Changes to the Medical Training Initiative (MTI) prioritisation process from 2017
The Department of Health & Social Care, Health Education England and the Academy of Medical Royal Colleges (AoMRC) agreed on changes to the arrangements for processing applications for MTI Certificates of Sponsorship (CoS) from applicants from countries other than those identified as DfID priority countries or World Bank Low Income and Lower Middle Income Countries (LI&LMI).
It has been reaffirmed by Department of Health, Health Education England and the Academy of Medical Royal Colleges that the priority focus of the MTI is to provide training opportunities for doctors from DfID priority or LI&LMI countries. They have therefore stated that applicants from countries not considered DfID priority or LI&LMI countries can have no guarantee or expectation of receiving a COS.
Verification of primary qualifications before UK registration
In June 2018, the General Medical Council (GMC) made changes to the verification of primary qualifications for overseas doctors. Information about the process is available from the GMC here.
Dual Sponsorship Scheme
The Dual Sponsorship Scheme is run by the RCOphth. It offers an opportunity for international medical graduates (IMGs) to undertake targeted training in ophthalmology for a limited time. Find out how to apply.
RCOphth acts as a sponsoring body for IMGs to gain registration with the General Medical Council (GMC) to undertake targeted training in a suitable training post in the UK. The Postgraduate Dean, College Tutor and Programme Director in the area where the training will take place must give support for the training post to be used under the Dual Sponsorship Scheme.
According to the GMC, a doctor applying for an offer of sponsorship must have been engaged in medical practice for three out of the last five years including the most recent twelve months. No exceptions can be made to this.
It is therefore essential that your DSS application is processed, and a certificate of sponsorship (CoS) issued before you finish your current clinical practice overseas. Clinical attachments/observerships are not counted as medical practice and should not be undertaken before or during the application process. Internships are not counted towards medical practice.
Information for UK sponsors
The RCOphth requires a detailed job description from the UK Trust (the employing institution). This job description must include a list of training objectives. These might include:
- To significantly improve the trainee’s ability to perform penetrating glaucoma surgery
- An improvement in the IMG’s ability to diagnose secondary glaucoma
The UK sponsor should provide the Chairman of the International Medical Graduates’ Training Sub-committee with a mid-term report of the sponsored doctor’s ability and progress after six months. The mid-term report should include details of progress towards the objectives set out in the job description. The UK sponsor should also provide the Chairman with an end of term report after 12 months about the doctor’s ability and progress, and it should state how the objectives have been met.
English language qualifications
The RCOphth only accepts the International English Language Testing System (IELTS) or the Occupational English Test (OET) for a DSS application.
The minimum IELTS scores that the GMC and RCOphth accept as evidence of knowledge of English for registration are:
- A score of at least 7.0 in each of the four areas tested (speaking, listening, reading and writing)
- And an overall score of at least 7.5
The GMC and RCOphth only accept the academic version of the IELTS test.
For the RCOphth to accept your Occupational English Test (OET) certificate, it must show:
- Your candidate number
- You took the medicine version of the test
- You achieved at least a grade ‘B’ in each testing area (speaking, listening, reading and writing)
- You achieved these grades in the same test
- You obtained the grades in your most recent sitting of the test
If you are applying for registration with a licence to practise through the GMC sponsorship route, you must demonstrate your knowledge of English using either an acceptable OET or IELTS certificate.
There is further information on the GMC’s website. Please follow this link about your knowledge of English to ensure you are eligible for the scheme and do not currently hold any qualifications that could allow you to apply directly to jobs with the use of the Dual Sponsorship Scheme.
Record keeping
During the period of sponsorship, you should keep a log of surgery you have carried out. This should record the number of procedures you performed and assisted at, rather than individual details. You should record the number of cases of posterior capsule rupture and vitreous loss on which you have operated. The log should be submitted with the IMG report on the Dual Sponsorship Scheme and certified by the UK Sponsor.
You should include a list of the surgical cases in which you’ve been involved within your CV. Please refer to the Dual Sponsorship Scheme booklet and FAQs for further details.
- Dual Sponsorship Scheme booklet – please read this carefully before deciding whether to submit an application form. Please note Route C and D are currently unavailable.
- FAQs – please read the Frequently Asked Questions before deciding whether to submit an application form.
- ODTO1-2024 – please download and complete to open your application.
Direct placement
Direct placement is an approved way for someone to be offered a specific training post without the post being advertised, shortlisted and interviewed by a properly constituted appointments committee.
If the RCOphth sponsors the doctor, the quality assurance of the offer of employment is based on a recommendation of the trainee from an overseas sponsor known personally to the UK consultant recommending the trainee for sponsorship. References are also required.
The RCOphth does not find training posts for doctors wishing to use the scheme. Training opportunities and sponsoring consultants should be identified before contacting the RCOphth to request sponsorship.
Work permit/Visa applications
It is the responsibility of the applicant and the relevant employing authority, (e.g. a hospital’s medical staffing department), to ensure the applicant has obtained the appropriate work permit/visa if required. Visa applications are not the responsibility of the RCOphth.
For the Home Office permit, the DSS comes under the Medical Training Initiative (MTI), a category of the Training and Work Experience Scheme.
The Government Authorised Exchange means that workers must be funded to the National Minimum Wage requirements for their skill and training level. This funding can come from the employing UK Trust, a foreign employer or via UK/foreign government grants and scholarships. As an IMG, you must be able to provide evidence of an external source of funding for your post – you cannot be self-funded.
The Academy of Medical Royal Colleges (AOMRC) promotes the MTI and acts as the national sponsor of the scheme for the requirements of the UK Borders Agency (UKBA). The role of national sponsor was previously held by NHS Professionals.
Government authorised exchange visa
To apply for the government authorised exchange visa, the UK employing hospital (Trust) will need to ensure that the completed MTI form is submitted to the AOMRC who will process the visa.
We recommend the MTI form is sent to the AOMRC once the application has been processed and only if support has been given by the RCOphth. Please contact [email protected] for further details.
Read about the UK government’s biometric residence permit here. You’ll get one automatically if your visa application is approved.
Duration of sponsorship
Training through the DSS is limited to 12 months with a maximum possible extension of between three and 12 months under exceptional circumstances and at the discretion of the International Medical Graduates Training Sub-committee.
Sponsored trainees must agree to return to their country of origin on completion of the training period. Work permits and visas to remain in the UK will be granted to only cover the period of training. Once the application to the DSS is accepted, at the recommendation of the RCOphth, the GMC will grant you registration. Please refer to the Home Office website for any other restrictions.
Please note that it is trainee’s responsibility to identify the UK and overseas sponsors. The RCOphth does not arrange training posts. A suitable post has to be identified and offered by the UK sponsor.
This scheme can only accept RCOphth-approved training posts and fellowships (fellowships are considered for educational approval on an individual basis). Honorary or locum posts are no longer approved for this purpose (College Council, October 2000). Fellows, Members or Affiliate Members of the College holding consultant posts in the NHS in the UK can act as UK sponsors for the Dual Sponsorship Scheme.
GMC identity checks
In order to grant registration, the GMC invites candidates to report to their London or regional offices for an identity check. This also involves submitting original documents. The GMC will give a case number and await further information from the RCOphth/IMG.
Certificate of Good Standing
The GMC will require a Certificate of Good standing. Please see the GMC website for further details.
Induction for international Doctors
To introduce overseas doctors to NHS working practices, an Induction for International Doctors is now available on the e-Learning for Healthcare (e-LfH) website.
e-LfH is a Health Education England Programme in partnership with the NHS and Professional Bodies and provides an e-Learning platform for NHS.
The Induction for International Doctors e-Learning programme is available to all Colleges/employers to use for their new non-UK qualified doctors.
This programme introduces internationally qualified doctors, who are new to UK clinical practice, to UK national ethical, social, legal and professional aspects. It has 26 e-learning modules in total. These are interactive sessions produced by Central Manchester University Hospitals NHS Foundation Trust (CMFT) and some sessions taken from other e-LfH programmes which supplement the focus of the programme.
Previous completers of a similar programme have found that it increased their knowledge about UK clinical practice and was useful in enhancing the patient care they provide. Sessions include case-based scenarios and are intentionally generic in content, thereby making them useful for doctors of any specialty and grade. It is expected that this e-learning programme will act as a driver for new international doctors to commence a focussed discussion with their educational supervisors, to develop professional development plans and to undertake additional training as per their specialty/local needs.