Internship and Foundation Training by UKFPO for IMGs

One of the main eligibility for securing full GMC registration with a license to practice is to have an approved pattern of internship (house-job). Otherwise, IMGs may have to resort to UKFPO foundation training or find an approved pattern of internship elsewhere before application for full GMC registration.

Foundation Training in the UK

The United Kingdom Foundation Program Office runs a two-year structured, supervised program called the foundation training, which is workplace-based learning for UK medical school graduates that exists to prepare junior doctors for specialty training by providing them with the medical knowledge and skills to meet the requirements of the GMC’s The New Doctor and the Foundation Program Curriculum.

In broad terms, foundation training is the UK version of the internship.

What are the GMC approved criteria for a non-UK internship?

Let’s run through the checklist.

  • Have you completed an internship undertaken immediately prior to (final year of study) or immediately following your graduation?
  • Was your internship a minimum of 12 months’ continuous medical practice in an approved training post? 
  • Did your internship include at least 3 months in medicine and 3 months in surgery, and lasted between 12 and 18 months OR at least 6 months in medicine and 6 months in surgery, and lasted for 18 months or longer? 

If you have answered YES to all the above questions, then, brace yourself with the good news that your internship has a very high chance of getting approved by the GMC (UK).

If, unfortunately, any of the answers is No, then as an IMG you will have to think about doing UKFPO Foundation training or get an approved pattern completed elsewhere in the world.

You can check here further about GMC’s criteria of acceptable pattern of internship.

But, I have only 2 months in medicine…

Medicine here is not only “General medicine”. The following rotations will also be counted towards 3 months of medicine:

  • Paediatrics
  • Cardiology
  • Nephrology
  • Gastroenterology
  • Endocrinology
  • Rheumatology
  • Community medicine
  • Any other branches of medicine.

Same goes for 3 months of surgery.  It’s not only in “General Surgery”. Any rotation in the followings will also count towards it.

  • Trauma & Orthopaedics
  • Urology
  • Ophthalmology
  • ENT
  • Neurosurgery
  • All other branches of surgery.
NHS intern doctors

I have gaps in my internship/house-job!

Let’s run through a checklist again:

  • Was your internship in total was minimum of 12 months?
    • If NO, then there is a chance it won’t be accepted as approved training. But, remember that, the final call is always at GMC’s discretion.
    • If YES, then the next question.
  • Were you absent more than 20 days (not taking into account the approved 5 weeks of annual leave)?
    • If YES and you can’t explain any valid reason (which is unlikely to happen) then there is a chance it won’t be accepted.
    • If NO, then the next question.
  • Did you not start medical practice after one year of internship or did you have more than 2 years gap between graduation and internship?
    • If YES and you can’t explain any valid reason (which is unlikely to happen) then there is a chance it won’t be accepted.
    • If NO, then brace yourself, you have nothing to worry about.

I want to really emphasize here about the negativity a lot of people that spread in social media saying that – “Your internship/house job won’t be accepted” or “This pattern is not accepted” or “You won’t get full GMC registration with it” etc. Please, don’t let those person get to you. They are not GMC. Period. For more information, check out our post on Breaks or Gaps in Clinical Practice.

I have known a lot of doctors getting full registration with scattered internship and medical education. All GMC needs is a proper explanation and proper paperwork. If any case your internship goes into question, you will possibly have to get Consultant Report Form signed by your supervising consultants. So stay prepared before you make that GMC registration application, as it may take longer for you than others, but always remember that there is light at the end of the tunnel.

All about UKFPO for IMGs

As from 2021, non-uk medical graduates (IMGs) can apply for foundation training by UKFPO along with UK/EEA graduates without any visa restriction . But the whole process to apply for it is different and a bit elaborate. We will go through the process in detail.

Do I need Foundation Training?

This is the very first question.

If you have completed an acceptable pattern of internship and by way of that, can become eligible for FULL GMC registration (provided you have taken PLABs)- then you ARE NOT eligible for foundation training and you DO NOT NEED this training for your further career in the UK. So, don’t feel that you have missed something by completing an internship back home.

If however, since graduation you have not completed any GMC approved form of internship OR you have the wish to start your medical career in the UK right after your graduation without spending time anywhere else – you need to take the path of foundation training in the UK.

Eligibility criteria for foundation training for IMGs by UKFPO

  1. Applicants have to have a valid medical degree approved by GMC (UK) by the start of the training.
  2. Expect to obtain GMC provisional registration with a license to practice (pass in both PLABs) by the start of the training.
  3. Have the written approval of their medical school Dean (or the Dean’s nominated representative o the equivalent official to the Dean) to apply for a UK Foundation Programme.
  4. Proof of English language proficiency:
    • Applicants must either have confirmation of English language proficiency indicated on their Dean’s Statement (and follows GMC guidelines) and their medical school must not be included on the GMC’s list of institutions they will not accept evidence from
    • OR, provide evidence of a valid IELTS certificate with a score of a minimum of 7.5 in each domain
    • OR, evidence of OET with a minimum score of 400 in each domain

If you fulfil the above criteria, you can apply to check whether you are eligible before applying for the foundation training programme itself. Eligibility application is an extra step non-uk medical graduates have to go through before the national recruitment for foundation training opens.

Eligibility application process

There are two steps:

  • Step 1: Completing an online eligibility application form in Oriel
  • Step 2: Uploading supporting evidence on Oriel (the application system)

Supporting evidences for eligibility application

  1. Colour / photograph page(s) of your passport containing your personal details; including nationality, photograph, date of birth, signature and date of expiry.
  2. Valid Dean’s statement (available on the UKFPO website).
  3. Medical school degree certificate or, if you have already qualified and do not have your certificate, an official letter from your Dean confirming your qualification. If you have not yet graduated, you should upload a copy of your Dean’s statement in this section.
  4. Evidence of satisfactory completion of IELTS must be submitted as part of the eligibility application form by providing the Test Report Form (TRF) number from your IELTS certificate, OR Evidence of completion of OET with a minimum score of 400 in each domain (listening, reading, writing and speaking) must be submitted as part of the eligibility application form. Your OET results must be dated no more than two years prior to the start of the programme.
  5. Evidence of any name change (if applicable).
  6. Evidence of your right to work in the UK (sponsorship can be arranged for those who are unable to provide evidence of their right to work).
  7. Passport photograph.

Is there anything I can do to assist my eligibility application and reduce the chances of it being rejected?

Yes. Taking extra care in completing your eligibility form may mean the difference between being assessed as eligible to apply or ineligible.

  • Ensure that you read the Eligibility Applicant Guidance 2021 for submitting supporting documentation as it contains explicit guidance which you should read and digest.
  • Ensure you have completed all sections of the form with the information requested.
  • Adhere to ALL deadlines.
  • Ensure your application is typed or word-processed. Handwritten documentation is not acceptable.
  • Ensure your declaration is signed in ink.
  • Ensure you supply one passport photo with your eligibility application.
  • Ensure any documents uploaded onto Oriel are clear.
  • Ensure the second page of the Dean’s Statement has your name on it and is signed.
  • Ensure your postgraduate experience is completed in full and correctly.

What are the steps an IMG has to take to obtain foundation training by UKFPO?

If an IMG is found eligible, only then they are able to apply for the foundation training by UKFPO when the application opens. If you can’t see the entire process from a birds eye view, it is impossible to plan ahead of everything you need to do. We will talk now about the steps briefly with an estimated timeline (for actual dates please refer to UKFPO applicant handbook).

ProcessTimeline (estimated)
Eligibility application (IELTS/OET completed)Late July
National Clinical Assessment (if applicable)Late September – Mid October
National Foundation Programme Application Period (Online)Mid October – Early November
Latest PLAB 1 exam date (if not passed already)Early November
Booking Situational Judgement Test (SJT)Mid November – Early December
SJTEarly December – Mid January
PLAB 1 pass (has to be confirmed)Late January
SJT scores releasedMid March
Offers and preferencesLate March
PLAB 2 pass (has to be confirmed)March/April
Matched to programmeApril
Provisional GMC RegistrationApril/May
Foundation Training startsAugust

Tests and Exams to pass before joining Foundation Training

From the table above we can chalk out what test/exams you need to pass in order to join UKFPO Foundation training as an IMG in the UK:

  • IELTS or OET
    • Without the required mark in any of these test, you can’t even apply for the eligibility process
  • National Clinical Assessment
    • If it is indicated for you to take this test from your eligibility application, you will have to take it during the time indicated.
  • PLAB 1
    • This can be done way early like in March (if you have graduated/passed your finals already). As from the timeline we can see, the lastest you can take and HAVE to pass in the November one.
  • Situational Judgement Test (SJT)
    • The Situational Judgement Test (SJT) is a test for employment and not a medical school exam.
  • PLAB 2
    • You have to take PLAB 2 by late February so that your pass results are available for applying for provisional GMC registration by April/May.

Frequently asked questions

I have heard it is tough for IMGs to get into UKFPO foundation training.

Not any more. Since October 2019, all medical specialties are included on the shortage occupation list, so all applicants will be allocated based on their application score and preferences using an algorithm. Nationality/citizenship will not play a role. If you need a work visa (Tier 2), you will be issued a certificate of sponsorship.

I wasn’t registered with any medical regulatory board during my internship

Are you sure about that? If you are 100% sure then, that means your internship was not actually an “approved training post”, OR your country doesn’t have a medical regulatory authority.  You can look for your country here, CGS contact database.

In this case, you have three options basically:

1. As you were employed in medical capacity without any form of registration, GMC may ask you to you get a GEN1 Employer reference form signed for that period while processing your GMC registration application.
2. Maybe get registered in any country’s medical regulatory board and do the internship there is an acceptable pattern.
3. Apply for provisional GMC registration and give application for UKFPO foundation training a shot!

I had gaps in my internship/house job. Is it acceptable?

As long as you have an explanation for that gap, GMC has no reason to deny it, provided that you submit all the evidence that you were asked to provide. And foreshadowing like this is impossible for anyone, as every application is judged by GMC on individual merit, a third party can’t guarantee anything. So, don’t lose hope if anyone has told you that you won’t get GMC registration because of gaps. It’s not straightforward like that. For more information, check out our post on Breaks in Clinical Practice.

I want to know more…

Check here UKFPO Resource Bank to find detailed guidance in every step of the way.

I touched on as many topics and queries I could think of regarding the UKFPO, but feel free to ask any further questions you may have in the comments below.

Good luck!