United Kingdom

Part One

| Professional recognition in your country

1.1. Which organisation recognises doctors eligible to practice in your country?

In case your country has more then one organisation which can provide professional recognition, please attach to this survey a simple list of names and websites where we can acquire more information.

1.2. What requirements/documents are necessary for a foreign doctor to practice medicine?

i.e. language skills, medical degree, insurance, immigration status.

English language skills – the GMC need to be satisfied that doctors can speak, read, write and listen in English before they give a licence. They may ask for evidence of English language capability.
Evidence of fitness to practice – the GMC need details of all postgraduate medical experience, non-medical experience and certain other activities for the last five years or since graduation. They may ask for employer references to cover non-medical work and need a certificate of good standing from each medical regulatory authority doctors have been registered or licensed with.
Specific information for European doctors or those with enforceable community rights. In certain circumstances people have the right to move and live freely within the European Union (EU) and the European Economic Area (EEA) countries. An enforceable community right, doesn't mean entitlement to registration. It is still necessary to satisfy GMC normal registration assessment process.
The doctor needs to have a primary medical qualification acceptable to the GMC for the purpose of registration with a licence to practise.

Where else can we find more information?

See GMC “before you apply” for all questions about applications to join the medical register in the UK https://www.gmc-uk.org/registration-and-licensing/join-the-register/befo...

Further detail on the evidence needed for standards of English: https://www.gmc-uk.org/registration-and-licensing/join-the-register/befo...

1.3. Are there any application deadlines (if so, when)?

Furthermore, how long does the professional recognition procedure usually take?

There are no deadlines for application to join the medical register for applicants, aside from the need to provide all documentation to the GMC within 28 days of the GMC acknowledging your intent to join the register. The GMC’s registrations processes are available all year around, however depending on the specifics for each individual application, the time taken to process individual applications will vary.
When all evidence is collated and sent, the GMC aims to carry out an initial assessment within five working days. They need all the documents and information detailed in their guide before beginning initial assessment. The information in application is valid for three months. This is the maximum GMC will keep application open.

Where else can we find more information?
See GMC “before you apply” for all questions about applications to join the medical register in the UK https://www.gmc-uk.org/registration-and-licensing/join-the-register/befo...

1.4. Are there any sort of examinations/interviews to apply for Medical Professional Recognition?

Currently non-UK graduates from the EU/EEA, there may only be an examination for standards of English if other acceptable evidence is not available, and an in-person identity check will also be needed in all applications.

The GMC is currently moving towards the use of a Medical Licensing Assessment (MLA) which will be introduced from 2022 for all doctors graduating from UK medical schools, and international doctors who wish to join the register.

When the UK leaves the European Union and the MLA is in place, EU/EEA graduates will also need to complete this test – current EU law would not allow this to be the case.
To apply to join the UK medical register you will need to:

check you are eligible
complete an application
pay a fee
provide the required evidence
attend an identity check.
The exact requirements are different for every type of registration application. The GMC has specific guidance depending on the doctor’s personal circumstances and which type of application they are eligible for.

Where else can we find more information?
See GMC “How to register”
https://www.gmc-uk.org/registration-and-licensing/join-the-register/befo...

1.5.1. What kind of professional medical degrees are there in your country?

Bachelor of Medicine, Bachelor of Surgery – often abbreviated to MBBS or MBChB (Medicinae Baccalaureus, Baccalaureus Chirurgiae). There are other abbreviations used by different institutions, but the degrees are fundamentally the same in terms of access to the foundation programme.

Where else can we find more information?
https://www.medschools.ac.uk/studying-medicine/course-types

http://foundationprogramme.nhs.uk/content/about

1.5.2. How do you access each degree?

Medical schools are able to set their own entry requirements. Generally, the minimum entry requirements to standard entry medicine are three As at A level or equivalent qualifications, though this may vary for more prestigious institutions, or if a medical school does not fill all of its places (also known as clearing). One subject, sometimes two, must be in a lab-based science (this means chemistry or biology) and some medical schools also require maths or physics at A level. Grades at GCSE or equivalent are usually considered as part of the application, but medical schools place varying emphasis on them. Some universities also offer shortened (four year) graduate medical degrees which can be accessed by people with or without a science background.
Where else can we find more information?
The UCAS website has a list of all medical degrees available in the UK, along with minimum entry requirements. More detailed information can be found in Entry requirements for UK medical schools: 2018.
GMC – Bodies awarding medical degrees
https://www.gmc-uk.org/education/how-we-quality-assure/medical-schools/b...

Part Two

| Training in your country

2.1. Which organisation is responsible for medical training in your country?

In case your country has more than one organisation with this function, please attach to this survey a simple list of names and websites where we can acquire more information.

England: Health Education England
Scotland: NHS Education for Scotland
Wales: Wales Deanery (Note: from October 2018 this organisation will fold and be replaced by Health Education and Improvement Wales)
Northern Ireland: Northern Ireland Medical and Dental Training Agency

The Foundation programme is co-ordinated by its own institution that is shared between the above agencies: United Kingdom Foundation Programme Office

2.2. Besides professional recognition, is there any other requirement for a doctor to start his training/begin to work (i.e. examination, clerkship, internship)? Namely, which documents/examinations are necessary when applying for training/job?

For UK graduates they must have a primary medical qualification, and have completed the two year foundation programme, which grants full registration following completion of the first year (only provisional registration is granted on graduation). Doctors may only apply for non-foundation programme work after they have completed foundation year one, however to apply for higher training, the full two year foundation programme must be completed.

As part of the foundation programme (or application to it), trainees must complete the Situational Judgement Test as part of the entry process, and complete the Prescribing Safety Assessment before being recommended for full registration.

2.2.1. Where are training positions advertised?

Most information relating to recruitment, deadlines are generally detailed on the specialty training webpage of HEE, however there is regional variation and while the above webpage does contain a great deal of UK-wide information, there are elements that will be England-only.

Other nation specific information can be found on the websites below.

Where else can we find more information?
https://specialtytraining.hee.nhs.uk/

https://www.nes.scot.nhs.uk/education-and-training.aspx

https://www.walesdeanery.org/

www.nimdta.gov.uk

2.3. Are there any application deadlines (if so, which)?

Application deadlines vary by specialty and region - please see above websites (particularly https://specialtytraining.hee.nhs.uk/ for more information)

Where else can we find more information?
See above websites

2.4. How do applicants choose what and where they would like to train?

Applicants can apply for a variety of specialties throughout the UK, and do so based on their own interests. Applicants also are free to apply to any part of the UK (depending on how the application process for the specialty is structured – i.e. individual nation or UK-wide), though there is an interview and testing process that will determine which doctors go where, with higher scoring doctors having first choice of their training location – London is almost always the first area to fill.

Where else can we find more information?
See above websites (particularly https://specialtytraining.hee.nhs.uk/ for more information)

2.5. Is there a fee/tuition for attending a training programme?

The training programme itself does not have a cost to the individual, however there are requirements of Royal Colleges that set the curriculum that do incur a cost, for example to access e-portfolio..

Where else can we find more information?
Though the accuracy of the information is disputed, a summary of costs for some specialties can be found through the Academy of Medical Royal Colleges

2.6. Do trainees receive a salary during training?

Yes

2.6.1. Moreover, what is the current salary and is overtime paid?

There are two national pay scales which doctors in training in England may be paid under depending on their contract of employment. The full details of both pay scales and other premia that vary by specialty are available to download in the 2017-2018 pay circular.
Junior doctors employed under 2016 terms and conditions of service:
Foundation Doctor Year 1 - £26,614; Foundation Doctor Year 2 - £30,805
Specialty Registrar (StR) (Core Training) - £36,461 - £46,208
Specialty Registrar (StR)(Run-Through Training) and Specialty Registrar (StR)(Higher-Training) and Specialist Registrar (SpR) - £36,461 - 46,208
Note that London has an additional supplement for trainees in the region owing to the high costs associated with living in this area.
Trainees may also receive extra pay for undertaking out of hours (or on-call) work.

2.6.2. What type of contracts are there? How long are the working and on-calls times?

The type of contract issued would dependon speciality and geographical location. Most junior doctors would work under a séries of short term contracts lasting 6 or 12 months throughout their training. However some junior doctors would have longer term contracts with their local eduction and training body which would last for their whole speciality training. .
Standard full-time work schedule: Minimum of 40 hours and maximum of 48 hours per week (or up to 56 hours if the European Working Time Directive is opted out of). This is averaged over a reference period which is defined as the length of the rota cycle, length of the placement, or 26 weeks – whichever is shorter.

2.6.3. Are sick leave, vacation days, maternity leave, voluntary work allowed and do they entail a reduction of salary?

Sick leave, annual leave and maternity leave are allowed and do not entail a reduction of salary. Time to undertake voluntary work would generally need to be applied for as a ‘out of programme experience or using annual leave and is unpaid in general.

Where else can we find more information?
https://www.bma.org.uk/advice/employment/pay/juniors-pay-england

2.7. In general terms, how is the training assessment done?

i.e. exams, evaluations, interviews, appraisal

Trainees must demonstrate their progress through their training at least once per year through an Annual Review of Competence Progression (ARCP), where the trainee’s portfolio of experience and completion of the curriculum is assessed. This will require completion of courses, Royal College exams, and undertaking specific procedures and managing specific conditions, among other things.

Upon completion of the full curriculum, the education and training body and the relevant Royal College will recommend to the GMC that the doctor be listed on the specialist or generalist register.

Where else can we find more information?
https://www.gmc-uk.org/education/how-we-quality-assure/postgraduate-bodies

Part Three

| Other details about training/working in your country

3.1. Is mobility possible inside and outside the country during your training?

If doctors wish to move within the UK, they must apply for an inter-deanery transfer, but there are limitations on how this can be used, and if it will be approved. It is not considered a right.

Trainees may take breaks from training to work outside of the UK, but there is a limit on how long this can be done for (maximum two years).

Generally, it is not possible to accredit training opportunities outside of the UK for the purposes of having this taken into account. (also some out of programme training opportunities do exist) There is no guidance available on whether it is possible to move into UK training part-way through a programme if a similar programme has been started outside of the UK (or vice versa), however this can be expected to be very unlikely.

Where else can we find more information?
https://www.bma.org.uk/advice/career/going-abroad/working-abroad/returni...

https://specialtytraining.hee.nhs.uk/nationalIDT

https://www.copmed.org.uk/images/docs/gold_guide_7th_edition/The_Gold_Gu... (pp.36-43)

3.2. How many trainees are there in your country?

Divided, if possible, by in each speciality.

Divided, if possible, by in each speciality.
60,810 doctors in training – breakdown can be found at link below

Where else can we find more information? https://www.gmc-uk.org/-/media/about/gmc_somep_2017_reference_tables_abo...

3.3. What are the success, training drop-out and post-training employment rates?

Unfortunately we do not have access to this information.

Where else can we find more information?

3.4. Is there an accreditation procedure for training centres (and do they include visitations)?

3.5. Is there any national recertification/revalidation scheme to practice?

Every licensed doctor who practises medicine must revalidate – the GMC provide comprehensive information on revalidation – see link below
Where else can we find more information?
https://www.gmc-uk.org/registration-and-licensing/managing-your-registra...

3.6. Are there any differences in the application procedure according to the country of origin of a trainee?

There are different ways to apply for registration with a licence to practise in the UK. It depends on nationality, qualification and experience. The GMC provide an online tool to identify the correct application and give guidance on the steps required.
Where else can we find more information?
https://www.gmc-uk.org/registration-and-licensing/join-the-register/regi...

3.7.1. Are there any restrictions for a foreign doctor who is undergoing training in your country to work there afterwards?

In addition to professional registration with the General Medical Council (GMC) any doctor wishing to work in the UK must satisfy immigration requirements and have permission to work. The immigration rules are set by the Home Office. There are currently no immigration restrictions for doctors who are EEA nationals.

Where else can we find more information?
https://www.gov.uk/government/organisations/uk-visas-and-immigration

3.7.2. Moreover, is it possible for a trainee undergoing training in another EU/EEA country to do part of his training in your country? If so, what are the necessary requirements/documents?

As eluded to earlier, it is not currently clear if trainees from the EU/EEA may join or leave a UK training programme part way through and have this training or previous training recognised by the GMC or relevant competent authority in the relevant EU/EEA authority. It is not expected that this would be offered.

An EEA graduate can normally apply for a training post in the UK under the same conditions as a UK graduate, access to these posts is not restricted. The trainee would be required to register with the GMC prior to application. Whether or not this training may count towards a qualification in another EEA country would be subject to those countries’ restrictions and requirements. A doctor completing a full training programme in the UK would be eligible to apply for a Certificate of Completion of Training (CCT).

3.8. Please summarise the general timeline between the time where a doctor has just graduated until he has attained a final senior post as an independent medical doctor.

In other words, please describe, in general terms, the training of a junior doctor in your country.

The pathway outlined below varies between different specialities and depending on whether working full-time or less than full-time

Where else can we find more information?
https://www.bma. org.uk/advice/career/studying-medicine/insiders-guide-to-medical-specialties/medical-training-pathway

3.9. Is it compulsory to have malpractice (or any other) insurance?

The requirement that all doctors hold adequate and appropriate indemnity cover is a responsibility enshrined in the GMC's 'Good medical practice', and as of 16 July 2014 this became a legal requirement under the Health Care and Associated Professions (Indemnity Arrangements) Order 2014.

3.10. What is the general perspective/position on immigration of medical trainees to your country?

Generally speaking, the BMA is very pro-medical migration and was able to lobby to remove the cap on immigration numbers for all doctors applying to enter the UK through the Tier 2 visa route. This is in the context of a broader political atmosphere that is hostile to immigration.

3.11. What is the general perspective/position on emigration of medical trainees to foreign countries?

This is not something that often happens with UK domiciled trainees owing to cultural language limitations. However, there is a fear around the impact on numbers of doctors of EU origin that may leave following the UK leaving the European Union - https://www.bma.org.uk/collective-voice/influence/europe/brexit/eu-survey

3.12. Are there any restrictions in your country to comply with the consolidated version of EU 2005/36?

3.13. Which organisation(s) specialise in assisting doctors in legal and work matters?

i.e. trade unions, medical chambers, other organizations.

Trade unions – BMA, BAPIO; Medical Defence Organisations (MDOs) - Medical Defence Union (MDU), Medical Protection Society (MPS) and Medical and Dental Defence Union of Scotland (MDDUS).

3.14. Is there any other information you consider relevant with regard to this subject?