The Savvy IMG

Pathway C: From IMG to UK Consultant (CESR-CP route)

Step-by-step guide for IMGs who have completed specialty training (residency) overseas and aim to become a UK specialist through the CESR-CP route.

Table of Contents

This pathway is suitable for you as an IMG in the UK if you fit the following profile:

This pathway is not applicable if you want to become a GP.

You can download a free summary table of the experience limits for all specialties. This article also clarifies the issues surrounding experience limits.

If you think you do not fit this profile or the pathway doesn’t sound right for you, make sure to go through the pathway finder tool!

International medical graduates pathway C to become a UK recognised specialist as a Consultant different steps including obtaining GMC registration applying for specialty training 5

By this point you will have probably read all about these steps before. I have provided links back to the accompanying blog articles and official websites below for each substep. Make sure you check the most up-to-date version of the official websites before taking action. Good luck on your journey!

Step 1. Obtain full registration with the GMC

Substeps Relevant articles and links to official guidance
Obtain evidence of English proficiency Read more about the English requirements in this blog article. Go through the blog FAQs about IELTS and OET. If you will not be taking PLAB, read about the types of alternative evidence accepted to demonstrate English proficiency. Review the GMC guidance about the English requirements.
Open account with GMC online Open your account here. Check the total costs of GMC registration here. This pertains to the PLAB route.
PLAB 1 & 2 + UK visitor visa if needed Read this article for all the essentials about PLAB 1 & 2. Some doctors are exempt from PLAB, do pay close close attention to this detail! Book PLAB 1 online through your GMC account. For PLAB 2 it’s best to enrol in an academy to prepare. These are the 15 things you should consider when looking for one. If you book PLAB in the UK, you’ll need to apply for a UK Visitor Visa. I used Airbnb during my stay in the UK where I had a room to myself, spending around £110 a week, and 8 mins walk to a station to get to my PLAB academy. Sign up here to get £25 off your first booking. Uber is a convenient way to get around the UK especially late at night when public transport may be closed or if travelling in groups. Get a discount when you use the code 7798ae to sign up.
As an alternative to PLAB you can submit an accepted Postgraduate Qualification (PGQ) Check the accepted Postgraduate Qualifications here. These include both UK and overseas qualifications.
Obtain other documents for GMC registration Step-by-step guide on how to obtain EPIC verification of your Primary Medical Qualification (PMQ) and Postgraduate Qualification (PGQ). You will need a certificate or letter from the hospital where you completed your internship or postgraduate experience. The letter must contain the dates and specialties of all your clinical rotations. GMC requirements for the Certificate of Good Standing (if applicable).
Apply for GMC full registration This is done online through your GMC account. You may need to submit some documents by post. All documents are valid for a certain time period only. Read about the deadlines here.

Step 2. Land your first NHS job

For most IMGs, your first job will be a non-training job. If you are eligible, your first job could be a training job in which case skip to step 3 – although this is very unlikely. If you managed to do this I would love to hear from you!

SubstepsRelevant articles and links to official guidance
Open account on NHS Jobs websiteNHS Jobs
Submit job applications for SHO level or Registrar level depending on previous experienceUnderstand the different titles of doctors here.
Attend interviewI got into Standalone FY2 using what I learned in the book Medical Interviews (get yours here on Amazon). This is definitely a must-read before attending any interview.
Accept a suitable offerFuture article
Apply for Tier 2 (work) visaTier 2 (work) visa
Relocate to the UKFuture article
Join a trade union and obtain medical indemnity cover cover

Read about these organisations in this article.

An article on how to find medical indemnity cover will be published in the future.

Step 3. Secure a training job

Since you have already completed residency overseas or you have exceeded the experience limits for ST1/CT1, you will have to enter training at a later year. For most specialties there are openings at ST3, while other specialties will also have openings at ST2 and ST4.

To find out what years are open, check the Oriel website for vacancies and the person specifications for the entry requirements.

SubstepsRelevant articles and links to official guidance
Work towards improving application to specialty training

What IMGs need to know about specialty training applications

Tips to succeed in your application to specialty training

Gain exemption from RLMT if needed

In general, specialties with a competition ratio of more than 2 are considered competitive therefore you are very likely to be rejected based on immigration status. You will need to gain exemption from RLMT to have a chance.

Check the competition ratios here.

Find out how you can gain exemption from RLMT here. Numbers 1, 4, 5, 6 and 7 are applicable.

Satisfy requirements for application to ST3/ST4

This typically includes the following:

  1. Passing a specialty exam AND
  2. Obtaining a certificate of core competences, or compiling a portfolio of evidence, or both AND
  3. Completing the required months of experience

Check the specific requirements for your specialty in the person specifications. Make sure you also check the right year, it will usually be ST3 or ST4.

Some specialties have openings for ST2. Please check Oriel for vacancies and the person specifications for the entry requirements.

Open account on OrielOriel website
Submit applicationsFuture article
Prepare physical portfolio if requiredCheck whether you need to present a physical portfolio in the application requirements of the specific specialty.
Attend interviewFuture article
Rank preferred regions to work in

Reviews for the different regions can be found on these websites:

Junior reviews

Accept offersThis is done through Oriel. You will be given a specific window period (usually 48 hours) to accept an offer or you will lose it.

Step 4. Complete training

Once you are in your training job, you simply have to complete the requirements of your specialty. This will involve compiling evidence of your skills and knowledge in your electronic portfolio, passing exams, and undergoing an Annual Review of Competence Progression (ARCP).

When you reach the end of your training programme, you will be awarded a CESR-CP. You then use this to apply for GMC Specialist Registration which will allow you to apply for Consultant jobs. 

CCT and CESR-CP are considered equal in the UK. This may not be the case overseas. If you plan to migrate after training in the UK, please check with the medical authority of the country you plan to work in.

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48 Responses

  1. Hi,
    This website is an amazing resource for understanding the UK medical educational system. Thanks!
    I’ve read most of the articles on this site but still have not been able to find an answer to my case. I have completed two years Diploma in Otorhinolaryngology (E.N.T.) post my Primary Medical Degree in my home country. How do I become a consultant in the UK through the CESR-CP pathway? Is there any other pathway I am eligible for?

    1. Hi there, yes the CESR-CP route is the main way. The other alternative is the CESR route. There is a lot to cover in your comment and I’m afraid I won’t be able to give you the detailed response you need to really develop a plan on this platform.

      For one-to-one guidance for your specific personal circumstances, I would recommend booking a general guidance session (40 mins) or even specialty guidance session (60 mins). For more details, please visit our page here.
      I hope to speak to you soon so we can come up with a plan and timeline that works for you.

  2. Hello! I’m glad to have found your website which is truly helpful!
    I had my PMQ and completed my pediatric residency training in the Philippines, also passed the Diplomate exam recently. As I understand, the CESR-CP route is the best one for me if I desire to pursue work in the UK. My question is,
    1. can I take the MRCPCH exam instead of PLAB? (Cause it’s super hard to book a test), 2. if I take the MRCPCH exam, will I be able to take the clinical part since as I’ve read I have to be endorsed by 2 sponsors to certify that I have a good training and considered ready to take the exam. Are these sponsors mean UK consultants?
    3. If I pass the 3 exams (FOP,AKT,TAS) can I apply for provisional registration? then apply for a job to gain experience then will be able to have endorsements from 2 UK consultants?

    Thanks for your help!

    1. Hi there!
      1. Yes, MRCPCH is an alternative to PLAB.
      2. From what I can see from the RCPCH website, there is no requirement to be a UK consultant since it is an international qualification that takes place in many countries outside the UK.
      3. Provisional registration is only for interns ie. FY1. You’ll need to get full GMC registration either via PLAB 1 & 2 or MRCPH (all 4 parts) before you can work in the UK.
      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!

  3. Hi
    I am a UK trained doctor who completed my MRCPsych exams in UK. I then moved to Australia and have worked as a senior Registrar in multiple specialities but NOT on a training scheme, as a salaried doctor for 2 years then as a locum. I have around 14 years experience as a Psych reg now and have worked in almost all states in Australia.
    I’d like to see if I can have my experience validated – am I eligible for any pathways in the UK to achieve CCT!

    1. Hi Julie! Doesn’t sound like you’d be able to get a CCT unless you complete the UK training, but with so much experience you should be able to put together an application for CESR. The college has some good support for this, definitely get in touch with them!

  4. Hi,
    Thanks for your useful information. I’m an IMG from Iran, passed 4yrs of urology specialty residency program after my MD, now practicing as a private urologist. I’m so interested to continue my education in a fellowship abroad. would you please help me which is the best way for me to get the UK license for practice and pursue my educations?
    Thank you

    1. Hi! You can do MRCS + IELTS/OET + get all the other GMC requirements then start applying for urology fellowships. Good luck!

  5. Hey Nick,
    Thank you for this amazing site,it really clears most of my doubts,
    However I had a couple of more doubts.
    To begin with I worked in Cardio thoracic as an SHO for one year post internship and then worked in Cardiac Anesthesia and have cleared my plab2 examination.
    My Goal is to get into surgical training Trauma and Orthopaedics>Rest of surgical branches.
    My plan is currently to work in the UK after getting my registration so that I have a NHS working experience for at least a year before I start with my training or until the next round of applications for training open up (November 2022)
    I will be aiming to complete my crest form during this time and get it signed by a consultant I’m working with in the uk.
    1.My cardio thoracic post was for one year after internship so will this count to my 18 months experience?
    (During this one year I was also rotated into COVID wards )
    Because I plan to apply for a non training job in the uk in a surgical branch to get a hang of the surgical experience.
    2.if at all you do mention yes ,that I exceed my 18 months of experience by the time I actually apply, what would you have done if you were me?
    3. I have assisted in many surgeries in that year and have a log book which is handwritten, is there a particular page/app/platform where in I can upload those details on an online platform? Or is there a particular format for a log book (if yes could you help me out with all the details/areas of the log book, cause I want to make sure I have all the essential details in my logbook)
    4. In my log book I’ve not put any patient details , my consultant has signed it off for me at the end of every month.(is the consultants signature mandatory?)
    4. What is a surgical Taster and how do I show evidence for the same.

    Hoping you will be able to answer my queries

    Thank you

    1. Hi Roy! Sounds like you have a good idea about how things work!
      1. Yes, although you could probably remove the time spent in COVID wards from your total surgical experience.
      2. No, because unfortunately there is no other entry point to cardiothoracic surgery except ST1 so the only way into training is to ensure you don’t exceed the experience limits.
      3. You can sign up to
      4. The log book needs to be verified so yes, it’s best to have a consultant signature.
      5. A taster can be a 1-week clinical attachment, you’d need a letter from the consultant as evidence. There are also specific surgical tasters arranged in the UK. You can also Google “surgical taster UK”. Evidence would be a letter of attendance.

      Good luck!!

  6. Hello. I’ve finished my MD Pathology in India and I’m working as a consultant histopathologist. Is the CESR-CP route applicable for me? Also, the person specifics website mentions specifications for ST1 histopathology, but not ST3. Is there no entry at the ST3 level for histopathology?

    1. Hi there, I’m afraid we’re not too familiar with Histopathology careers after ST1. Sorry about that! Please see the RCPath website and contact them for further details about pursuing a career here. Good luck!

  7. Thank you for this great website! I truly find it useful!
    I have couple questions:
    I understand, there are training and non training jobs, how do we tell the difference? By the title (SHO, registrar etc) or by the year (ST1-2-3-4-5…) or totally something else?
    Also how can I obtain certificate of core competence? Is it something that the people who trained me back home fill out? Or first should I have a job in UK, then I should make that person, who is responsible of me in UK, fill the form?
    Thank you!

    1. Hi Ayse! You apply for training jobs through the website Oriel and during the official application timelines.

      Regarding the certificate of core competence, it depends on the specialty. For example, the one for medicine requires that the person signing your form is GMC registered and has worked in the UK for at least 6 months in the past 5 years. They should also be able to confirm that you can successfully function within NHS organisational and management systems, and you are able to deal with ethical and legal issues related to UK clinical practice. So of course for this one, it’s almost impossible to get it signed overseas.

      Other specialties don’t have requirements like this so those one you might be able to get signed overseas, but it’s best to get it done in the UK.

  8. Hi Dr,
    I found this site very helpful. I am a speciality doctor trained in India, did residency in internal medicine and another 3 yrs in gastroenterology. I also did MRCP . How can I become a CESR CP consultant in UK? Also , how many yrs of training in UK is required?
    Kindly help

  9. Hello doctors,
    I have experience in general medicine for 4 years overseas as a service job ( excluding internship). Now I have GMC through PLAB route and confused which grade should I start? I have applied to many junior clinical fellow posts but without any success and I am afraid I am overqualified !
    And it will be impossible to apply for IMT ?

    1. Hi there! You’re not overqualified for those posts, and yes you can apply for IMT if you wish. It would be worth having your CV and job application reviewed. Doctor Jakes provides this service Or you can try asking in the IMG group on FB. Best of luck!

  10. Hi there,
    I really found your site very helpful for the overseas doctors like me.
    I have a couple of questions for you;
    I am an internal medicine doctor here in Pakistan and have complete MRCP back in 2019.
    1. Is it possible for me to start CESR-CP in acute medicine?
    2. At what level can I start and what will be the minimum tentative duration to be a consultant?
    Thank you

    1. Hiya! Thanks for visiting our website!
      1. Provided you meet all the other eligibility criteria, yes you can apply. Please be aware that MRCP is only one of the requirements.
      2. CESR-CP starts at ST4. Acute medicine is 4 years.

  11. hello, I just completed my otorhinolaryngology residency in India. I would like to know about the various options for settling and practicing in the UK as a specialist? do I need to take up MRCS A and B first?
    thanks for your help!

  12. Dear nick
    Hello and many many thanks for your invaluable information. you have helped me a lot and much of my confusion and stress have been relieved after reading your articles. just to be sure, I am an IMG that have completed my residency in the field of clinical oncology. as I understood the best option for me is to start with passing the PLAB. considering my specialty, do you have any special recommendations for me? would any other pathway be better for me? I am planning on becoming a specialist in the UK, preferably in clinical oncology.

    1. Hi there! Sorry for the late response! So glad you’ve found the website helpful. You’ll need to pass an English test before you can book PLAB so IELTS or OET would be the first step, then PLAB. The other option is to consider MRCP. Best of luck!

  13. Dear Nick,

    can I get your help.I have completed my Core Medical Training in an European country but I hold only MRCP 1. I can enter ST3 Haematology Training only with MRCP 1.Do I need to stand for MRCP2 and PACES?Or can I apply for CESR-CP?!

  14. Dear dr
    Iam orthopedic specilist in my country, what your advice for me? How can i choose which pathways is suitable for me?

  15. Hi can I try for mrcp
    And try pathway c
    As post intership experience is of 08 yrs
    In dealing with patients .
    If they consider that .


  16. Hey Nick
    Your website is really helpful
    I completed my mbbs from india in 2013 and since having working under government job in India without any specialization as general practitioner .
    Which pathways would be best suitable for me to work as a gp / consultant in uk .
    Regards .

  17. Hi! Thank you for sharing these valuable informations.
    I am a pediatrics specialist overseas. If I am able to file competency for earlier years, and join midway ST3/4, until I become a consultant, would that fall under CCT, or CESR-CP? You mention that CESR-CP may not be valid in countries other than UK, and I am not sure if settling in the UK, that’s why i am concerned.

  18. Hello,
    My question is if someone has done MBBS and internship from one of the recognised GMC institute overseas UK and currently a second year resident in Anesthesia and intensive care in a European country and wish to pursue further in UK, I mean from the 3rd year of residency
    What would be the ideal path

  19. Hi, thanks a lot for the information you provided. I have completed my post-graduation training & degrees in my country followed by recent completion of FRCS under JSCFE. I would like to know can i enter CESR-CP pathway. If it is, what should i do next. Please give your valuable opinion.

    Kind regards

    1. Hi there, it depends on the specialty. It’s possible to be considered overqualified for some surgical specialties. Please see these articles for more information about how to check if you are eligible:

      If you are eligible, you can follow the step-by-step guide listed above. Best of luck!

      1. Thanks Nick. Would you please give me a suggestion which route is best for me to become a consultant general surgeon in Uk?

        Best regards

  20. Hi!
    Your website is really informative and helpful as there is a slew of information out there.
    I had my PMQ and graduated 2014 in SLMC-QC which is fortunately included in the World Directory. I also finished my 3-year Internal Residency program in the Philippines officially last December 2019, and passed the PSBIM last March 2020. I have flown to UK ever since to get married and live here long-term under a presettlement visa (my husband is an EU settled citizen).
    As I understand from all of the info in GMC and other websites which you have wonderfully summarised here, the CESR-CP route is the best one for me if I desire to pursue work and hopefully further training here (please correct me if I’m wrong!). My question is, how will GMC be able to verify my postgraduate course (Internal Medicine in Php)? Will it be done through EPIC, or do I fill up some forms in GMC?
    If I register in your Masterclass, will I be able to learn more about this?

    Kind regards,
    Joy Cabrera

    1. Thanks for your comment Joy! Great to hear from a fellow Filipino IMG!

      Yes I agree, the CESR-CP route would be most suitable for you. There is no accreditation for your IM residency overseas. What you need to do is fulfill the eligibility requirements for ST3/ST4 medical specialties and work on your portfolio/interview skills. The eligibility requirements include full MRCP and the Alternative Certificate of Core Competences. You can download the Certificate from our useful links page here:

      This article should also be helpful:
      And you should review this website in detail:

      It would also be beneficial to have 6-12 months UK experience before starting a training job at ST3/ST4 level.

      Regarding the Masterclass, the general principles of the application strategy, and all the guidance on how to carry out an audit, gain poster presentations, organise teaching etc, can also be used for application to ST3/ST4.

      However, the recruitment process for ST3/ST4 is very different from ST1/CT1 and will not be explained in the course.

      Also the directory of interviews, conferences and courses etc are specifically for application to ST1 or CT1 level. There are 50+ ST3 specialties so we are unable to provide a specific directory for each and every one, but we will teach you how to do a relevant search.

      Please review the course content and decide whether this course will benefit your application attempt. Best of luck!

      1. Thank you for your response, Nick! I feel very relieved and to be honest, fortunate, for having found your website. I have been quite confused with all of the information in GMC and I didn’t know anyone that I could consult privately regarding this as most of my colleagues who practice overseas go mainly to US and Northern America, Australia and Singapore. For that, your website with information prepared in such friendly format is truly helpful for individuals like me.
        I will definitely check out the links you have posted. I haven’t fully decided yet if I will pursue the course, but I will definitely let you know when I have.

        Kind regards and best of luck to both of you. God bless!


  21. I am a UK graduate but still find your site very helpful. Want to ask if you do any sort of mentoring in regard to applying via CESR route (general medicine)

    1. Hi there! Glad you find it helpful 🙂 Unfortunately we don’t have that service, the Royal Colleges generally run seminars and workshops for CESR that you can look into. Or there may possibly be a CESR lead in your department that can help you out. Best of luck!

  22. Hi, thanks a lot for the article

    I want to know if this pathway is suitable for a surgical resident who completed a 3 years general surgery residency in her home country

  23. Thank you! I would like to know what is the path for an IMG (currently in the UK) who has finished cardiac surgery (not cardiothoracic) residency in Syria which is 2 years of multi-specialities surgery + 4 years of cardiac surgery and completed the MRCS exams and OET. If this person is looking to train in cardiothoracic suregry in the UK, how should they proceed? Thanks!

    1. Hi there, this pathway (CESR-CP) is the correct one. You can also consider Pathway D (CESR).

      For CESR-CP, essentially you need to check the eligibility requirements and portfolio and interview scoring criteria for ST3 Cardiothoracic surgery and work on those so you can apply for ST3 Cardiothoracic surgery. There is no specialty training for cardiac surgery only, so cardiothoracic surgery is most appropriate. All the steps are listed above. Best of luck!

  24. Hey there! I would like to know what is the path for an IMG who has finished internal medicine residency in India and completed the MRCP exams. If this person is looking to train in endocrinology or cardiology, how should they proceed? Thanks!

  25. Thank you for the excellent articles. My question is about the possible pathway for an MD graduate doctor from India to come and work in the UK. For instance, what would be a sensible pathway for a MS (OB/GYN) graduate from India to get GMC registration if she has one year working experience after completing MS? If she wants to be GP in the UK, can she appear for the PLAB exam in order to get GMC registration ? Or should she sit for the MRCOG? I am not sure of the experience limit of 18 months. Thank you so much.

    Kind regards,

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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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