Foundation Competencies
You are required to provide evidence of achievement of Foundation Competence when applying for CT1/ST1 level posts.
Important: Important
Please ensure you check the guidance carefully to confirm the appropriate method to demonstrate your foundation competence.
If you are required to submit evidence of competence, for example a Foundation Programme Certificate of Completion (FPCC) or a Certificate of Readiness to Enter Specialty Training (CREST), with your application, and do not do so then you will not be offered another opportunity to upload it and your application will not proceed to the next stage of the process.
The 2024 CREST form was updated in September 2024 to include an applicant checklist. Either version of the 2024 CREST form (last updated 2023 or 2024) will be accepted for 2025 recruitment rounds.
When applying to CT1/ST1 posts, you are required to provide evidence of achievement of Foundation Competence within the 3½ years prior to the intended commencement date for the advertised post(s).
Demonstrating foundation competence
The acceptable methods for demonstrating foundation competence are listed below.
Currently on a Foundation Programme
If you are currently undertaking a recognised foundation programme in the UK which is due to finish before the post to which you are applying commences, you will need to confirm the name of your Foundation School but do not need to submit any other evidence at the point of application. Any offer of a training programme will be conditional upon successful completion of the Foundation Programme and being awarded a Foundation Programme Certificate of Completion (FPCC) prior to the advertised start date for the post to which you have applied.
Already completed a Foundation Programme
If you have already completed a UK Foundation Programme, you will be asked to confirm that you have been awarded an FPCC , completed no earlier than 3½ years prior to the advertised start date for the training programme to which you are applying. A scanned copy of the FPCC must be uploaded to the Oriel application.
Currently on a Specialty Training Programme
If you are currently in active clinical or clinical and academic practice in a UK educationally approved training post (CT/ST/LAT or equivalent), holding either a National Training Number (NTN) or Deanery Reference Number (DRN) you will be considered as having had your foundation competence assessed on entry to your current post and do not need to demonstrate these again, regardless of when foundation competences were signed off.
Previously resigned from the specialty of application
If you have previously resigned voluntarily from the specialty to which you are now reapplying you will be considered as having had your Foundation competences assessed previously, providing that you can demonstrate evidence of satisfactory progress in the form of ARCP documentation for the duration of the training undertaken.
A completed Support for reapplication to a specialty training programme form will also be required.
Not completed a 2 year UK Foundation Programme
If you have started but not satisfactorily completed a 2 year UK Foundation Programme or a standalone UK Foundation Year 2 post, you can provide a letter written and signed by the Postgraduate Dean where the previous training took place. This letter must use the standard proforma. The letter must include:
- the dates of the previous training
- confirmation of the reasons for the resignation, removal or relinquishing of your post in the Foundation Programme
- confirmation that you have met the requirements and/or demonstrated the competences of foundation training
- confirmation that you have completed a period of remediation, if applicable
Certificate of Readiness to Enter Specialty Training
Important: Important
It is important that you use the correct version of the form and ensure that the document is completed correctly with all the information provided.
The 2024 CREST form was updated in September 2024 to include an applicant checklist. Either version of the 2024 CREST form (last updated 2023 or 2024) will be accepted for 2025 recruitment rounds.
You are only able to submit one CREST document per recruitment round. This document will be used across all applications in that round where you indicate that a CREST is required.
Please note: the initial national Academic Clinical Fellowship (ACF) recruitment round commencing in October in England only is linked to Round 1 for CREST review, so the document you submit in an ACF application will be used for any applications made within Round 1 in the same recruitment year.
If you do not fall into any of the above categories you will be required to submit a Certificate of Readiness to Enter Specialty Training (2024 version) signed by a consultant who has supervised you for at least 3 months (whole time equivalent and continuous period) in the 3½ years prior to the advertised start date for the training programme to which you are applying. You must not submit multiple certificates from different posts to show evidence of achievement of all competences and only one certificate should be submitted. A scanned copy of the certificate must be attached to the Oriel application form.
If the Certificate of Readiness to Enter Specialty Training is digitally signed, an email from the signatory's work email address, confirming authenticity, should be scanned and uploaded with the certificate.
When submitting the certificate, all competences must be signed as achieved at the time of application. Your certificate will not be accepted where it is stated that outstanding competences will be achieved before the advertised start date of the post.
Your Certificate of Readiness to Enter Specialty Training will be accepted where the assessed post has been wholly undertaken in the 3½ years prior to the commencement of the training post to which you are applying. Only the 2024 version of the Certificate of Readiness to Enter Specialty Training will be accepted. Forms from previous recruitment years will not be accepted.
The signatory for the certificate must not be the applicant’s spouse, partner or family member.
Where the signatory does not currently have General Medical Council (GMC) registration, it is your responsibility to ensure that adequate evidence of your signatory’s standing with a regulatory authority is provided. This evidence must be scanned and attached to the Certificate of Readiness to Enter Specialty Training. Where this evidence is not in English, an official English translation should also be provided. In cases where the signatory has historic but not current GMC registration, it is the current registration that is required. Previous GMC registration will not be accepted. Where adequate evidence is not provided, the Certificate of Readiness to Enter Specialty Training and the specialty training application will be rejected.
The only exception to this is if you are a refugee. Refugees (as defined on the UKVI website) are advised to contact the recruiting organisation for further guidance but should submit a Certificate of Readiness to Enter Specialty Training, if possible.
Where you are a refugee but you have worked in clinical practice in the UK, in a post that would meet the requirements for completion of a CREST, the expectation is that a CREST will be provided. If you have had no clinical employment in the UK, then you should contact the lead recruiter to discuss other ways in which your competence can be demonstrated.
In addition, you are required to have had 12 months experience after achieving full GMC registration (or equivalent post licensing experience) by the start date for the post you are applying for.
Before completing a Certificate of Readiness to Enter Specialty Training form, you are advised to read the applicant guidance.
Video: Is completing the CREST form the right step for you?
Female voice: CREST stands for Certificate of Readiness to Enter Specialty Training and this form enables applicants to demonstrate they have Foundation level competencies.
The CREST form is often completed by International Medical Graduates before coming to the UK. It allows you to demonstrate that you have Foundation Level competencies.
Before you can complete the CREST form there's a few questions that you need to ask yourself: Are you ready to begin post-Foundation Programme training? And do you have the necessary skills to begin GP training or Core Specialty Training?
If your answer to either question is no, do not fear. There are posts that you can take up to build your NHS experience and acquire the necessary skills to be a successful specialty or GP Doctor in Training.
You can apply for an F2 stand-alone post.
This is a one-year rotation that if successfully completed will lead to sign-off for Foundation competencies anyway. You will be well supported and supervised in the workplace, to develop the professional skills required. And you will gain the skills to help you during selection into GP or Specialty Training programmes.
You will find these posts advertised on the UK Foundation Programme website. That's foundationprograme.nhs.uk.
Alternatively, you can apply for a locally employed post also known as a Trust Grade post
Many hospitals apply the same level of support and supervision to Trust Grade posts as they would to Foundation and Core training positions. This is a good chance to get NHS experience in a specialty that interests you. This experience will help your core or GP application. You will find these posts advertised on the jobs page of your local hospital’s website.
If however you are confident that you have the competencies to start your specialty training that's great
It's time to fill out the form.
We wish you the best of luck on your journey to becoming a fully qualified GP or hospital and specialist doctor.
Media last reviewed: 7 December 2023
Next review due: 7 December 2024
Foundation Competence and CREST guides
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Evidence of Foundation Competence Applicant Guide
Guidance on demonstrating your Foundation Competencies
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Evidence of Foundation Competence Signatories' Guide
Guidance for signatories' on demonstrating Foundation Competencies
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Certificates of Readiness
Guidance on completing your Certificate of Readiness
Page last reviewed: 27 September 2024
Next review due: 27 September 2025