Recognised qualifications, endless potential
For European-qualified anatomical pathologists, transitioning to the NHS is now smoother than ever. Recognition of specialist qualifications from EEA countries means that most anatomical pathologists can register with the GMC and work as histopathology consultants in the UK. However, it’s not just about recognition; understanding the NHS’s unique approach to pathology can make a significant difference for those making the move.
This series explores the evolution of NHS pathology services, beginning with the Carter Review, which catalysed key changes in UK histopathology. We’ll dive into the practical impact on subspecialisation, digital pathology, and NHS networks, mapping how these changes could shape your NHS experience.
The Carter Review - a catalyst for modernising NHS pathology
In 2008, the UK government commissioned the Carter Review, a significant report aimed at transforming pathology services in the NHS. Led by Lord Carter of Coles, the review highlighted areas for improvement, pushing for efficient, cost-effective, and patient-centred pathology services. For European pathologists joining the NHS, understanding these reforms provides valuable context for today’s NHS setup.
Here’s a look at the key reforms and why they matter:
Centralisation of Pathology Services - centralising pathology services into regional labs, instead of maintaining many smaller units, was one of the Carter Review's foundational recommendations. This shift aimed to reduce duplicate work, improve quality control, and facilitate better investment in advanced equipment for enhanced diagnostic capabilities.
Emphasis on Digital Pathology - digital pathology was a major focus and something most pathologists get excited about! Digital platforms streamline histopathology workflows, enabling faster reporting, reducing storage needs, and allowing for easier peer reviews. The UK is currently one of the most digitally developed pathology systems in Europe—a potential game-changer for those accustomed to more traditional setups.
Standardised Processes and Reporting - the Carter Review recommended standardised protocols to ensure uniformity across NHS services. With a more consistent approach to diagnostics, patients receive equitable care, regardless of which hospital they attend, and what laboratory their biopsy gets sent to. This also aligns with the Royal College’s points-based system which is designed to support system-wide adoption of best practices. You can read more about the RCPath Points based-system here.
Optimising Workforce Efficiency - the review recognized the importance of a balanced, efficient workforce, advocating for an increased role for biomedical scientists (BMS) to relieve histopathologists, allowing them to focus on complex cases. This support system is crucial in reducing diagnostic backlogs and improving patient outcomes.
Building Clinical Networks for Subspecialisation - recognising the benefits of subspecialisation, the review encouraged collaboration across clinical networks. With centralised hubs, referrals to subspecialist pathologists are more efficient, improving access to expert diagnostics, especially for rare or complex cases.
The Modern NHS - so what can a European (EEA) pathologist expect?
In the years following the Carter Review, the NHS has made strides toward a more digital, centralised, and specialised pathology landscape. While some regions are more advanced in implementing these changes, the NHS’s commitment to modernisation is clear. For European pathologists, this means:
A digitalised workspace - NHS laboratories now offer state-of-the-art digital infrastructure, providing opportunities for remote working, enhanced workflows, and digital archiving.
Opportunities for subspecialisation - pathologists can increasingly specialise in one, two, or three specific organ systems or pathology subspecialties, supported by an efficient referral network not just in their laboratory, but in their regional (and national) network.
Job security and flexible working conditions - with high demand and ongoing recruitment needs, NHS consultants enjoy secure employment with the flexibility to work from home as digital systems continue to advance.
Competitive compensation - recent updates to NHS consultant pay scales have increased earning potential, making the NHS an attractive option for European-trained histopathologists. Here you can find the NHS pay circulars, and here we discuss their comparison with other European healthcare systems, focusing on the consultant pay in particular. With pay in the NHS now far higher than many other European countries, its a great moment to take that step upwards into the NHS and UK pathology sector.
Joining the Digital NHS Landscape
If you’re a European pathologist interested in joining the NHS, now is the time to explore your options. The UK welcomes EEA-qualified pathologists to contribute to a healthcare system embracing innovation and collaboration. If you're curious about GMC registration or how your experience could translate to NHS practice, reach out to IMG Connect to discover how you can step into a modernised, supportive, and specialised NHS environment. Alternatively, you can read through our Route to the UK blog for Pathologists blog published on our IMG Library.
Whether you’re ready to make the move or just starting to explore the possibilities, the NHS offers a promising, high salaried, digitally integrated, and patient-centred future for European-trained anatomical pathologists
The NHS pension scheme (2015) is a defined benefit pension plan, which means it guarantees a certain level of retirement income based on your salary and length of service.
It is considered one of the best pension schemes in the UK, offering long-term financial security and peace of mind for healthcare professionals, including doctors, consultants, nurses, and other NHS staff.
The 2015 Scheme is a Career Average Revalued Earnings (CARE) scheme. This is a form of defined benefit pension scheme, which means you get a guaranteed level of benefit at retirement payable according to a fixed formula. Pension benefits for all members are calculated using the same method and revaluation rate.
Key Features of the NHS Pension Scheme:
Employer Contributions: The NHS contributes a significant portion to your pension, making it a valuable part of your overall compensation package.
Lump-Sum Option: Upon retirement, you can choose to take part of your pension as a lump sum, which is tax-free up to a certain limit.
How Is the NHS Pension Calculated?
The way your NHS pension is calculated depends on which section of the NHS pension scheme you are a part of. There are three main sections:
The amount of pension you earn each year is determined by what is known as the ‘build-up rate’ which is usually shown as a fraction of your pensionable earnings. In this Scheme the build-up rate is 1/54th, so you earn a pension each year of 1/54th of your pensionable earnings.
For example, if you earn £18,000 in a year you would earn a pension for that year of 1/54th of £18,000, which is £333 (rounded down for illustration purposes only). This is the pension you would build up for that year
Your pension earned each year will be increased each year by a rate, known as ‘revaluation’, in the period before you retire or leave. In this Scheme the revaluation rate is determined by Treasury Orders plus 1.5% each year. Treasury Orders are the method by which the Treasury notifies the value of the change to be applied as part of revaluation
2015 Scheme (Career Average Revalued Earnings or CARE Scheme)
This scheme calculates your pension based on your average earnings throughout your NHS career rather than your final salary.
Each year, a portion of your salary is added to your pension pot, and it’s revalued with inflation annually.
Formula: Pension = (Annual earnings x Accrual rate) + Previous years’ pension
Example: If you earn £60,000 in a year and the accrual rate is 1/54, then:
£60,000 ÷ 54 = £1,111 added to your pension pot for that year.
Retirement Age and Pension Benefits
In the 2015 scheme, it aligns with your state pension age or the age of 65.
You can continue to build up pension rights in this Scheme until age 75 with no limit to the number of years’ pensionable earnings that can be taken into account.
This Scheme offers flexibility around retirement and you can choose to take part or all of your benefits between ages 55 and 75.
International doctors who work in the NHS will typically be placed in the 2015 scheme, although transfers from previous overseas pension schemes may be possible.
Costs and contributions
The cost of providing the NHS Pension Scheme is shared between members and employers. As a member you pay a contribution towards your pension based upon your pensionable earnings; the more you earn, the higher your contribution rate may be. Employers pay the rest.
Additional Benefits of the NHS Pension Scheme
Death in Service Benefits: Should something happen to you while working for the NHS, your dependents could receive a lump sum and a pension.
Ill-Health Retirement: If you are unable to work due to illness, the NHS pension scheme offers an early retirement option with pension benefits.
Employer Contributions: The NHS will contribute up to 23.7% of your pensionable pay, which is a significant boost to your retirement savings.
Reduce the amount of tax you pay: Pension contributions are taken from your pay before tax so you receive tax relief on any amount you pay. This can reduce the net amount that you pay depending on your contribution rate, earnings level and personal rate of tax
Why the NHS Pension Scheme Is Attractive to International Doctors
Financial Security: As an international doctor, securing a long-term financial future is essential. The NHS pension scheme ensures a stable income upon retirement, allowing you to focus on your career and patients.
Higher Employer Contributions: Few employers in the UK contribute as much as the NHS does toward pensions, making this a valuable benefit for those seeking NHS jobs.
Guaranteed Benefits: Unlike many private pension schemes, the NHS pension is guaranteed. You will know exactly what to expect at retirement, regardless of market fluctuations.
Work-Life Balance: NHS jobs come with excellent work-life balance, and the pension scheme is an added benefit to ensure your retirement is equally fulfilling.
The NHS pension scheme is one of the best retirement options available for medical professionals in the UK, offering a defined benefit plan that guarantees financial security. For international doctors interested in NHS jobs, this pension scheme is a huge perk.
Whether you are planning to work as a consultant or a junior doctor, the NHS ensures your retirement will be taken care of.
If you are considering a medical career in the UK, the NHS pension scheme is just one of the many reasons why the UK remains a top choice for international doctors.
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salaries in the UK, relocation and much more!
As an IMG looking to join the NHS, you might be wondering, "Where can I find NHS jobs?" The answer is straightforward: NHS Jobs is the official website where most medical roles within the NHS are advertised. It's your go-to platform for seeking employment across various hospitals and trusts in the UK, whether you're a junior doctor, consultant, or specialist (SAS).
Navigating the NHS Job Application Process
Register for an Account
Start by creating a profile on NHS Jobs. Provide your personal details, professional qualifications, and career history.
Search for Jobs
Utilize the search tool to find jobs that match your specialty and experience. You can filter results by grade, salary, and contract type.
Draft Your Application
Once you identify a suitable role, prepare your application. Highlight your medical training, employment history, and qualifications to align with the job requirements.
Submit Your Application
After finalising your application, submit it through the NHS Jobs website. Be ready to include necessary documentation, such as proof of GMC registration and references.
While this process may seem straightforward, it can be quite complex for international doctors unfamiliar with the UK medical recruitment system. This is where IMG Connect can significantly enhance your experience.
Why Choose IMG Connect?
Working with a specialised recruitment agency offers several advantages for international doctors:
Personalised Support and CV Writing
We assist you in crafting a compelling CV tailored to NHS standards, ensuring that your qualifications and experience are effectively presented.
Comprehensive Job Application Assistance
Our team guides you through every step of the application process, ensuring you submit a complete and competitive application.
Interview Preparation
We help you prepare for interviews, providing insights on what to expect and how to excel.
Visa and GMC Registration Support
Navigating visa applications and GMC registration can be daunting. We offer extensive support to simplify this process, ensuring all your legal documents are in order.
Relocation Assistance
Our relocation specialist, Anastasia, helps you find the right job location, arranges flights, and assists with accommodation and settling in.
Salary Negotiation
We advocate on your behalf to secure the best possible salary and employment package, reflecting your experience and qualifications.
Ongoing Support After Relocation
Even after you’ve started your role in the NHS, we continue to provide support, helping you navigate any challenges as you settle into your new life in the UK.
Which Option is Best?
While applying directly through the NHS Jobs website is a viable option, working with IMG Connect offers a smoother, more personalized experience. We take into account every aspect of your journey—from applying for your first NHS role to settling into life in the UK—maximizing your chances of success.
Start Your NHS Journey Today
Whether you choose to apply directly or with the support of a recruitment agency, the NHS Jobs website is an excellent starting point. For a simplified process and enhanced support in securing your dream role, contact IMG Connect today. We’re here to assist you every step of the way in your journey to becoming a doctor in the UK!
As an overseas doctor looking to work in the UK, it is essential to understand the salary that comes along with your NHS job and how this can be different from one country in the UK to another.
Whilst the NHS has guides that are used to fairly and uniformly determine consultant pay, these do differ across the UK.
Basic Pay
Consultants in England and the other home countries each have their own consultant contracts in place. These are based on a full-time work commitment of 10 programmed activities (PAs) per week, each having a time-tabled value of four hours.
The basic pay thresholds in England and their equivalents in the rest of the home countries are shown below:
England
Scotland
Wales
Northern Ireland
England
Consultants currently earn a basic rate of between £105,504 and £139,882 in England.
Threshold
Years completed as a consultant
Basic Salary
1
0
£105,504
2
1
£105,504
3
2
£105,504
4
3
£111,714
5
4
£114,894
5
6
7
8
6
9
£126,018
10
11
12
13
7
14
£139,882
15
16
17
18
8
19+
£139,882
The most recent full pay circular for England can be found here.
The National Clinical Impact Award (NCIA) scheme aims to reward consultants who contribute most to the delivery of safe and high-quality care and the improvement of NHS services. You can apply for a new award after you have completed a full year in an eligible role.
Scotland
Consultants currently earn a basic rate of between £96,963 and £128,841 in Scotland.
Threshold
Years completed as a consultant
Basic Salary
1
1 (starting salary)
£96,963
2
2
£99,011
3
3
£101,957
4
4
£104,906
5
5
£107,846
6
7
8
9
6
10
£114,846
11
12
13
14
7
15
£121,846
16
17
18
19
8
20+
£128,841
The most recent full pay circular for Scotland can be found here.
All consultants who have reached point five of the pay scale are eligible for consideration for discretionary points, except for distinction award holders. Consultants granted discretionary points are not normally considered again for two years, although this may vary.
Wales
Consultants currently earn a basic rate of between £100,000 and £146,000 in Wales.
Threshold
Years completed as a consultant
Basic Salary
1
0 (starting salary)
£100,000
2
1
£105,000
3
2
£110,000
4
3
£115,000
5
4
£123,000
6
5
£130,000
7
6
£138,000
8
7
£146,000
The most recent full pay circular for Wales can be found here.
Please note that the pay scale above is for substantive or permanent doctors in Wales.
There is a fixed pay point of £105,401 for locum consultants, which will apply regardless of years of consultant experience.
Commitment awards are available to all consultants after three years’ service at the top of the consultant pay scale, who demonstrate their commitment through satisfactory job plan reviews. They are then eligible at three-yearly intervals, until they have achieved eight award levels.
Northern Ireland
Consultants currently earn a basic rate of between £88,799 and £119,723 in Northern Ireland.
Threshold
Years completed as a consultant
Basic Salary
1
1 (starting salary)
£88,799
2
2
£91,581
3
3
£94,362
4
4
£97,141
5
5
£99,913
6
7
8
9
6
10
£106,520
11
12
13
14
7
15
£113,124
8
16+
£119,723
The most recent full pay circular for Northern Ireland can be found here.
When would I see an increase in my pay?
We are confirming when exactly SAS doctors would see the increase to their pay, but it has been agreed that the uplifts will be backdated to April 2024.
Job Planning and Programmed Activities
As part of your contract, your job plan will be created in partnership with your new NHS employer. This is an annual agreement that sets out your duties, responsibilities and objectives for the length of your contract.
There are four basic categories of contractual work which will be included in your job plan: direct clinical care (DCC), supporting professional activities (SPAs), additional responsibilities and external duties.
There are ways that consultants will be able to earn more than the basic rates above and these can include additional rotas and PAs. This will also be discussed in the creation of your job plan.
For more information on NHS doctor benefits and pay arrangements in the UK, take a look at our IMG Resources library.
For international doctors looking to work in the UK, it is important to understand the salary you will be offered with your NHS job and how this can be different depending on the country you are working in within the UK.
The NHS follow pay guidelines that are used to fairly and uniformly determine consultant pay, however, these do differ across countries in the UK.
What is an SAS doctor?
SAS stands for Staff grade, Associate Specialist, and Specialty Doctor. They will have at least four years of full-time postgraduate training, two of which have been in their relevant specialty.
They are experienced and senior doctors in fixed term or permanent posts (outside a training pathway).
Many SAS doctors have made a positive choice to step into a SAS position from a traditional consultant training pathway. This could be for reasons such as geographical stability or wanting to familiarise themselves with the NHS system before working up to a consultant position.
SAS doctors maintain their skills through the CPD system and there are routes, through gaining CESR (Specialist Registration) or applying for a training post, for SAS doctors to become consultants if they wish to.
Basic Pay
Specialist Grades and Specialty Doctors in England and the other home countries have their own contracts in place for senior doctors. These contracts are based on a full-time work commitment of 10 programmed activities (PAs) per week, each having a time-tabled value of four hours.
The basic pay thresholds in the UK are shown below:
England
Scotland
Wales
Northern Ireland
England
SAS doctors currently earn a basic rate of between £59,175 and £95,400 as Specialty Doctors and from £96,990 to £107,155 as Specialist Grade doctors in England.
Specialty Doctor
Years of experience
Basic Salary
0 (min)
£59,175
1
2
3
£68,174
4
5
6
£75,998
7
8
9
£84,121
10
11
12
£95,400
13
14
15
16
17
Associate Specialist / Specialist Grade
Years of experience
Basic Salary
0 (min)
£96,990
1
2
3
£100,784
4
5
6
£107,155
The most recent full pay circular for England can be found here.
Scotland
SAS doctors currently earn a basic rate of between £47,905 and £89,329 as Specialty Doctors and from £67,163 to £109,259 as Associate Specialists in Scotland.
Specialty Doctor
Years of experience
Basic Salary
0 (min)
£47,905
1
£52,001
2
£57,325
3
£60,179
4
£64,291
Threshold 1
5
£68,387
6
7
£72,574
8
9
£76,764
10
Threshold 2
11
£80,953
12
13
14
£85,141
15
16
17
£89,329
Associate Specialist
Years of experience
Basic Salary
0 (min)
£67,163
1
£72,562
2
£77,959
3
£85,088
4
£91,265
Threshold 1
5
£93,829
6
7
£97,174
8
9
£99,513
10
Threshold 2
11
£102,762
12
13
14
£106,009
15
16
17
£109,259
The most recent full pay circular for Scotland can be found here.
Wales
SAS doctors currently earn a basic rate of between £56,346 and £90,000 as Specialty Doctors and from £91,500 to £101,089 as Specialists in Wales.
Specialty Doctor
Years of experience
Basic Salary
1
£56,346
2
3
4
£64,915
5
6
7
£72,366
8
9
10
£80,099
11
12
13
£90,000
14
15
16
17
18
Specialist
Years of experience
Basic Salary
1
£91,500
2
3
4
£95,079
5
6
7
£101,089
The most recent full pay circular for Wales can be found here.
Northern Ireland
SAS doctors currently earn a basic rate of between £52,530 and £82,400 as Specialty Doctors and from £83,945 to £95,275 as Associate Specialists in Northern Ireland.
Specialty Doctor
Years of experience
Basic Salary
Pay Point
0
£51,000
1
1
2
3
£60,519
2
4
5
6
£67,465
3
7
8
9
£74,675
4
10
11
12
£82,400
5 - top
13
14
15
16
17
Specialist Doctor
Years of experience
Basic Salary
Pay Point
1
£83,945
1
2
3
4
£89,610
2
5
6
7
£95,275
3 (top)
The most recent full pay circular for Northern Ireland can be found here.
Job Planning and Programmed Activities
As part of your contract, your job plan will be created in partnership with your new NHS employer. This is an annual agreement that sets out your duties, responsibilities and objectives for the length of your contract.
There are four basic categories of contractual work which will be included in your job plan: direct clinical care (DCC), supporting professional activities (SPAs), additional responsibilities and external duties.
There are ways that consultants will be able to earn more than the basic rates above and these can include additional rotas and PAs. This will also be discussed in the creation of your job plan.
Getting to grips with the different titles given to doctors in the UK can be difficult, not least because they may differ from those used in other countries and there may be several titles to describe a certain role.
It is important for overseas doctors to have a working knowledge of the different doctor titles in the UK in order to understand how their experience may translate to the UK in terms of seniority of roles as well as the pay they may be entitled to.
In this blog we will be breaking down all the different names given to UK doctors (both in and out of training), clarifying the meaning of these terms to paint a clearer picture of designations in the NHS.
We will cover these titles within the following groups:
Doctors in Training
Doctors in non-Training Jobs
Broad Terms for UK Doctors
Doctors in Training
Doctors in GMC-approved training programmes have designations according to the period and specific year of their training – generally the abbreviation of the training, followed by a number.
Foundation Training
Other Titles / Designations: F1, F2, FY1, FY2, F3+, SHO, Junior Doctor, Trainee
These are doctors in a Foundation Programme, having graduated from medical school. In the UK, this is a 2-year programme equivalent to an internship.
During Year 1 of Foundation Training, doctors are referred to as F1/ FY1 and during Year 2, they are F2/ FY2.
Although Foundation Training lasts two years, doctors who may be unsure of which specialty to pursue may work in non-training jobs before applying to a training post. The naming structure for these roles is the same, depending on the years in their role.
Core Training
Other Titles / Designations: CT1, CT2, CT3, ST1, ST2, ST3, SHO, Junior Doctor, Trainee
These are doctors in Core Training who are at the initial stage of an ‘uncoupled’ training programme. An uncoupled training programme is one in which there is a break in training where doctors are required to apply to higher specialty training upon completion of core training. Core training usually lasts from two to three years.
For ‘run-through’ training programmes, doctors at ST1 would have come from Foundation Training and have automatic entry into higher specialty training through their initial application to ST1.
Specialty Training
Other Titles / Designations: ST3+, StR, SHO, Junior Doctor, Trainee
Higher specialty training generally begins at ST3/ ST4 and can go up to ST9 depending on the specialty.
The curriculum for each specialty will provide the typical training period, however this is indicative (doctors may take longer than this to complete their specialty training for any number of reasons).
SHO
The term SHO stands for Senior House Officer, less commonly known as a House Officer. This is an older term for a very junior doctor, typically equivalent to an F1/ F2, although the term can be used to describe doctors up to CT2 (up to higher specialty training).
Trainee
The term trainee can refer to any doctor in a training programme (generally from CT1 to ST9). These doctors may be referred to as residents in other countries. This can but does not generally include doctors in Foundation Training.
Doctors in non-Training Jobs
Doctors in non-training positions are often given titles which align with their training counterparts, so it’s easier to understand at what level they are practising, but there are no hard and fast rules.
SHO
Other Titles / Designations: Junior Clinical Fellow, Junior Doctor, Middle Grade
As with doctors in training, a non-training SHO would typically be equivalent to an F1/ F2, but it may be more common for a doctor not in training to have this title since an equivalent doctor in training would most likely be referred to as an F1/ F2.
Senior Clinical Fellow
Other Titles / Designations: Junior Doctor
This is a slightly confusing term which is usually for doctors at ST3+ level and generally have not completed a UK training programme. The role of these doctors often includes a combination of research and specialist clinical work.
SAS Doctor
Other Titles / Designations: Senior Doctor, Specialist
SAS stands for Staff grade, Associate Specialist, and Specialty Doctor. These doctors will have at least four years of full-time postgraduate training, two of which have been in their relevant specialty.
They are experienced and senior doctors in fixed term or permanent posts (outside a UK training programme) and can work across primary, community and inpatient care.
Many SAS doctors have made a positive choice to step into a SAS position from a traditional consultant training pathway. This could be for reasons such as geographical stability or wanting to familiarise themselves with the NHS system before working up to a consultant position.
Broader Terms
There are also several terms which may more broadly be used to describe a doctor's level.
Junior Doctor
This term can be used to describe anyone from F1 up to ST9These are qualified doctors in clinical training.
Registrar
Other Titles / Designations: SpR, Junior Doctor, Middle Grade
This is another slightly older term. Registrar or SpR (Specialty Registrars) refers to the main training grade where doctors are undertaking higher specialty training (this is the earliest you can specialise).
It can refer to both trainees and non-trainees and is generally equivalent to ST3 and above (doctors who have completed their foundation training but are still in training in a specialty area of medicine). This term is therefore commonly used to describe more senior trainees and generally aligns with its use overseas.
Senior Doctor
Other Titles / Designations: Specialist Grade, Specialty Doctor, Associate Specialist, GP, Consultant
As ‘junior doctor’ and ‘senior doctor’ are indicative of whether or not a doctor is in training, senior doctors are those able to practise independently – those working as a consultant, SAS doctor or GP.
Consultant
Other Titles / Designations: Senior Doctor
Consultants are senior doctors that have completed full medical training in a specialised area of medicine. They usually work in hospitals or community settings. They have clinical responsibilities and administrative responsibilities in managing SAS and junior doctors.
There are two types of consultants:
Substantive - These are consultant who have been appointed to the Specialist Register for their area of medicine by the GMC. These doctors will either have completed a GMC-approved training programme (CCT) or completed an application for CESR or CESR-CP. You can learn more about Specialist Registration for overseas doctors here.
Locum - These are consultants who are appointed into an equivalent consultant post but are not required to be on the Specialist Register. Locum consultants are unable to take up a permanent position (only fixed term). A locum consultant’s work tends to be more clinical, however there may also be teaching and management responsibilities involved. It is also important to distinguish between two types of locums here: Trust Locums and Agency Locums. As the name suggests, agency locums work with a private agency and will generally receive an hourly wage. Trust locums on the other hand are appointed by the NHS Trust themselves and will be on a fixed-term contract which can be renewed.
GP
GP stands for General Practitioner, and these are doctors who are responsible for the primary care of patients, covering illnesses and ailments across many specialist areas.
GPs are fully trained and are allowed to practice independently without supervision and all qualified GPs are listed on the GMC’s GP Register.
Unlike is often the case in overseas healthcare systems, general practitioners are not synonymous with doctors specialising in general medicine, so a general practitioner overseas may not necessarily have the same title in the UK.
Locum Doctor
These are doctors who are covering a role within a healthcare setting.
All doctors (aside from F1 doctors) can work as locums. Like all practising physicians, locum doctors are fully registered with, and regulated by, the GMC.
Sources
https://www.bma.org.uk/advice-and-support/international-doctors/life-and-work-in-the-uk/toolkit-for-doctors-new-to-the-uk/doctors-titles-explained
Hopefully, this article goes some way to demystify these terms and titles for international doctors interested in working in the UK. For more information including working in the NHS, doctors' benefits and salaries and how to register with the GMC, take a look through our IMG Resources library.
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:
The NHS Training Pathway
Graduation to Foundation Training
Specialty Training Programmes
Different types of Specialty 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?
Skip ahead to the relevant section if you know what you're looking for.
The NHS Training Pathway
Many IMGs looking to move to the UK (particularly more junior doctors) 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 and the salary most appropriate for them.
The NHS Training Pathway describes the journey from medical school to completion of specialist training and is the path most commonly followed by UK trainees.
Graduation to Foundation Training
After graduating 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 or F1) doctors will gain full registration with the GMC and can apply for further study and training in a specialised area – known as Core or Specialty Training, depending on the specialty.
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 or CT1 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.
Sometimes doctors do not complete the training pathways in the indicated time for a variety of reasons and it can take between 1 - 4 years longer than indicated in the curricula.
Types of Specialty Training Programmes
There are two different structures for Specialty Training programmes, and these vary between specialties.
Run-through Training Programmes
For these training programmes, you only have to apply once at the beginning of the programme. This is because you are recruited for the full duration of Specialty Training.
These training programme can last from approximately three years for general practice, to five or seven for other specialties such as histopathology.
Uncoupled Specialty Training Programmes
These programmes are 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 from three to five years.
Overall, Specialty Training programmes can take anywhere from 5 – 8 years in their entirety, depending on your medical specialty, for example 6 years for psychiatry.
Doctors are known as ST1-3 or CT1-3 during their Core Training and ST4+ level during Higher Specialty Training programmes.
Higher Specialty Training programmes are very competitive, and completion of a UK Core Training programme does not guarantee a Higher Specialty Training post.
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 able to make an application for Specialist Registration (or GP Registration) and are able to take up permanent consultant posts.
Training Positions vs Service Posts
As above, competition for places on training programmes within the NHS is very high. As such, we advise that IMGs who are interested in entering core or specialty training in the NHS first 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 and the NHS system, 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.
Specialist Registration for IMGs
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-CP route (Certificate of Eligibility for Specialist Registration via a Combined Programme)
Check to see if you're eligible for CESR-CP via the GMC website or read through our detailed blog through our IMG Resources library.
Secure a Trust Doctor Post (with the view to securing a training post at a later date)
You can apply for Trust Doctor or Service Role 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.
Getting started
Read more useful articles on finding an NHS trust doctor job, training pathways, doctor salaries in the UK, relocation and much more!
Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once as an IMG new to the UK.
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As there is no hard and fast rule for what position you will have after gaining a UK qualification, it is important for IMGs to understand the posts that are available to you after completing FRCR (Oncology).
FRCR (Oncology) is a highly beneficial qualification to achieve, but it does not guarantee you a consultant position in the NHS.
This can be a confusing area for overseas clinical and radiation oncologists, but this blog aims to de-mystify the subject. This article will explain the following topics:
What is FRCR (Oncology) and how does it fit into the UK training programme?
What grade will IMGs, new to the NHS, be offered with FRCR (Oncology)?
Can I take a permanent consultant post if I have FRCR (Oncology)?
CESR opportunities for clinical oncologists in the NHS
Skip ahead to the relevant section if you know what you’re looking for.
FRCR (Oncology) within the UK Oncology Training Programme
Fellowship of the Royal College of Radiologists (Oncology) or FRCR (Oncology) is the postgraduate qualification awarded by the Royal College of Radiologists, the body responsible for the specialties of clinical oncology and clinical radiology throughout the UK.
FRCR (Oncology) is a three-part exam which is a necessary part of the training programme of clinical oncologists in the UK.
For trainees who have chosen to pursue clinical oncology, FRCR (Oncology) Part 1 or CO1 must be passed by the end of ST4.
Clinical oncology trainees will then sit Final FRCR (Oncology), also known as Part 2A and 2B or CO2A and CO2B, usually from ST6 to ST7.
These final exams are important in that they assess a trainee’s knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.
Any UK-trained clinical oncologist applying for a CCT in order to work as a substantive consultant must have completed full FRCR (Oncology).
As shown above, UK trainees will also have completed MRCP (UK), although this is not required for overseas clinical oncologists.
Positions for Doctors new to the NHS with FRCR (Oncology)
As an IMG with full FRCR (Oncology), you will be eligible for consultant grade positions in the UK.
You are not guaranteed a consultant position, particularly if you do not have previous consultant position in your home country, but you will certainly be able to attain more senior positions in the NHS, such as a specialty doctor (SAS) or specialist grade.
Consultant positions are the most senior in the UK, and thus the highest paid position for doctors within the NHS pay system.
For further information on how NHS pay scales work for consultants, please see our detailed article here.
Of course, this is assuming that you have also completed the other necessary components to make you eligible for GMC registration.
Alongside your postgraduate qualification, you will need to have passed an English Language Test (either IELTS or OET).
Additionally, you must obtain a Certificate of Good Standing, and submit this to the GMC. Upon the receipt of these three components, you will receive full GMC registration.
Permanent Consultant Posts with FRCR (Oncology)
To take up a permanent consultant position in the NHS, you would need to have Specialist Registration. Specialist Registration (more specifically CESR for most overseas doctors) allows you to take up permanent or substantive consultant roles in the NHS.
The type of consultant position you would be eligible for with FRCR (Oncology) is a locum consultant post.
Firstly, we should clarify the meaning of the term ‘locum consultant’ in the UK. The NHS has two types of locums - Trust locums and Agency locums.
If you are an IMG with full registration, but you are not on the Specialist Register, you are only able to take on consultant positions as a trust locum, but no permanent positions.
Trust locums are hired on a fixed-term contract and are able to better acclimatize themselves to the NHS system, whilst receiving the support and guidance to work towards consultant positions and CESR.
Please note, you can only work as an agency locum if you have a British passport.
CESR Opportunities in the NHS
CESR or the Certificate of Eligibility for Specialist Registration is a route of entry to the Specialist Register for those doctors who have not followed a GMC-approved training programme.
You can read more about CESR in Clinical Oncology through our IMG Resources library here.
IMG Connect are able to help you to secure senior roles such as specialty doctor (SAS), specialist grade or locum consultant in Trusts that offer CESR support.
In these roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. These Trusts have a lot of experience in supporting overseas doctors to progress their careers through CESR.
You can collect evidence of your competences, particularly those specific to the UK Clinical Oncology curriculum and those you may not be able to achieve outside the UK.
These positions also facilitate a faster route to the UK than applying directly through the CESR route, which can take a substantial amount of time.
Get in touch with us to find out more about senior positions in the NHS with CESR support.
Getting started
We hope this blog has been helpful in clarifying your questions about securing senior posts in the NHS with FRCR (Oncology). If you have any further questions regarding the postgraduate exams, CESR or Oncology in the NHS - feel free to contact us directly.
Join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncologists and dedicated oncology recruiters.
In this group you will find tailored support for oncology IMGs, including access to our NHS and CESR webinars, completely free to all doctors.
You can access our IMG Oncologists community here.
Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.
NHS Hospitals across the UK are offering specialty doctor job plans in Psychiatry with the opportunity for programmed CESR support, giving psychiatrists the chance to quickly work towards Specialist Registration.
For experienced IMGs, this is a new and relatively quick route to your first consultant post in Psychiatry.
By taking up a service level job as an SAS Doctor with CESR support as part of the job plan, many overseas psychiatrists are securing a great start to their career in the NHS that is suited to their senior level experience, whilst taking the time to acclimatize to the NHS and their Trust.
CESR Programmes for Specialty Doctors
By taking such posts in the NHS, you can join diverse, dynamic and inspiring groups of specialty doctors and acting consultants all on the way to achieving Specialist Registration as part of a tailored programme. You can read more about CESR for psychiatrists here.
In offering such job opportunities, Trusts will provide a supportive environment with protected time to fulfill all the requirements of the CESR application in Psychiatry and its sub-specialties, gaining career-enhancing experiences as you do.
Acting up, dedicated peer groups, coaching & mentoring, scheduled learning and study time are some of the benefits that you could receive in one of these roles.
In such roles you will typically receive hands on support from consultant colleagues and exposure to a wide range of experience to specifically aid competency achievement for your CESR application in relation to the Specialty Specific Guidance (SSG) for your sub-specialty.
In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience.
Some Mental Health Trusts will also provide the following as part of their CESR programme:
A number of Supported Professional Activity (SPAs) sessions per week
Tailored experience to your CESR portfolio
Regular clinical supervision
A CESR mentor
Involvement in academic programmes and medical student teaching
Support in gaining research competencies
SAS Tutor support
CESR / SAS support forums and meetings
Finding SAS Roles with CESR Support
If you are an overseas doctor looking for a Specialty Doctor job with the chance to work towards your Certificate of Eligibility for Specialist Registration (CESR) in Psychiatry, speak to the IMG Connect team to discuss if this is a suitable route for you.
We have opportunities across the UK for international psychiatrists to take advantage of the CESR programme.
You can also send your CV to info@imgconnect.co.uk or register here. It takes less than 30 seconds to register!
IMG Jobs
Search and find live Psychiatry jobs in the NHS with CESR support
IMG Resources Library
Browse our library for more useful articles on NHS jobs in psychiatry, salaries for doctors in the UK and postgraduate qualifications for psychiatrists and much more!
Connect with us
Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.
For access to a community of like-minded psychiatry IMGs and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
For overseas doctors, there are several routes you can use to apply for GMC registration in the UK. The route that is right for you, depends on your qualification and experience.
GMC registration is essential for doctors practicing in the NHS, therefore it is important for overseas doctors to determine the most suitable route before securing a role.
This article will help you to identify the appropriate GMC application route for you as an IMG and will give you guidance on the steps you need to take, covering key areas including the following:
What is the GMC?
What do I need for GMC registration?
Routes to GMC registration:
PLAB
Accepted Postgraduate Qualifications / Licensing Exams
Relevant European Qualifications
Sponsorship & MTI
Specialist Registration – CESR, CESR-CP & CEGPR
#IMG Tips
How do I get started?
Please skip ahead to the relevant section if you know what you’re looking for.
The General Medical Council
The GMC is the body in the UK which is responsible for licensing and revalidating every doctor. Therefore, for every doctor practicing in the UK, GMC registration is essential – you cannot practice in the UK without full GMC registration with a license to practise.
The primary responsibility of the General Medical Council is to ‘protect, promote and maintain the health and safety of the public’ in addition to improving medical education and practice across the UK.
Requirements for GMC Registration
Registering with the GMC is a multi-stage process, including key timings, actions and documents. For full GMC registration, international doctors must provide evidence of:
1. (EEA doctors) Sufficient skill and knowledge – as an EEA physician, this would be your recognised EEA qualification.
OR
1. (non-EEA doctors) Sufficient skill and knowledge – as a non-EEA physician, this would either be PLAB, your Royal College postgraduate qualification (e.g. MRCP) or a GMC-approved qualification.
AND
2. English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).
AND
3. Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.
There are several steps involved in the registration process, but these are the three main components required in order to be eligible.
To understand the registration process more fully, read our blog on GMC registration for overseas doctors here.
PLAB
The PLAB exam is a two-part licensing exam that assesses a doctor’s ability to work safely as an SHO in the UK. As such, it does not demonstrate ability in any particular medical specialty.
For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries.
If taking this option, doctors can then take up training or a more senior post once they have established themselves in the NHS. Take a look at our comprehensive guides on PLAB for more information.
Is PLAB suitable for me?
The PLAB route may be suitable for you if:
You have not completed an internship, or your internship does not meet the acceptable pattern OR;
You have completed an acceptable pattern of internship, but have no other clinical postgraduate experience OR;
You are currently in or have completed postgraduate training (residency), and you want a faster route to full GMC registration.
Acceptable Postgraduate Qualifications or Licensing Exams
The GMC has produced a list of postgraduate qualifications which are accepted as sufficient evidence of the necessary knowledge, skills and experience required for full registration.
If these postgraduate qualifications are more than 3 years old when your application is made, you will have to provide further evidence of your recent medical experience.
UK Postgraduate Qualifications
Attaining a Royal College qualification is a preferred path for doctors who have already chosen their field of specialism i.e., pathology.
For senior doctors taking this route, they will gain access to more senior, well-paid jobs in the specialism of their choice.
For example, the Royal College of Physicians is the professional body that regulates all medicine specialties in the UK, and Membership of the Royal College of Physicians (MRCP UK) is the qualification attainable by examination. For overseas doctors, attaining full MRCP (UK) will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior medicine roles in the UK.
Take a look at our complete guides on the Royal Colleges in the UK through our IMG Resources library to understand more.
The full list of UK postgraduate qualifications can be found here.
Overseas Postgraduate Qualifications
There are also some overseas qualifications that meet the same standards as UK postgraduate qualifications, although they are not necessarily the same in every aspect.
You can find the full list of UK and overseas qualifications here.
Licensing Exams
Doctors who have passed an acceptable overseas registration exam can apply for full GMC registration.
You are eligible for to apply via this route if you:
graduated from a medical school outside the UK or Switzerland
and you:
hold an acceptable primary medical qualification
have completed an internship
have passed one of the following overseas registration exams:
United States Medical Licensing Exam (USMLE): Step 1, Step 2 clinical knowledge and Step 2 clinical skills; For Step 2 clinical skills, your pass must be between 16 April 2004 and 13 March 2020.
Medical Council of Canada Qualification Examination 2 (taken in English) on or before 27 October 2020
The Australian Medical Council Clinical Examination on or before 5 March 2020
have passed each part of the exam including the knowledge tests and clinical skills components in four attempts or less. If you sat any part of the exam more than four times before passing, you will not be eligible for this application.
Is the postgraduate/ licensing exam route suitable for me?
The postgraduate route to GMC registration is a popular one and facilitates the attainment of more senior roles in the NHS than for example PLAB (when combined with the relevant experience).
If you have already completed an acceptable postgraduate qualification in your home country, this is the most suitable pathway for you, as you will not have to sit additional exams.
The same goes for acceptable licensing exams, which also exempts overseas physicians from PLAB.
If you have not passed an acceptable overseas postgraduate qualification or licensing exam, you would have to complete the relevant UK postgraduate qualification.
Relevant European Qualification
If you hold a medical qualification awarded in the EEA or Switzerland, it may be classed as a Relevant European Qualification (REQ). You can find out whether your qualification is classed as a REQ by selecting your country through this link. Each country’s page covers the qualifications you would need to send to the GMC to support your application for entry onto the Medical Register, GP and Specialist Registers, and where appropriate, provisional registration with a licence to practice.
Is the REQ route suitable for me?
The Relevant European Qualification route to GMC registration is suitable for you if you hold a specialist certification that is recognised by the GMC. You can verify this through your country’s GMC page here.
Sponsorship & MTI
Some institutions can provide sponsorship for GMC registration. Doctors who receive sponsorship are therefore exempted from PLAB or the need to have an acceptable postgraduate qualification or licensing exam.
MTI
The Medical Training Initiative (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.
Although doctors practicing in the UK must be registered with the GMC, for MTI candidates, registration is typically supported by the Royal College, some NHS Trusts also have the right to register MTI doctors.
You can read more about the MTI scheme here.
Sponsorship
There are several types of sponsorship available to overseas doctors, such as sponsorship offered by NHS Trusts through International Fellowships or sponsorships for specific posts.
If you apply for GMC registration through sponsorship, you’ll have to satisfy the sponsor that you possess the knowledge, skills and experience required for practising as a fully registered medical practitioner in the UK.
Each sponsor may have their own scheme which has been pre-approved by the GMC, and since each scheme differs from the next, we advise that you check the sponsor’s official website and contact them for more information.
A key aspect of all sponsors' criteria is that a doctor applying for GMC sponsorship must have been engaged in medical practice for three out of the last five years including the most recent 12 months. It is important to meet these minimum criteria for the best chance of providing sufficient evidence to support your application.
The complete list of GMC-approved sponsors, including NHS Trusts and Royal Colleges, can be found here.
Is the sponsorship route suitable for me?
MTI is best suited to junior doctors and those who wish to return to their home country after the training period, whereas the criteria for other types of sponsorship can be more varied.
Specialist Registration
The Specialist Register is a register of doctors who can take up substantive consultant (permanent) posts in the UK. All doctors who wish to work as substantive consultant in the UK must show evidence of skills, knowledge, and experience in order to apply for Specialist Registration.
Specialist Registration is additional to full registration with the GMC. You can read more about the types of GMC registration here.
Doctors eligible for Specialist Registration apply directly to the GMC to demonstrate that their specialist training, qualifications, skills, knowledge and experience are equivalent to the requirements for CCT in the UK.
Doctors who have completed their specialist training in the EEA or Switzerland may be eligible for direct entry onto the Specialist Register through their Relevant European Qualification (REQ) and are awarded a CCT after a successful application.
CESR is the route to Specialist Registration for doctors who have not completed a GMC-approved specialty training programme i.e. doctors who have trained outside of the UK, Switzerland, and EEA countries. This is often the preferred route of IMGs.
For an in-depth guide to CESR, look at our blog for overseas doctors here.
Is Specialist Registration suitable for me?
Specialist Registration may be suitable for you if you (at minimum):
1. Hold a specialist qualification in the specialty you’re applying in
OR
2. Have at least six months of continuous specialist training in the specialty you’re applying in
You will have to provide evidence of your eligibility as part of your application, as well as evidence that you meet the requirements of the CCT curriculum in your specialty.
The indicative period of training to be awarded a CCT ranges from 5 years to 9 years in the UK (depending on the specialty), so if you have less training than this, it is unlikely that you will have the full evidence required for a successful application for Specialist Registration.
#IMG Tips
In short, there are routes that depend on qualifications or exams from countries you’ve trained in: licensing exams, acceptable postgraduate qualifications, or REQs; or if you do not hold any of these: MTI, UK postgraduate exams or PLAB.
Use the GMC route finder to double-check you are pursuing a route to registration that you are eligible for.
If your route requires additional exams, begin your preparation for these well in advance and always start with the syllabus or curriculum for your exam!
Read through the GMC’s page on required documents – the necessary documents can change, as the GMC adapts to changes in healthcare and current issues such as the COVID-19 pandemic.
If you’ll be completing exams to register with the GMC, complete these or begin the process before you focus on English language testing – your IELTS or OET only have a 2-year validity period!
Getting started
So, there you have it, the main routes to GMC registration for IMGs. Once you have determined your route to GMC registration, it’s time to either begin gathering the required documents for your application or begin your preparation for any exams you’ll need to sit.
Have you already registered with the GMC, or looking to get started? Get in touch with us here to discuss finding an NHS post.
If you have any other questions, please feel free to get in touch with our team.
For advice, guidance and news and updates for IMGs, join the conversation through the links below.
There are several routes a haematologist can take to register with the GMC and practice in the NHS.
Haematologists looking to secure a job in the NHS must satisfy certain criteria before fully registering with the GMC (General Medical Council) to receive a license to practice. For haematology, these criteria depend on where you received your training, and the qualifications you hold. In this blog, we’ll be giving you a snapshot of the steps you need to take to begin your journey to the UK as an overseas haematologist.
We’ll be covering the following:
Will my training be recognised in the UK?
How do I demonstrate my knowledge and skills as an EEA haematologist?
How do I demonstrate my knowledge and skills as a non-EEA haematologist?
How can I demonstrate my English language skills?
What is a certificate of good standing and how do I get one?
What do I need to register with the GMC?
Will I need a visa to work in the UK?
Skip ahead to the relevant section if you know what you’re looking for.
Recognition of training
For haematologists who trained in an EEA country (all countries inside the EU, also Lichtenstein, Iceland, Switzerland & Norway), there are several options potentially available to you.
Depending on the country and year you completed your residency or basic medical training, the GMC may automatically recognise your qualifications and grant you either General Registration, or Specialist Registration in the UK. To find out if your country’s qualifications will allow you to register for either GMC registration; check the relevant GMC page here.
Knowledge and Skills for EEA Haematologists
Basic Medical Training: If you meet the requirements for basic medical training, you will not need to demonstrate your medical knowledge and skills to work as a doctor in the UK, and would therefore not need to complete a Royal College postgraduate qualification or PLAB to register with a license to practice. You would be granted full registration in this case, without Specialist Registration.
Specialist Training / Residency: If you meet the criteria for entry onto the Specialist Register, then once you have completed the GMC application process, you would be granted Specialist Registration in haematology and can be appointed as a substantive or permanent consultant in the NHS. So as a haematologist, if you hold a Relevant European Specialist qualification, you would be put on the specialist register for haematology and can be appointed as a substantive haematologist in the NHS.
As an EEA haematologist, the main hurdle you will face will be demonstrating that your English skills are of a high enough standard to practice safely as a doctor in the NHS.
Therefore, for European haematologists, this is most likely the easiest route to becoming GMC-registered and being able to practice haematology in the UK.
If you do not meet the GMC requirements for your training to be approved for general or specialist registration, other routes you may consider to GMC registration include PLAB, or (via the postgraduate route) the Royal College exams for haematology (FRCPath). You can find out more about these alternative routes here.
Knowledge and Skills for non-EEA Haematologists
If you qualified as a haematologist outside the EEA, then you will have to demonstrate that both your medical knowledge and skills AND English Language capabilities meet the level required to practice safely in the UK.
Haematologists who have trained from outside the UK and EEA must demonstrate to the GMC they have sufficient knowledge & skills to practice safely in the UK. This can be done through three main routes:
Professional & Linguistics Assessment Board (PLAB): The PLAB exam is a two-part exam that assesses a doctor’s ability to work safely as an SHO in the NHS, as such it does not demonstrate ability in haematology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine. That said, for some senior doctors PLAB can be an attractive option, offering a quicker route to the UK, whilst still securing competitive salaries. If taking this option, haematologists can then take up training or a more senior post once they have established themselves in the NHS. Take a look through our comprehensive guides on PLAB.
Royal College of Pathologists: The Royal College of Pathologists is the professional body that regulates the specialism of haematologists in the UK, and Fellowship of the Royal College of Pathologists (FRCPath) is the full qualification attainable by examination. For overseas doctors, attaining FRCPath will satisfy the knowledge & skill criteria for GMC registration and facilitate application for more senior roles in UK pathology. Take a look at IMG Resources library for a complete guide to FRCPath to learn more.
Please note that only UK trainee haematologists are required to also complete the MRCP (UK) examinations. You can read more about this here.
GMC-recognised or equivalent qualifications: Some overseas qualifications and licensing exams are recognised by the GMC and accepted for registration purposes. This is to say these qualifications or licensing exams are considered as meeting the same standards as the Royal College qualifications.
To find out if your qualification is accepted by the GMC, take a look at our blog: Overseas accepted postgraduate qualifications
English Language Testing
Both EEA and non-EEA haematologists, regardless of experience and country of origin, must demonstrate that they have a sufficient grasp and competence of the English language. 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
Experience in English-speaking countries
For doctors who have at least two years of their most recent experience in an English-speaking country, you can use a reference from your current employer or employers over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.
Certificate of Good Standing
All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.
The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. You can find out which medical regulatory authority to contact via the GMC website here.
If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed.
Please note that each certificate is only valid for three months from the date it's signed and must be valid when we approve your application.
GMC Registration
Once you’ve completed your English language exam, you can now apply for full GMC registration with a license to practice. For registration, you must provide evidence of:
English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years).
AND
Certificate of good standing – the certificate from your medical regulatory authority which demonstrates good standing.
AND
(EEA haematologists) Sufficient skill and knowledge – as an EEA haematologist, this would either be your recognised EEA qualification.
(Non-EEA haematologist) Sufficient skill and knowledge – as a non-EEA haematologist, this would either be PLAB, MRCP or a GMC-approved qualification.
To understand the registration process more fully, read our article on GMC registration for overseas doctors here.
Visas
If you or your family are from the EU, Switzerland, Norway, Iceland or Liechtenstein and started living in the UK by 31 December 2020, you may be able to apply to the free EU Settlement Scheme. Otherwise, you will need to apply for a visa from the Home Office.
A Tier 2 visa is the document given to a skilled worker by the UK Home Office following a job offer from a UK employer with a valid Tier 2 Sponsorship License. The list of valid Tier 2 Sponsors can be found here.
Understand Tier 2 visas and Certificates of Sponsorship in depth by taking a look at our article: Tier 2 Visa application process & documents needed.
Wondering whether you can relocate with your family? Take a look at our blog on the Tier 2 dependent visa below: Tier 2 Dependent visa - Can I bring my family with me to the UK?
So there you have it! Hopefully this clarifies any questions or doubts you may have on your route to the UK as a haematologist planning a career in the NHS. If you have any questions, or wish to know more about the haematology job market then get in touch with our team.
For regular news and updates on all things pathology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
The NHS offers an extensive training scheme and career development for medical oncologists, and the quality of this programme is recognised as a gold standard across the medical community.
The training provided to UK medical 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 medical 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 medical oncology?
What happens after completing the medical 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 Medical Oncology Training Pathway
The NHS training pathway is the name given to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training within i.e. within medical oncology.
It is important for IMGs to understand this as it helps to provide an understanding of at what stage they can most likely enter the system if they are interested in postgraduate training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors with receive provisional registration from the GMC which allows 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 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 Medical Oncology
The Specialty Training programme in Medical 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 Joint Royal Colleges of Physicians Training Board 2021 Medical Oncology Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.
Medical oncology training as an uncoupled programme
As medical oncology is a medicine specialty, aspiring oncology trainees will complete a period of core/ internal medicine training that lasts a period of two years.
This is 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.
Medical oncology higher specialty training will be in total (including OCS) an indicative four-year clinical training programme leading to single accreditation in the specialty. There are no critical progression points during higher specialty medical oncology training, though trainees will be subject to an annual review of progress via the ARCP process and will have to complete all curriculum requirements including passing the medical oncology Specialty Certificate Examination (SCE) 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.
Selection
Here, trainees will either choose to enter into either Internal Medicine Training or into training to become a general practitioner.
Specialty Training (ST1 – ST6+)
Internal Medicine Stage 1 Training (ST1 – ST2)
In this first stage of the Internal Medicine training programme, 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. You can find the Curriculum for Internal Medicine Stage 1 Training here.
This will culminate 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 pass the MRCP examinations prior to beginning Specialty Training in Medical 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.
Medical oncology recruitment into ST4 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. Here, the focus is on a trainee’s development of the common oncology capabilities relating to the key areas of overlap between the two specialties (medical and clinical oncology), as well as continuing to develop the generic capabilities expected of all doctors.
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.
Medical oncologists will have the scientific understanding which underpins radiation-based cancer treatments. During the OCS training year, 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 curricula for medical and clinical oncology have been aligned to reflect this relationship and include aspects of common training that constitute the Oncology Common Stem (OCS), improving transferability and flexibility for trainees who wish to move between the two specialties.
Please note that medical oncology trainees will not be expected to independently plan or deliver radiation-based cancer treatments.
Medical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST6)
Following successful completion of OCS, medical oncology trainees will complete a subsequent higher specialty-specific programme, this takes place from year 4 – 6. The focus here for trainees is on acquiring medical oncology-specific capabilities, alongside consolidation and further development of the common oncology and generic capabilities.
Trainees will then sit the Medical Oncology Specialty Certificate Examination, usually in the penultimate year of higher specialty training. The globally-recognised exam offers medical oncologists a postgraduate qualification which demonstrates achievement of a standard required of UK specialist trainees.
Please note, the medical oncology SCE is a compulsory component of assessment for the achievement of Certificate of Completion of Training (CCT).
To learn more about the medical oncology SCE, read our detailed blog here.
Completion of the Medical Oncology Specialty Training Programme
Upon completion of the medical oncology training programme, the choice is made whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Medical 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, medical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their medical oncology training outside 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 Medical Oncology Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Medical 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
AND
12 months post-internship experience by the time you 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 without prior NHS experience.
So here you have it, the NHS Specialty Training pathway for medical oncology trainees in a nutshell. The training programme forms the basis of medical oncology training in the UK, and for overseas 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 medical oncology in the UK.
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