needs to ensure that all the application documentation has been received, including the structured reports from referees, and complete the verification process. This part of the process can be lengthy, as the GMC may need to ask for further information.

When the application is passed to the RCR we have 36 working days to review and submit our evaluation to the GMC.

The GMC will then need time to reach their final decision, so in total you should expect it to take 2-3 months before you are informed of the outcome of the evaluation. 

You will receive a report directly from the GMC that will explain why your application has not been successful. This will contain recommendations outlining the additional evidence required.

You should read the Specialty Specific Guidance carefully as this defines the type of evidence that you should provide to demonstrate you have the knowledge, skills and experience required to practise as a specialist or GP in the UK. You should also review the relevant curriculum.