The Savvy IMG

CESR-CP now recognised as CCT

The GMC has now confirmed that eligible doctors on the CESR-CP pathway will now be awarded CCT upon completion of training instead of CESR. This was first mentioned in a letter to the British Association of Physicians of Indian Origin (BAPIO) and it has now been confirmed.

Table of Contents

Updated: June 26, 2020

The GMC has now confirmed that eligible doctors on the CESR-CP pathway will now be awarded CCT upon completion of training instead of CESR. This was first mentioned in a letter to the British Association of Physicians of Indian Origin (BAPIO) and it has now been confirmed.

But what does this mean and why does it matter?

Being on the GMC Specialist Register is required if you want to apply for a permanent Consultant post in the UK. CCT, CESR-CP and CESR are the three routes to the GMC Specialist Register, and they differ by how much of your training was completed in a GMC approved training programme. 

  • CCT is the pathway for those who entered a GMC-approved UK training programme from year 1 and completed a UK training programme in full.
  • CESR-CP is the pathway for doctors who entered a GMC-approved UK training programme after year 1, usually in year 3 or 4, and therefore partially completed a UK training programme.
  • CESR is for those who never entered a GMC-approved UK training programme at all and did not complete any part of a UK training programme. This means they completed all of their training outside the UK or through UK non-training jobs.

Related: The 4 types of GMC registration

While the UK considers all 3 equivalent, CESR is often considered inferior to CCT by several medical authorities overseas. Some countries will not recognise those on the CESR-CP pathway as being Consultants because the certificate given to them at the end actually states “CESR”. 

This has been a sore point for many IMGs who may have plans to migrate after completing some of their training in the UK. Why should CESR-CP be recognised as equal to CCT in the UK but not elsewhere?

Fortunately, the GMC recognises the difficulty that IMGs have faced and will now award a CCT instead of CESR for those on the CESR-CP pathway.

The original letter from the GMC to BAPIO proposing this change:

The announcement confirming this change can be found in this BMA news article:

Questions you might have

So who is eligible for CCT under the new rules?

Doctors who complete the minimum number of years in UK specialty training as required by European legislation. 

What is the minimum time required for CCT in European legislation?

The GMC has listed the minimum number of years that you need to complete in UK training or order to gain CCT. You can review the list here:

If your specialty does not have a minimum number of years, then unfortunately you cannot gain CCT, the only option is CESR.

What if you don’t complete the minimum number of years?

The main entry point for training programmes after year 1 is in year 3 or year 4. This means you would still have 4-6 years of UK training to complete so you are still likely to meet the minimum requirements for CCT.  However, if you join training later than ST3/ST4, and do not meet the minimum number of years required for CCT, then you will be awarded CESR instead. Related: What IMGs need to know about applications to specialty training (residency) in the UK

What if you were awarded CESR in the past but were on the CESR-CP pathway?

The GMC has confirmed that these changes will be applied retrospectively. So if you were previously awarded a certificate of CESR even though you were on the CESR-CP pathway, you can now apply to have this changed to CCT. You can review the GMC guide on how to do this here: Related: The COVID-19 pandemic in the UK and IMGs

Changes to the Savvy IMG website

As a result of this announcement, we will need to update our many parts of our website. Please bear with us as the following articles are updated:


Changing the certificate of those on the CESR-CP pathway from CESR to CCT is a big step for IMGs who join UK training mid-way. This is excellent work by BAPIO and we hope that more changes will come to improve the working conditions and prospects for IMGs in the UK.

You might also like

20 Responses

  1. Hi.
    Thank you for creating this excellent forum giving us all the information we need as IMGs, and thank you for your personalized answers.
    I am a Nigerian trained Neurologist with 5 years of experience working in clinical roles in Dubai.
    Is CESR suitable for me or I have to go through ST3?

    Thank you.

    1. Hi John, thank you for visiting our site, we really appreciate it and we are so glad that you’re finding the website helpful. I would look into the requirements of CESR neurology and see if you can meet them. If you can then go for it! It might be most helpful for you to start working in the UK first then you’ll get a feel of which path is best for you. If you are looking for one-to-one guidance for your specific personal circumstances, you might be interested in booking a session to discuss your options. For more details, please visit our page here.
      Best of luck!

  2. Good day, thank you for bringing up hopes for IMG
    I am awarded RCPCH in 2018. planning to move to the UK and join the training through ST3 post after the national round.
    could I achieve CCT if I join the program from the ST3 level and continued to the ST8. or still be awarded only CESR.

    1. Hi Ahmad! If you complete the minimum required number of years in UK training, then you should get CCT. Sounds like you will if you plan to complete 6 years of UK training. Good luck!

  3. Hi Nick. Thanks for bringing to the fore this valuable and scarce information.
    I completed my fellowship training of 6 years duration in internal medicine with subspecialty in dermatology in 2011. i practiced for 6 and 1/2 yrs consultant physician and dermatologist in Nigeria before migrating to Saudi. I now work in Saudi as Consultant in internal medicine from may, 2018 till date. i have just recently completed MRCP UK but without dermatology Subspecialty certificate. i wish now to migrate to the UK, do you think i stand a chance of gaining placement for ST3 training in dermatology?

    1. Hi Gabriel, great career! Since IMGs are allowed to apply for training, you definitely have a chance, but to succeed you’ll need to build up your portfolio score and do well in the interview. You can check the scoring criteria for dermatology in the ST3 Recruitment website (please see the link in our useful links page). All the best!

  4. Hi,
    I have working as full consultant in Gastroenterology in Bangladesh. I have done MRCP,MD (Gastroenterology) from Bangladesh and SCE in gastroenterology. I have done previously 1 yr non training post in UK in 2016. I m JEG certified in Upper GIt endoscopy from UK. AND also doing confident in colonoscopy. I have 8 years experience in GASTROENTEROLOGY. Is there any chance of doing CESR in Gastroenterology from Bangladesh as i am in bangladesh now.

    1. Hi there! Yes you can try, please check the GMC website for the CESR requirements for gastro. Good luck!

  5. Hi Nick ,
    Would this apply to doctors that were issued with JCPTGP as most international regulators only recognise CCT’s. Have you come across this ? as it effects all GP’s trained pre-2005 who have had a certificate of prescribed experience which meets all the training requirement in all but name . Thank you . Peter

    1. Hi there, as far as we know this does not apply to GP because GP doesn’t have a CESR-CP pathway. But please contact the GMC directly to confirm. They respond quickly by email or FB messenger.

  6. Hi, I completed my FRCS in general surgery in 2012 with Vascular surgery as special interest before Vascular Surgery became specialty by itself and obtained CCT through CESR in 2018. The GMC awarded me CCT in General Surgery with no Special interest though the application and operative requirements were for vascular surgery special interest in view of my experience. They say I can’t get Vascular surgery special interest as it is a separate specialty now and need to apply separately for it including showing FRCS in Vascular surgery or equivalent! Can I challenge this?

    1. Hi there, you can try if there is an appeal or complaints procedure but we don’t know anyone who has done this. You can try asking in one of the IMG groups on FB if anyone has had any similar situation and how they dealt with it. We wish you the best! Please let us know how it goes.

  7. Hi nick
    Glad I could find a place where most of the things are so sortedly explained
    I’m a practicing orthopedic surgeon in India since 2007 as a partner director in a multi speciality hospital and now I plan to relocate to the UK , what pathway should I take and is there any office here in India which I can visit in person ?
    Thanks and regards

  8. Hi Nick,

    First and foremost, can i say that you are doing a great job writing these guides for IMGs. I can attest to difficulties faced by IMGs especially trying to look up information that is not widely available!

    I would like to ask if you have any idea, if i extend my training time by another year, would that be taken into account (my training time is 3 years but the minimum is 4 years)?

    Thank you.

    Kind regards,

    1. Hi Jason, thanks for visiting our site! Glad you find it helpful! As far as I know, it’s not possible to extend training in that way. You can try asking the relevant Royal College and Health Education England to see if this is an option. Please let us know what they say!

      1. Hi Nick,

        Finally managed to get some updates. This is an email sent out to all psychiatry trainees by the head of school:

        “ CESR-CP pathway is effectively no longer. Anyone in an ST post right now, whatever the past history and whatever the stage of training, will get a CCT, no confusion.

        The only people who will still miss out are the ones with an outcome 6 dated before 1st January 2021, who did CAMHS and GA and did not do a core job with a NTN for at least a year- to make up the minimum legal training time of 4 years. But that will be a very very small number. The law changed on the 1st of January 2021 with Brexit. Unfortunately, it cannot change retrospectively. Last year the law was ‘re-interpreted’, not changed for the retrospective CESR to CCT applications.”

        Hope this also helps anyone else who is looking for an answer.


        1. That’s excellent! Thank you for the update, I’m sure many IMGs will be delighted with the news!

  9. Hi,
    Thank you for this write up
    I am an radiologist trained in India and have 5 years post MD experience in non teaching hospitals.
    I was wondering if ill be eligible for ST3 position or would I automatically fall into CESR route on account of prior experience.


  10. Hi, guys

    Thank u so much for such amazing job. I’m always delighted with your articles. I have a question. I’m a neurosurgeon by backgroung currently working in the NHS as SHO. Can I become a consultant through non training post here? I have been looking for this info for a long time, but still no clear. You guidance would be highly appreciated. Thank u so much.

Leave a Reply

Your email address will not be published. Required fields are marked *

Meet the Team

Hi, we’re Drs Nick & Kimberly Tan, the two IMGs behind The Savvy IMG. We write comprehensive guides, create courses, and provide one-to-one guidance to help other overseas qualified doctors on their journey to the UK.
We have scoured the official guidance to put these posts together, but we can make mistakes! If you spot anything that is incorrect, please get in touch and we’ll put it right.
Photo of Dr Nicholas Tan