Medical psychotherapy CESR Portfolio Guide
Complete guide to the Medical psychotherapy Portfolio Pathway: 9 High Level Outcomes (HLOs), 10 evidence sections, and a 10-year currency window. Based on official GMC Specialty Specific Guidance, published by Royal College of Psychiatrists (RCPsych).
SSG Version: 07/10/2025
High Level Outcomes (HLOs)
The Medical psychotherapy SSG defines 9 High Level Outcomes (HLOs) that Portfolio Pathway applicants must demonstrate competence in.
Professional Values and Behaviours
- 1.1 Professional Relationships
- 1.2 Professional Standards
Professional Skills
- 2.1 Communication
- 2.2 Clinical skills
- 2.3 Complexity and uncertainty
Professional Knowledge
- 3.1 Knowledge of legal and organisational frameworks in your UK jurisdiction
- 3.2 Working within NHS organisational structures
Health Promotion and Illness Prevention
- 4.1 Health promotion and illness prevention in community settings
Leadership and Teamworking
- 5.1 Teamworking
- 5.2 Leadership
Patient Safety and Quality Improvement
- 6.1 Patient safety
- 6.2 Quality improvement
Safeguarding Vulnerable Groups
- 7.1 Safeguarding
Education and Training
- 8.1 Education & Training
- 8.2 Supervision
Research and Scholarship
- 9.1 Undertaking research and critical appraisal
Evidence Requirements
The SSG specifies 10 evidence sections. Each section describes what evidence to provide and how to present it.
Evidence of training, qualifications, and employment
Evidence to demonstrate how you meet your self-identified KSE cohort, including evidence of your core competencies and specialist training and/or experience.
What to provide
- KSE cohort statement
- CV
- Primary medical qualification (PMQ)
- Specialist medical qualification(s)
- Specialist training curriculum/syllabus and assessments
- Employment letters
- Job descriptions
How to present
Grouped by type of evidence
HLO 1 Professional Values and Behaviours
Evidence of professional relationships and standards.
What to provide
- Feedback from colleagues and patients
- Correspondence demonstrating collaboration
- Reflective practice
- Structured reports
- Successful annual appraisal in the last 5 working years
- Evidence of personal psychotherapy (typically over at least 3 years)
How to present
Grouped by the type of evidence (e.g., all patient feedback together). Submitted in one PDF bundle by organisation.
HLO 2 Professional Skills
Evidence of communication, clinical skills, and managing complexity and uncertainty.
What to provide
- General psychiatric cases (4 for Cohort 1A, 5 for 1B, 10 for 2)
- Evidence of leadership in triage and referral decisions for 10 referrals
- 10 specialist psychotherapy assessment consultations
- Specialist psychotherapeutic treatment cases (quantity depends on major modality and cohort)
- 2 completed cases in each of the 2 additional modalities
How to present
Organised by case and coordinated to tell the story of the patient. General psychiatric cases organised by diagnosis. Psychotherapy treatment cases numbered and organised by modality.
HLO 3 Professional Knowledge
Evidence of advanced knowledge of legislative framework and working within NHS structures.
What to provide
- Approval under the UK Mental Health Act as Approved Clinician OR 2 cases (tribunal/court/MoJ/safeguarding/Section 12 reports)
- WPBA/feedback/reflection demonstrating advanced awareness of legal and ethical limits to confidentiality
- CPD appraisal demonstrating knowledge of governance matters
How to present
No evidence is required to be uploaded into this section. All evidencing requirements for HLO3 will be submitted under other HLOs.
HLO 4 Health Promotion and Illness Prevention
Evidence of health promotion and illness prevention in community settings.
What to provide
- Evidence around understanding factors contributing to health inequalities (submitted under HLO2)
- Minutes of professional meetings demonstrating multidisciplinary working
- Evidence of working with carers
- Evidence of taking an advocacy role in developing health and social care
How to present
No evidence is required to be uploaded into this section. All evidencing requirements for HLO4 will be submitted under other HLOs.
HLO 5 Leadership and Teamworking
Evidence of teamworking and leadership skills.
What to provide
- Job description and reflection on leadership role
- Log activity of role covers
- Appraisal of role
- Attendance at management and leadership related CPD events
- WPBAs such as DONCS Chairing Meeting
- Reflection on Change management or Service development activity
How to present
Grouped by activity.
HLO 6 Patient Safety and Quality Improvement
Evidence of patient safety and quality improvement initiatives.
What to provide
- Appraisal evidence demonstrating learning from Serious untoward incidents/complaints
- Shadowing a Serious Incident review or PSIRF Investigation
- Involvement in resolution/investigation of complaint or adverse event
- Meeting minutes demonstrating active participation in clinical governance
- Active participation in a minimum of one quality improvement project
How to present
Grouped by activity/event. Quality improvement projects bundled together with all relevant evidence.
HLO 7 Safeguarding Vulnerable Groups
Evidence of safeguarding knowledge and skills.
What to provide
- Completion of child and/or adult safeguarding training within the last 3 working years
- Summary of at least 2 patient cases involving a safeguarding concern
- Meeting minutes evidencing attendance and contribution to safeguarding/child protection meetings
How to present
Grouped by activity. Information about UK Prevent training submitted together. Safeguarding meetings submitted together.
HLO 8 Education and Training
Evidence of education, training, and supervision skills.
What to provide
- Job description and reflection on teaching/trainer role
- Teaching activities on applications of psychotherapeutic approaches
- Evidence of undertaking assessment and supervision of junior colleagues/trainees
- Psychotherapy supervision of junior colleagues within the last 5 years (min 1 year with 3+ trainees)
- Facilitation of a regular group of doctors/medical students (e.g., Balint group)
How to present
Grouped by activity. Teaching evidence collated by session, assessment and supervision.
HLO 9 Research and Scholarship
Evidence of undertaking research and critical appraisal.
What to provide
- Job description and reflection on research role
- Relevant research qualification certificate and dissertation
- Critical appraisals presented at Journal club/peer review
- Attendance at CPD events for good clinical practice in research
How to present
Grouped by activity. Each critical appraisal with corresponding triangulated evidence submitted separately.
Knowledge Requirements
Primary Path
Completed Core Psychiatry Training (or equivalent) AND MRCPsych (or equivalent) passed AND Completion of accredited specialised psychotherapy training with registration (or eligibility for registration) with a recognised UK psychotherapeutic body (BPC/UKCP/BABCP).
Alternative Path
Completed all elements of Core Psychiatry Training (or equivalent) with or without MRCPsych AND Experience in psychiatry after completion of core training of a minimum of five years OR Completion of higher training (minimum of three years) in another psychiatric specialty.
Applicants must self-identify their KSE cohort (1A, 1B, or 2) based on their core competencies and specialist training/experience. This determines the exact volume of evidence required.
Referee Requirements
Referee Reports Required
Current suitability for specialist registration
- Consultant in your specialty or similar
- Clinical supervisory position such as an Educational or Clinical supervisor
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
General psychiatric cases (Cohort 1A)
4 cases
General psychiatric cases (Cohort 1B)
5 cases
General psychiatric cases (Cohort 2)
10 cases
Triage and referral decisions for psychological therapy
10 referrals
Specialist psychotherapy assessment consultations
10 consultations
Psychodynamic major modality treatment cases (Cohort 1A)
8 cases
CBT major modality treatment cases (Cohort 1A)
12 cases
Systemic major modality treatment cases (Cohort 1A)
12 cases
Completed cases in each of the 2 additional modalities
2 cases each
Quality improvement project
1 project
Patient cases involving an adult or child safeguarding concern
2 cases
Psychotherapy supervision of junior colleagues
3 or more trainees
Currency Window & Evidence Volume
Currency Window
Years
Your evidence is expected to be submitted from the timeframe as described within each HLO (the time frame is all in WTE and doesn't need to be consecutive) and overall, within the last ten years. If you have worked less than full time (LTFT) or have had a break in practice in the last five years, evidence can be provided from additional years or whole-time equivalence (WTE).
Evidence Volume
No more than 1500 pages of evidence
Additional Notes
You must self-identify your KSE cohort (1A, 1B, or 2) – this will inform your evidence submission.
We recommend that you do not submit more than one PDF document for each organisation per HLO.
If you have a piece of evidence that is relevant to more than one area, do not include multiple copies in your evidence. Instead, include one copy and list it in your application under each relevant area.
All case history evidence should be organised by case and coordinated to tell the story of the patient and the work of the applicant.
At some stage in your career, you must have undertaken personal psychotherapy, typically over at least three years.
Frequently Asked Questions
What is the Medical psychotherapy CESR portfolio?
How many framework units does Medical psychotherapy require?
What evidence is required for Medical psychotherapy specialist registration?
How long is the currency window for Medical psychotherapy?
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