Medical Training Initiative (MTI)

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Medical training initiative

The Medical Training Initiative (MTI) is a national scheme designed to allow a small number of doctors to enter the UK from overseas for a most of 24 months, so that they can benefit from training and development in NHS services before returning to their home countries. The scheme is made with the coalition among the Royal Colleges, Trusts, Deaneries and Academy of Medical Royal Colleges (AoMRC) along with their overseas relationships.


What are the benefits of MTI?

  • You are getting the specialty training for 2 years under a qualified NHS consultant and on top of that a postgraduate diploma- Diploma in UK Medical Practice (DipUKMP) will be awarded after the completion if you are sponsored by Royal Colleges. If you are sponsored by your country/third-party, in place of that diploma, you will receive a training completion certificate.
  • In addition to receiving up to 24 months of specialised medical training, doctors on the MTI have also can attend a variety of workshops and seminars, gain fellowship to their relevant medical college and in some instances, sit their Medical Royal College Part 2/final examination.
  • You will be getting a sponsored GMC registration so technically you won’t have to go through any hoops of examinations just for GMC registration (like PLAB) before getting into Medical Training Initiative (MTI) in the UK.
  • You may also earn the salary of the equivalent doctor in the UK if you’re not funded otherwise.

The process of getting into the MTI

Before going into detail whether you are eligible to apply for the Medical Training Initiative in the UK, I want you to understand the complexity of the process. The role of certain organizations need to be clarified first:

General Medical Council (GMC)

They give the person full registration with a license to practice on the basis of a GMC approved sponsor. This is the third way a doctor can get registered, with the first being passing the PLAB exams, and the second having an approved postgraduate qualification. Please keep in mind that if anybody tells you that you can practice in the UK without GMC registration, they are lying. 

Medical Royal Colleges

They assess the people whether they are eligible for the MTI posts. They also urge the trusts and deaneries to make more Medical Training Initiative (MTI) posts in the UK.

Trusts and  Deaneries

They work to find out which posts can be filled with MTI individuals without affecting the UK trainees, and also may help in finding individuals if they have overseas relationships. Trusts are where you’re actually will be working and trained under the Deanery (now LETBs).

Academy of Medical Royal Colleges (AoMRC)

The Academy works with UKVI to issue a certificate of sponsorship (CoS) which will get you GMC registration and a TIER 5 visa. They are the one pulling all the strings in the Medical training initiative (MTI) scheme in the UK.


I am interested. Am I eligible?

Good question! In February 2018, Health Education of England (HEE) and AoMRC has set new standards for the MTI.

Each Royal College has their own set of entry requirements. For the purpose of discussion Royal College of Physicians, London has been chosen. I would advise you to go through the Royal College website for your choice of specialty. Links are at the end of this post.

Entry Requirements by Royal College of Physicians, London

As for Royal College of Physicians (RCP), criteria for application (ALL must be fulfilled):

  • You must hold a primary medical qualification recognised by the GMC and verified by EPIC.
  • You need to have a postgraduate qualification (MRCP (UK) part 1, MD, or other higher degree in medicine or a medical sub-specialty).
  • You must have 3 years of post-qualification experience (including 1 year’s internship and at least 1 year in the specialty where you intend to train whilst in the UK).
  • You must have been in clinical practice for 3 out of the last 5 years including the 12 months prior to GMC registration having being granted. There should be no gaps in employment. Please note that the GMC does not consider clinical observerships as clinical practice. It is important that you remain in clinical practice throughout the application process.
  • You must possess the skills, competencies and understanding of medicine at least equivalent to a UK graduate at the end of their CMT.
  • The Royal College of Physicians (RCP) cannot sponsor doctors who have failed the PLAB test.

EPIC verification will also be required to individuals applying for GMC Registration after June 11, 2018. To know more about how to verify your primary medical qualification, please read about ‘EPIC’ for GMC Registration.

Other requirements:

  1. A valid IELTS/OET, as outlined in English Proficiency for PLAB, GMC & Tier 2 Visa
  2. You must be able to provide a certificate of good standing (CGS) from the regulatory body in the countries where you have practiced in the last 5 years. The CGS must confirm all of the following:
    • You are authorized to practice medicine in the relevant country.
    • You have not at any stage been disqualified, suspended, or prohibited from practicing medicine.
    • The regulatory authority is not aware of any matters that raise doubts about your good standing.
      Keep in mind that the CGS must be no more than 3 months old when it is submitted.

The Application Process for MTI (at RCP, London)

If you fulfill all of the eligibility criteria, you will need to email your CV and the completed initial form to mti@rcplondon.ac.uk. They tend to respond within ten working days.

1. Application

Once your CV and initial form have been received, the supervising consultant in the UK will be contacted to confirm the details of your post. An application pack will then be sent to you. You should complete the application form and send it with all of the following documents:

  • Sponsor form (form will be provided by the RCP) – this form needs to be completed by your consultant or head of department in your home country.
  • Two reference forms (forms will be provided by the RCP)
  • Copy of your passport
  • Copy of your IELTS certificate or details of exemption from the IELTS
  • Copies of your medical qualifications
  • Translations of your medical qualifications if they are not in English
  • Letter from the dean of the medical school from which you graduated
  • Copy of certificate of good standing
  • Letter from the UK hospital confirming your appointment
  • Evidence of funding for the post
  • Your statement agreeing to the level of funding which you have received from any of the sources listed in the ‘funding’ section above
  • Initial fee of £100

The UK consultant will submit the following documents:

  • Detailed job description and timetable/rota
  • Interview notes
  • Confirmed offer of employment
  • A completed Trust form (form provided by the RCP)
  • A letter to support the post from the training program director or regional specialty adviser
  • A completed MTI Tier 5 application form (if applicable)

2. Assessment of the application

When all the necessary documents have been assessed, your application will be sent to a panel for assessment, which usually takes up to 10 working days. If your application is successful, you will receive a letter via email confirming this, which will also provide instruction to begin the GMC registration process and instruction to pay the RCP appointment fee.

3. GMC registration & ID Check

You will then need to complete the GMC online registration process through the sponsorship route. Copies of relevant documents requested will be sent directly to the GMC by the RCP together with a certificate of sponsorship. The GMC has a fee that is separate to the RCP sponsorship fee.

Once the registration process is complete, the GMC will send you an email inviting you to attend the compulsory identity check. You will need to go to the GMC’s office along with your original documents. The GMC will take a photograph of you to keep for their records. Full registration will not be granted until this identity check has been completed.

4. UK Visa Sponsorship for Medical Training Initiative (MTI)

If you require a Tier 5 visa, then you will need to forward the GMC ID check invitation email to the RCP in order to enable them to apply for the Tier 5 certificate of sponsorship. This is because GMC registration is a requirement for the Tier 5 visa.

TIER 5 visa application

The Medical Training Initiative (MTI) scheme falls under the Tier 5 government authorized exchange visa, which is specifically designed for doctors coming to the UK to train for a maximum of 24 months. For a Tier 5 MTI visa, evidence regarding your post to the Academy of Medical Royal Colleges (the official visa sponsor) will need to be provided once the GMC has approved your application in order to get your Tier 5 certificate of sponsorship (CoS) issued.

From 1 April 2017, CoSs will be issued according to the following priority:

1. DFID 28 priority countries – 5 working days
2. Low and lower-middle income countries – 2 weeks
3. All other countries – subject to availability

Once your Tier 5 CoS has been issued, it is your responsibility and cost to apply for the Tier 5 visa via gov.uk website.

The Academy of Medical Royal Colleges (AoMRC) certifies maintenance funding for all doctors requiring a Tier 5 visa. You can apply for Tier 5 dependent visas for your spouse and children if you would like them to reside in the UK with you. Please make sure you have read the UKVI requirements on this well in advance. The visa sponsor does not certify funding for dependents.

The AoMRC is also an ‘A-Rated Sponsor’. This means MTI applicants will not be required to provide evidence of £945 in a savings account as part of their Tier 5 visa application.

Fees

There is an initial fee payable when the application pack is submitted. Once approved for sponsorship there is an appointment fee. Payment can be made by cash (in person on arrival), cheque/bank draft, or bank transfer. Cheques or bank drafts can be posted and should be made payable to the Royal College of Physicians. Bank details will be provided in the application pack.

  • Initial fee (non-refundable): £100
  • Appointment fee: £700

The Medical Training Initiative (MTI) process in the UK can be briefly understood from the flowchart below:

Medical Training Initiative MTI

Frequently Asked Questions

Can I get an exemption from appearing in IELTS/OET?

For sponsorship purposes, the only doctors that can get exemption are nationals of those countries where English is a native language AND also practice in a country where English is a native language. The GMC will make the final decision regarding any exemptions. It is the same situation while trying to get registered via the PLAB route. But here, Tier 5 Visas doesn’t need assessment of your knowledge of English, so IELTS is only for GMC registration, thus “IELTS for UKVI” is not inevitable.

What is the Certificate of Sponsorship required by the GMC?

There are two types of ‘Certificate of Sponsorship’ relevant to the MTI scheme:
1. A professional certificate of sponsorship. This shows the GMC that the individual has support from the relevant professional body for registration on the medical register. The GMC accept sponsorship only from approved Sponsors e.g. Medical Royal Colleges, certain NHS Trusts.
2. A visa certificate of sponsorship is provided by the Academy (AoMRC) and shows the UKVI that the individual has support from an approved body for the relevant visa.

I took the PLAB but didn’t pass. Can I try for MTI instead?

Unfortunately, no. If you had attempted the PLAB test and were unsuccessful, you are not eligible for the MTI scheme.

Can I use my personal funds to support an MTI placement like a clinical attachment?

No. The MTI placement funding can come from any source (e.g. the employing UK
trust, a foreign employer or UK/foreign government grants and scholarships) except the applicant’s personal funds.

Can I bring my family with me?

Yes you can. Please read over this section on family members from the UK Tier 5 Visa page.

Does the MTI scheme provide accommodation?

No, accommodation is not provided as a standard part of an MTI placement. The employing Trust may be able to assist with finding accommodation, either via hospital owned accommodation or via contacts to help MTI participants find local accommodation. MTI participants would generally be expected to pay for accommodation costs.

Am I allowed to do locum work under the MTI?

MTI participants are allowed to work in locum posts, as long as the hours of this post do not exceed 20 hours per week. If your additional post is outside of your main hospital or NHS Trust, you should notify the Academy either on the original MTI Application Form, or in an Exception Report. Both these documents and the MTI Guide, which contains guidelines for locum posts and more, are available here.

Am I allowed to use NHS services?

If your placement in the UK is longer than six months, you may pay an immigration health surcharge which provides you with the same access to NHS services as UK residents. The health surcharge is to be paid as part of your visa application process, and may vary depending on the length of your stay.

If I’m on a TIER 5 visa, can I switch to a TIER 2 visa?

No. The Tier 5 regulations state that those on a MTI Tier 5 Visa can change employment but only up to the maximum 24 months stay – they cannot move to a Tier 2 Visa.
An MTI participant could return to their home country after their Tier 5 Visa expires and then seek employment in the UK under a Tier 2 Visa, but this would be outside the remit of the Academy and the MTI scheme.

So how do I apply for the specialty I want?

Different specialties must be applied for via their respective Royal College. If your specialty does not fall under the list of Medical Royal College below, please contact the MTI team at the Academy at mti@aomrc.org.uk. They will be able to advise you further.

To conclude, if you are looking to move to the UK and make a career as a doctor here, MTI is not for you. This post will not give you any extra advantage over other doctors who worked in the service posts (non-training) in the NHS before applying for core/specialty training. For senior doctors who already have full membership of a royal college, it will be  of little benefit for them from the perspective of career progression, but the doctors who are looking for UK experience prior to their part 2/final part of their Royal College Membership, MTI is beneficial.

As always, if at any point there is any error that needs to be corrected, please feel free to contact us. Good luck!

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Two international medical graduates who work as Internal Medicine Trainees in the UK write this blog with the aim to guide others around the world.

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