CEPS without the panic
Planning Clinical Examination and Procedural Skills evidence in GP training
Clinical Examination and Procedural Skills — usually shortened to CEPS — are part of Workplace Based Assessment in GP training.
They are not something to leave until the end of ST3.
The guide on this page summarises national RCGP guidance and is designed to be used alongside your current ePortfolio, Educational Supervisor advice and any local deanery or training scheme requirements. Local schemes may give additional advice, but national RCGP guidance should remain the main reference point.
What are CEPS?
CEPS provide evidence that you are developing the clinical examination and procedural skills needed for independent general practice.
It is not simply a record that you have “done” an examination. CEPS should show:
You can choose an appropriate examination or procedure,
You can perform that examination safely with informed consent
You are able to recognise relevant findings and use those findings in your clinical reasoning.
CEPS evidence should come from clinically appropriate examinations or procedures with real patients in real clinical settings.
RCGP specifically states that CEPS cannot be assessed in a skills lab as sufficient evidence of competence.
Examination or procedural learning can also be reflected on in a Learning Log Entry, but this is not the same as observed CEPS evidence. More on this later.
Key things to understand early
Start early, CEPS should happen throughout training
The RCGP expects CEPS evidence to be gathered regularly throughout each review period and recorded in the ePortfolio.
GP trainees should complete CEPS throughout training, with some relevant CEPS added in each training year.
Leaving CEPS until late ST3 can make things unnecessarily stressful.
Mandated CEPS need observed evidence of competence
By CCT, trainees need observed evidence of competence in all mandated intimate examination CEPS. These include:
Breast examination
Rectal examination
Prostate examination
Male genital examination
Female genital examination, including both speculum and bimanual pelvic examination
These must be observed and documented on a CEPS evidence form by a suitably trained professional.
Breadth matters
The mandated intimate examinations are not the whole CEPS requirement.
Trainees also need a range of other Clinical Examination and Procedural Skills relevant to general practice. RCGP is clear that a range cannot be demonstrated by only two CEPS, or by several CEPS all from one type, such as repeated ENT CEPS only.
All mandated intimate examination CEPS
These mandated CEPS need to be observed and documented by a suitably trained professional. The most recent evidence for each mandated CEPS should support competence for independent practice by the end of ST3.
The most recent evidence for each mandated CEPS should support competence for independent practice by the end of ST3.
Earlier in training, developmental feedback is expected.
A trainee in ST1 or ST2 does not need every observed CEPS to be signed off as fully competent immediately. As with all WPBA, the aim is to show progression.
By CCT, however, the evidence needs to support competence for independent practice.
Who can assess mandated CEPS?
The assessor needs to be appropriately skilled in the examination or procedure being assessed. They need to be able to recognise abnormal findings and provide meaningful feedback.
RCGP states that if the assessor is another doctor, they must be ST4 level or above, or SAS equivalent. If the assessor is another healthcare professional, such as a specialist nurse, they must confirm their role and training so the Educational Supervisor can be satisfied they have been appropriately trained.
In practice, this means the assessor’s role should be specific enough to show relevant expertise. For example:
“breast specialist ANP” is clearer than “nurse”
“gynaecology registrar ST5” is clearer than “doctor”
“urology specialist nurse” is clearer than “clinic nurse”
This helps your Educational Supervisor and ARCP panel understand why the assessor was appropriate.
Wider GP relevant CEPS
In addition to mandated intimate examinations, RCGP expects a range of CEPS relevant to general practice.
The Portfolio includes seven GP-focused observed CEPS categories:
Respiratory system
Ear, nose and throat
Abdominal system
Cardiovascular system
Musculoskeletal system
Neurological examination
Child aged 1–5 years
There is no single national list of “desirable” CEPS that every trainee must complete in exactly the same way. RCGP states that the range and number of observations will depend on the trainee’s needs and the professional judgement of their Clinical and Educational Supervisors.
The RCGP WPBA summary sheet also notes that there are no set numbers for non-intimate/system CEPS, although being graded as able to complete unsupervised in all seven GP-focused system categories would provide strong evidence of CEPS competence.
Local deaneries or schemes may give additional advice about what they expect to see at ARCP, so check your local guidance as well as national RCGP requirements.
How observed CEPS works in the ePortfolio
For an observed CEPS assessment,
The trainee usually generates an assessment request or ticket for the person who observed the examination or procedure.
The trainee enters the relevant context and examination or procedure.
The observer then completes the CEPS assessment form.
FourteenFish guidance explains that assessment requests are created from the Education Assessments section of the Portfolio, and that assessments need to be completed in full by the supervisor or assessor to become visible for ARCP.
The written feedback and the ticked level of competence should make sense together. Helpful feedback is valuable, but the key point is that the documented assessment should support the level of competence recorded.
If the ticked competence level and written comments appear inconsistent, supervisors or ARCP panels may ask for further evidence before signing off competence.
Planning CEPS across posts
CEPS is easiest when you think about it early in each post, not just when an ESR deadline is approaching.
At the end of each post or review period
Use ESR preparation to ask:
Have I added CEPS evidence during this review period?
Which mandated CEPS are complete, developing or still outstanding?
Which wider CEPS areas are well evidenced?
Is my evidence broad enough, or is it clustered in one area?
Have I discussed CEPS progression with my Educational Supervisor?
What needs carrying forward into my next post?
At the start of a new post
Use your placement planning meeting to ask:
What CEPS opportunities might this post offer?
Who can observe me?
Are there clinics or settings where mandated CEPS may arise?
What local processes do I need to know?
What should I raise early with my Clinical Supervisor or Educational Supervisor?
In primary care, CEPS opportunities can be more accessible than trainees expect. If a patient attends and needs an examination, supervisors often have time built into clinics for discussion, debrief or opportunistic observation.
A clinically appropriate examination can become useful CEPS evidence if the patient consents, the supervisor observes, and the Portfolio entry is completed.
Common CEPS Pitfalls
Leaving CEPS too late: Mandated intimate examination CEPS often need planning. If you are not getting opportunities, raise this early with your Clinical Supervisor, Educational Supervisor or training programme.
Collecting repeated evidence in one area only: Repeated CEPS in one system can be useful learning, but it may not show the breadth required for general practice.
Assuming an LLE replaces observed CEPS: A Learning Log Entry can support evidence of learning and progression, but it does not replace mandated observed CEPS evidence.
Using an assessor whose role is unclear: If the assessor is not a doctor at ST4 level or above, make sure their role and relevant expertise are clear.
Relying on simulation: Simulation and skills labs can support learning, but RCGP states that CEPS cannot be assessed in a skills lab as sufficient evidence of competence.
Not checking local expectations: RCGP guidance sets the national framework. Local schemes and deaneries may give additional advice about what they expect to see.
CEPS as a Learning Log Entry
Observed CEPS is the core WPBA requirement where CEPS evidence is mandated.
However, CEPS-related Learning Log Entries can also be very useful.
They can show learning, reflection, clinical reasoning and progression in the CEPS capability and other curriculum capabilities.
They do not replace mandated observed CEPS evidence.
RCGP learning log guidance states that log entries should generally show reflective practice, critical thinking and analysis, self-awareness, evidence of learning and appropriate links to curriculum capabilities.
A CEPS-related LLE may be useful when an examination or procedure helped you reflect on:
Why the examination or procedure was needed
How you explained the examination and gained consent
Dignity, chaperone use and patient comfort
Adapting your examination to the patient or setting
Recognising normal or abnormal findings
Uncertainty or difficulty interpreting findings
How the findings changed your management
Informal feedback received
What you would do differently next time
What learning need you will carry forward
A strong CEPS-related LLE links examination to clinical reasoning.
The question is not only: What did I examine?, but also Why did it matter, what did I learn, and how will this change my practice?
Final message for trainees
CEPS is not just a last-minute ST3 tick-box.
Start early. Think about the opportunities in each post. Make sure mandated CEPS are observed by appropriate assessors. Build a broad range of GP-relevant CEPS evidence. Use LLEs to show learning and progression, but remember that they do not replace required observed CEPS assessments.
If you are unsure whether your CEPS evidence is enough, discuss it early with your Clinical Supervisor or Educational Supervisor.
Guidance checked and useful links
Guidance checked: June 2026
This page is based primarily on RCGP WPBA and CEPS guidance. FourteenFish information has been used for practical Portfolio workflow. Local deanery and training scheme expectations may add further detail.