Foundation competence guide

The 'foundation competence applicants' guide'  has been produced centrally, and relates to recruitment to all CT1/ST1-level posts. This can be found on the medical recruitment website. This is particularly aimed at those who require alternative evidence of competence who have not completed UK-affiliated foundation training. In addition to the applicants guide, the document library also contains a guide to assist signatories when signing off applicants competences.


It is a requirement for all IMT applicants to have achieved the competences equivalent to that of a trainee who has completed UK foundation training.

The way in which this is demonstrated varies depending on the previous training of the candidate. There are five main categories of candidates with a section explaining what each of these mean and how foundation competence can be demonstrated:

  • Current F2 - candidates currently on the second year of a UK affiliated foundation programme
  • Completed F2 - candidates who have a completed a UK affiliated foundation programme, within three and a half years of the advertised post start date (February 2021 for 2024 recruitment)
  • Current specialty trainee - candidates who are currently working in active clinical or clinical and academic practice in a UK educationally approved training post (holding a national training number or deanery reference number) and had their foundation competences assessed upon appointment
  • CREST  - candidates who do not fit into one of the above categories and must supply a Certificate of Readiness to Enter Specialty Training (CREST) to demonstrate foundation competence
  • Refugee doctors - candidates with refugee status who circumstances prevent them supplying the standard evidence at time of application.

Candidates who are currently on a foundation training programme

Candidates currently on a UK/UK-affiliated foundation training programme will not need to provide evidence of achievement of foundation competence at time of application - due to not yet having completed foundation training in full.

This means that any IMT post offer you are made will be subject to your successful completion of foundation training and your being awarded a Foundation Programme Completion Certificate (FPCC) before August 2024. 

Please note that this also applies if you are undertaking a stand-alone FY2 programme, provided it is within a UK/UKFPO-affiliated foundation school.

Please visit the foundation programme website for more information.

The information you will need to provide is as below:

On your application: give the name of your foundation school.

Candidates who have already completed foundation training

Three and a half year limit

Please note - as stipulated in the IMT person specifications - candidates must have evidence of achievement of foundation competences within three and a half years of the advertised post start date, so as to ensure competence is up to date.

If you have completed foundation training since February 2021, all you will need to do is upload your Foundation Programme Completion Certificate (FPCC).

On your application: select the appropriate options on the application form, and upload the certificate(s) to your Oriel account; further guidance is available in the 'Providing evidence' tab.

Before 2021

In the event you have completed foundation training prior to February 2021, you must use the Certificate of Readiness to Enter Specialty Training to provide assurance that you have been maintaining foundation competence - further information can be found on the CREST tab. 

If this applies to you, it is very important that you answer the question correctly on Oriel and supply a CREST, rather than your FPCC. Applications that require a CREST and do not submit one with their application will be rejected, with no opportunity to supply the correct evidence.

Candidates currently working in clinical practice in a UK training post

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.

It is very important that you only answer 'yes' to the question on Oriel if you hold a UK training post with a national training number or deanery reference number. Applicants that incorrectly declare that they fit into this category will be rejected, with no opportunity to supply the correct evidence. If you are unsure whether this you fit into this category, please contact the PSRO.

The information you will need to provide is as below:

On your application: add your national training number (NTN), or deanery reference number (DRN) for core programmes, to the personal section of the application, and in the employment section enter details of your training programme.


If you have not completed, or will not complete, a UK-affiliated foundation training programme between February 2021 and 2 August 2024, you will need to take alternative steps to demonstrate your achievement of foundation competence.

Certificate of Readiness to Enter Specialty Training

The 'Certificate of Readiness to Enter Specialty Training' provides a list of the foundation competences you are required to have gained prior to entering an IMT programme. The form is downloadable from the document library.  Also available is detailed guidance for applicants and signatories on using the certificate. These can be found on the medical recruitment national website. 

Unless you have refugee status and need more time to have your CREST completed, this form must be completed and submitted with your application and cannot be submitted retrospectively. If you do not attach a CREST form to your application when submitting, you will not be offered another opportunity to upload it and your application will not progress any further. 

A single version of the 2024 certificate only

Please note that only the 2024 version of the 'Certificate of Readiness to Enter Specialty Training' may be used and previous versions of the certificate will not be accepted. Please also be aware that you may only submit one version of the certificate, it is not permissible to submit multiple versions to demonstrate a complete set of competences. It is possible for signatories to use evidence from witnesses for competences that they have not personally observed. Signatories may receive alternative evidence they know to be reliable from a colleague (if the colleague is a trainee, they must be working satisfactorily as a senior trainee or above).

Completed by supervisor

  • You must have it completed by a consultant who has supervised you for a minimum of three months since February 2021.
  • This must be a single period of at least three consecutive months and is whole-time equivalent.
  • This certificate can only be signed by a Consultant or equivalent. For the purposes of this documentation, Consultant includes General Practitioners, Clinical Directors, Medical Superintendents, Academic Professors, and locum Consultants with a CCT/CESR and who are on the specialist register.

Evidence of signatory's professional registration

It is your responsibility to provide adequate evidence of the professional status of any signatory who is not registered with the GMC.  

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, you will be unable to progress to the next stage of the recruitment process.

Using the certificate

On your application: select the appropriate options on the application form, and upload the certificate to your Oriel account; further guidance is available in the 'Providing evidence' tab.

CREST Checklist: Please see the CREST 2024 checklist, to assist you when completing the form. 

Refugee doctors

In most cases, applications made without evidence of foundation competence, other than those currently in UK foundation training, will not be eligible and their application will be rejected.

However, it is recognised refugee doctors may have exceptional circumstances, and may not be able to provide a Certificate of Readiness to Enter Specialty Training at time of application. 

Applicants in this position will be given more time to submit a certificate. Although this will be required before being able to take up any offer of a programme.

Applicants with refugee status should contact their local postgraduate region for further advice on how to get a completed certificate. Where possible, regions will be able to provide assistance for bona fide refugee doctors in obtaining a Certificate of Readiness to Enter Specialty Training.

Unless you are a current foundation trainee, current specialty trainee holding a DRN or NTN, or are a refugee doctor with difficulty completing a CREST, you will be required to upload/attach evidence of your achievement of foundation competences (where applicable) with your application form. 

Deferring post start date

If you wish to defer your post start date, you must still be able to demonstrate evidence of achievement of competences in line with these rules.

Current foundation trainees who wish to defer the start date due to a period of illness or maternity leave taken during foundation training, which has extended the date for completion of the programme, do not need to submit any documentation during the recruitment process. This will be submitted nearer the agreed start date to your new employer.

Evidence must be uploaded where necessary

If you are required to supply evidence but submit your application without it, your application is likely to be rejected as ineligible. Therefore, please ensure you have this ready to attach to your application prior to submission.

If your status requires evidence to be supplied at time of application, the application form prompts you to attach this and will not let you submit without. 

Uploading/attaching documentation

Where required to provide evidence with your application, an electronic version must be uploaded to your application form when prompted.  

There are two ways of doing this. You can either do it by uploading the correct documentation during the application process, or you can upload documents to your document library/repository on Oriel. The link to do this is on your Oriel dashboard. 

Please ensure you select the correct category, only categories which match the options you choose in the form can be attached to your application. 

The maximum size of an upload is 10MB. However, if the document you wish to upload is bigger than 10MB, you can divide and upload this as multiple files.

In the event you encounter any difficulties with uploading or obtaining a document - please submit a query via the candidate portal.