A Guide To IMG Applications For Specialty Training in the UK

UK Medical Training Pathway

This section of the article will give a brief overview of a doctors’ career path and doctors’ training to become a consultant in the UK. 

Helpful note on UK terminology: unlike in many countries (such as the US) ‘residency’ and ‘resident’ do not refer to that stage in a doctor’s career during which they train in a specialty. Instead they are most commonly used in the context of British Citizenship. Similarly, ‘attendings’ abroad are consultants in the UK.
 

Foundation Training

The UK medical training is composed of foundation training lasting two years followed by speciality training. During Foundation Year 1 (FY1/F1), doctors only have provisional GMC registration. In FY2, doctors have full GMC registration. FY1 is the equivalent to the internship year done abroad and is fully paid. 

 

Speciality Training/Medical Residency/Surgical Residency

Speciality Training is the equivalent of ‘residency years’ abroad and is required to become a consultant in the UK. Speciality training programmes can be uncoupled or run through. 

• Uncoupled speciality training consists of Core Training (CT) and higher Speciality Training (ST). It is important to note that uncoupled speciality training posts require two applications - one for core training and another for higher speciality training. 

The length of core training depends on the speciality and ranges from 2-3 years (CT1-CT3). 

Applicants apply for higher speciality training following the successful completion of core training. The length of higher specialty training is dependent on the individual speciality. Speciality training designations either start as ST3 or ST4 depending on whether core training was two or three years respectively. For example, if core training was two years, then applicants start at ST3. 

The following specialities offer uncoupled training: internal medicine (all branches), anaesthetics, emergency medicine, psychiatry, surgical specialities except cardiothoracic/neurosurgery. 

• Run-Through Training requires one application with designations beginning at ST1. It is important to note that there is only one application required here. 

Specialities with run-through training are neurosurgery, cardiothoracic surgery, paediatrics, obstetrics and gynaecology, ophthalmology and radiology. 
 

Higher Speciality Training Exams

Exams will be different depending on the individual speciality chosen. Please note that these exams must be undertaken during training and not after training is complete. 

Uncoupled specialities require applicants to pass an exam before finishing core training in order to progress into higher speciality training. 

Run-through specialties are similar in that candidates must pass an exam in order to progress from earlier training years to later training years. 

All exams must be passed before the end of higher speciality training before candidates are awarded their CCT (Certificate of Completion of Training). Getting the CCT accreditation indicates that you are now a consultant in that speciality. 
 

International Medical Graduates (IMGs)

The beginning point of practicing medicine in the UK will be dependent on the amount of previous clinical experience. Clinical experience gained as a result of a placement during medical school does not count.

The UK requires 24 months of clinical experience, typically 12 months of an internship year (correlates to foundation year 1 in the UK) and an additional 12 months following the internship year. 

For foreign medical graduates who have not completed an internship year, you must apply to the UK Foundation Programme (see above for further breakdown). 

For those who have completed an internship year (12 months equivalent to UK Foundation Year 1) then three options are available: 

• Standalone FY2 year 

• WAST (Widening Access to Speciality Training) 

• 12 months in an acute speciality - this can be done in the UK or overseas or a combination of both. 

 

IMG Doctors

Speciality training positions can be very competitive depending on the speciality in question. There is no favouritism based on where applicants have graduated from. This means that candidates from international medical schools (IMG medical schools) and those from British schools have the same chances of gaining these training posts. 

 

Internal Medicine Training (IMT)

IMT training replaced Core Medical Training (CMT) in August 2019. IMT is an option for those who have completed foundation training (or the overseas equivalent) who want to pursue a medical speciality. IMT is three years but some specialties accept trainees after two years.

Such specialties include clinical genetics, haematology, infectious diseases and tropical medicine. These are known as group 2 specialities where trainees will work towards a single CCT. Recruitment level is ST3 recruitment as trainees have completed only 2 years of IMT. 

Specialities that require 3 years of IMT include cardiology, neurology, acute internal medicine and palliative medicine to name a few. Recruitment level is at ST4 for these specialities as trainees will have completed 3 IMT years. These are known as group 1 specialities where trainees will work towards a dual CCT. 

Core medical training applications and core medical training interviews have been replaced by IMT applications and IMT interviews. 

 

Internal Medicine Application

As with most medical training applications, the IMT application is run through Oriel. It is highly recommended that training doctors check the IMT recruitment timeline early in the year to ensure that no important dates are missed. 

It is important to note that following submission, it is not possible to amend the application except for personal contact details and references. 

1. Part 1: consists of personal details, contact information and equality and diversity information. Residency/Visa status can be entered here. Employment history is required for up to three years prior to the applications. Gap periods of over 28 days should be declared. 

2. Part 2: consists of training history and previous training details. Candidates will also need to provide contact details of three referees that have supervised them in the last two years of training/undergraduate career. One of the three referees must be the current supervisor candidates have. Candidates will be given the opportunity to answer questions relating to fitness to practice and any criminal records. Declarations and Competence and Eligibility are covered here. 

3. Part 3: consists of evidence for self-assessment scoring and supporting information. All applicants select options from a list in sections such as undergraduate, postgraduate, additional achievements (prizes/awards), presentations, publications, teaching, quality improvement and leadership. Different options have different scores and applicants may be required to produce evidence to support a particular claim. Details of the scoring system can be found here.

Supporting information is also provided in part 3. Here candidates provide supporting evidence of their eligibility to the training programme. This might include MRCP examinations (not a requirement at this stage but desirable), interests outside of medicine, commitment to speciality, self-reflective practice, multi-professional teamwork and training courses that have been attended. 

 

GP Training

For those who are family doctors outside the UK who wish to practice in the UK, the GP International Induction Programme is the most common route taken. More information can be found about this programme here. 

For those interested in GP recruitment and are not qualified overseas, the application is nationally selected and there is no priority for British medical graduates compared to IMGs. 

The selection process usually consists of the GP entrance exam also known as the Multi-Speciality Recruitment Assessment (MSRA exam) and further interview assessment at a selection centre. The MSRA exam consists of two parts: the Professional Dilemmas Paper and Clinical Problem Solving Paper.

 

References: 

1. Savvy IMG - https://thesavvyimg.co.uk/what-you-need-to-know-about-applications-to-specialty-training-in-the-uk/