General practice in the UK is a difficult but rewarding career pathway. General practice is a broad field which provides many opportunities to develop academically and clinically, and to explore different aspects of medicine.
Although challenging, general practice can be rather flexible and allow for a good work-life balance and freedom to pursue personal interests. This guide is aimed at both UK and international medical graduates (IMGs) and will detail the road to becoming a General Practitioner (GP) in the UK.
IMGs: Visa and relocation:
If you are applying for GP training in the UK as an IMG, you will not have any visa restriction, as long as the following criteria are met:
Eligibility for full registration with, or current possession of licence to practise from, the GMC at the intended start date of training. This equates to having completed the first year of the UK Foundation training programme, or an overseas equivalent. You must have evidence to prove the required competencies have been achieved.
12 months of medical experience after a full GMC registration or equivalent post-licensing experience in your current country of training, and evidence to commence specialty training in the form of a Certificate of Readiness to Enter Specialty Training (CREST).
CREST needs to be signed by a registered medical practitioner. They can be registered with the GMC or any other medical regulatory board, however if they are registered with a non-GMV board they must provide current evidence of their registration alongside with a translated copy if the registration is not in English.
Step 1: Medical School and early postgraduate training:
To become a general practitioner, you must first complete 4-6 years of medical school and achieve a medical degree. Whilst in medical school, you may engage with general practice through joining societies or attending conferences focused on general practice.
After medical school, you must undergo either the 2-year-long UK Foundation Training programme, or an overseas equivalent of this.
Once trainees have successfully completed this and are holding, or are eligible for, a full GMC registration and in case of IMGs also a CREST, they may apply for an ST1 of GP specialty training programme through an open competition.
Step 2: GP specialty training:
The entry to the GP specialty training programme is through an open competition. Once you have been awarded a place on the programme, you will be able to register with the Royal College of General Practitioners (RCGP) which will grant you access to the Trainee ePortfolio.
The training duration is a minimum of 3 years of full-time training, but this may be longer if you choose an academic programme, or in some other circumstances. The training normally includes 18 months in approved hospital posts, and 18 months in an approved GP practice in your deanery. The hospital specialties available to complete during your GP training include General Medicine, Elderly care, Paediatrics, Obstetrics and Gynaecology, and others. The options may vary depending on your deanery.
Some deaneries offer a small number of places for Academic Clinical Fellowships and Global Health Fellowship programmes which differ slightly from regular GP training. Some trainees may also be undertaking a Broad-Based Training (BBT) or may have applied for a Combined Training pathway in which case the time spent in a GP practice will be less than in a regular GP training programme.
Throughout the training, your Trainee ePortfolio will serve as a means to document your progress. The portfolio will be reviewed annually by the Health Education England local office or deanery- this is called the Annual Review of Competence Progression (ARCP).
This review is sent to the GMC to be evaluated to ensure that you are making adequate progress towards receiving a Certificate of Completion of Training (CCT).
The assessment will be carried out throughout all training posts in the form of Workplace-Based Assessments (WPBAs), and at the final stages of training, all trainees will be required to undergo a final assessment in the form of Membership to the Royal College of General Practitioners (MRCGP) assessment.
Step 3: MRCGP assessment and end of training:
The MRCGP consists of two parts: the Applied Knowledge Test (AKT) and the Clinical Skills Assessment (CSA). You must pass both of these components to gain an MRCGP qualification, be able to finish your training, and acquire a CCT.
At the end of the training programme, the RCGP will hold a final ARCP to review whether you have gained the competencies required for licensing and registration and met all the conditions required to finalise your GP training (including passing the MRCGP assessment).
If you have met these conditions, you will be signed off to finish your training and will be able to receive CCT. If you do not meet them, you may be awarded additional time to finish your training.
Step 4: receiving your CCT and taking up a job as a GP:
To receive your CCT, you must apply to both the GMC and the RCGP. The GMC will invite you to apply to them in the last 4 months of your training through the email address the GMC holds for you. When you sign off the final ARCP form, and press the ‘Apply for CCT’ button in your ePortfolio, you will automatically apply to the RCGP who will then review the evidence of completion of required competencies.
If these have been completed, the RCGP will make a recommendation to the GMC to award a CCT. The GMC will process and review this recommendation, and if you are successful, you will be awarded a CCT. After this, you must wait for your name to be entered onto the GP register to be able to take up employment in general practice.
To work as a GP, you must also be on the National Medical Performers Lit (NPML) for the country you wish to work for, except in Scotland where there is no central list and each health board is responsible for their own performers list.
If you are not eligible for a CCT but have adequate training
The Certificate of Eligibility for GP Registration is a possible route to enter the GP register for those who are not eligible for a CCT but believe that their training, qualifications, and experience are equivalent of those acquired in the UK GP training programme. This route is often used by medical practitioners who trained outside the UK.
To apply for a CEGPR, you must provide a folder of evidence of your qualifications and experience in line with the GMC guidance. The GMC will review this evidence and pass it to the RCGP for evaluation. Following this evaluation, the RCGP will make a recommendation back to the GMC which will then review the recommendation and accept or decline your application.
If the application is declined, they will provide the reasons for this and advice on how to achieve the required competencies. If your application is approved, you will be included in the GMC’s GP register.
Once your application has been decided on, you should apply to join the GP International Induction programme (IIP). If this programme is successfully completed, it will allow you to enter the NMPL.
Step 5: Continuous professional development:
The RCGP states that to retain your GP qualifications and ability to practise, you must acquire 250 credits every 5 years and undergo revalidation.
Credits can be acquired by attending courses and conferences and by participating in e-learning through the RCGP. This is termed Continuous Professional Development (CPD).
Resources for doctors who wish to train as a GP in the UK
British Medical Association (BMA). Training in the UK and your visa. Reviewed Apr 2022. Available from: https://www.bma.org.uk/advice-and-support/international-doctors/studying-and-training-in-the-uk/training-in-the-uk-and-your-visa (accessed Apr 2022)
Study Medicine Europe. How to become a GP in the UK: a step-by-step guide. Published Mar 2020. Available from: https://www.studymedicineeurope.com/article/how-to-become-a-gp-in-uk-step-by-step (accessed Apr 2022)
The Royal College of General Practitioners (RCGP). GP specialty training. Publishing date not listed. Available from: https://www.rcgp.org.uk/training-exams/discover-general-practice/qualifying-as-a-gp-in-the-nhs/certificate-of-completion-of-training-cct-guidance-for-gp-trainees.aspx (accessed Apr 2022)
Road to UK. Specialty training in general practice (GP) for IMGs. Publishing date not listed. Available from: https://roadtouk.com/postgraduation/specialty-training-in-general-practice-gp/ (accessed Apr 2022)
Meyyappan C. The Medical School Application Guide (theMSAG). How to become a GP: UK. Published Jun 2019. Available from: https://themsag.com/blogs/applying-to-medical-school/how-to-become-a-gp-uk (accessed Apr 2022)
The RCGP. Certificate of eligibility for GP registration. Publishing date not listed. Available from: https://www.rcgp.org.uk/training-exams/discover-general-practice/qualifying-as-a-gp-in-the-nhs/certificate-of-eligibility-for-gp-registration-cegpr.aspx (accessed Apr 2022)