Medical Training Initiative (MTI) for IMGs

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 doctor 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.
  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 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
  • Initial fee of £100

2. Interview

If you get shortlisted after this submission you will interviewed. 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)

3. 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.

4. 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.

5. 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 website.

Fees for Medical Training Initiative (MTI) UK

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

Medical Training Initiative (MTI) Pathway of GMC registration

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

Pros & Cons of MTI UK

Medical Training Initiative (MTI) in the UK is made for “Brain Gain not Brain Drain” – the scheme is made to improve healthcare by training foreign doctors for a period of time. Even though they can’t prevent from doctors wishing to settle and continue to work in the UK (with a separate visa and separate employer) after their MTI is over, from royal college’s perspective it is discouraged as it defeats the aim of the whole scheme.

Pros of medical training initiative (MTI)

  • You aren’t required to go through any other exam to complete your Full GMC registration. You are getting it sponsored and it doesn’t go away.
  • You will be in a training post with a designated Education supervisor (a UK consultant) who will guide you how to get everything done.
  • You will be paid as per the pay scale
  • You can bring your dependants with you

Cons for medical training initiative (MTI)

  • Firstly, MTI posts may not be available for your chosen specialty.
  • Your stay in a tier 5 visa will not be counted towards indefinite leave to remain (ILR) or british citizenship.
  • If you come via your country’s college, you may have other restrictions.
  • The process is not pass/fail exam thus it takes considerable amount of time and a lot of paperwork from various places.
  • The overall challenge of settling into a new system without being properly induced can prove to be difficult during initial months.

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 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 create a topic in RoadToUK Forum.

Good luck!