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CESR Specific guidance for Respiratory Medicine

• March 02, 2022

This guidance is to help doctors who are applying for entry onto the Specialist Register with a CESR in Respiratory Medicine. The indicative period of training for a CCT in Respiratory Medicine is seven years and it is unlikely that you would achieve all the learning outcomes required for a CCT in a shorter period of time.

It is worth noting that it is sometimes more difficult to make a successful CESR application if you have not worked in the NHS. This is because key features of training and practice in the NHS are not always covered in the same way outside it. If you require help finding an NHS position that will support your CESR application, please do get in touch by sending across your CV to [email protected]

This article will outline the documents that can be used for your application. This guidance on documents to supply is not exhaustive and you may have alternative evidence. You do not necessarily have to supply every type of evidence listed, but you must submit sufficient evidence to address each of the required learning outcomes and the associated capabilities.

Learning outcomes

The curriculum is structured into high-level learning outcomes, known as Capabilities in Practice (CiPs).

Generic CiPs

1. Able to function successfully within NHS organisational and management systems

2. Able to deal with ethical and legal issues related to clinical practice

3. Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement

4. Is focussed on patient safety and delivers effective quality improvement in patient care

5. Carries out research and manages data appropriately

6. Acts as a clinical teacher and clinical supervisor

Clinical CiPs

1. Managing an acute unselected take

2. Managing the acute care of patients within a medical specialty service

3. Providing continuity of care to medical inpatients, including management of comorbidities and cognitive impairment

4. Managing patients in an outpatient clinic, ambulatory or community setting, including management of long term conditions

5. Managing medical problems in patients in other specialties and special cases

6. Managing a multi-disciplinary team including effective discharge planning

7. Delivering effective resuscitation and managing the acutely deteriorating patient

8. Managing end of life and applying palliative care skills

Specialty Specific CiPs

1. Managing all aspects of thoracic malignancy and terminal disease including diagnostic pathways and working with the MDT

2. Managing integrated respiratory medicine across the primary and secondary care interface including management of long-term disease

3. Managing complex and unusual respiratory infection including contact tracing and public health (in particular atypical pneumonia)

 4. Managing the service and patients with respiratory failure in multiple settings including hospital and in the community

5. Tertiary subspecialties interface: managing patients across the secondary and tertiary interface; in particular patients with lung and heart transplants and pulmonary hypertension

 6. Managing the use of drugs and therapeutic modalities specific to the practice of respiratory medicine

Types of evidence

-Primary medical qualification (PMQ)

-Specialist medical qualification(s)

- Curriculum or syllabus (if undertaken outside the UK)

- Specialist registration outside the UK

- Honours and prizes

- Other relevant qualifications and certificates

- Appraisals and assessments

- RITAs, ARCPs and training assessments

- 360˚ and multi-source feedback

- Awards and discretionary points letters

- Personal development plans (PDP)

- Logbooks

- Consolidation, cumulative data sheets, summary lists and annual caseload statistics

- Medical reports

- Case histories

- Referral letters discussing patient handling

- Patient lists

- Departmental (or trust) workload statistics and annual caseload statistics

- Rotas, timetables and job plans

- Courses relevant to curriculum

- Portfolios (electronic or revalidation)

- Employment letters and contracts of employment

- Job descriptions

- Job plans

- Research papers, grants, patent designs

- Publications within specialty field

- Presentations, poster presentations

- CPD record certificates, certificates of attendance, workshops and at local, national and international meetings or conferences

- CPD registration points from UK Medical Royal College (or equivalent body overseas)

- Membership of professional bodies and organisations

- Teaching timetables

- Lectures

- Feedback or evaluation forms from those taught

- Letters from colleagues

- Attendance at teaching or appraisal courses

- Participation in assessment or appraisal and appointments processes

- Audits undertaken by applicant

- Reflective diaries

- Service Improvement and clinical governance meetings

-Evidence to support awareness and following Health and Safety requirements.

This can be demonstrated by:

• declaration of health on your application form

• attendance at appropriate course

• involvement in infection control (membership of committees etc)

• logbook information on infections

• audit on infections and subsequent changes in activity

-Communication with colleague

- Patient communications

- Working in multidisciplinary teams evidence

- Management and leadership experience

- Chairing meetings and leading projects

-Honesty and integrity

You can demonstrate this with:

• the declarations on your application form

• statements from your referees

• appraisal forms

• having no restrictions on your registration (UK based doctors)

• Certificate of Good Standing (overseas based doctors).

-Equality and human rights (including disability, human rights, race, religion and ethnicity awareness and equal opportunities)

You can demonstrate this with:

• evidence of attendance at relevant courses (please provide details of course content)

• feedback from patients and colleagues

• statements from your referees

• testimonials.

-Data protection

You can demonstrate this with:

• attendance at relevant courses (please provide details of course content)

• feedback from patients and colleagues

• your application and evidence being appropriately anonymised.

Submitting your evidence

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.

This includes:

• Names (first and last)

• Addresses

• 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:

• Gender

• 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

Our top tips for a smooth CESR application process

1. Understand the time and effort that is required to make a successful application. You are asked to provide evidence that you have fulfilled all the learning outcomes defined in the curriculum. Doctors who have gone through the formal training programme will normally have taken around eight years to gain these outcomes, so it is not something you can gather overnight.
2. Recognise that you will need others to support you in the application process. Think about who can help, explain to them what help you need and ask if they can support you
3. CESR places most emphasis on evidence gathered in the last five years. If you are providing evidence from before this time, think about what you can do now to show that you still have these capabilities. For example, if you still have contacts in that unit you could ask if they would be prepared for you to go back and have some workplace-based assessments in that area. The Trust would probably want you to have an honorary contract for this.
4. Choose the referees for your structured reports carefully. The GMC provides guidance on who should give structured reports, but you should also think about who values you enough to put in the time and effort to ensure that their report provides the information you need.
5. Make sure you understand which evidence needs to be verified and that you follow the correct verification procedure, to ensure that all your evidence is accepted and does not need to be resubmitted. If in doubt, the GMC can advise on what needs to be verified and what types of verification can be accepted
6. Take care to arrange your evidence following the order it is set out in this guidance, so it is easier for assessors to find the evidence they need for each of the sections.
7. Finally: keep going and don’t lose heart! There will probably be a point in the middle where the task feels huge. When this happens, allow yourself a couple of weeks off CESR then look at it afresh.

How we can help

Many of the positions we have in general 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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