Guide For Overseas Doctors To Working As A GP in the UK

Whether you have never lived in the UK before, or you are returning to practice in the UK after training or practising elsewhere, the process of starting a career in a new environment can be daunting. 

This guide is intended to support all doctors who qualified, trained, or practised abroad, and are considering a career in general practice in the UK. It aims to facilitate the decision of whether living and working as a GP in the UK is the right path for you, and to provide an overview of what it entails.

 

Living in the UK:

When moving to the UK, you will find there is a large variety of places to choose from. Wales, Northern Ireland, England, and Scotland each differ from the other in terms of economy, politics, housing costs and options, education systems, healthcare provision, and other aspects of living, thus it is important to research this to ensure you have chosen a region best suited for you and your family.

The UK government (gov.uk) website provides a guide for moving to the UK, and each of the 4 UK nations also have their own government websites that contain information on travel, housing, visa, education, and healthcare. 

 

The National Health Service (the NHS):

The National Health Service was founded on the principle that everyone should have access to good healthcare, regardless of wealth. It covers all stages and types of healthcare, and with over 1.5 million employees it ranks within the top 5 largest workforces in the world.

Each of the 4 nations of the UK is responsible for running their own NHS, thus there is some variability between healthcare provision in each of the nations. The Royal College of General Practitioners (RCGP) provides fact sheets that give some detail on the NHS in England, Scotland, Wales, and Northern Ireland, and each of the nations has an NHS website with additional information.

 

The role of a GP in the UK:

General practitioners are invaluable to the smooth running of the NHS. They carry out the vast majority of patient contact in the NHS, and as healthcare is increasingly moving into the community, GPs often lead multi-disciplinary teams of different medical professionals and take part in establishing a more integrated care for patients. 

GPs are responsible not only for managing a patient’s physical health, but also the psychosocial aspects of their health. They often care for multimorbid patients and play an important role in advocating for patients and coordinating their long-term care with other medical specialists. 

The work of a GP in the UK is very variable and can be tailored to one’s preferences. GPs in the UK can choose to develop a special interest to focus more on certain aspects of medicine, and each region of the UK is slightly different to practise in, ranging from jobs in rural areas like the Scottish Highlands, through university towns like Oxford, to GP jobs in big cities like London or Glasgow. 

You can also choose between working as a GP partner, a salaried GP, and a locum GP, so between co-owning and co-running a practice, working for a partner or NHS practice, covering for other GPs within different practices respectively. 

 

Qualifying as a GP in the UK:

To qualify as a GP in the UK, you need to complete the following 3 steps:

1. Acquire a Licence to Practice and register with the General Medical Council (GMC); this is necessary to become a doctor in the UK

2. Acquire your GP registration. In the UK this typically involves a three- or four-year training programme split between an approved training practice and approved hospital or integrated training posts. You will need to pass various assessments and the MRCGP examination.

3. Complete the induction and inclusion on the National Medical Performers List (NPML)

 

This can take a variable amount of time depending on your nationality, level of training, and the country where you gained your medical qualifications. Generally, it takes several months.

If you obtained your GP qualification in the country within the EEA or in Switzerland, and if this qualification is listed in the Directive on Recognition of Professional Qualifications for that country, you will be entitled to mutual recognition of this qualification. 

If the qualification is not included in the Directive, you are entitled to an assessment of the qualification which will compare the curriculum you have undertaken to the UK curriculum. If you fall into the latter category, you must apply for a Certificate of Eligibility for GP Registration. 

If you are a national outside the EEA and Switzerland, it is necessary to have a job offer and a Tier 2 (general) visa to work in the UK. The requirements you need to meet to acquire this can be found on the gov.uk website, and guidance is also available through the British Medical Association (BMA) website. 

There are some exceptions to this, such as being the spouse or a family member of an EEA or UK citizen, and these are explained on the gov.uk website as well. If you do require a visa, you can apply for a Certificate of Sponsorship once you have secured a job offer.

Once you have received a CoS, you must apply for your visa within 3 months, but you cannot apply more than 3 months before the start date of your job.

The BMA offers a free Immigration advice service for doctors or trainees/students wishing to relocate to the UK.

To be able to acquire a medical licence and registration to practise in the UK, you will need to provide evidence. This includes:

• Evidence of sufficient English language skills- most non-EEA nationals will be asked to provide this, and EEA and Swiss nationals may also be asked to do this. For this, you will usually need to have completed either the international English Language Testing System (IELTS) exam certificate, or the Occupational English Test (OET) exam certificate with a sufficient score. With one of these certificates, you may apply for the Professional and Linguistic Assessment Board (PLAB) test. This test is used to verify that doctors graduated outside the UK have the same skills as a doctor starting their 2nd year of the Foundation Programme in the UK.

• Evidence of your fitness to practise- information regarding all postgraduate medical experience, non-medical experience, and other relevant activities within the last 5 years, or since graduation. You may be asked to provide employer references and a certificate of good standing from all medical regulatory bodies which you have been registered or licensed with.

• Primary medical qualification evidence (Primary source verification) - all applicants with a non-UK medical qualification are required to show evidence of their primary qualification, alongside other documents. These need to be verified to receive a registration and a license. You may check whether your primary qualification is acceptable on the GMC website.

 

Certificate of eligibility for GP Registration (CEGPR):

When applying for a CEGPR, you will need to provide verified evidence that shows that you have achieved all the competencies required by the current GP curriculum in the UK, as well as referees that can provide commentary on your skills. 

You will also be required to provide primary evidence of your work in the form of case studies and patient logs. On average, most applicants provide 500-800 pages of evidence.

After you have applied, it can take approximately 6 months for the application to be considered. A detailed guide to this process is available on the GMC website and will be linked in the ‘Resources’ section of this article.

This process is slightly different if you have obtained your qualification and postgraduate training in Australia, as the curriculum is similar to that in the UK. The streamlined process for Australia (SPA) requires a reduced amount of evidence and takes approximately three and a half months.

 

Professional organisations and Resources:

• RCGP - professional body responsible for the standards of GPs in the UK

• BMA - trade union and professional association of doctors in the UK, within which the General Practitioners Committee represents all GPs in the UK; offers an Immigration advice service for doctors wishing to relocate to the UK and other services

• GMC - independent organisation that helps protect patients and improve medical education in the UK; provides useful guidelines on qualifying as a GP in the UK

• British International Doctors’ Association (BIDA)- promotes equality and fairness for all doctors and dentists working in the UK

• British Association of Physicians of Indian Origin (BAPIO)- membership organisation for doctors of Indian sub-continental origin including India, Pakistan, Bangladesh, Sri Lanka and Nepal

• GOV.UK - provides guidance on different aspects of re-locating to the UK and life in the UK

• NHS England/NHS Inform Scotland/Wales NHS/Health and Social Care Northern Ireland

 

References:

1. Royal College of General Practitioners (RCGP). Living and working in the UK as a GP: a guide for overseas doctors and their families. Available from: https://www.rcgp.org.uk/training-exams/discover-general-practice/overseas-doctors-guide.aspx (accessed Mar 2022)

2. NHS. Information for overseas doctors. Available from : https://www.healthcareers.nhs.uk/explore-roles/doctors/information-overseas-doctors (accessed Mar 2022)

3. British Medical Association (BMA). BMA services for international doctors. Reviewed Dec 2021. Available from : https://www.bma.org.uk/advice-and-support/international-doctors/how-the-bma-can-help-you/bma-services-for-international-doctors (accessed Mar 2022)

4. General Medical Council (GMC). Brexit- guide to registration for doctors. Published Jan 2021. Available from : https://www.gmc-uk.org/news/news-archive/brexit---information-for-doctors (accessed Mar 2022)

5. GMC. Evidence to support your application. Available from : https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/evidence-to-support-your-application (accessed Mar 2022)

6. GMC. Using your IELTS certificate. Available from: https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/evidence-of-your-knowledge-of-english/using-your-ielts-certificate (accessed Mar 2022)

7. GMC. A guide to the PLAB test. Available from : https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab/a-guide-to-the-plab-test (accessed Mar 2022)