Intended for healthcare professionals

Careers

I trained overseas, what do I need to do to work in the UK as a doctor?

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m396 (Published 03 February 2020) Cite this as: BMJ 2020;368:m396
  1. Abi Rimmer
  1. The BMJ

Starting out in a new country can be a challenge. Abi Rimmer speaks to three experts about how to make the transition as smooth as possible

Get a licence to practise

Christine Clements, from the General Medical Council, says, “To practise medicine in the UK you need to hold registration with a licence to practise.

“There are four types of registration that allow doctors to work in different posts: provisional,1 full,2 specialist,3 and GP4 registration. Our website has guidance and an interactive tool to identify which type you will need.5

“Exact requirements vary depending on personal circumstances and which type of registration you are eligible for, but it usually involves completing an application, submitting your processing fee, providing any required evidence, and attending an identity check.

“Most doctors will pursue the ‘full registration’ route to practise unsupervised in the UK. To be eligible for full registration you must have the necessary knowledge of English; an acceptable primary medical qualification; the knowledge, skill, and clinical experience to practise medicine in the UK; and be in good standing.

“You can provide evidence of your knowledge and skills in one of four ways: pass the GMC’s professional and linguistic assessments board test; be sponsored by a GMC approved sponsor; hold an acceptable postgraduate qualification; or demonstrate eligibility for entry onto the specialist or GP register by gaining a certificate of eligibility for specialist registration or a certificate of eligibility for general practice registration.

“In addition to our formal registration process we recommend that you familiarise yourself with our guidance, the UK healthcare system, and any external requirements that may be needed to work in the UK.

“We also run free Welcome to UK Practice workshops,6 offering practical guidance to adjust to working in a new culture. Participants explore real life ethical scenarios where approaches may differ in the UK, connect with peers, gain confidence in facing difficult ethical situations, get support from our liaison service, and reflect on their learning.

“The registration process can seem daunting so please do contact us if you get stuck.”

Consider indemnity requirements

Kathryn Leask, Medical Defence Union medicolegal adviser, says, “There are a number of legal and regulatory requirements for doctors new to working in the UK.

“Firstly, you’ll need to register with the GMC and have a licence to practise. To maintain this, you must revalidate every five years which requires having a designated body and a responsible officer, as well as engagement with the appraisal process.

“Next, make sure you have adequate insurance or indemnity in place so that patients are not disadvantaged if they make a claim against you. This is an ethical requirement and doctors working for an NHS body, or the HSC in Northern Ireland, should have access to NHS indemnity through a clinical negligence scheme. Since April 2019, this also includes doctors working in general practice in England and Wales.

“If you are not NHS indemnified—for example, because you are working in the independent sector—you’ll need to make your own arrangements for professional indemnity for claims such as through a medical defence organisation (MDO).

“MDO membership is also recommended for areas that are related to your clinical practice but not covered by NHS indemnity. These can include attendance at an inquest; a complaint to the GMC; or a professional, disciplinary, or criminal investigation, as well as help with media enquiries. In addition, MDOs offer a helpline where you can get ethical and medico-legal advice about your clinical practice.

“Thirdly, make sure you are familiar with the local policies and procedures in your workplace. Each new role you accept should begin with a comprehensive induction programme. This will not only help you to settle in smoothly but also to ensure patient safety is maintained.

“Finally, get up to date with professional and ethical guidance such as from your royal college, the National Institute for Health and Care Excellence, and the GMC. In addition, you should have an understanding of UK ethics and the law. Your MDO website is a good place to go for the latest updates.”

Share experiences with colleagues

Sujesh Bansal, trust international tutor and consultant anaesthetist at Manchester University NHS Foundation Trust, says, “After the initial joy of getting GMC registration, questions about next steps are natural. How can I maximise my chances of securing a job? How can I ensure that my move to the UK is smooth and stress-free?

“You should make yourself attractive to hospitals by tailoring your application to the specifications of each role, so that you can shine during the shortlisting and job interview. Most overseas doctors lack experience in areas like clinical governance, quality improvement, teaching, and training. Pre-emptively improving in these specific areas will certainly bolster your chances in job hunting.

“Doctors newly arrived from overseas can sometimes struggle with the transition into UK clinical practice because some ethical, legal, social, and professional aspects are different from their home country. Robust information, enhanced induction, and appropriate support are the key to a stress free first job in the UK. Health Education England’s eLearning for Healthcare has a free ‘Induction for international doctors’ eLearning programme7 which will be a good foundation for working in the NHS.

“Don’t be shy; network with fellow doctors and find a peer buddy in your hospital —they can provide valuable insight into the working of the department which can make all the difference. The social support of peer buddies who have gone through similar experiences is invaluable while you try to settle in the UK. Also try to meet your consultant supervisor early on, so you can work on formative development plans and have support and mentorship to do your job effectively and safely.

“But, most importantly, remember that the NHS is a great place to work, with evidence based clinical practice and a long history of training the best doctors, so enjoy this exciting journey.”

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