About 12-18 months before your CCT (certificate of completion of training) you should have a Penultimate Year Assessment (PYA) ARCP for each specialty you are training in, which finalises your training requirements and CCT date.
Prior to your CCT date, you should ensure that all the mandatory components from your PYA and ARCP have been completed. All that is required is completion of your Form R (downloaded from Synapse), which should be sent to the renal TPD for signing. Try to do this 4 months or so before your expected CCT date.
ARCP
If you are accrediting in renal medicine and general (internal) medicine, then you will need an ARCP outcome 6 for both. An ARCP outcome 6 is essentially your sign-off from the programme, and when the STC ensure that your PYA requirements (in addition to the mandatory stuff) have been fulfilled.
You should seek to get these signed from the both the respective TPDs; the current renal TPD is Satish Jayawardene, and G(I)M TPD is Rexford Musa. Once this is completed, the deanery will recommend that you get your CCT.
GMC
The college or faculty should alert the GMC that you are eligible for entry onto the specialist register and the GMC will contact you so that you can apply to join the register (currently costs £420, 2016). You have 12 months from your expected end of training date to submit your application. After 12 months you will have to apply instead for a full Certificate of Eligibility for Specialist Registration (CESR) or Certificate of Eligibility for GP Registration (CEGPR) to enter the specialist or GP registers
You must hold full registration with a licence to practise at the time you apply for your CCT. Please see the guidance on applying for a licence to practise.
You should make your application through your GMC online account. Then, you can check the status of your application by choosing My Registration, and then My Applications.
Please see the detailed guidance on making an application.
http://www.jrcptb.org.uk/trainingandcert/Pages/Completing-Training.aspx