Post Graduation Pathways in the UK for IMGs

Postgraduation (PG) in the UK is a long and diverse road for a doctor after taking PLAB exam or getting GMC registration in some other ways. It’s a lot to think about after you’ve achieved GMC registration and started working in the UK. The lack of knowledge about the whole path ahead of you may land you in a situation where you tell yourself you could’ve done it differently.

Where do I start post graduation in the UK?
How different is it compared to my country?
How long will it take to complete my training?

Let’s get to the point.

Career progression in the UK

First of all, to have an understanding as to where can an IMG start, the overall knowledge about the postgraduation or training structure and the hierarchy of doctors in the UK after PLAB or gaining GMC registration is very important. Please have a look here first, Overview of Specialty (or GP) Training in the UK. The terminologies are used here assuming you know them from the above post.

Stages of transition to the UK

Now, let’s think about at what stages in an International Medical Graduate’s (IMG) career may this transition to the UK may happen.

  1. Fresh Graduates, didn’t finish an internship
  2. Fresh Graduates, just finished the internship
  3. Worked for 2-3 years after internship
  4. Worked for longer than that
  5. Registered as specialist/GP somewhere else than the UK
  6. Long clinical gap after graduation and internship

I will explain the situations separately in sections by sections. Don’t get confused by what’s mentioned in other sections as that may not be applicable to your case.

Fresh Graduates

This stage is the most ideal for making your transition to the UK as a doctor as it’s easier at this stage to start from the bottom and work your way up in postgraduation

Completed the acceptable pattern of internship

If you have completed an acceptable pattern of internship, then the primary target for you is to obtain Full GMC registration, which will enable you to work as a doctor in the UK and start a NON-TRAINING JOB. To obtain that you will have to take the PLAB exam and its prerequisites.

To start the preliminary planning please have a look here, how to plan for PLAB 1 and IELTS. If you’ve decided on PLAB and have everything figured out, check out our extensive post on planning your PLAB journey.

You can also look into applying for FY2 LAT/LAS posts if you wish, or even think about applying for WAST if you are interested in pursuing psychiatry or GP training and want to start from the basics.

Have NOT completed an acceptable pattern of internship

It’s highly suggested that you complete an acceptable pattern of internship and then attempt for GMC registration if you have time to do so.

Please look here to find out more about acceptable pattern of internship and how it is related to full GMC registration, GMC Approved Internship & UKFPO FOundation training.

If you can’t at all, then you can try for foundation training under UKFPO (which is internship training for the UK graduates). It is difficult for an IMG to get into if they’ve not already got a settled visa status, which is why it’s recommended to complete an acceptable pattern outside of the UK if possible.

Worked for 2-3 years after Internship

Your entry into the system is also just like the same as a fresh graduate i.e. clearing the PLAB exams, getting the GMC registration and all, BUT you have an advantage as you’ve worked in your country under full registration (of your country). You can have the foundation competencies a.k.a Certificate of Readiness to enter Specialty Training (CREST) signed off from your supervising consultants who you may have worked under for continuous 3 months or more. This form will enable you to apply for training posts.

You can also think about completing parts of membership exams (MRCP/MRCS etc) first from your home country and then come to the UK, giving your career progression a boost.

To know more about foundation competencies please have a look here, Oriel alternative certificate of foundation competence. Read the guide and the documents in the resource bank carefully.

Even though if your foundation competencies are accepted, it is highly recommended to start with a non-training job first, not directly apply for Core / Specialty Training (CT1/ST1). An orientation to the UK health care system is necessary in order to progress better prior to commencement in the core/specialty training.

Worked for a long time outside UK

It can be a bit difficult to start from the bottom i.e. being a junior doctor again in your case. But, I suggest if you can do that, it will bear fruit later on. Also, your experience will reflect on your salary, so don’t worry about getting underpaid.

PG Qualification Pathway

That being said, the pathway can broaden for you a bit. You can take the PLAB > GMC registration > Non-training job pathway, and you can also consider taking the MRCP/MRCS pathway.

The membership and fellowship of royal colleges are approved postgraduate qualifications. If you have one, you won’t need to take PLAB for GMC registration, but other prerequisites still hold, like IELTS/OET or getting your PMQ verified by EPIC. Have a look here to know the GMC approved postgraduate qualifications from UK as well as different countries.

MTI Pathway

Another route many are interested in knowing about is the Medical Training Initiative (MTI). MTI will not allow you to settle in the UK nor will it count towards your 5 year duration for Indefinite Leave to Remain (ILR), but you can apply for a job and switch to a TIER 2 working visa from a TIER 5 visa for MTI. MTI is not suggested if you wish to continue to work in the UK, but rather as a stepping stone for your own training back home.

Look here further for details as to how to make an application for GMC registration with an approved post-graduate qualification. 

To understand the comparison between PLAB and MRCP, please have a look here in this post, PLAB vs MRCP: What do you need to know!

Registered Specialist/GP or trainee in non-UK countries

If you have obtained a specialist degree/in the training in your country, there is a pathway for you to apply to get into GMC’s specialist register. It is called CESR / CEGPR (Certificate of Eligibility for Specialist or GP Registration) pathway.

There can be a lot of pitfalls and delays. The paperwork can be enormous and very time-consuming. You won’t be able to get enough clinical experience or you may be restricted to work under one trust all along with your career. So, this pathway is not recommended but if you have the support you can go for it.

See Speciality Specific Guidance for CESR and CEGPR from the official GMC website to find out what and how you might have to prove your evidence of being a specialist.

Long clinical gaps after graduation or internship

First things first, don’t lose hope.

Will I get GMC registered with this long clinical gap?

It is a very common question whether GMC registration will be a problem for doctors with long clinical gaps. But, take a step back and ask yourself, have you not faced clinical problems and scenarios in your PLAB exams? Yes, you did and you passed them. 

They may want details of your past professional experience. If you were not involved clinically, state whatever you were doing, it can be you were involved in a teaching job, or worked on your studies and post-graduate exams, or just took care of your family. It has been known that many doctors got FULL GMC registered just fine without any hassle with long clinical gaps after passing the PLAB exams so long as the requested documents are provided.

You can have a look here to find out what evidences are needed for GMC registration application and also our post on breaks in clinical practice

Will it be difficult getting a job?

That is very variable from person to person, as how you present yourself in NHS jobs profile plays a vital role in getting a call back for interview. If you feel that you’ve been away from the clinical setting for some time, you can opt for a clinical attachment. The general approach is to contact hospitals you’re interested in observing at and then completing the associated form and paperwork. There may or may not be an associated cost.

Or you can do some basic courses like BLS/CPR training which will also help you get an edge in your job application. You can look for approved CPR training courses by Resus UK.

If you’re still wondering about pathways beyond this, check out some of our specialty specific posts:

Good luck to you all!