CESR advice

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CESR Timeline Howells 2019.pdfhi all,

I have been asked a numerous times recently about CESR and any advice I have for applying.

I would say planning ahead is key, with prospective evidence being easier to tailor for the application, knowing as much as possible about the requirements and your strategy would be vital.

After that it is one foot after the other for years on end ;) 

Worth checking out the work going on in Emergency Medicine, notably in Derby, Lancashire with Dr Dan Boden but also elsewhere in the country where CESR rotation schemes have been set up.

Dr William Niven has also produced a CESR Guide, again in Emergency Medicine, link below;


Talk to your colleagues to share advice as there will be people in your area who have gone down this route who can give you top tips and hopefully provide some work-place based assessments!

I have gathered some ideas from various places about how to support SASGs better and will post below but if anyone has any other thoughts about supporting the needs of SASGs, please comment!

I will also add a copy of my 'CESR Timeline' to give an idea of the process (or my attempt at it in any case).

Best Wishes and Good Luck!

(if you are not put off)

Dr Dave

The key points for a CESR Support Scheme include;



  • ·      SASGs provide an essential role in many areas of health service provision within the UHB.
  • ·      There are clinical areas within the UHB that rely on Locum SASG and/or Locum Consultant appointments to maintain patient safety at significant cost.
  • ·      SASGs require access to training and development to meet the requirements of revalidation, drive independent practice and follow specialist interests..
  • ·      Supporting SASGs in their development goals will aid recruitment and retention of SASGs and have beneficial effects for the department as a whole.
  • ·      Some SASGs have a desire to join the Specialist Register in their respective fields, either through (re)joining a training scheme or through the CESR route.
  • ·      There is an appetite from CAVUHB SASGs to engage in a system that supports them through the CESR process.
  • ·      There is an appetite from Health Education and Innovation Wales to support the development of SASGs.
  • ·  Many areas (in England) already have well-advertised CESR development schemes/posts.
  • ·      It would be in the interests of certain clinical directorates to establish formal and recognised CESR development posts for SASGs.
  • ·      Even where formal SASG CESR development posts are not implemented, the principles of CESR development schemes match the goals outlined in the Wales SAS Charter. 

Increased support for SASGs following the CESR route to specialist registration with the GMC would benefit the UHB by;

  • ·      Recruitment and retention of high quality SASGs from the UK and abroad.
  • ·      Improving medical engagement amongst SASGs.
  • ·      Developing the skills of SASGs within the UHB.
  • ·      Providing a supply of locally trained consultants in key areas of the UHB.


SASG CESR development schemes typically include the following components;




  • ·      Executive Board support.
  • ·      Involvement of the SAS Tutor 
  • ·      Business planning for a SASG CESR workforce development scheme.
  • ·      Identification of a clinical area that would most benefit from SASG development.
  • ·      Senior Clinical Board engagement in SASG development.
  • ·      An identified consultant leader as a point of contact for the scheme. 
  • ·      Recognition of SPA time for supervisors.
  • ·      Engagement with the relevant Royal College(s) on requirements/ evidence gathering for CESR Applicants.
  • ·      Advice from doctors that have attained or attempted specialist registration via the CESR route.



  • ·      Awareness raising of a SASG CESR Support Scheme.
  • ·      Advertising for SASG applicants internal/external to the UHB.
  • ·      Identification of highly motivated SASGs, aware of the demands of CESR application.
  • ·      A fair and transparent candidate selection process.
  • ·      Organisation of a rotation that would meet the necessary clinical and educational needs in a flexible ‘SASG-friendly’ manner.
  • ·      A SASG CESR support group to access and cascade advice and share experiences.

Individual Support


  • ·      Objective setting and accountability through Professional Development Planning.
  • ·      Job Planning to provide a realistic balance of DCC/SPA commitments.
  • ·      Protected time to complete CESR-related work.
  • ·      Annual appraisal.
  • ·      Annual assessment of competencies as separate from appraisal.
  • ·      A Named Educational Supervisor.
  • ·      Regular clinical and managerial supervision.
  • ·      A designated CESR mentor.
  • ·      Early identification of potential referees (typically 6 consultants, including the clinical director are required) to facilitate reference writing (references are extensive and require the consultants to be familiar with the candidate’s clinical, professional and academic work and request examples of direct experience of such work).


Addressing Development Needs


  • ·      Access to training opportunities and clinical work equivalent to those offered to Higher Trainees.
  • ·      Support for Royal College Examinations, if required.
  • ·      Regular assessment through workplace-based assessments.
  • ·      A commitment to support study leave applications and funding for identified learning needs. 
  • ·      Secondments to gain the necessary experience to meet the requirements of the relevant specialist curriculum, preferably as part of a planned and predictable rotation.
  • ·      Provision of regular/rota’d on-call experience where this is not a regular part of the SASGs’ role.
  • ·      Clinical activities coded under the individual SASG’s name.
  • ·      Support for taking on management/leadership roles.
  • ·      SASG representation on committees, directorate meetings, interview panels and/or delivery of educational programmes.
  • ·      Appointment to locum consultant posts where appropriate.
Edited by DrDave
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