Specialty specific guidance for CESR in Clinical Pharmacology and Therapeutics

The new Clinical Pharmacology and Therapeutics (CPT) 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 January 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.

2022 curriculum

Our standards for postgraduate medical curricula are Excellence by Design and the framework for Generic Professional Capabilities. These help postgraduate medical training programmes 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. This means 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 Clinical Pharmacology and Therapeutics curriculum is made up of six Generic CiPs which are common to all physicianly specialties, eight clinical internal medicine CiPs and seven Specialty CiPs unique to Clinical Pharmacology and Therapeutics.

In demonstrating these capabilities, a successful applicant will be awarded a dual CESR in Clinical Pharmacology and Therapeutics and General 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 - Performing the clinical assessment, investigation and management of adverse drug reactions, medication errors and overdose at an individual and (where relevant) population level
  • CiP 2 - Providing specialist management of patients with complex prescribing needs, including multimorbidity, polypharmacy, adherence issues, and medication intolerance
  • CiP 3 - Providing analysis and expert opinion on pharmacokinetic, pharmacodynamic and pharmacogenomic factors to guide therapeutic decisions
  • CiP 4 - Providing evidence-based practice and contributing to the evidence base in a therapeutic area of interest
  • CiP 5 - Advising on the cost effective, safe and rational use of medicines on a population level
  • CiP 6 - Delivering effective education in clinical pharmacology, therapeutics and prescribing to promote safe and effective use of medicines across the whole workforce
  • CiP 7 - Providing expertise in the design and delivery of experimental medicine, and other types of clinical pharmacology & therapeutic research, including preclinical and clinical studies

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 Clinical Pharmacology and Therapeutics curriculum. This curriculum will train doctors that are specialists with generalist skills to manage the acute unselected take and care of acutely ill patients.

Advanced Specialist Area Modules are no longer specified and there will be flexibility for trainees to develop an area of therapeutic expertise during training and subsequent professional development. This is in line with Shape of Training and the need for generalists although trainees will still be able to develop a specialist interest which will be of benefit to employers/service.