Clinical Radiology CESR Portfolio Guide
Complete guide to the Clinical Radiology Portfolio Pathway: 12 Capabilities in Practice (CiPs), 3 evidence sections, and a 5-year currency window. Based on official GMC Specialty Specific Guidance, published by Royal College of Radiologists (RCR).
SSG Version: 27/10/2025
Capabilities in Practice (CiPs)
The Clinical Radiology SSG defines 12 Capabilities in Practice (CiPs) that Portfolio Pathway applicants must demonstrate competence in.
Demonstrate the professional values and behaviours expected of all doctors as outlined in Good Medical Practice
As doctors, consultant radiologists adhere to the principles of Good Medical Practice as stipulated by the GMC
- Knowledge: Has awareness of the principles of Good Medical Practice
- Knowledge: Has awareness of how to make the care of, and effective communication with, patients their first concern; treating patients as individuals and respecting their dignity, with sensitivity to religious, cultural and socioeconomic factors
- Knowledge: Understanding of the processes in healthcare to protect and/or advocate for patients and the framework for handling adverse events
- Skills: Has the ability to apply the principles of Good Medical Practice
- Experience: Demonstrates effective clinical leadership and team working, adhering to Good Medical Practice principles
- Experience: Works in partnership with patients, respecting their right to privacy and dignity
Successfully function within the health service and healthcare systems in the UK
Like all consultants working within the NHS, radiologists need to understand organisational and management systems so that they can engage positively with them and optimise patient care
- Knowledge: Understands the structure and organisation of the health service and system, including the independent sector and community and primary care
- Knowledge: Understands how services are commissioned, funded and audited
- Knowledge: Understands how services are deemed to be clinically effective and cost-effective
- Knowledge: Understands how resources are managed, being made aware of competing demands and the importance of avoiding waste
- Skills: Engages positively with organisational and management systems
- Skills: Identifies changes to improve organisational and management systems
- Skills: Has the ability to evaluate and implement patient pathways effectively to maximise patient care
- Experience: Adheres to relevant professional communication policies
- Experience: Demonstrates engagement with leadership of audit or quality improvement
Engage in reflection, clinical governance and quality improvement processes to ensure good practice
Consultant radiologists are expected to stay up to date with their knowledge and skills, and look for ways to improve the quality of their services
- Knowledge: Has awareness of how to appropriately raise concerns, including errors
- Knowledge: Identifies and advocates for clinical quality and improvement
- Skills: Has the ability to evaluate the development, and implementation, of quality improvement research
- Skills: Understands the difference between QI, audit and research
- Skills: Has the ability to promote a culture of openness and accountability, including awareness of the duty of candour to patients
- Skills: Appropriately raises concerns regarding negative professional behaviour, such as bullying
- Skills: Demonstrates commitment to continuing professional development by maintaining and/or developing skills relevant to higher training, special interest and/or local service need
- Experience: Facilitates and leads on QI and audit projects to improve patient care and experience
- Experience: Shares good practice
- Experience: Engages in clinical governance meetings, including peer feedback meetings
- Experience: Recognises and acknowledges where personal issues impact upon good practice and seeks appropriate help
- Experience: Acts on patient safety issues and escalates or reports these appropriately though operational processes
- Experience: Attends courses or demonstrates learning activity that results in leading a change in the department
Engage in evidence-based practice and safeguard data, including imaging data
Consultant radiologists require the skills used by all doctors to practice evidence-based medicine
- Knowledge: Demonstrates an understanding of the principles of research, research methods and the translation of research into clinical practice
- Knowledge: Understands and critically appraises new technological developments, including radiological applications of Artificial Intelligence (AI)
- Knowledge: Understands the role of the framework protecting the confidentiality of patients’ health and care information (such as the Caldicott Guardian) and making sure it is used properly
- Skills: Identifies and critically appraises literature to inform practice
- Skills: Interprets and communicates research evidence in a meaningful way to patients to support them in making informed decisions about treatment
- Experience: Participates in modification or development of department protocols based on changing evidence
- Experience: Follows guidelines on ethical conduct in research and consent for research
- Experience: Understands and applies information governance principles to safeguard imaging data in the context of education
- Experience: Adheres to data governance regulations and protocols
- Experience: Applies information governance principles to safeguard imaging data in the context of research
Act as a clinical teacher and supervisor
Consultant radiologists teach medical students, junior doctors and other healthcare professionals
- Knowledge: Understands the role and develops the ability to provide training or teaching in a clinical context
- Knowledge: Understands and develops the ability to act as a trainer in a clinical context
- Knowledge: Understands and applies information governance principles to safeguard imaging data in the context of education
- Skills: Delivers effective feedback with action plan
- Skills: Adds addendums to reports by trainees and joint reporting rotas with trainees
- Skills: Has the ability to deliver structured training as well as case-based training
- Skills: Has the ability to supervise less experienced trainees in carrying out appropriate practical procedures
- Skills: Has the ability to supervise less experienced trainees in their clinical assessment and management of patients
- Skills: Applies information governance principles to safeguard imaging data in the context of education
- Experience: Delivers effective teaching, supervision and assessment of clinical trainees and other healthcare professionals
- Experience: Has the ability to act as a clinical supervisor to doctors in earlier stages of training
Work well within a variety of different teams, communicating effectively with colleagues and demonstrating the skills required to lead a team
Clinical radiology relies on a multi-professional team and good communication is an essential component of sound practice, team working and patient-centred care.
- Knowledge: Has awareness of own leadership style and how this impacts on others
- Knowledge: Recognises own limitations and comprehends situations where others are better equipped to lead or where delegation is appropriate
- Knowledge: Recognises the need to adapt their communication approach according to the audience
- Knowledge: Has awareness of the strength of a multi-professional team and recognises the contributions of all its members (medical, clinical and allied professionals) in delivering excellence for patients
- Skills: Effectively leads a multi-professional team, allowing all voices to be heard and considered, and fosters an atmosphere of collaboration
- Skills: Critically appraises performance of colleagues, peers and systems, appropriately escalating concerns and promoting an open and transparent culture of learning and development
- Experience: Promotes and actively participates in multidisciplinary and interprofessional team working, communicates effectively and recognises and respects the roles of all members of the team
- Experience: Demonstrates flexibility in behaviour and is able to adapt techniques and approaches within the multi-professional team to improve engagement in difficult situations
- Experience: Supervises, challenges and mentors colleagues and peers to enhance performance
- Experience: Has the ability to effectively undertake correspondence with clinical teams involving patient management, including reference to organising procedures/conveying crucial findings to clinical teams within radiology reports
Appropriately select and tailor imaging to patient context and the clinical question(s)
Consultant radiologists will discuss clinical cases with referrers and allied imaging professionals and advise on appropriate imaging according to the individual patient, clinical background and the clinical question posed.
- Knowledge: Understands the role of all modalities of radiology and their application in clinical patient management
- Skills: Exercises evidence-based practice by utilising relevant guidelines, such as iRefer, and current peer-reviewed literature to inform imaging selection for all patient groups
- Skills: Safeguards all patients, including paediatric patients and people of childbearing age
- Skills: Acts in accordance with current safety guidelines and legislation in respect of ionising radiation and other imaging techniques/equipment
- Skills: Has the ability to advise referrers and patients regarding radiation exposure tailored to individual clinical contexts to facilitate informed decision-making
- Experience: Collaborates effectively with referrers and imaging department non-medical staff to determine the most appropriate imaging pathway for a given presentation
- Experience: Has the ability to protocol radiology investigations appropriately
Provide timely, accurate and clinically useful reports on imaging studies
Consultant radiologists provide actionable reports on imaging studies that are performed on patients.
- Knowledge: Understands that the practice of clinical radiology requires the generic and specialty-specific knowledge, skills, attitudes and procedural competency to diagnose, and sometimes manage, patients referred for imaging to investigate a wide range of symptoms and conditions and perform image-guided procedure.
- Skills: Contributes to the reporting of imaging studies in a wide range of clinical scenarios, to include in-patient care, emergency lists and routine out-patient work
- Skills: Formulates a clinically useful written report targeted appropriately to the referrer, providing, where appropriate, a refined differential diagnosis, demonstrating clinical judgement and providing recommendations for further investigation and/or management
- Skills: Communicates pertinent imaging findings to referrers and, where appropriate to patients, in a time-appropriate manner, including significant, unexpected or incidental findings
- Experience: Combines a sound knowledge of radiological anatomy, physiology and pathology and adopts a safe, systematic approach to interpretation of imaging
- Experience: Demonstrates insight into level of personal expertise and appropriately refers/seeks second opinion
- Experience: Identifies and appropriately responds to imaging findings that raise safeguarding concerns
Appropriately manage imaging examination lists/procedures according to clinical need and professional expertise
Consultant radiologists will be able to directly examine a patient in real time with imaging such as ultrasound and perform image-guided procedures
- Knowledge: Understands the role of all modalities of radiology and their application in clinical patient management
- Knowledge: Shows insight in reports or vetting for appropriate management of patients
- Knowledge: Maintains an up-to-date knowledge of cardiopulmonary resuscitation (CPR) techniques
- Knowledge: Understands and safely prescribes medication relevant to imaging and procedures
- Skills: Follows local imaging guidelines (such as NICE or local hospital guidelines) appropriately
- Skills: Has the ability to manage and prioritise patient lists effectively according to local resources and clinical need
- Skills: Has the ability to explain imaging examinations, risks and findings, facilitating informed patient choice
- Skills: Obtains informed consent for relevant imaging examinations and/or procedures from all patients, including vulnerable groups, showing sensitivity to issues of equality and diversity
- Skills: Implements current health and safety and infection control techniques in the context of imaging examinations/ procedures
- Experience: Delivers high-throughput patient-facing lists
- Experience: Demonstrates insight into level of personal expertise and appropriately refers/seeks second opinion
- Experience: Manages adverse reactions (including anaphylaxis) to administered contrast and drugs
Evaluate image quality and utilise the knowledge of imaging sciences to optimise image quality
Consultant radiologists need to be able to evaluate image quality and utilise knowledge of imaging physics to maximise the diagnostic certainty of an imaging test
- Knowledge: Has training in basic imaging sciences and radiological techniques
- Skills: Appropriately refers to image quality within written reports when there is impact on diagnostic certainty
- Experience: Evaluates image quality across all modalities
- Experience: Feeds back to the imaging team appropriately to facilitate maintenance of equipment
- Experience: Develops guidance to improve practice
Safely manage the imaging and image-guided intervention needed to support emergency care
Imaging is required to support the 24/7 emergency service provided by the NHS. Consultant radiologists will be competent in interpreting and performing imaging examinations and/or procedures that are required in the emergency context
- Knowledge: Understands the role of all modalities of radiology and their application in clinical patient management in an emergency setting
- Knowledge: Maintains knowledge of appropriate indications and applications for image-guided biopsies and drains
- Skills: Maintains skills required to interpret, report appropriate imaging in an emergency setting and advise on, direct and facilitate interventional procedures when necessary
- Skills: Produces reports in a timely manner according to clinical need in the context of emergency care
- Skills: Shows insight in reports or vetting for appropriate management of patients
- Experience: Performs or arranges (as appropriate) any clinically urgent image-guided interventional procedures
- Experience: Has the ability to make appropriate clinical recommendations in the body or conclusion of reports
Effectively contribute a clinical/imaging opinion to a multidisciplinary (MDT) meeting
Imaging is often central to decision making regarding patient management and onward investigation. Consultant radiologists review imaging of cases to be discussed at MDT meetings and presents relevant findings pertinent to clinical decision making.
- Knowledge: Maintains knowledge of local and national guidelines alongside current peer-reviewed literature to ensure recommendations are evidence-based, clinically relevant and safe
- Skills: Has the ability to review imaging studies to provide an answer to a clinical question posed by the MDT
- Skills: Has the ability to integrate clinical, pathological and radiological information to refine a differential diagnosis
- Experience: Contributes to/leads the decision making of the MDT by clearly articulating a clinical opinion
Evidence Requirements
The SSG specifies 3 evidence sections. Each section describes what evidence to provide and how to present it.
Evidence of training and qualifications
Evidence of your training as background evidence of the competencies you obtained then. This allows the evaluators to see your whole career pathway.
What to provide
- Primary medical qualification (PMQ)
- Specialist medical qualification(s) (e.g., FRCR)
- Recent specialist training curriculum or syllabus
- ARCPs and Educational and Clinical Supervisor reports (if UK trained in past 5 years)
How to present
Upload in one file per institution your specialist qualification diploma, your curriculum and other evidence about your training. Call this 'Evidence of training and qualifications – institution name'.
Evidence of employment and practise
Evidence of your employment in posts and duties (including training posts) and evidence relating to your practise.
What to provide
- CV
- Employment letters
- Job descriptions
- Rotas (On-call/weekly activity rotas)
- Appraisal (most recent and covering last 3 years)
- Multisource feedback (MSF)
- Patient feedback
- Reflective practice
How to present
Grouped together or included in the file next to the item on which you have reflected.
Annex A – submission of radiology reports (CiPs 7, 8, 9, 10, 11)
Evidence of reporting competence across a range of modalities and practical procedures, including basic interventional procedures.
What to provide
- Plain film, mammography, CT, US, fluoroscopy
- Practical procedures – image-guided biopsy, drainage and vascular access and basic catheter/wire manipulation, contrast studies
- Radionuclide studies
- Emergency context reports
- Basic practical procedural activity
How to present
Submit your reports in order of system (Breast, Cardiac, GI and hepatobiliary, Head and neck, MSK, Neuroradiology, Obstetrics and gynaecology, Paediatric, Thoracic, Uroradiology, Vascular, Haematology and oncology, All systems). Include a summary list of the reports in the order that they are submitted.
Knowledge Requirements
Primary Path
FRCR
Alternative Path
Very robust and clear alternative evidence of knowledge and skills that covers the syllabus for the First and Final Examinations. Such evidence might include emergency radiology in the acute setting, cross-sectional and fluoroscopic imaging, participation in MDT meetings with case histories and notes and assessment of these skills and competencies and regular assessment during training.
Applicants who do not hold the FRCR must provide evidence additional to that required by applicants who do hold the FRCR in full. Where applicable, this will be described under the relevant CiP.
Referee Requirements
Referee Reports Required
Current post
- One should be the clinical lead or clinical director for your current post
- All referees should be able to comment on you practice and provide assurance around your knowledge, skills and experience in the specialty
- Structured references from referring clinicians are also encouraged
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
Examples of your involvement in complaints and significant incidents, including reflective activity
1-3 examples
Examples of independently completing a quality improvement project (QIP) or department service review, improvement or innovation
1-3 examples
Set of MSF from colleagues and patients
At least 1 set
Examples of audits
1-3 examples
Examples of reflective activity relevant to CiP 4
1-3 examples
Consecutive months of multidisciplinary team (MDT) meeting activity
6 consecutive months
Radiology reports
60 reports minimum
Currency Window & Evidence Volume
Currency Window
Years
Evidence of your skills or experience should be from the last five years of your clinical practise WTE (whole time equivalent) and does not need to be consecutive. If you are working less than full time (LTFT), evidence can be provided from the last five years of WTE; however, you must ensure any breaks in your practise are explained in your CV.
Evidence Volume
Most applications contain no more than 150 uploaded documents.
Additional Notes
Do not submit original documents. You must provide your evidence electronically.
You will need to make sure your evidence meets our requirements, this includes: Anonymising (redacting) identifiable information, Verifying your evidence to confirm its authenticity, Authenticating overseas qualifications, Translating any documents not in English.
If you have a piece of evidence that is relevant to more than one CiP, do not include multiple copies in your evidence. Instead, include one copy and list it in your application under each relevant area, stating that the evidence is located elsewhere, and you would like to cross-reference it.
You must look at the presentations and conditions in Table 1 in the curriculum for information about the presentations, conditions and modalities in each system-based area.
Your reports must be from within the last five years and preferably as recent as possible. The range of reports should be varied and include examples of normal and abnormal reporting.
The reporting should be your personally generated, independent reporting activity and confirmed appropriately by a head of department or similar.
Frequently Asked Questions
What is the Clinical Radiology CESR portfolio?
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