You are required to complete this certificate with your ST3 application.

Important: Important

  • You must scan, upload and attach the document (as one single document) to your application form before submission.
  • 2024 is the only version of the certificate which will be accepted for the 2024 recruitment year; alternative certificates prior to the 2024 version will not be accepted. 

Please note that it is a matter of professional probity for both applicant and consultant signatory to complete this form accurately and honestly. Any false declaration in this form will result in any offer of a training post being withdrawn and consideration being given to you and/or your consultant signatory being referred to the GMC or other appropriate regulator.

Instructions to applicants

When using this certificate, please note the following.

  • Unless you have exceptional circumstances, for example, you are a refugee, you will be required to submit the fully completed certificate with your ST3 application, so it is advised that you prepare your documents in advance.

  • This certificate can only be signed by consultant in clinical radiology or interventional radiology who meets one or more of the following criteria:

    • holds the Fellowship of the Royal College of Radiologists (FRCR) diploma 
    • is a fellow of the Royal College of Radiologists
    • holds a senior position equivalent to a clinical director, head of radiology service or head of radiology education
  • Consultants are only eligible to sign these certificates if they have worked with you for a minimum continuous period of 3 months since 1 January of the year 3 years prior to the advertised post start date (for example, 1 January 2021 for the 2024 recruitment rounds); certificates must have been signed subsequent to this date.

  • The 3 months should be wholly within the time limit, is whole-time equivalent and could be spread out over a period much longer than this; for example, if you are doing research but have been undertaking clinics during this time to maintain your clinical skills, the 3 months may be spread over the 3-year period.

  • If your signatory is registered with any medical regulatory authority other than the General Medical Council (GMC), then you should also make sure they submit current evidence of their registration with that authority. A certified translation should be included if this is not in English. Failure to provide this will result in you, the applicant, being rejected. Historic registration with the GMC will not be accepted. The signatory must have an accurate knowledge of the clinical radiology curriculum and ideally should have worked within the NHS in the last 5 years. If a signatory who has worked within the NHS in the last 5 years cannot be provided, we will accept a signatory without that experience provided that they hold a senior position equivalent to a clinical director, head of radiology service or head of radiology education. 

  • You should not use a signatory with whom you have a close personal relationship.

  • You should provide the signatory with a copy of your portfolio evidence. Where supervisor reports and/or formal assessments such as Multi Source Feedback are available you should include these in your portfolio for review.

  • You must have all capabilities and competences listed on this certificate signed off, either personally witnessed or via second-hand evidence, by time of application to be eligible. If you cannot demonstrate that you have achieved all your professional capabilities in one post, you may submit additional evidence to the signatory who, if they agree that it demonstrates capability/competence may accept it in lieu of direct observation. If you cannot demonstrate every professional capability, you will not be eligible for specialty training at ST3 level. If the signatory is unable to confirm any of the capabilities and competences listed, your application will not be progressed.

  • You do not need to have demonstrated all capabilities or competences within the time period in which you must have worked with the signatory, but whoever is signing the form needs to be satisfied that there is no reason why these are in doubt and that they believe you are sufficiently able to progress to ST3.

  • The certificate must be complete in every detail, including details about the person completing it for you. Incomplete certificates may lead to your application being deemed ineligible for this recruitment round. It is strongly recommended that you check the form after your signatory has completed it. 

  • It is expected that the 2024 version of this certificate will be accepted in subsequent recruitment years. Confirmation of which versions of the certificate are permitted will be included on any updated version of the certificate.

Page last reviewed: 12 October 2023
Next review due: 12 October 2024