Unlike many countries, a doctor can NOT become a General Practitioner (GP) in the UK just with their primary medical qualification. The general practice (GP) training in the UK is a program that an overseas doctor (IMG)/UK graduates have to go through after completing the recruitment process. They then become eligible to register as a GP after successful completion of the training. The path may differ slightly for IMGs in the UK.

General Practice in the UK

GPs see patients of all ages, from newborn babies to the elderly. The ongoing relationship that GPs establish with their patients, and then the ability to offer continuity of care is one of the most important and enjoyable aspects of the job.

GPs treat all common medical conditions and if needed, they refer patients to hospitals and other medical services for urgent and specialist treatment. They focus on the health of the whole person combining physical, psychological, and social aspects of care.

Career Opportunities of a GP

There are many options to develop your career within or alongside traditional general practice. Many GPs choose to work one or two sessions per week (i.e. half days) in a different role. It may be necessary in certain cases to gain additional qualifications (ex: sports medicine). In any case, it is important to keep up to date with relevant courses and training. So let’s talk about what you can do:

  • Develope a special interest within GP work in areas such as adolescent health, child and adult safeguarding, diabetes, palliative medicine, minor surgical procedures, and musculoskeletal medicine.
  • Become a clinical assistant to a consultant in a hospital outpatient clinic participating in research and development (R&D) for university departments, NHS research networks, and pharmaceutical companies.
  • Teach medical students either at their university or within the GP practice (or both)
  • Teach at postgraduate level – doctors in their second year of foundation training (F2) or those in a specialist GP training post (GP registrars)
  • Become a GP appraiser with local colleagues
  • Advise or serve on a Clinical Commissioning Group (CCG) or other health service bodies
  • Examine for the Royal College of General Practitioners (RCGP)
  • Work as a volunteer in the community and for charities
  • Work in occupational medicine (focusing on health in the workplace) for the NHS, the military or private industry
  • Work for a local or national sports team
  • Work with special groups of people in prisons, the armed services and on ships
  • Work as a police doctor and becoming a forensic medical examiner
  • Work in medical journalism or medical politics

For further detailed discussion regarding where can your career as a GP can lead please read Explore General Practice as a career.

Let’s look at some statistics

The statistics above are for the Round 1 fill-up rate for the CT1/ST1 specialties. We can clearly see a few important points:

  • The highest number of training posts available are for General Practice.
  • This statistics is only for round 1 and not the re-advert round. Unlike many other specialties, applying in GP training is RLMT exempt. This means that an IMG can apply in both rounds of General practice (GP) training in the UK and that there is no visa restriction in applying round 1.

How GP training is structured

As mentioned already, the actual General practice (GP) training for IMG/UK graduate is for 3 years, but you would have to have completed foundation training OR gain equivalent competencies before you can apply for GP training.

  1. Foundation Training
  2. General Practice Training
  3. GPs with Extended Roles (GPwER)

1. Foundation training

If you are a non-UK/EEA medical graduate, then you have three options:

  • Obtain the equivalent of foundation training outside the UK
  • Obtain the equivalent of foundation training inside the UK
  • Getting into the foundation training by UKFPO.

You can get the certificate of readiness to enter specialty training (CREST) form signed by your overseas consultant if you had worked under them for at least three months after completion of your formal internship/house job and fulfill the points mentioned in the CREST form.

The same way, you can start working in the UK as a non-training doctor and after working under a consultant for at least three months, you can get those competencies signed off.

More information regarding joining UKFPO Foundation training – Internship and UKFPO can be found here.

Getting into UKFPO’s two-year foundation training is not applicable for those who have finished formal internship/house job following their graduation. If you hadn’t done your formal internship/house job after graduation for any reason (like taking USMLE, etc), you should do it before you think about moving to the UK. You will have to take PLAB both ways (UKFPO or home country’s internship), as you did not graduate from the UK/EEA.

Click this photo to take the FREE course!

2. General Practice Training

The training program lasts a minimum of 3 years where the rotations are primarily divided in two settings:

a. Hospital Setting

Based on the deanery and available rotations, a trainee is expected to spend 18-24 months rotating in different hospital specialties including (but not limited to) obstetrics and gynaecology, paediatrics, geriatric medicine, accident and emergency or psychiatry, etc working at the level of core trainee (IMT1/ST1-3) in those specialties.

b. Approved General Practice Setting

The remaining 12-18 months will be spent on the general practice area which is approved for training purposes. This can be divided into 3 six months rotations where hospital rotations can happen in between.

c. MRCGP Exams

While in training, along with maintaining the portfolio to meet the training requirement a GP Trainee will also have to pass the MRCGP exam with two parts- Applied Knowledge Test (AKT) and Clinical Knowledge Assessment (CSA) in order to be eligible to get registered as a General Practitioner by GMC.

3. GPs with Extended Roles (GPwERs)

Previously known GPs with Specialist Interest (GPwSI). A GPwER is a GP who undertakes, in addition to their core general practice, a role that is beyond the scope of GP training and the MRCGP and requires further post-graduate training.

The extended role can cover areas that are non-clinical e.g. local medical committee, commissioning group or an interest in education (trainer, GP Tutor, appraiser). It could be clinical as well, for example (but not limited to):

  • Dermatology
  • COPD
  • Cardiology
  • Woman’s health
  • Musculoskeletal healthcare/ sports injuries
  • Reproductive health.

Please note that a “GP with a specialist interest in Dermatology” is not a “Dermatologist”. A GPwSI is primarily a generalist with some more specialist interest. A good specialist and a good GPwSI have many areas of similarity but have different skills to help in patient care. A GPwSI is bringing the wide spectrum of their clinical expertise and understanding of family and psychosocial issues to the clinical context.

Currently, there is no established accreditation as to how a GP can become GPwSI/GPwER. For now, It is advised by RCGP to follow the generic framework and contact providers and commissioners to understand local requirements until a proper framework is established.

What can an IMG (non-UK, non-EEA, without a settled visa) do to join GP training?

As mentioned already, there is no visa restriction (RLMT) to apply for general practice (GP) training for IMG in the UK. So if the following criteria are met, an IMG can go through the recruitment process and get into GP training.

  • Be eligible for full registration with, and hold a current license to practice from, the GMC at the intended start date
  • 12 months of medical experience after full GMC registration (or equivalent post licensing experience), and evidence to commence specialty training in the form of a Certificate of Readiness to Enter Specialty Training (CREST).

Please note that this 12 months of experience starts from your getting full registration in your country as well. And this is the minimum, there is no maximum experience limit like in some surgical specialties.

  • Hold a current and in date valid driving license or provides an undertaking to provide alternative means of transport when providing emergency and domiciliary care to fulfill the requirements of the whole training program.
  • Advanced Life Support Certificate from the Resuscitation Council UK or equivalent by intended start date.

Evidence of Foundation Training

Certificate of Readiness to Enter Specialty Training (CREST) will be accepted where the assessed post has been wholly undertaken in the 3½ years prior to the commencement of the training post to which the applicant is applying.

CREST can be signed off by your supervising UK consultant while you are doing a non-training job or by your consultant back at home while you worked being a fully registered doctor provided you fulfilled the criteria mentioned in the form.

CREST form cannot be signed off for the duration of your work while you were in house-job/internship. You have to work as a fully registered doctor.

GP Training application process

It is a three-stage process.

  1. Application
  2. Assessment of eligibility (Stage 1)
  3. Long listing
  4. Multi Specialty Recruitment Assessment (MRSA): The MSRA is a computer-based assessment which forms the short-listing process (Stage 2). It consists of two papers:
    1. Clinical Paper,
    2. Professional dilemma paper (Situational Judgement test).
  5. Offers: There is a direct pathway to offers if you score 575 in MRSA. Otherwise, you will have to face an assessment in the selection center (Stage 3) where the applicants will go through simulated consultations and a written prioritization task.
  6. References
  7. Clearing
  8. Offers of employment and pre-employment checks.

For updated dates, always check the official recruitment website, National GP ST1 Recruitment site.

Ask a GP: Dr David Hopes

Dr. David Hopes works as a General Practice (GP) partner in England, and also is the Associate Dean of the Plymouth GP vocational training scheme (VTS). Aside from that, he works as an appraiser for other GPs and an educational supervisor for those in training.

He sat down with us to talk about life as a GP along with why he became one. Dr. Hope offers priceless advice regarding the pathway, gives his thoughts on how one could prepare to enter GP training, discusses the difference between a salaried GP and a GP partner, and some of the challenges he faced as a GP.

Dr David Hopes, Associate Dean, Plymouth GP VTS

Frequently Asked Questions

That’s all about GP training in the UK. If you are interested in other specialties check our blogroll and look for “Specialty training in the UK” tab under Professional Development.

Good Luck!

45 thoughts on “Specialty Training in General Practice (GP) for IMGs”

  1. Dr Akshatha Nagaraj

    Hi. I have completed my MBBS, have an year of experience in emergency medicine, and an MD in preventive and social medicine (community medicine) while simultaneously doing a general practice under a senior physician for 3 years.
    my question is, what pathway should I be applying? MRCGP UK or is there any other pathway for me to get eligibility to get a GMC registration and practice.

      1. Dr Akshatha Nagaraj

        So is there no need for me to apply for MRCGP? I have read that article. I found something about GP international induction programme. If you could kindly tell me more about that and how to go about it

        1. You can not apply for MRCGP UK without being a GP trainee in the UK. GP international induction programme (IIP) is for those who have qualified as a GP in the following countries EEA cuntries or Australia, Canada, New Zealand & South Africa. They have to first get into GMC GP register by proving that their GP training in those countries were equivalent to that of UK.

          Please remember, GMC GP registration is not similar GMC registration you would obtain by taking PLAB. For GMC GP/Specialist registration you have to go through a recognised training.

    1. Hi, I am an IMG residing in Canada currently, registerd in GMC,I had around 10 years experience in ER ,but I am out of practice for two years now,my question is whether this gap affects recruitment decisions,
      Also in Canada I did some observerships/ clinical assisting( as no license for independent practice),Could I mention those attachments in employment history in oriel application or not.
      Thanks

  2. Hello sir,! thanks a lot for this article, its been of immense help.!
    I am a post MBBS graduate(2018), with 1 year internship(’18-’19) and 1.5 yrs experience(’19-current), have cleared PLAB-1, waiting for PLAB-2. Pursuing GP training.
    I have a few queries:
    1. Do you think I am qualified enough to directly apply for GP training?
    2. Do you recommend going for 1 year of FY2 before applying for GP training?
    3. Is there any course/position other than FY2 which isnt 1 year long, anything which is 3-6 months?
    4. Suppose I apply for GP training by getting my CREST signed in my home country, and not get selected, then if I want to go for FY2, can I still do that by withdrawing my CREST form?

    Hoping to hear from you soon,
    Thank you!

    1. 1. You do not recommend anyone to start off directly in the training. But if you think you can handle, you can go for it.
      2 and 3. FY2 means the level of your job. It doesn’t mean 1 year. It is only 1 year if you join FY2 Standalone Training post. We do recommend at least working in the NHS (in a non-training post at least where you will not be bound for a year like in FY2 standalone training) prior to joining any training. These jobs can be easily found on the NHS jobs website. Take a free course on this.
      4. Yes, you can apply for jobs at the FY2 level, even if you have a CREST form signed.

  3. Hello. My questions is regarding the CREST form. Does the specialist (i.e. my supervisor) who signs on the CREST form have to be UK consultant? Could the medical experience from my own country count as well?

    1. If your home consultant has personally witnessed you doing all the things mentioned in the CREST form and you were working as a full registered doctor during that period of work – yes, they can sign off. Please read the CREST guidance document as well.

  4. I am an IMG with MRCGP int and mrcp 1,2 .My general practice experience is over 9 years including two years in palliative medicine I wish to relocate and practice as GP in the UK, do I still need to sit for the PLAB for GMC registration.please note that I have valid OET as per GMC requirement. Would the RCGP offers any support for helping me register in the GMC regarding my qualifications and experience

  5. Sir i have overseas experience of working as a medical officer of 7 years,can i apply for gp speciality in uk after gmc registration?.thank you

  6. Rikako Rikako

    Hello
    Thank you for nice information. I would like to clarify more about 1) CREST form and 12 months experience 2) to ask for some advise on my personal situation 3)timing of taking stage 1 to 3.
    1) CREST form and 12 months experience
    I completed 24 months internship in my home country in 2007 and I have been working full timely in the hospital until now in medicine department. Then I just finished plab1 in 2019, not yet finished plab2 because of exam cancellation. My GMC registration would be in 2021 the latest. In this situation, can I get the CREST form from my current boss (consultant) and skip 12 months experience (= can I skip non-training job in the UK to get CREST and directly apply for GP traning?)or do I still have to work 12 months after getting GMC registration?
    2)My personal situaiton
    As I wrote above, I am 10 years plus experienced doctor and I would like to get into GP training as quickly as I can. Achieving high score in MSRA and getting direct offer after MSRA would be ideal. I am waiting for plab2 now, and do you think it will be worth to start studying for MSRA in this current period?or it may be too much to do?
    3)Timing of taking stage1-3
    The timing of taking stage 1-3 should be consective or we can divide the periods to take them? For instance, one can take stage 1 in 2019, stage 2 in 2022 and stage3 in 2025?

    1. You can get CREST form signed anywhere if you have completed the things mentioned in the CREST form and have somewhat verifiable evidence to support that.
      The experience does not have to be after GMC registration, it has to be after being full registered anywhere.
      No, you can’t do that. To get recruited you have to complete everything in one recruitment cycle.

  7. naganjaneyulu lachi

    can u pls clarify my doubt by doing the internship we can apply and write MRCS exam part A and after completing the internship we can write part B MRCS exam so that we are eligible for speciality training in uk . sir i am an indian student can u please clarify my doubt i will decide my future sir, please
     

  8. Hello RoadtoUK team, great blog again..
    I am appearing for Plab2 in next few months (depending on situation). My question is about schedule of MSRA. I looked at some pages from gprecruitment website, but those were kind of confusing.. Could you guide on.
    1. How many times they hold MSRA test every year?
    2. What approximate months they hold it in each year?
    3. Approximate how many days/ months before the actual exam is the deadline to submit the application to be qualified to sit for an upcoming exam? (say exam is on Aug 1st is the deadline June 1st or something like that)
    4. I understand to get CREST, I need to have at least 3 months working with someone at UK, so what I am trying to work out (backward working) is that at least when I should start my job, so that I could complete three months’ requirement and am able to submit my application before the submission deadline is over.
    Thanks for your continued help!
    Have a good one.

    1. 1. As there are two recruitment rounds, so the MSRA exam can be taken twice a year depending you are deemed eligible to apply for it from your application to the training that needs it. Once you pass it stays valid for 2 years thus you can even apply for the next recruitment round w/o resitting MSRA if your first round doesn’t go well.
      2. You will find the MSRA window here
      3. See the link above for the recruitment timeline
      4. AT LEAST 3 months, not 3 months as a constant. A consultant may not just sign you off by seeing you working for 3 months. 3 months is practically a very little time to achieve all those competencies you need. You definitely need to invest 6 months-1year for CREST signing. Follow our FREE course: CREST & Portfolio : A comprehensive guide for IMGs

      1. Ismat Jahan Bhuiyan

        Thanks a lot for your kind response.you both are doing a tremedous job,ivan.would you please clarify a bit.If i want to do mrcgp do i need gmc registration first?

        1. Please do share our articles if you find them useful so that interested others can get the help too.
          Royal College of General Practioners (RCGP) is the body which are providing membership. MRCGP (UK) is only available for GP trainess in the UK that means, yes you have to get GMC reg, apply and be successful in the recruitment process of GP training. Read more here: Specialty Training in General Practice
          There is also provision of International Doctors (who do not wish to practice medicine in the UK) to be a member of RCGP by taking MCCGP (International). This exam WILL NOT make you a GP in the UK. It’s a recognition of your expertise in this area by the RCGP only.

  9. Hey, first of all thank you for this very complete article. I just have one question : I got my medical degree in July 2019, but I did not register with the medical council in my country as I prefer to study full time for the PLABs. Is it going to be possible for me to complete the whole 12 months experience required in the UK after GMC Registration or is it going to be a problem that I never practiced after graduation in my own country ? And at last during those 12 months are you considered an employee (with a salary) or do you have to provide for yourself until you are a GP trainee..? Thank you so much in advance !

    1. You can have the 12 months of experience in the UK after you get GMC registration and yes, you will get paid for any work that you do, training or non-training.

  10. JEEWA VENGADASALAM

    Is MRCGP exams more difficult than MRCP exam? I have read articles that the passing rate is lower among IMG compared to UK graduates

    1. I always see difficulty of exams are subjective. If you could point me towards that article maybe I will be able to comment more.

        1. I am sure things have changed since this article were published. 5 years is a long time to cause change and make the exam more standardized so that doctors doesn’t face racism. Yes, this article is from 2014.

  11. PRAKASH VARATHARAJOO

    i am a certified licensed Malaysian doctor (a G.P) and not a registered doctor with GMC ,how do i get myself enroll with GP(masters) course and at the same time i work to support my studies?

    1. I sm sorry I quite didn’t understand your query. There is nothing like GP master’s course.
      You either work in the clinical training as a doctor or study in a university as a postgraduate student. You can’t do both due to visa issues and time commitments.

      1. PRAKASH VARATHARAJOO

        thank You Ivan ..can you please explain to me what is clinical training as a doctor and how to do that trining?

  12. Thank you Ibrahim for such a detailed input about GP training.I wanted to clear one thing I have just passed plab2 and sorting my GMC at the moment.I am interested in GP training but the problem is ihave done obstetrics and gynaecology post graduation back home which finished in 2013 December and i relocte to UK in 2014 june since then I was trying my luck in MRCOG but it was no good.I am out of practice for last 5 years so my question is If I get my competencies signed from my home country are they going to accept it as it would be more tham 3 and half years back?
    Thank you

  13. Hi. Nice post. Just so I understand, I’ve worked 6years in my country but I want to get my competency signed in the UK. Will I still be eligible to apply?

    1. Thanks. Yes. You will have to at least work for 3 months minimum under a consultant in the UK to be eligible to get those competencies signed. Make sure you communicate this to your consultant when you start working.

  14. Profkay09@gmail.com

    Quite informative. If I want to apply to another speciality while in GP training, do I have to give off my GP training post or if I was unsuccessful in my radiology application, can I continue with my GP training

    1. You can continue with your GP training until and unless you go to that point where you ACCEPT another offer made to you.

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