Community Sexual & Reproductive Healthcare CESR Portfolio Guide
Complete guide to the Community Sexual & Reproductive Healthcare Portfolio Pathway: 10 Capabilities in Practice (CiPs), 3 evidence sections, and a 5-year currency window. Based on official GMC Specialty Specific Guidance, published by College of Sexual and Reproductive Healthcare (CoSRH) of the Royal College of Obstetricians and Gynaecologists (RCOG).
SSG Version: 08/04/2026
Capabilities in Practice (CiPs)
The Community Sexual & Reproductive Healthcare SSG defines 10 Capabilities in Practice (CiPs) that Portfolio Pathway applicants must demonstrate competence in.
The doctor is able to apply medical knowledge, clinical skill, and professional values for the provision of high quality, safe and empathetic patient centred care.
PROFESSIONAL IDENTITY: NHS PROFESSIONAL
- Able to take history and perform clinical examination and use appropriate investigations to establish diagnosis
- Facilitates therapeutic decision making for people of all sexes and genders
- Facilitates discussions
- Provides treatment
- Applies all legal and ethical frameworks appropriate to clinical practice
The doctor is able to work and communicate effectively as part of a multi-disciplinary team while demonstrating appropriate situational awareness, professional behaviour, and professional judgement
PROFESSIONAL IDENTITY: NHS PROFESSIONAL
- Teamworking
- Understands decision making
- Manages stress and fatigue
- Makes effective use of resources including time management
- Understands human behaviour and demonstrates leadership skills
- Demonstrates personal insight
- Manages conflict
The doctor is able to work successfully within health services at organisational and systems levels
PROFESSIONAL IDENTITY: NHS PROFESSIONAL
- Influences and negotiates
- Understands systems and organisational factors
- Participates in clinical governance processes
- Understands the healthcare systems in the four nations of the UK
The doctor is able to manage data and digital information appropriately and design and implement quality improvement projects
PROFESSIONAL IDENTITY: NHS PROFESSIONAL
- Works effectively within the digital environment
- Understands quality improvement (safety, experience and efficacy)
- Undertakes and evaluates the impact of Quality Improvement interventions
The doctor is able to engage with research to promote innovation
PROFESSIONAL IDENTITY: NHS PROFESSIONAL
- Demonstrates research skills
- Innovates
- Demonstrates critical thinking
The doctor is able to manage and lead a multi-professional team delivering a Sexual and Reproductive Health Service
PROFESSIONAL IDENTITY – SYSTEMS LEADER and CHAMPION (DESIGN)
- Demonstrates commitment to provision of a service, which is continually monitored, and responsive to both positive and negative events
- Recruits, manages, and develops the members of various professional groups that make up multidisciplinary staff
- Manages and sustains financial resources effectively
- Demonstrates commitment to continuous quality improvement and resulting service development
Working in partnership with all other relevant organisations, the doctor is able to champion the sexual and reproductive healthcare needs of people from all groups within society, to enable people to realise their right to optimum sexual and reproductive health; and plan and deliver an SRH Service, within which the principles of Public Health are embedded and contribute to the vision for the future direction of healthcare
PROFESSIONAL IDENTITY – SYSTEMS LEADER and CHAMPION (DESIGN)
- Considers the impact of the broader social and cultural determinants of health when planning and delivering SRH care.
- Participates in setting the direction of future SRH care at local, regional, and national level
- Formulates and articulates problems so they can be addressed using public health intelligence
The doctor is competent to assess and manage people presenting for sexual and reproductive healthcare throughout their life course
PROFESSIONAL IDENTITY: CLINICAL EXPERT (DELIVER)
- Manages fertility control
- Manages pregnancy planning and preconception care
- Manages early pregnancy, unplanned pregnancy, and abortion care
- Manages non-complex genitourinary tract presentations
- Manages abnormal vaginal bleeding
- Manages pelvic pain
- Manages urogynaecological symptoms
- Manages screening relevant to SRH
- Manages adolescent sexual and reproductive health
- Manages premenstrual syndrome
- Manages menopause and postmenopausal care
- Manages transgender health problems
- Manages reproductive mental health (SRH for people with diagnosed and undiagnosed mental health conditions)
- Manages sexual wellbeing
- Manages sexual violence
The doctor is able to directly facilitate learning through the provision of teaching, training, mentorship, and assessment to a wide variety of learners from various professions
PROFESSIONAL IDENTITY: EDUCATOR/TRAINER (TRAIN)
- Delivers effective teaching
- Supervises and appraises
- Facilitates inter-professional learning
- Develops people
The doctor is able to manage educational programmes that deliver SRH learning to a wide variety of professionals in a wide variety of settings
PROFESSIONAL IDENTITY: EDUCATOR/TRAINER (TRAIN)
- Understands educational programmes within SH/SRH
- Demonstrates ability in planning, delivery, and evaluation of training programmes
Evidence Requirements
The SSG specifies 3 evidence sections. Each section describes what evidence to provide and how to present it.
Evidence of training, qualifications, and employment
Evidence of your training as background evidence to allow evaluators to see your whole career pathway.
What to provide
- Primary medical qualification (PMQ)
- Specialist medical qualification(s) (e.g., MCSRH or equivalent mapping)
- Other relevant qualifications and certificates (e.g., Dip GUM, DLM, MBA)
- CV
- Employment letters
- Job descriptions
How to present
Copies of certificates and syllabus, independently verified PMQ if not registered, authenticated specialist qualifications.
Evidence relevant across all CiPs
Different forms of assessment which form part of the CSRH curriculum that can be submitted as part of a CiP and cross referenced throughout the application.
What to provide
- Reflective Practice
- Case histories / Medical reports
- OSATS
- Multi-source feedback (MSF)
- Evidence of independent self-directed learning
- Case-based Discussion (CbD)
- Mini-CEX
- Directly Observed Clinic (DOC)
- Log of experience or procedure
- Letters discussing patient handling
- Patient lists
How to present
Anonymised for individual patient data, triangulated with other evidence, clearly linked to key skills.
Community Sexual & Reproductive Healthcare – Capabilities in Practice (CiPs)
Specific documentation and recommended evidence to demonstrate the key skills in each CiP.
What to provide
- Certificates of completion for recommended courses
- Referral letters
- Case histories
- Patient feedback
- DOCs
- Reflections on complex cases
- Minutes from multidisciplinary meetings
- Colleague 360 feedback
- Quality Improvement projects
- Clinical audits
- Peer-reviewed publications
- Logbook of training experiences
How to present
Gather evidence by area of capability (CiP), attach under the relevant section, use file names entitled by the key skill the evidence is fulfilling.
Index Procedures
29 index procedures require procedural-based assessments (PBAs) with specified minimum assessors and competence levels.
| Procedure | Category | Min PBAs | Min Assessors | Min Level |
|---|---|---|---|---|
| Insertion and removal of intrauterine contraception (IUC) | Contraception | 3 | 2 | 5 |
| Complex insertion and removal of intrauterine contraception (IUC) | Contraception | 3 | 2 | 5 |
| Insertion of contraceptive implant | Contraception | 3 | 2 | 5 |
| Complex removal of deep/impalpable contraceptive implant | Contraception | 3 | 2 | 5 |
| Surgical management of 1st trimester miscarriage and 1st trimester abortion including MVA | Abortion Care | 3 | 2 | 5 |
| Ultrasound early pregnancy - normal early pregnancy | Ultrasound | 3 | 2 | 5 |
| Ultrasound early pregnancy – miscarriage | Ultrasound | 3 | 2 | 5 |
| Ultrasound early pregnancy - retained products of conception | Ultrasound | 3 | 2 | 5 |
| Ultrasound early pregnancy – ectopic pregnancy | Ultrasound | 3 | 2 | 5 |
| Ultrasound gynaecology - normal female pelvic reproductive tract | Ultrasound | 3 | 2 | 5 |
| Ultrasound gynaecology - endometrial abnormality | Ultrasound | 3 | 2 | 5 |
| Ultrasound gynaecology - uterine abnormality | Ultrasound | 3 | 2 | 5 |
| Ultrasound gynaecology - ovarian abnormality | Ultrasound | 3 | 2 | 5 |
| Ultrasound gynaecology - assessment of pelvic pain | Ultrasound | 3 | 2 | 5 |
| Ultrasound contraception - normally sited IUC | Ultrasound | 3 | 2 | 5 |
| Ultrasound contraception - abnormally sited IUC | Ultrasound | 3 | 2 | 5 |
| Ultrasound contraception - normally sited SDI | Ultrasound | 3 | 2 | 5 |
| Ultrasound contraception - abnormally sited SDI | Ultrasound | 3 | 2 | 5 |
| Biopsy of genital skin | Clinical Procedures | 3 | 2 | 3 |
| Endometrial biopsy | Clinical Procedures | 3 | 2 | 5 |
| Hysteroscopy | Clinical Procedures | 3 | 2 | 5 |
| Insertion, fitting and removal of female barrier contraception | Contraception | 3 | 2 | 5 |
| Insertion, fitting and removal of vaginal supportive pessary | Clinical Procedures | 3 | 2 | 3 |
| Bimanual examination | Clinical Procedures | 3 | 2 | 5 |
| Speculum examination | Clinical Procedures | 3 | 2 | 5 |
| Cervical screening (cytology) | Clinical Procedures | 3 | 2 | 5 |
| Proctoscopy | Clinical Procedures | 3 | 2 | 5 |
| Ablation of genital lesions/warts | Clinical Procedures | 3 | 2 | 5 |
| Light microscopy | Clinical Procedures | 3 | 2 | 5 |
Knowledge Requirements
Primary Path
Membership of the College of Sexual and Reproductive Healthcare (CoSRH) (MFFP/MCOSRH) obtained by examination/assessment.
Alternative Path
A detailed, thorough, and succinct cross-referencing mapping exercise, demonstrating how each and every MCSRH competency (Part I and II) has been covered in your own qualifications and how.
There are currently no qualifications from outside Europe that enable automatic entry to the Specialist Register in any specialty. Alternative evidence will be assessed on a case-by-case basis.
Referee Requirements
Referee Reports Required
Recent direct observation of your knowledge, attitude and skills.
- Appraiser
- Line manager
- Educational Supervisor (ES) or Clinical Supervisor (CS) familiar with the CoSRH curriculum
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
Summative OSATS for newly acquired skills
OSATS
Summative OSATS for continuing competency
OSATS
Colleague multi-source feedback (TO1 forms)
MSF
Currency Window & Evidence Volume
Currency Window
Years
The last five years of clinical practise except for level 5 competency Objective Structured Assessment of Technical Skills (OSATS) which should be submitted from the last three years of practice to confirm current maintenance of skill and independent clinical practice. If applicants are less than full time or have had a career break, evidence from additional years can be provided.
Evidence Volume
around 1000 pages of evidence
Additional Notes
Assessments and appraisals cannot be signed off retrospectively. OSATS, Mini-CEX, CbDs and DOCs must be signed off by supervisors concurrently when the assessment takes place (or no longer than three months after the assessment takes place).
Legal restrictions in abortion care can also impact on skills acquisition. Skills competencies not attempted because of either of the above should be clearly recorded in the application in the appropriate workplace-based assessment.
Unlike for trainees within a specialty training programme, the portfolio application does not provide an Educational Supervisor.
If the Letters of Competence in intrauterine (LoC IUT) and subdermal implant contraception (LoC-SDI-IR) are evidenced, OSATs in insertion and removal of IUC, insertion and removal of implant, speculum examination and bimanual examination are not required.
Frequently Asked Questions
What is the Community Sexual & Reproductive Healthcare CESR portfolio?
How many framework units does Community Sexual & Reproductive Healthcare require?
What evidence is required for Community Sexual & Reproductive Healthcare specialist registration?
How long is the currency window for Community Sexual & Reproductive Healthcare?
What index procedures are required for Community Sexual & Reproductive Healthcare?
Related Specialties
Start Your Community Sexual & Reproductive Healthcare Portfolio
Map your evidence to the Community Sexual & Reproductive Healthcare framework, track readiness, and export your GMC submission.