Portfolio Pathway (CESR)
Introduction to Portfolio Pathway
The Portfolio Pathway programme (previously referred to as the 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 Assessment Group (PAG) 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 Assessment Group (PAG) meet once a month to discuss applications received from the GMC. A minimum of two evaluators review each application. PAG 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 PAG.
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 quality assurance 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.
Portfolio Pathway (CESR) Programmes
In response to various factors affecting the landscape of the anaesthetic workforce, some trusts are offering Portfolio Pathway (CESR) programmes to help candidates who wish to apply for the Portfolio Pathway. The College has recently launched a recognition process for these Portfolio Pathway Programmes to ensure that they are of a high standard and offer the appropriate educational support for doctors going through the programme.
Portfolio pathway application in a non-CCT specialty
Some doctors may be eligible to apply for entry onto the Specialist Register via 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 entry onto the Specialist Register via Portfolio Pathway for Anaesthetics. More information can be found on the GMC's Portfolio Pathway 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. Below is a list of accepted tests of knowledge. 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 |
| EU | 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 in the NHS and many have previous experience of gaining GMC specialist registration through the Portfolio Pathway (formally referred to as CESR) process.
The College welcomes applications from doctors interested in becoming a member of the Portfolio Assessment Group. Full support and guidance is provided by the College Portfolio Pathway team, alongside CPD points for applications assessed, annual events and training sessions. 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 Portfolio Pathway 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 PAG, please read and complete this application form, and email it to portfolio@rcoa.ac.uk .
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Last reviewed: February 2025
Next review due: May 2025