The Savvy IMG

Pathway D: From IMG to UK specialist (CESR/CEGPR 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 for IMGs who aim to become a UK-recognised Consultant or GP. It is suitable for you if you fit the following profile:

You can check the experience limits of the pathway you want to pursue in the person specifications under the section “Career Progression”. Alternatively you can download a free summary table of the experience limits for all specialties.

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 D to become a UK specialist as a GP or Consultant CESR CEGPR different steps including obtaining GMC registration evidence for CESR or CEGPR 2

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

SubstepsRelevant 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

SubstepsRelevant articles and links to official guidance
Open account on NHS Jobs websiteNHS Jobs
Submit job applications for Registrar level, specialty doctor, or locum consultant depending on previous experienceUnderstand the different titles and levels of doctors here.
Attend interviewI got into Standalone FY2 using what I learned in the book Medical Interviews (get you copy 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. Collect evidence of skills and knowledge

SubstepsRelevant articles and links to official guidance
Check what evidence is required for your specialty on the GMC websiteGMC guidance per specialty  CESR and CEGPR
Contact the relevant Royal College or Faculty for ongoing support with your applicationDirectory of all Colleges and Faculties
Self-explanatory ongoing substeps
  • Obtain what evidence you can from overseas experience.
  • Collect the remaining evidence prospectively through your UK job.
  • If your current job does not provide the opportunities to collect the necessary evidence, look for jobs that will.
  • Change jobs as necessary to collect all evidence.

Step 4. Submit portfolio of evidence

Once you have compiled your portfolio of evidence you will need to submit this to the GMC. If approved you will be awarded CESR or CEGPR which will allow you to enter the GMC Specialist Register or GP Register. With this type of registration you can apply for Consultant or GP jobs. 

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

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16 Responses

  1. I am British medical student (with British citizenship), with the plan to eventually practice in USA, but will finish my Foundation programme (after medical school) in UK and then migrate to do my residency training (in internal medicine) in USA after which I may or may not do a further fellowship (thinking of Cardiology at the moment) in the states.

    Now, due to visa issues surrounding getting green card, I am worried about having to return from USA to UK and not being able to practice in UK due to my residency/training being done in USA.

    My question is:
    1) Will my internal medicine residency in USA give me exemptions of doing the IMT training?

    2) If I then also complete a cardiology training in USA, can I then use CESR to enter consultant cardiologist role in UK? As a British citizen will it be easier for me to transition this way?

    3) Is CESR route equivalent to CCT? Will trusts, perhaps, discriminate when it comes to hiring a CESR-trained doctor over a CCT-trained doctor?

    1. Hi there! It’s great to think ahead about your options. To answer your questions:

      1. Not directly, but if you meet the eligibility criteria for ST3 then you won’t need to repeat IMT. Basically this involves passing MRCP (all parts), and having the alternate certificate of core training signed off. You probably won’t be able to get this signed of in the US though as the person signing it must have at least 6 months experience working in the NHS in the past 5 years, and I doubt your attendings in the US would have that – but you never know! You’d probably have to work as a trust grade in the UK for 3-6 months to get it signed off here. Once you have that and PACES then you can apply for ST3 cardio.

      2. You can go through the CESR route if you wish to work in the NHS as a substantive consultant, there would not be any differences in the requirements or application process for British and non-British citizens. If you want to work in the private sector only, you may not need to go through CESR at all.

      3. The NHS is in dire needs of Consultants in all specialties tbh so it doesn’t make much of a difference now. That’s what we’ve heard anyway! Best to speak to consultants in the UK to get a feel of things. They look at your application as a whole in general so if you have an impressive CV vs a CCT trainee who has only completed the bare minimum, then you’d most likely be favoured. All the best!

  2. Hello! I am a junior doctor working in Singapore. I graduated from a local university with a MBBS degree and am planning on obtaining the MMed (FM) and MRCP (UK). Thank you for your articles on Pathway D (CEGPR) and E (not aiming to be a GP/Consultant), I have read both of them. I have a few questions I would like to ask:

    (1) How does the type of family medicine work (e.g. running outpatient GP clinics) differ if I choose Pathway E instead of D? If I choose Pathway E, am I still able to practise in the outpatient GP clinic setting?
    (2) What are the other type of medical jobs for doctors on Pathway E?
    (3) What are the other type of medical jobs for doctors on Pathway D, besides running a GP clinic?
    (4) Based on your experience, what are the things I can do to increase the likelihood of a successful CEGPR application? I have read GMC’s requirements for joining the GP register (including the evidence that has to be submitted) – it is indeed quite substantial.

    Thank you so much for your help!

    1. Hi there!

      Thank you for sharing your background and for your clear questions!

      1. You need to be on the GP specialist register to be able to work as a GP. This involves either completing 3 years of UK GP training, or showing that you have the equivalent training overseas through the CEGPR route. TBH, the CEGPR can take as long or even longer than simply completing UK GP training, but it puts you in a more difficult position because you’ll be unfamiliar with the UK health care system which is crucial to GP work.

      2. You can apply for any NHS hospital based role in any specialty you’re comfortable working in. This will mostly likely be in a ward setting or in the emergency department. You could also work as a resident medical officer in a private hospital but those jobs are not as well supported as the NHS.

      3. Lots of GPs have other roles such as teaching medical students, training other GPs, writing medical-related articles, working in management etc. Please join the FB group “alternative careers for UK doctors” for other ideas.

      4. We don’t have any experience of CEGPR I’m afraid, you may want to ask IMGs in the FB groups. However we do know it is a daunting process that doesn’t always end well. In our personal opinion, it is honestly easier and better to complete training in the UK since this is where you aim to practice. The healthcare system in the UK is going to be very different from Singapore, and navigating the health care system is a very big part of being a being a GP.

      Is there any reason you want to complete training in Singapore but then practise as a GP in the UK?

      1. Hi Nick,

        Thank you for your reply!

        (1) May I find out why the CEGPR can take as long or even longer than simply completing UK GP training? Is it in terms of the amount of time it takes to prepare the evidence, or the waiting time for approval?

        (2) Hmm so this means that I am only able to practice in a tertiary healthcare setting, and not in outpatient primary care? If I were to work in a NHS hospital, what is the average monthly salary I can expect, and how is the career progression?

        I am keen on completing my training in Singapore as all local graduates have a 5-year bond to serve. If I were to complete training in the UK, it would be 5 years later.

        Thank you so much for your help!

        1. Hi Jane,

          1. Yes, it usually has to do with completing evidence and the approval process. The difficult part is deciding you want to come to the UK after training and then trying to dig up records in the past. However if you already know you want to come here, then if you collect evidence prospectively rather than retrospectively, it may not take as long. You can contact the RCGP regarding help with the CEGPR process, they should hopefully be able to guide you along the way. Dr Aman Arora would also be a good contact for this.

          2. You can read more about salaries here. Even if you’re not in training, you will receive a similar salary at a similar level. Career progression is more or less self-directed. If you want to progress, you can do so by applying for more senior jobs once you have the necessary experience and exams.

          Thanks for clarifying! You can try to complete CEGPR prospectively in that case. Hope it works out for you!

  3. Hi,I am a general practitioner working in UAE,basically from India.I have never worked in UK nor have a GMC registration.I have heard about CEGPR route for getting the licence to work in UK. I have 5 years of GP experience in total.Is it necessary for a PLAB or MRCGP exam? or Is there a pathway for direct training?Please guide me.
    Thanks in advance
    Dr Najeeb

    1. Hi there, PLAB and MRCGP are not strictly required as far as we’re aware but please contact RCGP for more information about CEGPR. If you do not gain registration through CEGPR and you wish to enter GP training in the UK, then you will need to pass PLAB to work in the UK. Hope that helps!

  4. I have never been to England. I am not planning to work as a doctor in the UK now or in the near future. I have an officially approved postgraduate radiology qualification certificate in my country (4 years + 6 months + 2 weeks). (Not on the GMC recognized postgraduate qualification list) I want to take the FRCR exams only for certification. Is OET or IELTS required? If not, what is the GMC record type? How was it?
    Second, how can I get involved in the NHS after completing FRCR 2A (while waiting for 2B)?
    Thank you in advance for sparing your precious time.

    1. Hi there, I don’t think OET or IELTS is required but you’ll need to verify that on the official RCR website. You will not get GMC registration until you have completed all parts of FRCR so you won’t be able to work as a doctor in the NHS in between exams, but you might be able to get a non-doctor job like a sonographer or radiology technician. Please join the IMG Radiology group on FB for more specialist advice. Best of luck!

  5. Dear Nick
    Thank You very much for your comprehensive explanations of all the pathways.
    Are there any third party agency/consultant who would specifically assist in CESR applications ( like migration agents)?

    1. Hi there, we’re not aware of any that help with this. The Royal Colleges tend to hold workshops and seminars and some UK hospitals will have someone to guide you as well, but you still have to do everything yourself. If we come across any, we’ll write about them. Try asking in the IMG FB groups as well. Let us know if you encounter any! Best of luck!

    1. Neonatology is considered a non-CCT sub-specialty, the CCT specialty is Paediatrics. If you practice in neonatology only you can get specialist registration via CESR only as a neonatologist and will not be able to practice is any other branch of paediatrics. The curriculum for neonatology that you need to fulfil can be found here:

      For further guidance, please contact RCPCH.

      Best of luck!

  6. Hi
    Thanks for great explanation.
    I am a medical oncologist
    Currently work at UK
    Have about 10 years of overseas experince and alot of certificate
    However,my problem is that i do not have a logbook from working overseas
    I have multiple certificates, CME,Quality projects,Audit and poster presentation.
    I have 2 questions if you do not mind before i join the course:-
    1-Do you have a service to submit to you all the data and evidence i have then you can review and give advise before actual submission?
    2-If i got official stumped/sealed certificates from my previous consultants overseas that i have went through number of cases and project,can GMC accept that?
    many Thanks

    1. Hi there! To answer your questions:
      1. No, we don’t I’m afraid. We’re not aware of any service like this. Usually doctors going through the CESR route whilst already in the UK have a supervisor they can discuss these things with,
      2. They should be accepted but please check the GMC criteria carefully for the full requirements.

      Logbooks and patient lists are usually integral parts of the CESR application. For further advice on CESR for your specialty, we recommend contacting the GMC, the Joint Royal Colleges of Physicians Training Board, and the Royal College of Physicians. RCP holds seminars and workshops about CESR applications that you may find useful. Best of luck!

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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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