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Frequently asked questions - Combined Programme (CP)

This page provides common questions and answers for doctors applying for a Certificate of Eligibility for Specialist Registration (CESR) or GP Registration (CEGPR) through the combined programme (CP).

For detailed information about how to apply please see our combined programme application guidance. You can find out about fees in our fees section. You can find out which application type you are eligible to make by answering a few questions in the applications section.

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Click on a question in the list below to see the answer.

Eligibility

  1. 1. How will I know if I am eligible to apply for a CESR or a CEGPR through the combined programme?
  2. 2. I have been appointed above ST1. Does this mean I should apply for a CESR or a CEGPR through the combined programme?
  3. 3. I was enrolled at ST3 and I was an SHO before 1 September 2005. Am I eligible to apply for a CESR or a CEGPR through the combined programme?
  4. 4. If I complete all my training except passing an exam, can I apply for a CESR or a CEGPR through the combined programme?
  5. 5. If I have been appointed to a recognised training programme, why can’t I have a CCT?
  6. 6. Is there a minimum time that I must spend in a Specialty Training programme to be eligible to apply for a CESR or a CEGPR through the combined programme? 
  7. 7. If my training included time working outside the UK and I have since been appointed to a Specialty programme, will I be eligible to apply for a CESR or a CEGPR through the combined programme?
  8. 8. What am I eligible to apply for if I have changed specialties and have been appointed into a Specialty Training programme in my new specialty? 
  9. 9. I have achieved the required competencies in approved training posts earlier than specified by my Specialty Training programme. Can I apply for specialist registration now?
  10. 10. Do I have to have been appointed after August 2007 to be eligible for this route?
  11. 11. I have undertaken training outside of my structured programme. What should I apply for?

Enrolment

  1. 12. Does my Royal College or Faculty have to enrol me?
  2. 13. When does my Royal College or Faculty have to enrol me by?
  3. 14. Does my Royal College or Faculty have to maintain a record of every training number that I have held?

Entry level to specialty training programme

  1. 15. What happens if the Royal College or Faculty disagrees with the deanery’s position?

Assessment

  1. 16. Which curriculum will I be assessed against?
  2. 17. Can I bring forward my end of training date once I am in post if you take into account competencies that I achieved prior to entry to Specialty Training that were not considered for my appointment?
  3. 18. Can I bring forward my end of training date if I achieve competencies earlier (during training programme)?
  4. 19. If I was appointed to a Specialty Training programme, but my training period has been extended and I have now fulfilled sufficient time in posts approved by the GMC, am I eligible to apply for a CCT?
  5. 20. What happens if I am on a CCT programme and I undertake a period of training not approved by the GMC in the middle of my programme?

Application process

  1. 21. When can I make my application?
  2. 22. Do I have to wait until I have had my final ARCP before applying?
  3. 23. How long will it take for me to receive my certificate and have my name entered onto the Specialist Register or the GP Register?
  4. 24. What happens if I have submitted an application, but my expected end of training date is subsequently extended?

General

  1. 25. When was the combined programme application system introduced?
  2. 26. Can Colleges charge me an enrolment fee?
  3. 27. What is the fee for a CESR or CEGPR through the combined programme?
  4. 28. Do I have to become a member of my College?
  5. 29. Are CESR and CEGPR equivalent to a CCT?
  6. 30. Is it true that CESR and CEGPR are not recognised in Europe whereas CCT are?

Eligibility

1. How will I know if I am eligible to apply for a CESR or a CEGPR through the combined programme?

You will be eligible if you have been appointed to a Specialty Training programme by a postgraduate deanery and have been awarded a National Training Number (NTN). You will have enrolled with your Royal College or Faculty who will have confirmed, as part of this enrolment, that if you complete your training programme satisfactorily, you are eligible to apply for a CESR or a CEGPR through the combined programme for entry onto the Specialist or GP Register.

If you are not sure what type of certificate you are eligible to apply for, you can find the right guidance for you in the how to apply for specialist and GP applications section.

2. I have been appointed above ST1. Does this mean I should apply for a CESR or a CEGPR through the combined programme?

Not necessarily. If the competencies that have been accepted to allow you to be appointed above ST1 were achieved in posts approved for the specialty to which you have been appointed then you will be eligible to apply for a Certificate of Completion of Training (CCT). For example if your competencies were achieved in SHO, LAT, FTTA or FTSTA posts then you are likely to be eligible to apply for a CCT.

3. I was enrolled at ST3 and I was an SHO before 1 September 2005. Am I eligible to apply for a CESR or a CEGPR through the combined programme?

If you were an SHO in UK approved training posts before 1 September 2005 (or training posts approved by a competent authority in another EEA member state) then if you are appointed in open competition and meet the person specification for the Specialty Training programme to which you have been appointed, we will accept this as approved training for award of a CCT on successful completion of the programme. However, from taking up your appointment you must pass any exams or assessments set out in the assessment system for your specialty for successful completion of your Specialty Training programme.

4. If I complete all my training except passing an exam, can I apply for a CESR or a CEGPR through the combined programme?

No. You are required to have completed all the necessary assessments before leaving the Specialty Training programme to be eligible to apply through the combined programme for entry onto the Specialist or GP Register.

If you leave before you complete the Specialty Training programme, you may apply through the standard CESR or CEGPR route at a later date.

However, if you subsequently do not pass the required exam for that specialty you will need to demonstrate in other ways that you have obtained the required knowledge and competencies (and maintained those skills since leaving the programme).

5. If I have been appointed to a recognised training programme, why can’t I have a CCT?

To be eligible for a CCT all of your training must have been undertaken in posts and programmes approved* for the specialty you were appointed to.

If you have been appointed above ST1 level and have undertaken time in posts not approved* for the specialty to which you were appointed then you will be eligible to apply through the combined programme for entry onto the Specialist or GP Register.

*Approved by one of the following organisations:

Period Organisation
Before September 2005 (for specialists) The relevant medical College
Before September 2005 (for GPs) The Joint Committee on Postgraduate Training for General Practice (JCPTGP)
Between September 2005 and March 2010 Postgraduate Medical Education and Training Board (PMETB)**
From April 2010 The GMC
**Before 31 July 200 Some training posts that were completed before 31 December 2006 may have been approved retrospectively by the Royal College or Faculty for that specialty (including General Practice). This approval will have been granted before 31 July 2007 and the doctor will have a letter from the Royal College or Faculty confirming this.

6. Is there a minimum time that I must spend in a Specialty Training programme to be eligible to apply for a CESR or a CEGPR through the combined programme?

No. Although there is no minimum time that you must spend in a Specialty Training programme, to be eligible, following entry to the programme, you must have had:

For specialist trainees or General Practice trainees on a programme longer than three years in duration

  • A minimum of two ARCPs one of which must be the final ARCP. You are likely to have spent at least two years in the programme.

For General Practice trainees on a three year training programme

  • A minimum of one ARCP form which must be the final ARCP (which will include success in the nMRCGP exam). You are likely to have spent at least one year in the training programme.

ARCPs are annual reviews, we expect for this minimum that you will normally have trained for 12 months for each form completed (part time trainees, those with periods of absence or where forms cover less than 12 months, will need to provide pro rata numbers of forms). For further information on ARCPs please see the MMC Gold Guide.

7. If my training included time working outside the UK and I have since been appointed to a Specialty Training Programme, will I be eligible to apply for a CESR or a CEGPR through the combined programme?

Yes, unless your overseas training had prospective approval.

We only provide prospective approval for trainees who have been appointed to approved training programmes, which means trainees with overseas training must have been part of an approved UK training programme at the time of going overseas or out of programme.

8. What am I eligible to apply for if I have changed specialties and have been appointed into a Specialty Training programme in my new specialty above ST1?

As you have been appointed above ST1 recognition has been given that you have achieved competencies in your previous specialty. For you to be eligible for entry onto the Specialist or GP Register with a CCT, your previous specialty programme must have been approved for the specialty to which you have now been appointed. If it is not, then you are not eligible for a CCT and must apply through the combined programme route.

9. If I have been appointed at ST3 level having achieved the required competencies with only 21 months in approved training posts, am I on a CCT programme or a CESR or CEGPR?

Appointments to training programmes at any level including ST3 are the responsibility of the relevant Postgraduate Dean. The GMC has no rules, as such, which would prevent a trainee in this position obtaining a CCT. What we will look for is that at completion of training, the minimum indicative training duration has been undertaken, and that the requirements of the associated assessment system have been satisfactorily demonstrated.

Spending less time in training does not automatically mean a trainee is on a CESR/CEGPR (CP) programme.

10. Do I have to have been appointed after August 2007 to be eligible for this route?

No this route is open to trainees who have been appointed to Specialty Training (or previously Specialist Training) who fulfil the other eligibility requirements.

11. I have undertaken training outside of my structured programme. What should I apply for?

Between 1 January 2007 and 1 April 2010 it was a requirement for all out of programme training or experience to have the prospective approval of the Postgraduate Medical Education and Training Board (PMETB). From 1 April 2010, this must have been approved by the GMC.

Up to 31 July 2007, Colleges (for specialists) and the Joint Committee for Postgraduate Training for GPs (JCPTGP) (for GPs) were permitted to give retrospective approval.

If you received retrospective approval before 31 July 2007 or prospective approval from PMETB or the GMC after this date then you may be eligible to apply for entry onto the Specialist or GP Register with a CCT, CESR/CEGPR(CP). Otherwise either your end of training needs to be amended to reflect that the unapproved time is not counted or you will need to apply for entry onto the Specialist or GP Register via standard CESR or CEGPR.

Enrolment

12. Does my College have to enrol me?

Yes. Combined programme trainees are to be treated in the same way as CCT trainees. Colleges must enrol all trainees and also to recommend to us when they have successfully completed Specialty Training.

13. When does my College have to enrol me by?

It is important that your College enrols you as soon as possible after you start your Specialty Training programme. This is to ensure that you know whether you are working towards entry onto the Specialist or GP Register with a CCT or with a CESR or CEGPR. Some Colleges may wish to wait until the first ARCP has confirmed your appointment level. This means that some Colleges use a two stage enrolment process, the first stage indicating which route you are following and the second confirming the expected end of your training date. An end of training date may not be brought forward after the first ARCP.  If this happens that you will need to apply for entry onto the Specialist or GP Register via standard CESR or CEGPR.

14. Does my College have to maintain a record of every training number that I have held?

For the purposes of the combined programme, your Royal College or Faculty needs to record the NTN that you hold at point of enrolment (for your enrolment letter) and at the point of end of training (for recommendation to us that you have completed training).

In some circumstances you may be enrolled twice, for example you would be enrolled for Core Medical Training then may have a further enrolment letter with a different NTN when you move into your specific specialty.

To monitor your training, your Royal College or Faculty may need to track your NTN.

Entry level to specialty training programme

15. What happens if the Royal College or Faculty disagrees with the deanery’s position?

The purpose of the enrolment process it not to decide whether you should be appointed, but to decide what level you should enter at. Colleges have agreed person specifications for appointment and entry to the different stages of the training programme and you will have demonstrated your achievement of the relevant specialty competencies in the application process against these person specifications.

The enrolment process is an opportunity for the College to check that:

  • the deanery has followed the agreed person specification
  • your evidence demonstrates that you have achieved the appropriate competencies to be appointed above ST1
  • they are satisfied with your expected completion of training date

If the Royal College or Faculty and deanery do not agree, the College must tell you of their position. If you then contact the Royal College or Faculty to challenge the decision, this may be referred to us for a final decision.

Assessment

16. Which curriculum will I be assessed against?

We will automatically assess you against the curriculum in place at the time of your appointment to a Specialty Training programme. If we approve a new programme and you transfer to this new programme then you will be assessed against the curricula for the new programme (it will be your responsibility to provide us with evidence of this transfer from the deanery). Your deanery should make it clear to you, to us and to your College which programme you have been appointed to.

17. Can I bring forward my end of training date once I am in post if you take into account competencies that I achieved prior to entry to Specialty Training that were not considered for my appointment?

No. The Combined Programme application process is for doctors who enter a training programme above ST1 level and successfully complete the remainder of the programme. If you have all the required competencies for GP or specialist registration before your expected completion date you will need to apply through the standard CESR or CEGPR application process and provide all the necessary evidence.

18. Can I bring forward my end of training date if I achieve competencies earlier (during training programme)?

This is only possible if an existing process is in place and approved by the GMC for CCT trainees, currently this is only approved for a CCT in Paediatrics.

19. If my expected end of training date is extended due to issues relating to performance or not passing my exams, can I apply for a CCT as I have now fulfilled sufficient time in approved posts?

No. When you were appointed you were considered to have achieved certain competencies that enabled you to be appointed above ST1. This evaluation has not changed and you are still on a training programme leading to entry onto the Specialist or GP Register with a CESR or CEGPR even if your training period is extended.

20. What happens if I am on a CCT programme and I undertake a period of training not approved by the GMC in the middle of my programme?

To be eligible for a CCT you must successfully complete the full programme in approved* posts.

If you undertake any part of your training programme in unapproved posts then this cannot count towards the CCT requirements and, if it is counted, you are not eligible for the award of a CCT.

If the final part of your training (the final 6 months) is spent in approved training then you are eligible to apply for a CESR or a CEGPR through the combined programme.

If you undertake the final part of your training in unapproved* posts then you must apply through the standard CESR or CEGPR process.

*Approved by one of the following organisations:

Period Organisation
Before September 2005 (for specialists) The relevant medical College
Before September 2005 (for GPs) The Joint Committee on Postgraduate Training for General Practice (JCPTGP)
Between September 2005 and March 2010 Postgraduate Medical Education and Training Board (PMETB)**

 

 

From April 2010

 

 

The GMC
**Before 31 July 2007  Some training posts that were completed before 31 December 2006 may have been approved retrospectively by the Royal College or Faculty for that specialty (including General Practice). This approval will have been granted before 31 July 2007 and the doctor will have a letter from the Royal College or Faculty confirming this.

Application process

21. When can I make my application?

We will contact you between six and three months prior to your end of training date and invite you to log into your GMC Online account and submit your application for entry onto the specialist or GP Register via the combined programme or CCT.  This information will be advised to the GMC by your College.

22. Do I have to wait until I have had my final ARCP before applying?

No. You may apply as soon as you receive your invitation from the GMC, but, your application will not be finalised until we receive a recommendation from your Royal College or Faculty and they will require your final ARCP before they can do this.

23. How long will it take for my name to be entered onto the Specialist Register or the GP Register and my certificate to arrive?

Providing we have received your application we will normally grant it within 15 working days after we have received a recommendation from your Royal College or Faculty, but no earlier than 10 days before your completion of training date.

Your status on the Register will be updated on the date your application is granted. Please check our online Register (opens in a new window) before you take up a post that requires you to be entered onto the Specialist Register or the GP Register.

We will send your certificate to your registered address when we have granted your application. However, your certificate will not be sent earlier than 10 working days before your end of training date.

You can check your status on the Register in GMC Online or on the online Register.

24. What happens if I have submitted an application, but my expected end of training date is subsequently extended as I have not passed the final exam?

You have the option of withdrawing your application and applying again when you are in a position to do so, or we will retain the application and put it on hold until three months after your expected end of training date (if you fail an exam we will retain the application until the next available sitting of the exam). After that time we will close your application and refund part of the fee.

General

25. When was the combined programme application system introduced?

The application process was introduced with effect from 20 April 2009 in time for those completing their training in July and August 2009.

26. Can Colleges charge me an enrolment fee?

Yes. We recognise that Colleges may charge you for enrolment and/or use of online e-portfolios/log books and for exams if you are in training leading to the award of a CCT. To be eligible for a CESR or CEGPR through the combined programme you would be required to be enrolled with the Royal College or Faculty and follow the same programme as a CCT trainee from point of entry to Specialty Training and use the same assessment systems.

27. What is the fee for applying for a CESR or a CEGPR through the combined programme?

Details of fees can be found on our fees page.

28. Do I have to become a member of my College?

We ask Colleges to monitor your training throughout your programme. They will:

  • enrol you when you enter an approved training programme
  • confirm your expected end of training date considering any training you have undertaken prior to entry to the programme
  • inform you whether you are working towards a CCT or CESR or CEGPR through the combined programme

At the end of training they recommend to us whether you have successfully completed all the requirements of the curriculum. To do this your Royal College or Faculty may require you to become a member or may charge you for this work.

29. Are CESR and CEGPR equivalent to a CCT?

The important factor is whether or not a doctor is entered onto the Specialist Register or the GP Register. The Specialist and GP Registers do not show which certificate was awarded. We do not award CCT, CESR or CEGPR without entry onto the Specialist Register or GP Register.

CESR/CEGPR(CP) and CCT all demonstrate that a doctor has been assessed against the same standards set out in the relevant specialty curriculum and allow the doctor, providing they satisfy all of our other requirements, to have their name entered onto the Specialist Register or GP Register.

Doctors who practise as substantive or honorary consultants in the NHS must be on the Specialist Register. Doctors who practise as GPs in the NHS, other than as trainees, must be on the GP Register. It is not a legal requirement to hold a CCT to work as a specialist or a GP.

30. Is it true that CESR and CEGPR are not recognised in Europe whereas CCT are?

This is not quite true. Doctors recognised as a specialist or GP in one member state may apply for recognition in another member state. This includes holders of CCT, CESR and CEGPR who are EEA nationals.

Some CCT holders will be able to have their qualification automatically recognised in another EEA member state. This only happens when the:

  • CCT is awarded in a specialty which is listed for the UK in EU Directive 2005/36/EC
  • holder is a national of a European Member State (or has European Community rights)
  • holder holds a European primary medical qualification

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