We would like to take this opportunity to update you on the further guidance published by the GMC on CESR combined programmes (CESR-CP). On 7 October 2020, a new rule comes into effect where the GMC will now issue a certificate of completion of training (CCT) to doctors on a CESR combined programme (CESR-CP) where there is no minimum UK training time listed for ICM on in the European Union legislation. Doctors entering or who have entered the ICM training programme on a combined programme taking into consideration prior unapproved training posts will now be eligible for a CCT. 

There are no changes to the main CESR (also known as ‘Equivalence’) route to specialist registration.

We felt the need to follow-up on a few questions we had for them on the process:

Single ICM CCT programme

FICM Question: When we register a doctor as a Single ICM Trainee and want to count their overseas/non-training posts, will they now be working towards a CCT rather than a CESR-CP?

GMC Answer: The Faculty will need to follow the process as per usual, i.e. register trainees bringing overseas / non-training posts onto the programme as a CESR-CP. When it comes to their final recommendation onto the Specialist Register, so long as the trainee meets all the eligibility criteria they will be recommended for a CCT by the Faculty. 

FICM Question: What is the eligibility criteria Single ICM Trainees need to meet in order to be recommended for a CCT by the Faculty?

GMC Answer: Completion of Stage 1, Stage 2, FFICM exam, Stage 3 and receiving a final ICM ARCP Outcome 6.

Impact on dual CCT training programmes

FICM Question: How will this work for dual trainees, for example those training in both Anaesthesia and ICM?

GMC Answer: The trainee will receive a CCT in their partner specialty (eg Anaesthesia) if they meet the minimum training requirement defined in the EU legislation. If they do not, then by default the trainee will be granted a CESR-CP for both ICM and Anaesthesia at the end of their training. 

FICM Question: What eligibility criteria do ICM Dual Trainees need to meet in order to be recommended for a CCT by the Faculty?

GMC Answer: Completion of Stage 1, Stage 2, FFICM exam, Stage 3 and receiving a final ICM ARCP Outcome 6.  You will also need to meet the eligibility criteria for your partner specialty too.  Please contact them directly.


Understanding the Prevocational Medical Education and Training (PMET) Order

FICM Question: If a specialty has a minimum training time under the ‘PMET Order’ (for example Anaesthesia has 3 years) are we saying that 3 years of training can include the following:

  • Non-training posts such as Trust Fellow, Clinical Fellow, OOPE, OOPC, SAS (Associate Specialist, Specialty Doctor, Staff Grade) and Consultant posts completed within the UK? 


  • Overseas training?

If yes, then if it transpires that a doctor has completed all 3 years overseas would they be working towards a CCT in Anaesthesia?

GMC Answer: The minimum UK training time refers to approved training posts within the UK programme where the trainee held a National Training Number (NTN) – this would exclude unapproved posts such as those you’ve listed and only applies to UK training posts.

FICM Question: Page 9 of the guidance is slightly confusing, it states ‘Where a specialty only has a minimum training time which is listed under the PMET Order, this minimum number of years training can include training undertaken within and outside of the UK’. Please can you clarify this further?.

GMC Answer: This is the exception. The PMET order only applies to one of the specialties listed – Aviation and Space Medicine. This can include training undertaken outside the UK.