Navigating the Portfolio Pathway (CESR) in Acute Internal Medicine: A Practical Guide

For international medical graduates or UK doctors who haven't followed a traditional training route, obtaining a Certificate of Eligibility for Specialist Registration (CESR) is an effective route to achieving consultant status in the UK. While the pathway can be complex and time-consuming, with the right preparation, it is entirely achievable.

To help you better understand the Portfolio Pathway process for Acute Internal Medicine (AIM), we’ve outlined what you need to know and included several practical tips to help you on your journey.

What is The Portfolio Pathway?

Formerly known as CESR, the Portfolio Pathway is the route to specialist registration for doctors who have not completed a GMC-approved training programme, but who are able to demonstrate that they have the knowledge, skills and experience (KSEs) required for practising as an eligible specialist in the UK.

This route allows doctors who haven’t completed a UK CCT (Certificate of Completion of Training) programme the chance to apply for entry onto the Specialist Register, which is required to work as a substantive consultant in the NHS.

 

The Portfolio Pathway process for Acute Internal Medicine

In Acute Internal Medicine, it is essential to show a comprehensive scope of practice, including acute care skills, leadership, and service development – the Portfolio Pathway in AIM offers skilled clinicians the opportunity to formalise their expertise and take on senior roles in hospitals across the UK.

Your portfolio must demonstrate equivalence to the Acute Internal Medicine 2022 Curriculum. The GMC expects that applicants show evidence across all curriculum domains, including:

Clinical Skills - Acute care, differential diagnosis, treatment plans

Procedures - Core AIM procedures like central line insertion, non-invasive ventilation management, and chest drains

Leadership & Management - Evidence of service development, audits, and leadership roles

Teaching & Training - Formal teaching sessions delivered, involvement in supervision

Research & Scholarship - Participation in audits, quality improvement projects, publications (if available)

 

 

Building your Portfolio: Step-by-Step Guidance:

Preparing for the Portfolio Pathway is intensive and requires careful planning, evidence collection, and organisation.

1. Curriculum Mapping

• Map your existing skills and experiences against the Acute Internal Medicine curriculum
• Identify gaps and plan ways to fill them (courses, placements, additional roles)

 

2. Evidence Collection

Gather evidence across all aspects:

• Clinical logbooks
• Workplace-based assessments (CBDs, mini-CEX, DOPS)
• Supervisor reports
• Audit and quality improvement project reports
• Certificates of courses (e.g., ALS, leadership courses) Reflective pieces

Evidence should be recent (ideally within the last five years), anonymised, and in English or translated by a certified translator.

 

3. Structuring Your Portfolio

Use the GMC’s guidance:

• Organise evidence clearly
• Label each document
• Ensure every piece of evidence is directly mapped to a curriculum competency

 

4. Submission

Applications are submitted online via the GMC portal. The process includes:

• Submitting a detailed application form
• Uploading your evidence
• Fees payment
• Awaiting assessment by the GMC and specialty advisory committees

The process takes several months, and you may be asked to provide further information

 

Tips for Success

• Start early and allow plenty of time to gather evidence.
• Be meticulous with organisation and curriculum mapping.
• Seek regular feedback from supervisors.
• Engage professional support early to avoid costly mistakes.