CESR and Equivalence

CESR and equivalence

Equivalence is the process of assessing an applicant’s training and experience against the current training programme requirements, as set out in the 2021 CCT in Anaesthetics curriculum, in order to gain a Certificate of Eligibility for Specialist Registration (CESR) for the Specialist Register held by the General Medical Council (GMC).

The current CCT curriculum for anaesthesia was introduced in 2010. Although there have been some amendments, such as the introduction of Units of Training in Perioperative Medicine, it remains largely unchanged over the last decade. Standards for curricula set by the GMC have driven the development of a new curriculum and this has afforded anaesthesia the opportunity to create a more learning-centred approach to the development of anaesthetists in training. Further background can be found here (https://www.rcoa.ac.uk/training-careers/training-anaesthesia/2021-anaesthetics-curriculum.

The approval and implementation of the RCoA 2021 curriculum will impact CESR applications. All applications will eventually be required to follow the 2021 curriculum but there will be a period of transition when applicants can align their application to either the 2010 or the 2021 curriculum.

The approval date of the new curriculum is the date of final approval by the GMC. The implementation date is the date on which anaesthetists in training begin to use the new curriculum and was on 4th August 2021. All anaesthetists in training must transition to the new curriculum within two years of the implementation date.

Current and future CESR applicants are asked to review the following options:

  1. For candidates who have an application in progress with GMC online collecting evidence to support a CESR application against the 2010 curriculum on the approval date, these applicants can continue with this application and submit this within the 12 month timeframe permitted for completing the application and submitting it to the GMC. If these applicants want to apply against the new curriculum they will need to withdraw their current application and re-apply to align their evidence against the new curriculum.


  1. For applicants who started an application with GMC online from approval date of the 2021 curriculum until implementation date of the 2021 curriculum (4th August 2021), these applicants have a choice of using the 2010 or the 2021 curriculum. This must be submitted within the 12 month timeframe permitted for completing the application and submitting it to the GMC.


  1. For applicants who started an application with GMC online on or after the implementation date of the 2021 curriculum (4th August 2021), only the 2021 curriculum can be used. Applications must be submitted within the 12 month timeframe permitted for completing the application and submitting it to the GMC.

If the applicant is unsuccessful and needs to submit a Review application, this would be assessed against the same curriculum as the initial application.

New specialty specific guidance has been developed to support CESR applications which align to the new curriculum and is available on the GMC website. Candidates who can choose between curricula (options 1. and 2. above) are encouraged to seek guidance from the GMC and review the RCoA material relating to the old and new curricula. Candidates can then gauge which would best suit their situation. They are also encouraged to work closely with their local training teams.

If choosing the new curriculum, candidates will find the GMC online application process more closely aligned with the learning domains of the 2021 curriculum. This should benefit both candidates and assessors.


Dr Sarah Ramsay, Chair RCoA Equivalence Committee

Dr Ros Bacon, Deputy Chair RCoA Equivalence Committee

Chris Scorer, Specialty Training Administrator, RCoA

The process involves submitting a body of evidence of training which demonstrates competence, skills and knowledge to the GMC. The College will assess the application against the UK curriculum before providing a recommendation to the GMC, who will then make a decision.

Successful CESR applicants are eligible to join the specialist register. Those on the specialist register are able to apply for consultant roles.

Please note that Equivalence procedures are the responsibility of the GMC. Applications are made through their Certification Department and initial enquiries should be directed there.

Information on what evidence needs to be included as part of your application can be found in the Specialty Specific Guidance located on the GMC Website.

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.

Accepted test of knowledge

Fellowship of the Australian and New Zealand College of Anaesthetists

Fellowship in Anaesthesia of the Bangladesh College of Physicians and Surgeons (since 1997)

Fellowship of the Royal College of Physicians and Surgeons of Canada

MD in Anaesthesia from Ain Shams University

EU accepted tests of knowledge

European Diploma in Anaesthesiology and Intensive Care

Fellowship of the Hong Kong College of Anaesthesiologists (since 2001)

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

Diploma in Anesthesia from the Japan Society of Anesthesiology (since 1986)

Fellowship of the Australian and New Zealand College of Anaesthetists

Fellowship in Anaesthesiology of the Royal College of Physicians and Surgeons of Pakistan (since 1998)

Fellowship of the College of Anaesthetists in Ireland

Master of Medicine in Anaesthesia from the National University of Singapore

Fellowship of the College of Anaesthetists South Africa

MMed in Anaesthesiology from University of Stellenbosch

Diploma in Anaesthesiology Korean Society of Anaesthesiologists

MD in Anaesthesiology from the University of Colombo

Fellowship of the Royal College of Anaesthetists

Certificate of the American Board of Anesthesiology

Masters in Anaesthesia from University of Zimbabwe (since 1992)

Frequently asked questions

The Equivalence 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 reading the application and forming a provisional decision, before attending the meeting to discuss their findings with the 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 Equivalence 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.

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. See the GMC Website for further information.

A doctor who has obtained the UK CCT or a European recognised EU/EEA specialist qualification – as they may be automatically entitled to entry onto the Specialist Register.

Unfortunately it is College policy not to comment on the 'equivalence' of the FRCA to other qualifications – there is no direct equivalent

No. The College can provide advice on the type of evidence required but will not review your application before submission nor provide any indication as to the likely success of the application. Applicants are encouraged to read the specialty specific guidance and generic guidance very carefully before submitting their application to the GMC.

No, the College does not arrange training. Applicants in the UK should speak with the College Tutor in their hospital to discuss the options for obtaining the additional training. Applicants can however contact the College to find out whether the proposed additional training is appropriate.