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Equivalence and Equal Value in CESR Applications at the GMC


Eleena Misra recently succeeded in persuading a Registration Appeals Panel (‘RAP’) of the General Medical Council that another of her clients, seeking to be admitted to the Specialist Register, in order to pursue a career as a substantive Consultant in the NHS, fulfilled the requirements of Article 8(2) of the Postgraduate Medical Education and Training Order 2010 (‘PMET Order’). In so doing, Eleena highlighted the error which a number of assessors across various specialties make, which is to conflate equivalence with an exact replication of the relevant CCT curriculum and to misunderstand the distinction between the curriculum, applicable JCST Guidelines and Certificate of Eligibility for Specialist Registration (‘CESR’) Guidance published by the GMC itself. In this case, the RAP agreed with her core submission that her client met the test of equivalence as explained by the Court of Appeal in Nakhla v GMC [2014] EWCA Civ 1522 and to expect a CESR applicant to replicate exactly that which a CCT trainee did would be to undermine the whole point of Article 8(2). In this instance, the expert witness appointed by the GMC had fallen into error by believing it to be a mandatory requirement that the applicant registrant produce evidence of three original / first-author publications in an indexed journal in order to prove that he was at the requisite standard in respect of research skills. This was notwithstanding the fact that the applicant had produced substantial evidence of his past, present and anticipated future research activity including a research publication in a high impact leading journal, two years spent as a Clinical Research Fellow in a large teaching and research hospital and a recent Masters’ degree which involved substantial research and a 15,000 dissertation. The GMC had acknowledged the doctor to be “an excellent doctor” in all material respects and one who was “clearly highly regarded as an experienced and skilled doctor, popular with colleagues and patients…” but insisted that the suggested three publications which feature in the relevant JCST Guidelines but NOT the Curriculum were an unfortunate but necessary stumbling block. Happily, for the applicant, the RAP upheld his appeal and determined that he should be allowed onto the Specialist Register. It reiterated the test set out in Article 8(2) and the need to focus on the mandatory requirements of the Curriculum itself.

Eleena Misra has a wealth of experience in representing doctors in CESR applications and appeals having appeared before the Postgraduate and Medical Education Training Board (‘PMETB’) before the GMC took over its functions and before the GMC since then. Clients have sought her out for her direct, strategic and practical advice as well as for delivering fearless and focused advocacy in hearings and appeals. If you wish to make contact in connection with an application or appeal of this nature, either through a solicitor or via direct access, please contact her Clerk, William Meade.

Registration Appeals Panel, General Medical Counsel, employment, NHS

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Eleena Misra KC

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William Meade (Senior Clerk)

07970 649 755