The Savvy IMG

CREST 2024: An IMG’s Key to UK Residency

Explore the 2024 updates to the CREST form - a crucial document for International Medical Graduates aiming for UK residency.

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The Certificate of Readiness to Enter Specialist Training (CREST) form is one of the most important documents for International Medical Graduates (IMGs) aiming to enter UK residency training. The 2024 updates to the CREST form have introduced significant changes that promise to simplify the process for IMGs. This article delves into these updates, their implications, and offers guidance for navigating the new CREST form effectively.

What is the CREST form?

If you want to get into the first year of any UK specialty training or residency, then you need to fulfill certain eligibility requirements. One of those requirements is proving that you have achieved what is called “foundation competences”. There are two ways that you can provide evidence of this as an IMG.

  1. You are currently working in the FY2 Stand-alone programme, or you have satisfactorily completed FY2 Stand-alone within 3.5 years of starting specialty training OR
  2. You submit a valid CREST form – a form that essentially confirms you have achieved the same competences as a doctor in the FY2 Stand-alone programme.

Without one of these two requirements, you cannot proceed with an application to UK residency.

What were the previous CREST forms like?

In previous years, the CREST form was updated annually becoming more and more complex each time. It finally culminated in the 2021 version which was a beast of a document. The form was several pages long with complex detailed descriptors and requirements making it extremely difficult to get signed off in a regular hospital post. Doctors would often need to request rotations into different specialties, and have multiple meetings with their consultants providing pages and pages of evidence to get the form signed.

This whole process took up a lot of time for both parties, and we speculate that Consultants just had enough. And so the 2024 version was introduced.

Why is the CREST 2024 version easier for IMGs?

The most striking change in the 2024 CREST form is the simplification of competency requirements. Previously, the form detailed 28 competencies under clinical care alone. The updated version narrows this down to five general statements about care, drastically reducing the detail and scope of competencies needed for verification.

Further simplifications are evident across the board, from sections addressing personal well-being, and even involvement in quality improvement. The form no longer has the previous detailed descriptors that often required presentation of specific evidence just for the form to be signed off. Now the statements are simpler, more concise, and easier to sign off from just observing a doctor’s day to day work in any specialty.

This shift likely aims to lower the hurdles for IMGs and consultants alike, facilitating a smoother process. It seems to be not just about reducing paperwork; but also a strategic move to make the form more universally applicable across specialties and easier for consultants to sign off.

Can CREST 2024 be signed off overseas?

The form still lacks any specific requirements for the signatory to be working in the NHS, so yes, it can be signed off by a Consultant overseas. In fact, with the simplification of the competences, it would actually be much easier to do so.

However, it’s important to state that it’s still recommended to get some NHS experience before starting a UK training post. Getting the CREST form signed overseas still does not prepare you for working in the UK, and starting in a training post as your first UK job is a known risk for IMGs. Several have been taken out of training, had their training extended, or even investigated and referred to the GMC. We definitely don’t want that happening to you!

What has stayed the same for IMGs in the CREST form 2024?

Many of the requirements for the signatory (the person signing the form) remain the same.

  • They must be a Consultant
  • If they are GMC registered, they must be on the specialist register
  • They cannot be a relative or spouse
  • You must have worked with them for at least 3 months within 3.5 years of the date you aim to start UK residency
  • They must have supervised you during a period of employment, not a clinical attachment or observership

For the full details, please read the CREST form itself and the accompanying guidance documents.

What are the implications for competition for UK residency?

The 2024 CREST form represents a significant step toward making the UK residency application process more accessible for IMGs. With this, we expect the number of applicants for UK specialty training to increase even further. But we don’t think this should put off aspiring IMGs. Many applicants will be doctors just trying their luck, but we both know that won’t achieve anything. Serious applicants still have a good chance of success as long as you prepare early and strategically!

Where to find the latest CREST form?

The latest form will always be available on the Health Education England website here. Be sure to read the form in full as well as the accompanying guidance.

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Looking for a step-by-step guide?

Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.


Looking for a step-by-step guide?

Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.


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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.
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