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The NHS specialty training programme for clinical oncologists is recognised around the world. The quality and depth of oncology training and career development in the UK is recognised as a gold standard across the globe, making it a major attraction for many IMGs when considering a career in the UK. The NHS training programme for oncology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of oncology around the world and throughout the profession. In this article, we will explore the training pathway for clinical oncologists in the UK, covering the following topics: What is the NHS Training Pathway? How do you enter the training pathway? What does the specialty training programme look like for clinical oncology? What happens after completing the clinical oncology training programme? Can I enter specialty training in the UK as an IMG? Skip ahead to the relevant section if you know what you’re looking for. The NHS Training Pathway for Clinical Oncologists The NHS training pathway refers to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training and being awarded a CCT. It is a good idea for overseas trainees to familiarise themselves with this as it helps to provide an understanding of at what stage they can most likely enter the system, either in a training or non-training post. Entering the NHS Training Pathway After graduating from medical school, doctors receive provisional GMC registration, allowing them to enter the Foundation programme (a two-year work-based training programme). Upon completion of the first year of this programme (FY1), doctors will gain full GMC registration with license to practice and will be able to apply for further study and training in a specialised area i.e. medicine. This is known as Internal Medicine Training (IMT), formerly known as Core Training (CT). Specialty Training in Clinical Oncology The Specialty Training programme in Clinical Oncology runs over a 6-year period, and doctors will usually take the indicated time, or slightly longer to complete the Specialty Training programme. Successful applicants entering into year one of specialty training (ST1), will follow the Royal College of Radiologists’ 2021 Clinical Oncology Specialty Training Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers. Clinical oncology training as an uncoupled programme Clinical oncology specialty training begins at ST3, so after foundation training, there are two options open to trainees before they can start specialist clinical oncology training: Internal Medical Training (IMT) Acute Care Common Stem (ACCS) For IMT, this is a two-year training period and the ACCS training programme lasts 3 years. Both pathways are followed by an open competition to enter a higher specialty training post. It is important to note that the application following core training is competitive and does not guarantee a specialty training post. Clinical oncology higher specialty training is indicatively a five-year clinical training programme (including Oncology Common Stem), leading to single accreditation in clinical oncology. There are a few critical progression points during higher specialty training in clinical oncology, and trainees will also be subject to an annual review of progress via the ARCP process. They will have to complete all the curriculum requirements including passing the MRCP and FRCR (Oncology) exams prior to obtaining CCT. Foundation Training (FY1 – FY2) The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills and forms the bridge between medical school and speciality training. This first year of Foundation Training (or FY1) is referred to as an internship. For IMGs applying for GMC registration, it is essential you can meet the requirements for an internship. Selection Here, trainees will either choose to either Internal Medicine Training (IMT), Acute Care Common Stem training (ACCS), or training to become a general practitioner (GP Training). Specialty Training (ST1 – ST7) Internal Medicine Stage 1 Training (ST1 – ST2) Year one trainees begin at ST1 of the Internal Medicine Training Programme. In this first stage, trainees develop a solid foundation of professional and generic clinical capabilities, preparing them for participation in acute medicine at a senior level and to manage patients with acute and chronic medical problems in outpatient and inpatient settings. The curriculum for IMT Stage 1 Training can be found here. The two-year training period culminates in trainees sitting the MRCP (UK) exams. For more information on the Royal College of Physicians examination suite, take a look at our IMG Resources library here. Please note, trainees must have gained full MRCP prior to beginning Specialty Training in Oncology. Selection Here, trainees will either choose to continue with Internal Medicine Training for a further year, to continue with training in a specialty that supports acute hospital care, or to provide primarily out-patient based services in e.g. oncology. Clinical oncology recruitment into ST3 posts usually occurs after 2 years of Internal Medicine Stage 1 training. However, trainees who complete the full three-year IMT programme are also eligible and there is no preferential selection for trainees who have completed either two or three years of training. Oncology Common Stem (ST3) The Oncology Common Stem (OCS) has a duration of one year and usually takes place in year 3 of specialty training (ST3). Here, the focus is on a trainee’s development of generic capabilities-in-practice (CiPs) expected of all doctors, as well as the common CiPs relating to the key areas of overlap between medical and clinical oncology. Clinical Oncology and Medical Oncology are the two main medical specialities that manage patients with non-haematological malignancy. They often work in partnership with each other, and both offer systemic therapy to patients, but only clinical oncologists administer radiotherapy and there are other differences in work-pattern, approach and focus. During OCS training, trainees will gain knowledge of radiotherapy planning and delivery. This will enable them to coordinate the care of cancer patients with the wider multidisciplinary team (MDT), managing patients throughout a treatment pathway. The new curricular structure of the OCS means that trainees who successfully complete the training year will have gained the necessary competencies to progress to ST4 in either clinical or medical oncology. For oncologists wishing to pursue clinical oncology, the first exam in the Fellowship of the Royal College of Radiologists assessment series, First FRCR (Oncology) (Part 1/ CO1), must be passed by the end of ST4. Candidates do not need to have held a clinical oncology training post to attempt the exam however, so candidates are eligible to sit the exam during ST3. Click here to learn more about the full FRCR (Oncology) examination suite. Clinical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST7) Once trainees have completed the OCS, they will then move onto a subsequent higher specialty-specific programme of their choice I.e. clinical oncology. This programme lasts for four years and takes place from ST4 to ST7, the focus here being to acquire clinical oncology specific CiPs, culminating in trainees’ achievement of Fellowship of the Royal College of Radiologists (FRCR Oncology). The higher specialty-specific programme for clinical oncologists is administered by the Royal College of Radiologists, so the Medical Oncology SCE is not a requirement for clinical oncologists. Trainees will then sit the Final FRCR (Oncology) Part 2A and 2B exams (CO2A and CO2B), usually from ST6 to ST7. This is to assess their knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer. Completion of the Clinical Oncology Specialty Training Programme Upon completion of the clinical oncology training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Clinical Oncology. This will be based on high-level learning outcomes – capabilities in practice (CiPs) set out in the curriculum by the Royal College. You can find the 2021 curriculum here. At this point, clinical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register for clinical oncology and can now take permanent consultant posts in the NHS. Specialist Registration for overseas doctors Doctors who completed part or all of their clinical or radiation oncology training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here. Joining the Clinical Oncology Specialty Training Programme as an IMG It is possible for overseas doctors to join the Specialty Training programme in Clinical Oncology in the UK, however it is very competitive. IMGs interested in UK specialty training must have: Full GMC registration Completion of a minimum 12-month (FY1 equivalent) internship English language test PLAB or a recognised European Medical Degree AND 12 months post-internship experience by the time you start begin ST1 Please note, whilst UK trainees are not given priority for specialty training spaces, it can be extremely difficult to join the Specialty Training programme if you do not have previous NHS experience. So there you have it, the NHS Specialty Training pathway for clinical oncology trainees. The training programme forms the basis of clinical oncology training in the UK, and for overseas clinical or radiation oncologists interested in joining the training programme, good knowledge of the pathway allows you to better understand the alignment of your overseas training with the relevant stage of Specialty Training for clinical oncology in the UK. For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below:
Here we take a closer look at the Medical Training Initiative (MTI), a placement scheme for more junior overseas doctors to come to the UK to receive training and development within the NHS. To be eligible for an MTI post, certain criteria must be met. These are summarised below along with a broad look the following: What is the Medical Training Initiative? What training will I receive through the MTI? Am I eligible for an MTI post? What does the application process for the MTI involve? What are the advantages and disadvantages of the MTI? Do I need a visa for the MTI? How can I use the MTI for GMC registration? How much will I be paid throughout the MTI? What is the full process for MTI? I’ve completed the MTI, what’s next? Skip ahead to the relevant section if you know what you’re looking for. The Medical Training Initiative The Medical Training Initiative, or MTI, is a training programme that provides junior doctors from all over the world the opportunity to gain clinical training and development in the UK for a maximum of 24 months. The MTI as a training scheme is mutually beneficial for both junior doctors and the NHS, in that doctors from several countries and specialisms around the world can work and train in the UK, gaining knowledge and experience which they can take back to their home country, while giving NHS Trusts a high-quality, longer-term alternative for unfilled training vacancies and rota gaps. Training The training provided through the MTI scheme will vary between programmes; however, it will typically follow the CCT curriculum (Certificate of Completion of Training). The level of training will be highly dependent on the doctor’s interests, competence and the training available within the placement hospital. At the beginning of each placement, doctors are allocated an Educational Supervisor who will help to set the doctor’s specific training objectives to meet over the 24 months of the placement. Eligibility The MTI has been designed specifically with junior doctors in mind, therefore sponsorship will not be offered to consultants, specialty doctors or for locum-appointed service posts (LAS). The criteria also differ among MTI programmes, so eligibility criteria should be checked directly with the Royal College before applying. However, the general elements of eligibility include the following: Country requirements - priority is given to doctors from countries classified as low income or lower middle income by the World Bank. Doctors from outside of these countries may also apply, but there may be a long wait time and no guarantee of acceptance. Evidence of skills and knowledge – the requirements for evidence of skills and knowledge vary based on the MTI programme, but the potential requirements for evidence of skills and knowledge include: PLAB exams Part 1 of relevant Royal College exam e.g. MRCP Specialist qualifications from your home country Evidence of English language skills - almost all MTI programs accept what test is approved by the GMC, meaning either of the IELTS or OET can be used for MTI. Sufficient clinical experience - most MTI programmes will require a minimum of three years' experience, including one year of internship and one year in the relevant specialty. Active medical practice - candidates must have been actively practicing clinically for at least three out of the last five years including the past 12 months before the application as well as throughout the application process. The Application Process There are two ways to join the MTI programme: Apply for an MTI-match programme – certain specialisms have programmes which match doctors to a job. For these, you apply for the relevant programme, providing the necessary documentation. If your application is successful, you will be allocated a suitable job, which can take up to 12 months. Find an NHS job before applying for the MTI – in cases where specialties do not have an established match programme, candidates are required to apply directly for an NHS post. Once the candidate has been accepted for the role, they can then apply for the MTI scheme through the relevant Royal College. If you would like to know more about finding NHS posts for the MTI scheme, you can get in touch with us here. Specialties may use either, or a combination of these two methods, so we suggest visiting the Royal College and searching for their information on the MTI scheme. The availability of MTI posts will vary between each Royal College, as certain specialties are more consultant-led, meaning there are fewer training posts for junior doctors. Once again, we suggest finding out more from the relevant Royal College. Advantages and Disadvantages of the MTI Scheme Advantages Training – MTI doctors will receive training and development support in their clinical, communication and leadership skills, as well as supervision by a consultant. You will also have the opportunity to create a training plan with the support of an Educational Supervisor. Reduced cost – for posts that accept specialist qualifications from the applicant’s home country, the associated costs are lower as you will not have to pay for the PLAB or Royal College exams which can be costly, especially where retakes are needed Alternative to PLAB and the Royal College – As some posts accept a candidate’s specialist qualifications from overseas, this allows you to bypass the Royal College and PLAB exams (N.B. if you have passed both parts of PLAB or ever failed either of the exams, you are not eligible for MTI) Diploma of UK Medical Practice - If you complete an MTI post that is at least 12 months long, with the Royal College of Physicians (RCP) or the Royal College of Paediatrics and Child Health (RCPCH), you can apply for the DipUKMP, a professional diploma which can be used as part of the portfolio of evidence required for specialist registration (CESR or CESR-CP). Disadvantages Not all posts are paid - Some MTI posts require you to secure funding for your training, for example through scholarships or funding from an organisation in your home country, such as a government agency or university (N.B. personal funds cannot be used). Junior posts – More senior doctors wanting to take this route to the UK will receive a lower salary and more junior role than if taking the postgraduate route. British citizenship or ILR - For doctors who wish to make a permanent move to the UK, the 12-24 months spent in the UK on the MTI scheme will not count towards the 5-year requirement for British citizenship or indefinite leave to remain (ILR). Return to home country – at the end of the 24-month period, MTI doctors are legally required to leave the UK and return to their home country. MTI Posts Offer Tier 5 Visas MTI candidates require a Tier 5 visa to travel to the UK. Applications for the visa can only be made after receiving the Certificate of Sponsorship. Applications for Tier 5 visas must be made from your home country (or the country you work in), but never from the UK. The visa must only be used for travel to the UK at the beginning of the placement and will activate after your arrival, lasting for exactly two years from your arrival date. Please note that Tier 5 visas cannot be extended. GMC Registration All doctors practicing in the UK MUST be registered with the GMC. For MTI candidates, registration is typically supported by the Royal College, but some NHS Trusts also have the right to register MTI doctors. English Language Testing As always with GMC registration, candidates will also need to provide evidence of English language skills. This can be done by passing either the IELTS (International English Language Testing System) or the OET (OET – Occupational English Test). Detailed guides to these tests can be found below: IELTS – a guide for overseas doctors OET – a guide for overseas doctors Pay Received for MTI Posts MTI posts are either paid, or candidates are required to secure funding for their placement as detailed above. Where the placements are paid, the salary received by the MTI doctor corresponds to trainees at a similar level in the UK. All trainees can expect to commence their MTI training at an equivalent salary to ST3 level. Some hospitals may take prior international experience into account while others do not. This is at the discretion of the hospital and not the Royal College. Hospitals can also decide whether to employ MTI doctors under the 2002 or 2016 junior doctor contract, which have slightly different pay scales. Therefore, it's best to verify as early as possible where your placement will be paid, whether your prior experience will be taken into account, and under what pay scale you will be paid. Steps through MTI We’ve detailed the general processes involved in MTI below, from a candidate’s initial application for a post, to their final interview with the Royal College after gaining GMC registration: I’ve completed the MTI, what’s next? Ordinarily, on completion of the MTI scheme, doctors return to their home country with the training and experience they gained from working in the NHS. Some doctors may want to remain in the UK after completing the MTI for a number of reasons. This can be done if the doctor finds another NHS post, in which case, they may be able to switch from the Tier 5 visa to the Tier 2 Health and Care Worker visa. For more information on the Health and Care Worker Visa, please see here. If you want to find another NHS post after completing the MTI, applying for your first NHS job follows the same process as any other doctor. You will need to consider what job it is you would like to obtain and what location in the UK you would prefer to relocate to. For guidance on jobs in your specialty in the UK, please see our IMG Resources library. Once you are ready to start the application process you can get in touch with us – IMG Connect can offer you expert advice and representation throughout the recruitment and relocation process. For regular news and updates on the Royal Colleges, GMC registration and working in the NHS, follow us on social media and join the conversation below:
One of the main reasons that overseas doctors want to work in the Emergency Medicine departments across the UK, is the excellent opportunity for access to training such as the Specialist Training Programme, career progression, including CESR, and sub-specialty development. This short article provides useful information on the training and development available, how to access the training, the best route to becoming a consultant in the UK with entry to the specialist register, no matter what stage of your training. Emergency Medicine Training, leading to CCT We start with an overview of the Emergency Medicine Training in the NHS. Trainees may enter the emergency medicine training programme via: The EM (Emergency Medicine) core training programme at ST1. This is a three-year core training programme (starting from ST1 and ending at ST3). For the first two years, trainees will spend 6 months in EM, Intensive Care Medicine, Anaesthetics and Acute Medicine. This is followed by a further year in trauma and paediatric EM. The start of specialty training (ST4-6) subject to having achieved the necessary competences required for completion of ST3. Once ST6 is completed, then a doctor will be added to the specialist register for medicine and hold the title of CCT. This means that they can apply for and practice at a consultant level in the NHS. CESR For senior Emergency Medicine doctors (experienced specialty doctors, consultants and heads of departments) there is also the option of CESR. You can apply directly for CESR from overseas, or secure a post in the NHS with CESR support and complete your application in the UK. This is a good option for those wanting to take up their first role in the NHS as a speciality doctor (leading to consultant) or as a locum consultant. Applying from abroad can be lengthy, and it is certainly not the quickest route towards specialist registration. Most IMGs prefer to secure a post with CESR support, so speak to your IMG Consultant to learn more about the best route to the UK for senior doctors seeking consultant jobs in Emergency Medicine. Most senior Emergency Medicine job vacancies advertised will offer support with CESR, access to training and career progression, and senior managers will encourage you to develop your own professional interests. Emergency medicine departments in the NHS are particularly supportive of doctors seeking to develop both personally and professionally. To find out what jobs are on offer take a look here. If you think that a Specialty Doctor post with CESR support is suited to you, or if you are a consultant or head of department, then you can find out more information here. For further advice on how to secure the right job for you in the NHS, take a look at our the following article. IMG Jobs Search and find live emergency medicine NHS doctor jobs in the UK IMG Resources Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to see what Emergency Medicine job opportunities there are for you, including access to CESR support, Core and Specialty training.
The NHS offers extensive training schemes and career development for all of its doctors, and such programmes are recognised as a gold standard across the medical world. Training in the NHS is always in keeping with advances in medical sciences and the progressive landscape of the medical profession, including the more complex ailments of a growing and ageing population. The NHS frequently updates and develops its training programmes, making them attractive to UK graduates and doctors, as well as overseas doctors seeking the very best training. In this article we will cover the following topics: Why is it important for IMGs to understand the NHS Training Pathway? The NHS Training Pathway From Graduation to Foundation Training Specialty Training Programmes Different types of Specialty Training programmes Uncoupled specialty training programmes Run-through Training Programmes Completion of Specialty Training Programme Should I apply for a training or service post? As an IMG can I get onto the specialist register? How do I secure a service post? With the view to securing training at a later date. Why is it important for IMGs to understand the NHS Training Pathway? Most IMGs looking to move to the UK will be keen to enter into UK Specialty Training at some point, and as such it is important to understand the UK training pathway from start to finish in order to map your NHS career effectively. Furthermore, greater understanding of the NHS structure and training offered to doctors in the UK will help an IMG to understand at what grade they can likely enter the system. The NHS Training Pathway The NHS Training Pathway is the term given to the journey from medical school to completion of GP or specialist training and is the path most commonly followed by UK trainees. From Graduation to Foundation Training Upon graduation from a medical school, doctors gain provisional registration with the GMC allowing them to enter the Foundation Programme - a two-year work-based training programme. Upon completion of the first year (FY1) doctors will gain full registration with the GMC and can apply for further study and training in a specialised area – known as Specialty Training. Specialty Training Programmes Completion of the Foundation Programme allows doctors to apply for Specialty Training in an area of medicine or general practice. There are 60 different specialties to choose from. A doctor entering year one of Specialty Training is known as an ST1 doctor. Specialty Training programmes can take between three and eight years depending on the specialism chosen. Doctors can pass through the training quicker depending on how fast they achieve their competencies. However, rarely do doctors complete the training pathways in the indicated time for a variety of reasons. On average the training takes between 1 - 4 years longer than indicated in the curricula. Different types of Specialty Training Programmes There are a number of different types of Specialty Training programmes, which are different for each specialty. Uncoupled Specialty Training Programmes These programmes split into Core Training and Higher Specialty Training. Core Training lasts for either two or three years and once complete, allows you to apply for Higher Specialty Training, which can take between 3 – 5 years. Overall, Specialty Training programmes can take between 5 – 8 years in their entirety, depending on your medical specialty. Doctors will be known as ST1-3 during their Core Training and ST4-6/7/8 level during Higher Specialty Training programmes. Higher Specialty Training programmes are very competitive, and completion of Core Training does not guarantee a Higher Specialty Training post. It is worth noting that in August 2019 the core medical training programme will be replaced by the Internal Medicine Training Programme, described as ‘a new training model designed to equip doctors with skills and confidence to lead on the care of patients in general ward and acute care settings’. Run-through Training Programmes For these training programmes you only have to apply once, at the beginning of the programme, as you are recruited for the full duration of Specialty Training. They can last from approximately three years for general practice, to five or seven for other specialties. Completion of Specialty Training Programme Upon successful completion of either a run-through or coupled training programme doctors are awarded a Certificate of Completion of Training (CCT). At this point doctors are entered onto the specialist register (or GP Register) and are recognised as a consultant. Should I apply for a training or service post? As above, competition for places on training posts within the NHS is highly competitive. As such for IMGs interested in securing a place on a training post in the NHS, we advise that IMGs obtain a service post for 1 – 2 years. Following this contract you can apply for a training post, for which you will be given priority. Not only will this approach give you the best chance of securing excellent training and career progression opportunities in the NHS, it will also give you the chance to settle in to the UK, get to know your trust better, and help you understand the training post that will suit you the most. Service posts also offer very competitive rates, so whilst you are getting to know the NHS and settling into life in the UK, you can also ensure that you are financially rewarded. As an IMG can I get onto the specialist register? IMGs that enter the UK training programmes later on and have not completed the full programme can still get on the specialist register via the CESR route (Certificate of Eligibility for Specialist Registration) Check to see if you're eligible via the GMC website or read through our overview on CESR and eligibility for CESR. How do I secure work as a trust doctor? With the view to securing a training post at a later date. You can apply for Trust doctor or service roles online via the NHS Jobs website. However, working with IMG Connect can offer more jobs than are available online with the added benefit of an IMG Consultant speaking directly with services on your behalf to expedite the process and negotiate the best doctor salary for you. IMG Jobs Search and find live NHS doctor jobs in the UK IMG Resources Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more! Get in Touch Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.
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