Navigating the Portfolio Pathway (CESR) in Emergency 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 Emergency Medicine 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 Emergency Medicine

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

Clinical Skills - Experience in managing emergency cases, trauma, and resuscitation.

Leadership & Management - Evidence of leading teams, handling emergencies, and managing complex situations.

Teaching & Training - Evidence of involvement in teaching or supervising junior doctors or students.

Professionalism - Demonstrating a high level of professional behaviour in all clinical and non-clinical situations.

 

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 2021 Emergency Medicine curriculum and the 14 high-level Learning Outcomes
• 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 (e.g. CBDs, Mini-CEX, DOPS)
• Management of major trauma and critical illness
• Participation in rota management and governance
• Evidence of clinical competency
• Teaching sessions and feedback
• Clinical audit and QI projects
• Supervisor reports
• Evidence of Continuing Professional Development (CPD)
• Certification in Emergency Medicine
• 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.