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Form for applying for confirmation of UK training
posts.
You should use this form if you are a UK or EEA national and require formal
You can read more about the
confirmation of postgraduate medical training posts in the UK:
GMC on our website:
This confirmation will be provided under Article 50(1) and Annex VII of
www.gmc-uk.org
Directive 2005/36/EC.
This is a fillable PDF. You may type into the sections where we require answers.
We may be asked to provide your registered address to the British Medical Association, medical defence organisations and medical Royal Colleges
and faculties so that they can keep their records up to date. We will only do so where we are satisfied you are already a member. If you do not want
us to give your registered address to these organisations, please tick here. 
To see the levels of information we share with different parties, please see our privacy policy at www.gmc-uk.org/privacy/
Please send your completed application along with all the required documentation to:
General Medical Council, Specialist Applications Team, 3 Hardman Street, Manchester M3 3AW.
What to submit
Along with your completed application form, you should also send us the following:
Evidence of training posts
Please submit Record of In-Training Assessment (RITA) or Annual Review of Competence Progression (ARCP) or
Vocational Training Record (VTR) forms as proof that you have satisfactorily completed the approved training posts. These
forms must show your national training number (NTN).
If you are unable to submit RITA, ARCP or VTR forms
Please provide letters from medical staffing or personnel departments at the hospitals or NHS trusts where your training took
place. These letters must be original (not photocopies), be on headed paper and show:
•
the type of post you held
•
the exact start and finish dates of the post
•
the specialty the post was in
•
the name of the hospital
•
the name of your supervising consultant
•
that the post held was recognised and approved for training
Your personal details
GMC reference number
Title (Dr, Mr, Mrs, etc.)
Family name or surname*
First name*
Other names*
Your contact details
Full address
Postcode
Country
Home telephone
Work telephone
Mobile telephone
Email address
Preferred method of contact
email
letter
You may type into all the areas of this form where we require information
All dates must be written in the format dd/mm/yyyy
Your primary medical qualification (PMQ)
Full title of your PMQ
Name and full address
(including country) of the
university (and college, if
appropriate) that awarded
your qualification
Date qualification awarded
dd
mm
yyyy
Posts held
Please provide details of all the UK training posts you have held. Start with the most recent and work backwards.
1
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
2
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
This form was last updated on 27 November 2014
Please make sure that you are using the most up-to-date version of the form.
Telephone us on 0161 923 6602 (or +44 161 923 6602 if calling from outside the UK)
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Page 3 of 7
You may type into all the areas of this form where we require information
All dates must be written in the format dd/mm/yyyy
Posts held
Please provide details of all the UK training posts you have held. Start with the most recent and work backwards.
3
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
4
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
5
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
This form was last updated on 27 November 2014
Please make sure that you are using the most up-to-date version of the form.
Telephone us on 0161 923 6602 (or +44 161 923 6602 if calling from outside the UK)
CN10
Page 4 of 7
You may type into all the areas of this form where we require information
All dates must be written in the format dd/mm/yyyy
Posts held
Please provide details of all the UK training posts you have held. Start with the most recent and work backwards.
6
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
7
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
8
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
This form was last updated on 27 November 2014
Please make sure that you are using the most up-to-date version of the form.
Telephone us on 0161 923 6602 (or +44 161 923 6602 if calling from outside the UK)
CN10
Page 5 of 7
You may type into all the areas of this form where we require information
All dates must be written in the format dd/mm/yyyy
Posts held
Please provide details of all the UK training posts you have held. Start with the most recent and work backwards.
9
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
10
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
11
Start date
dd
mm
yyyy
Finish date
dd
mm
yyyy
If part time, percentage of whole time equivalent (wte)
Is this a recognised training post?
%
Yes
No
Post title
Specialty
Name, address, and country
of institution or hospital.
Name of supervisor
Supervisor’s post title
This form was last updated on 27 November 2014
Please make sure that you are using the most up-to-date version of the form.
Telephone us on 0161 923 6602 (or +44 161 923 6602 if calling from outside the UK)
CN10
Page 6 of 7
You may type into all the areas of this form where we require information
All dates must be written in the format dd/mm/yyyy
Declaration
I apply for a formal confirmation of my UK training posts and confirm the following:
1. I consent to the GMC contacting other third parties, including the Royal Colleges or Faculties, medical regulatory
authorities, government bodies and others in connection with my application as may be reasonably necessary.
2. I consent to my personal data being given to other third parties, including the Royal Colleges or Faculties, medical
regulatory authorities, government bodies and others in connection with my application as may be reasonably
necessary.
3. I understand that before my application is considered complete the GMC may request additional documentation.
4. I understand that if I supply any serious misrepresentation with the intention to mislead, it will result in my application
being rejected and I will be reported to the Fitness to Practise Directorate and any other medical regulatory authority
with whom I hold registration.
5. The information given on this form is true, complete and accurate and that no information requested or other relevant
information has been omitted.
6. I have enclosed all of the appropriate documentation (listed above).
Your signature
Please sign and date below to confirm all of the above declarations
Signature
Date
dd
mm
yyyy
This form was last updated on 27 November 2014
Please make sure that you are using the most up-to-date version of the form.
Telephone us on 0161 923 6602 (or +44 161 923 6602 if calling from outside the UK)
CN10
Page 7 of 7