Portfolio Pathway

Certificate of Eligibility for Specialist Registration

Departmental CESR/Portfolio Pathway Lead: Dr Anne Hicks

The "Portfolio Pathway" (formerly CESR) is a self-led route to specialist registration for those who have not completed a formal GMC-approved training programme, but who are able to formally demonstrate that they have the knowledge, skills and experience necessary to practice as a Consultant.

At first glance, the process to CESR can be daunting and overwhelming as it requires vast amounts of evidence across the whole RCEM Curriculum. The key to a successful application lies in organisation and systematic evidence collection. Getting familiar with the Specialty Specific Guidance (SSG), RCEM curriculum, SLOs, and a basic structure will be fundamental.

Despite the portfolio pathway is not a training program and it requires a monumental display of self-organisation and motivation, there is enough documentation and resources to guide your effort and make it more digestible. Understanding the process and support both from your trust and educational supervisor are also essential to succeed.

This section highlights key aspects of the evidence-collection process and provides a basic general structure for the Portfolio Pathway.

Patient Lists

This is probably the main difference with a formal training program. You'll need a LOT of patients & lists.

Start making your patient Logbook & patient List from the start.
Patient lists should be done yearly in order to demonstrate work rate, patterns and coverage of patients from different areas. List all your patients!
Select interesting patients and write 2-3 lines of reflection in the ED case logbook. (Aim 1 per week, you only need 50/year in each speciality)

You need several logbooks:

Adult ED case logbook 50 patients total over 3 years with reflection.
ED procedure logbook 50 patients per year for 5 years
Adult ED deep case logbook 10 patients minimum
Paeds ED case logbook 50 patients total with 2-3 lines of reflection
Acute Medicine logbook 30 patients total with 2-3 lines of reflection
ICM logbook 30 patients total with 2-3 lines of reflection
Anaesthetics logbook 30 patients total with 2-3 lines of reflection
Total list: demonstrate: #adults/children, #resus/majors/ambulatory #admissions/discharge

You can use the Total List to demonstrate:

your involvement or role in cases
The types/complexity of cases you are involved in
The volume of cases you undertake
Triangulation with rota, timetable and job plan information
Triangulation with logbook information

https://anaesthetics.app is an excellent option for creating and maintaining your total patient lists. It has predefined tabs according to speciality making it quicker to fill and you can obtain a PDF summary of the main data or the actual list in an excel sheet

WBPA Targets

The total amount of WBPA is not difficult to achieve but these should represent all the different SLOs.
Significant emphasis has been put on ESLEs, make sure to complete at least 2 per year.

Emergency Medicine (Total)

12 x DOPS
12 x MiniCEX
12 x CBDs
US Evidence

EM Yearly Requirements

Audit/QIP
3 x ESLE (SLO 2-8)
1 x FEG (Emergency Medicine Supervisor)
1 x MSF (12 including 3 consultants - Multi SLO)
CPD - Link each event to most pertinent SLO

Anaesthetics

Minimum 3 months Anaesthetics
Anaesthetics - Initial Assessment of Competence (IAC)
5 x ACEX
6 x DOPS
8 x CBD
HALO in Sedation
MSF min 12 including 3 consultants
1 x ESLE
1 x FEG
US Evidence (IVA - FiB)

Paediatrics

Minimum 3 months Paeds EM
4 x CBDs
4 x Mini-CEX
4 x DOPS
3 x ESLE
1 x FEG
MSF min 12 including 3 consultants

ICU

Minimum 3 months ICU
4 x CBDs
4 x Mini CEX
4 x DOPS
1 x MSF
1 x FEG

Evidence Organisation

Ideally, you should collect your evidence directly into folders so you know where you are lacking and where you have enough

You should create the following folders:

CV
Evidence of Qualifications
Evidence of Employment
SLO1
SLO2
SLO3
SLO4
SLO5
SLO6
SLO7
SLO8
SLO9
SLO10
SLO11
SLO12

A cover letter is very useful to the RCEM evaluator because it helps you stay organised, prevent duplication, and triangulate. They stress that they really don’t want you to duplicate evidence so a cover letter allows you to easily reference other files. You can either submit one cover letter, or after you’re ready to upload you can split the final cover letter into each section. Either way this is something to be concerned by the the time you are ready to apply.

This guide has been compiled by Dr Felipe Urriola-Perez.

Feel free to contact the Derriford CESR team if you are interested in folder/cover letter templates or need more guidance on how to organise your evidence collection using Notion.

Useful Links & Documents

SSG - Updated Specialty Specific Guidance

RCEM Curriculum

CESR – St. Emlyns Blog

CESR or CCT – RCEM Learning

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