Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)
NHS INTERVIEW MASTERCLASS — WEEK 3 DAY 3
You Have Been Told The CESR / Portfolio Pathway Is Your Route To Becoming An NHS Consultant. Here Is What Nobody Is Telling You About What Happens On Day One Of Your First NHS Role.
I am going to say something this morning that most CESR advisers will not say to you.
Not because it is controversial.
Because it requires them to admit that the advice they gave you — about the CESR Portfolio Pathway — is incomplete in a way that is costing doctors years.
The Portfolio Pathway — formerly known as CESR — is the GMC route to Specialist Registration for internationally trained doctors who have not completed a UK-approved training programme. It allows you to demonstrate that your training, qualifications, and experience are equivalent to a UK Certificate of Completion of Training (CCT). And achieving it places you on the GMC Specialist Register — the legal requirement to be appointed as a substantive NHS consultant in the UK.
Every internationally trained doctor pursuing this route knows that.
Here is what they do not know.
The CESR evidence portfolio must be built in real time — from your first NHS shift.
The evidence framework is built around Capabilities in Practice (CiPs) — the competency framework that replaced the old curriculum-based CESR assessment in 2021. Every specialty has its own CiP framework. And the evidence it requires cannot be generated retrospectively.
It requires Workplace-Based Assessments completed by GMC-registered consultant supervisors who have directly observed your practice. Mini-CEX, DOPS, CbD, MSF — these must be done in the moment, in the NHS, during real clinical encounters.
Every month you spend in an NHS role without a named educational supervisor actively supporting your portfolio collection is a month of CESR evidence you can never recover.
This means the most important decision you make is not which specialty to pursue CESR in.
It is which NHS Trust to join first.
Before you sign any NHS contract, confirm three things in writing:
One — will they assign you a named educational supervisor with CESR Portfolio Pathway experience who will conduct regular WBAs?
Two — will they provide access to the case mix and governance opportunities the GMC's evidence framework requires for your specialty?
Three — will they support your engagement with the relevant Royal College curriculum and your CiP framework from your first week?
If the Trust cannot answer yes to all three — that is information you need before you sign.
Getting the entry Trust right is the difference between a three-year CESR journey and a six-year one.
DM me "CESR" and I will tell you exactly what this means for your specialty, your entry grade, and your portfolio plan from day one.
Post 2 drops at 9:00 AM. Don't Miss it!
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