The advanced clinical practitioner role in emergency departments in the UK has developed in an ad hoc manner, without a national framework of registration requirements. This article describes the structure adopted by one NHS trust in England to certify the clinical competence of advanced clinical practitioners in emergency departments through the completion of two portfolios, with a third portfolio to record professional development. The portfolios cover history taking, clinical examination, and interpretation of information and basic investigations to enable the practitioner to undertake medical clerking of a patient attending the emergency department. The portfolios contain evidence of learning and observation of practitioners by middle-grade doctors and consultants.