Navigating the Portfolio Pathway (CESR) in General (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 General (Internal) Medicine (GIM) 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 General Medicine

The CESR application for General Medicine requires comprehensive documentation, including evidence of clinical practice, professional skills, and leadership. The following outlines the key components of the portfolio:

Curriculum Vitae (CV) - An up-to-date CV outlining your medical education, experience, and qualifications.

Training Evidence - Documents showing the full scope of your training, including logbooks, certificates, and evaluations.

Clinical Experience - Evidence of supervised practice in clinical settings, including any hospital rotations.

Reflection - A detailed reflection on your medical practice, focusing on clinical experiences and outcomes.

Supervisors’ Reports - Reports from your supervisors assessing your clinical skills and competencies.

Knowledge and Skills Evidence - Documents demonstrating your knowledge and competencies in core areas of General (Internal) Medicine.

Audit and Research Projects - Evidence of any relevant audit or research experience.

Teaching Evidence - Evidence of your involvement in teaching or training junior doctors.

Continuing Professional Development - Evidence of ongoing CPD activities relevant to your specialty.

 

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 2022 General (Internal) Medicine Curriculum

• You’ll need to evidence capabilities across all domains:
  • Clinical capabilities in practice (CiPs)
  • Specialty CiPs (e.g., acute care, managing long-term conditions)
  • Generic professional capabilities (GPCs)

Identify gaps and plan ways to fill them (courses, placements, additional roles)

 

2. Evidence Collection

You'll need to collect and submit robust, verifiable documentation. Common forms of evidence include:

• Structured reports from supervisors
• Workplace-based assessments (e.g., Mini-CEX, CbD, DOPS)
• Clinic letters and case summaries
• Rotas demonstrating involvement in acute take
• Audit/QI projects
• Teaching and leadership portfolio
• CPD and appraisal documentation
• Logbooks (on-call, procedures, cases)

Evidence should be recent (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.