The path towards CESR demands becoming a reflective practitioner, broadening and deepening skills and knowledge of the Emergency Medicine curriculum, so being able to demonstrate performance as an Emergency Medicine Consultant equal to that of colleagues who have passed through the Emergency Medicine CCT training scheme.
This article outlines the types of documents that can be used in order to evidence your eligibility for specialist registration in emergency medicine.
The Emergency Medicine curriculum is divided into 12 Specialty Learning Outcomes (SLOs). You will need to ensure that the different types of evidence you provide cover all learning outcomes.
As a general guide, most applications are expected to include around 100 electronically uploaded documents.
It is strongly advised that CESR applicants work towards completing all parts of the FRCEM exam, as these are adapted to the curriculum and form basic tests of knowledge considered essential for an EM consultant. Those applicants without the Fellowship examination rarely provide adequate alternative evidence.
Anaesthetics and Intensive Care Medicine
You are expected to have either completed posts of a minimum of three months (full time equivalent) in each of these specialties, or a combined Anaesthetics/ICM post of a minimum of six months’ (full time equivalent) duration, comprising three months aggregated time in anaesthetics and ICM. Provision of the Initial Assessment of Competence (IAC) in Anaesthesia is mandatory.
You are required to demonstrate that you have spent some time in this specialty and that you have acquired knowledge of the treatment of medical patients beyond that given in the Emergency Department. While these competencies could be achieved from within the Emergency Department working with medical colleagues, it is preferable to have worked in areas outside ED in order to demonstrate this. A logbook of medical cases must be provided.
Paediatric Emergency Medicine
In order to achieve sufficient exposure to paediatric patients, you are recommended to have spent a minimum of three months (full time equivalent) in a Paediatric Emergency Department, or a General ED with more than 16K Paediatric attendances a year. A logbook of paediatric cases must be provided, and the majority of paediatric evidence must demonstrate input from PEM or paediatric specialists.
The types of evidence you can use in your application and include but are not limited to the following:
-Primary medical qualification (PMQ)
- Specialist medical qualification(s)
- Recent specialist training
- Specialist registration outside the UK
- Other relevant qualifications and certificates
- Employment letters and contracts of employment
- Job descriptions
- Departmental (or trust) workload statistics and annual caseload statistics
- Rotas, timetables and job plans
- CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences
-Membership of professional bodies and organisations
- Higher specialty training (HST) curriculum competences
- Extended Learning Supervised Learning Events (ESLE)
- 360˚ and multi-source feedback
- Medical reports
- Case histories
- Referral letters discussing patient handling
- Patient lists/caseload statistics
- Courses relevant to the curriculum
There are 11 ACCS Learning Outcomes and 12 Emergency Medicine SLOs incorporating the ACCS learning outcomes. In each of the SLOs your evidence needs to demonstrate progression to the highest level of entrustment, consistent with operating at consultant level.
Thus your evidence should demonstrate the following:
SLO 1: Care for physiologically stable adult patients presenting to acute care across the full range of complexity
SLO 2: Support the ED team by answering clinical questions and making safe decisions
SLO 3: Identify sick adult patients, be able to resuscitate and stabilise and know when it is appropriate to stop
SLO 4: Care for acutely injured patients across the full range of complexity
SLO 5: Care for children of all ages in the ED, at all stages of development and children with complex needs
SLO 6: Deliver key procedural skills
SLO 7: Deal with complex and challenging situations in the workplace
SLO 8: Lead the ED shift
SLO 9: Support, supervise and educate
SLO 10: Participate in research and managing data appropriately
SLO 11: Participate in and promote activity to improve the quality and safety of patient care
SLO 12: Manage, Administer and Lead
It is important that you anonymise your evidence before you submit it to us. You must remove:
• All patient identifying details
• Details of patients’ relatives
• Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted.
• Names (first and last)
• Contact details such as phone numbers or email addresses
• NHS numbers
• Other individual patient numbers
• GMC numbers
The following details don’t need to be anonymised:
• Date of birth It is your responsibility to make sure that your evidence has been anonymised. Evidence which has not been anonymised will be returned to you. More information can be found on their website.
- Testimonials and letters from colleagues
- Thank you letters, cards from colleagues and patients
-Complaints and responses to complaints
Many of the positions we have in Emergency Medicine subspecialities are able to support you with your CESR application. If you would like to speak to our team about these opportunities do send your CV to [email protected].
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GMC-uk.org, 2022. Specialty specific guidance for CESR in Emergency Medicine. [online] Gmc-uk.org. Available at: