Anaesthetics CESR Portfolio Guide
Complete guide to the Anaesthetics Portfolio Pathway: 14 High Level Outcomes (HLOs), 8 evidence sections, and a 5-year currency window. Based on official GMC Specialty Specific Guidance, published by Royal College of Anaesthetists.
SSG Version: 24/10/2025
High Level Outcomes (HLOs)
The Anaesthetics SSG defines 14 High Level Outcomes (HLOs) that Portfolio Pathway applicants must demonstrate competence in.
Professional behaviours and communication
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Demonstrate the high-level learning outcomes for professional behaviour and communication with source evidence mapped to the required KSE.
Management and professional/regulatory requirements
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Demonstrate management, professional and regulatory KSE using direct evidence, reflection and supervisor or colleague feedback.
Team working
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Demonstrate safe and effective team working across anaesthetic practice.
Safety and quality improvement
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Provide evidence of safety, governance, audit or quality improvement activity relevant to anaesthetic practice.
Safeguarding
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Demonstrate safeguarding knowledge, skills and professional judgement in relevant clinical contexts.
Education and training
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Show teaching, supervision and educational activity, including feedback or evidence of teaching quality where available.
Research and managing data
Generic professional capability domain in the Anaesthetics 2021 curriculum.
- Show research, evidence-based practice, data governance or critical appraisal activity.
Perioperative medicine and healthcare promotion
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate perioperative care, health promotion and efficient use of healthcare resources.
General anaesthesia
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate safe general anaesthetic practice across breadth, case mix and supervision levels.
Regional anaesthesia
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate safe and effective regional anaesthesia, including required supervision levels where specified.
Resuscitation and transfer
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate leadership in resuscitation, stabilisation and transfer/retrieval decisions.
Procedural sedation
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate safe and effective procedural sedation in relevant clinical settings.
Pain medicine
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate assessment and management of pain in inpatient, perioperative and multidisciplinary contexts.
Intensive care medicine
Clinical curriculum domain in the Anaesthetics 2021 curriculum.
- Demonstrate intensive care knowledge, skills and experience where required by the anaesthetic curriculum domain.
Evidence Requirements
The SSG specifies 8 evidence sections. Each section describes what evidence to provide and how to present it.
Training, qualifications and employment
Core background evidence about training, qualifications and posts.
What evidence should show
Your career pathway, qualifications, formal assessment, employment history, post duties, clinical and non-clinical commitments, and teaching/training involvement must support the Anaesthetics KSE and match your CV.
What to provide
- PMQ evidence where required by GMC registration status
- Specialist medical qualifications and accepted test of knowledge evidence
- Recent specialist training curriculum or syllabus, formal assessments and ARCPs where relevant
- Up to date CV
- Employment letters and job descriptions matching the CV
How to present
Group employment and role evidence clearly by post or institution. Do not submit original documents; submit verified electronic copies.
Experience and logbook
Validated logbook and experience evidence across Domains 1-14 and SIAs.
What evidence should show
Evidence should demonstrate breadth and depth of anaesthetic experience and practice, including case mix, supervision level, elective and emergency balance where relevant, role in procedures and maintenance of skills.
What to provide
- Validated logbook with summary totals by relevant procedure and clinical area
- Detailed case evidence showing case mix, weekly rotas, dates, ASA rating, age of patients and applicant role
- Relevant grouping for Domains 1-7 and 10-14
- Separate sections for General Anaesthesia, Paediatric Anaesthesia, Obstetric Anaesthesia, Neuroanaesthesia, Cardiothoracic Anaesthesia and SIAs where relevant
How to present
Present logbooks in clear consolidated sections rather than as a long undifferentiated spreadsheet. Remove patient identifiers and make the evidence accessible to evaluators.
Supervised Learning Events or alternative WPBA methods
SLEs/WPBAs used to demonstrate domain KSE.
What evidence should show
SLEs or equivalent WPBA evidence should show progression, reflection on learning, consultant or trainer feedback, and competence across different aspects of the relevant domains.
What to provide
- SLEs or similar WPBAs across the relevant domains
- Assessments with feedback and reflection rather than unsupported satisfactory entries
- Evidence at the required supervision level where the SSG specifies one
How to present
Map each assessment to the relevant domain or SIA and cross-reference rather than duplicating the same document.
Personal activities and reflections
Reflective and activity-based evidence supporting domain KSE.
What evidence should show
Personal activity and reflection evidence should show how activity developed the applicant's knowledge, skills, professional behaviour and patient safety practice.
What to provide
- Courses, e-learning and certificates relevant to the domain or SIA
- Teaching, simulation, audit, quality improvement, guideline, research or presentation evidence where relevant
- Reflective pieces explaining learning, change in behaviour and relevance to patient care
How to present
Place reflections and activity evidence under the relevant domain or SIA and cross-reference where a single item supports multiple areas.
Multi Source Feedback
Formal colleague feedback evidence.
What evidence should show
MSF should provide broad colleague feedback and demonstrate relevant professional behaviours, team working and clinical practice. Current appraisal or revalidation evidence may avoid repeating GMC feedback requirements where clearly documented.
What to provide
- MSF completed every five years
- At least 15 assessors and eight respondents for each MSF
- Any available MSF evidence that supports the relevant domain or SIA
How to present
Upload the MSF once and cross-reference it to every domain or SIA it supports.
Patient feedback
Formal patient feedback evidence.
What evidence should show
Patient feedback should show current patient-facing professional practice and support the relevant communication, teamwork and clinical domains.
What to provide
- Patient feedback completed every five years
- At least 15 patient responses
- Reflection on feedback where available
How to present
Upload patient feedback once and cross-reference it to relevant domains and SIAs.
Consultant colleague or multi-trainer feedback
Supervisor, colleague and multi-trainer feedback evidence.
What evidence should show
Consultant or trainer feedback should support competence across Domains 1-14 and any selected SIA, especially where evidence is older or where clinical judgement and breadth need corroboration.
What to provide
- Satisfactory consultant colleague or multi-trainer feedback
- Testimonials from consultant colleagues or supervisors where older evidence needs current corroboration
- Feedback linked to specific domains, clinical practice and SIAs
How to present
Cross-reference each report or testimonial to the relevant domains and avoid duplicate uploads.
Special Interest Area evidence
Anaesthetics SIA evidence from the supporting SIA guidance.
What evidence should show
Applicants must evidence KSE in at least one SIA, with an indicative 12 months whole time equivalent across an allowed SIA combination and evidence aligned to the relevant HLO and required KSE.
What to provide
- Logbooks and SLEs at the required supervision level
- Evidence of SIA experience across the chosen SIA or SIA combination
- Relevant audits, quality improvement projects, guidelines, policies, presentations or other activity evidence
- Satisfactory MSF or consultant feedback where relevant to the selected SIA
How to present
Group SIA evidence by selected SIA, state the selected SIA pathway, and cross-reference shared documents instead of uploading duplicates.
Special Interest Areas
Knowledge Requirements
Primary Path
RCoA accepted test of knowledge, commonly Final FRCA or accepted equivalent
Alternative Path
Comparable test of knowledge or mapped evidence if accepted by evaluators
Applicants need to show a test of knowledge as part of the application. The RCoA maintains accepted tests of knowledge.
Referee Requirements
Referee Reports Required
Current or recent practice
- At least one structured report from a doctor holding a managerial or educational lead role such as Clinical Director, Clinical Service Lead, College Tutor, Regional Adviser or Portfolio Pathway programme lead
- Other referees should be able to comment directly on current breadth and level of anaesthetic practice
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
Expected evidence volume is around 800-1000 pages and no more than about 100 electronic uploads.
evidence_volume
MSF should be completed every five years with at least 15 assessors and eight respondents.
multi_source_feedback
Patient feedback should be completed every five years with at least 15 responses.
patient_feedback
SIA evidence should demonstrate an indicative 12 months whole time equivalent, either through one SIA or an allowed combination.
special_interest_area
Currency Window & Evidence Volume
Currency Window
Years
Evidence of knowledge, skills and experience should generally come from the last five years of clinical practice, whole time equivalent. Older evidence should be supported by recent testimonials, assessments and logbooks showing maintenance of competence.
Evidence Volume
Applicants should submit no more than 1000 pages of evidence, around 100 electronic uploads. Between 800 and 1000 pages is expected to demonstrate the KSE.
Additional Notes
The current GMC Anaesthetics source consists of a main SSG PDF and a separate SIA PDF.
Portfolio pathway applicants need to demonstrate the 14 curriculum domains and at least one SIA.
Domain evidence can be cross-referenced where one item supports multiple domains; duplicate uploads should be avoided.
Local terminal download of the current GMC PDF returned HTTP 403 in this environment, so the official PDF URL is recorded until the binary can be captured.
Frequently Asked Questions
What is the Anaesthetics CESR portfolio?
How many framework units does Anaesthetics require?
What evidence is required for Anaesthetics specialist registration?
How long is the currency window for Anaesthetics?
Start Your Anaesthetics Portfolio
Map your evidence to the Anaesthetics framework, track readiness, and export your GMC submission.