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‘Rings of fire’: the hoops to jump through for Community Sexual and Reproductive Healthcare equivalence
  1. Jane Dickson
  1. Acting Consultant in Sexual and Reproductive Health, Oxleas NHS Foundation Trust, Woolwich, London, UK
  1. Correspondence to Dr Jane Dickson, Oxleas NHS Foundation Trust, 20 Market Street, Woolwich, London SE18 6QR, UK; jane.dickson{at}

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I have recently been successful in my application for a Certificate of Eligibility for Specialist Registration (CESR) in Community Sexual and Reproductive Healthcare (CSRH). Other than the generic information available, there were few resources to guide me through the application. Consequently, I made many mistakes along the way. I have written this article to help others navigate the process and hopefully help prevent them from making the same mistakes that I did. The process is not easy but it is entirely possible to succeed with perseverance.


After 8 years as a principal in general practice, I realised that the community family planning clinics I did additionally were the only aspect of my work that I enjoyed. I left general practice to become the clinical lead of the Greenwich Sexual and Reproductive Health (SRH) Service in January 2005. I have worked in a ‘consultant’ position since this time and the creation of the new specialty of CSRH allowed me to apply to the General Medical Council (GMC) for entry onto the specialist register by virtue of equivalence [i.e. the CESR].

Why apply?

Doctors in my position are usually recognised as ‘specialists’ locally, yet recognition by the GMC is a far more ‘transferable’ asset. Lead SRH doctors who are not consultants have often undertaken significant training in the specialty and already have many of the competencies required to prove equivalence. The new specialty of CSRH is dependent upon others in my position undertaking the CESR process to increase the number of consultants. This will develop the opportunity for career progression in CSRH and will guarantee that patients are seen in services appropriately led with excellent governance and consistency. It is also an enormous boost to your self-esteem when successful!

How to begin

In order to demonstrate equivalence, it is necessary to prove that the competencies of a ‘Day …

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