Portfolio pathway

Introduction to Portfolio pathway

Certificate of Eligibility for Specialist Registration (CESR) is the process that enables doctors who don't hold a Certificate of Completion of Training (CCT) to join the GMC's specialist register and therefore be eligible to take up substantive consultant posts.

The process entails applicants submitting a body of evidence to demonstrate that they have acquired the Knowledge, Skills, and Experience (KSE) necessary for practicing as a Consultant in the UK. The specific requirements are defined in the Specialty Specific Guidance, published by the GMC.

Who is eligible for Portfolio pathway

The process is open to anyone who has obtained their qualifications and/or experience outside of the European Union (EU) or European Economic Area (EEA), or who has achieved their competencies outside of a GMC-approved approved training programme within the EU. Please see the GMC Website for further information.

The role of the GMC

The Portfolio pathway process is owned by the GMC and applications are made to them. Applications are then assessed by the College's Portfolio pathway Committee who, based on the evidence presented, make a recommendation to the GMC; the GMC subsequently issue a decision.

The role of the College

The Portfolio pathway Committee meet once a month to discuss applications received from the GMC. A minimum of two evaluators review each application. Committee members prepare for the meeting by reviewing the application and forming a provisional decision, before attending the meeting to discuss their findings with other assessor(s). Once a decision has been made the College secretary completes an evaluation form and makes a recommendation to the GMC on behalf of the Portfolio pathway Committee.

The ultimate decision is legally the GMC’s and they can ask for clarification regarding elements of the recommendation prior to implementing the recommendation. They have review committees for QA which look at whether the evidence College evaluators rely on supports the conclusions they draw. The review committee has the power to reverse the recommendations.

The College can provide advice on the type of evidence required but will not review any application before submission nor provide any indication as to the likely success of the application.

The College does not arrange additional training for any areas of practice that an applicant believes requires further development. Applicants in the UK should speak with the College Tutor in their hospital to discuss the options for obtaining any additional training.

CESR Programmes

In response to various factors affecting the landscape of the anaesthetic workforce, some trusts are offering CESR programmes to help candidates who wish to apply for the Portfolio Pathway. The College has recently launched a recognition process for these CESR programmes to ensure that they are of a high standard and offer the appropriate educational support for doctors on these programmes. 

Portfolio pathway application in a non-CCT specialty

Some doctors may be eligible to apply for a Portfolio pathway in a non-CCT specialty, which if successful leads to specialist registration in that specialty. Non-CCT applicants will be expected to submit much the same evidence as those applying for a Portfolio pathway in Anaesthetics. More information can be found on the GMC's CESR application in a non-CCT specialty page.

To be eligible to apply you must have either a specialist qualification from outside the UK in any non-CCT specialty or at least six months continuous specialist training outside the UK in any non-CCT specialty.

Guidance for non-CCT Portfolio pathway applications in:

Tests of knowledge

Applicants need to demonstrate that they have a test of knowledge as part of their application. If your qualification is not in this list, evidence should be provided including a validated certificate of completion, with the full details of the curriculum and assessment criteria in force at the time of the award. This should be in English and validated by the institution.

Please note, there is no direct equivalent to the FRCA and it is College policy not to comment on the 'equivalence' of the FRCA to other qualifications.

Awarding country/body Qualification(s)
Australia Fellowship of the Australian and New Zealand College of Anaesthetists
Bangladesh Fellowship in Anaesthesia of the Bangladesh College of Physicians and Surgeons (since 1997)
Canada Fellowship of the College of Physicians and Surgeons of Canada
Egypt MD in Anaesthesia from Ain Shams University

European Diploma in Anaesthesiology and Intensive Care

Hong Kong Fellowship of the Hong Kong College of Anaesthesiologists (since 2001)
India Please refer to the National Medical Commission of India website for accepted Colleges for the MD in Anaesthesiology in India and for the Diplomate of the National Board (DNB) in Anaesthesiology
Japan Diploma in Anesthesia from the Japan Society of Anesthesiology (since 1986)
New Zealand Fellowship of the Australian and New Zealand College of Anaesthetists
Pakistan Fellowship in Anaesthesiology of the College of Physicians and Surgeons of Pakistan (since 1998)
Republic of Ireland Fellowship of the College of Anaesthetists in Ireland
Singapore Master of Medicine in Anaesthesia from the National University of Singapore
South Africa

Fellowship of the College of Anaesthetists South Africa

MMed in Anaesthesiology from University of Stellenbosch

South Korea Diploma in Anaesthesiology Korean Society of Anaesthesiologists
Sri Lanka MD in Anaesthesiology from the University of Colombo
United Kingdom Fellowship of the Royal College of Anaesthetists
United States of America Certificate of the American Board of Anesthesiology
Zimbabwe Masters in Anaesthesia from University of Zimbabwe (since 1992)


Portfolio Assessment Group

The Portfolio Assessment Group (PAG) plays an active role in the assessment of individual applications for entry to the GMC Specialist Register. All our members are practicing substantive consultants or SAS grade anaesthetists in the NHS and many have previous experience of gaining GMC specialist registration through the CESR process. 

The College welcomes applications from doctors interested in becoming a member of the Portfolio Assessment Group. Full support is provided by the College CESR team and the team will also send each PAG member an annual report detailing the number of applications they have reviewed, for use in their CPD portfolios. Those who have achieved CESR are also welcome to join.

The PAG Terms of Reference and the roles and responsibilities of a PAG member have recently been updated to facilitate the workload and future collaboration with the GMC. For further information, please read the job description here.

If you are interested in joining the Portfolio Assessment Group (PAG), please email cesr@rcoa.ac.uk with the following details: 

  • name
  • GMC number 
  • hospital/trust you are currently based at 
  • brief statement outlining your interest in joining the PAG.

If you would like to contact us, you can email cesr@rcoa.ac.uk or call the Workforce and Careers Team on +44 20 7092 1721 .

Please let us know what you think. If you feel the information on this page could be improved, please get in touch with us.

Last reviewed: 31 December 2022
Next review due: 1 January 2024