Specialty specific changes for CESR in Neurology
The new Neurology curriculum was published in August 2022. For a transition period you can make your CESR application in either the new curriculum or the previous version of the curriculum.
This option is available until the transition deadline of 31 August 2024.
Specialty specific guidance
We’ve produced guidance documents for each version of the curriculum with the Joint Royal Colleges of Physicians Training Board.
How to apply
You can apply through your GMC Online account. There is one application form which includes sections for both versions of the curricula. You should declare which curriculum version you wish to be assessed against in sequence one and only provide evidence in the sections of the application relevant to your curriculum.
Our new standards for postgraduate medical curricula Excellence by Design and its framework for Generic Professional Capabilities help postgraduate medical training programmes re-focus trainee assessment away from an exhaustive list of individual competencies, towards fewer broad capabilities needed to practice safely from your first day as a consultant.
As a result, the 2022 physicianly curricula are outcomes-based, meaning that trainees will be assessed against the fundamental capabilities required of consultants in the working week. These include the general skills which all doctors need to have (the GMC’s Generic Professional Capabilities) as well as those needed to carry out all the specific day to day tasks undertaken by a consultant physician (Capabilities in Practice – CiPs).
The Neurology curriculum is made up of six Generic CiPs which are common to all physicianly specialties, eight Clinical CiPs in internal medicine, eight Specialty CiPs unique to Neurology and three further CiPs for Stroke Medicine.
Stroke Medicine is essential to Neurology practice in the NHS. As such, anyone entering the specialty register for Neurology via the new curriculum is expected to be capable of managing a stroke clinic unsupervised as part of their practice.
In demonstrating all these capabilities set out above, a successful applicant will be awarded a CESR in Neurology and an additional CESR in internal medicine.
Completion of three years Internal Medicine Training replaces Core Medical Training as the core training programme.
Content shared between all physicianly specialties
There are six CiPs which are shared between all physicianly specialties:
- CiP 1 - Able to function successfully within NHS organisational and management systems
- CiP 2 - Able to deal with ethical and legal issues related to clinical practice
- CiP 3 - Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement
- CiP 4 - Is focused on patient safety and delivers effective quality improvement in patient care
- CiP 5 - Carrying out research and managing data appropriately
- CiP 6 - Acting as a clinical teacher and clinical supervisor
Clinical internal medicine content
- CiP 1 - Managing an acute unselected take
- CiP 2 - Managing the acute care of patients within a medical specialty service
- CiP 3 - Providing continuity of care to medical inpatients, including management of comorbidities and cognitive impairment
- CiP 4 - Managing patients in an outpatient clinic, ambulatory or community setting, including management of long-term conditions
- CiP 5 - Managing medical problems in patients in other specialties and special cases
- CiP 6 - Managing multidisciplinary team including effective discharge planning
- CiP 7 - Delivering effective resuscitation and managing the acutely deteriorating patient
- CiP 8 - Managing end of life and applying palliative care skills
Specialty Specific Content
- CiP 1 - Managing disorders of cognition and consciousness
- CiP 2 - Managing headache and pain
- CiP 3 - Managing seizures and epilepsy
- CiP 4 - Managing inflammatory and infectious disorders
- CiP 5 - Managing movement disorders
- CiP 6 - Managing neuromuscular disorders
- CiP 7 - Managing traumatic brain injury and patients requiring neurorehabilitation
- CiP 8 - Managing neuropsychiatric disorders and functional neurological disorders
In addition, applicants must demonstrate capabilities in Stroke Medicine:
- CiP 1 - Managing the care of acute stroke patients, including hyperacute care and cerebral reperfusion strategies.
- CiP 2 - Managing the primary and secondary prevention of stroke and Transient Ischaemic Attack
- CiP 3 - Managing early and late stroke rehabilitation in hospital and community settings
Changes in assessment tools
There has been no change to the workplace based assessment methodology.
Changes in knowledge and skills
All JRCPTB specialties identified as group 1 will dual train in internal medicine (IM) and the IM learning outcomes have been embedded in the Neurology curriculum. This curriculum will train doctors that are specialists with generalist skills to manage the acute unselected take and care of acutely ill patients.
The neurology curriculum will incorporate the capabilities described in the new stroke curriculum, which will be necessary for doctors to contribute to the care of stroke patients.
The curriculum includes three procedures only one of which – lumbar puncture - is necessary for trainees to achieve level 4 competence by completion of training. Performing Botulinum Toxin and Greater Occipital Nerve block injections are included, but trainees will not be expected to be carry out these procedures independently.