As a doctor, considering a move from the United States of America to the United Kingdom can be both an exciting and daunting prospect. Our highly dedicated and well-trained consultants at IMG Connect specialise in recruiting and relocating international medical graduates (IMGs) to help ease this transition. The National Health Service (NHS) presents a range of opportunities for consultants and specialists, so throughout this guide we'll delve into the bureaucracy, qualifications and registrations necessary for making this significant career move a seamless success, alongside highlighting the pros of working within a world-renowned healthcare system and discussing the main differences between US healthcare and the NHS.   Why do so many American doctors transition to the NHS? Well, not to brag but... the NHS is a cornerstone of UK society, providing healthcare to millions of residents and visitors. Equally, for its doctors it can offer: Job Satisfaction - whilst working in any public sector, you’re lucky enough to witness the good, the bad and the ugly parts of human nature. Within the NHS, there is a profound sense of pride in patients and professionals alike where it feels uniquely special to be a part of something so uniquely accessible. As a doctor working in the NHS, you will never have to turn away a patient in need and will be able to abide by the Hippocratic Oath without conflict. Read here for some detailed insights from trusted NHS Staff about their experiences. Work-Life Balance - many physicians report more manageable work hours compared to the often-gruelling schedules in the US, promoting a healthier work-life balance. In terms of annual leave, you’ll be given a mandatory 27 days paid annual leave, often around 10+ days of paid study leave and always the flexibility, where possible, to fit your work commitments around your personal or family commitments. Enriched Cultural Experience & Travel - anyone relocating to the UK can see an enriched cultural experience, with opportunities to explore its history, diverse and eclectic cities and its famed countryside, and, if you live in England or Wales you can take a quick train to Scotland and experience its breathtaking natural scenery or explore an ancient castle. It is also no secret that Americans love a city-break in Europe, living in the UK will make that dream a reality. Taking just a  2-3 hour  flight to walk along Amsterdam’s canals, visit a Parisian café or drinking wine al fresco in Rome. Further destinations, like Marrakesh, will take just 4.5 hours before you’re there, soaking in the African sun. Job Security - whilst not particularly unique to the NHS, as one of the largest employers in the world, the NHS provides stable job opportunities with long-term career prospects and can often offer opportunities to not just yourself, but if your spouse is looking for a role too, they’ll often be a position in the local NHS trust that they can apply for! Professional Growth - the NHS prioritises ongoing education and professional development, allowing doctors to enhance their skills throughout their careers. If you’re looking to continue developing your specialisation whilst in the UK, you won’t be short on opportunities. Diversity in Practice - the NHS serves a broad demographic, enabling doctors to gain experience in treating a wide range of conditions with diverse patient populations. Equally, the nature of free and assessable healthcare allows for the entire population to be treated, regardless of their socio-economic status or stability of income. We will see many doctors, moving from the US to the UK, seeking to provide non-discriminatory quality of care.   What are the key differences between US healthcare and the NHS? At IMG Connect, we want you to be as secure and prepared as possible when making any major decisions, so understanding the differences between the US healthcare system and the NHS will help you plan for you big move in the best possible way. Here are some of the main distinctions we think are key to preparing for your new role in the UK: Funding and Access - the NHS is primarily funded through taxation, providing universal access to healthcare services for all residents. Patients do not receive bills for most services, which can alleviate the financial burden often associated with medical care in the US, where it is largely insurance-based, with a mix of private and public funding. Care Delivery Model - the NHS emphasises primary care as the cornerstone of its healthcare delivery system. General practitioners (GPs) serve as the first point of contact for patients, coordinating referrals to specialists as necessary. This system fosters continuity of care and a more integrated approach, with the stated aim of treating patients through primary and community care before they end up in hospital which costs the NHS a significant amount more in money and resources. Administrative Complexity - While the NHS has its own set of complexities, it generally features a more streamlined administrative process compared to the US. The goal is to minimise bureaucracy and focus on patient care, further benefitting the population’s health and stability. Focus on Preventive Care - the NHS places a strong emphasis on preventive care and public health initiatives, striving to keep populations healthy and reduce the burden of chronic diseases. This focus is integrated into primary care practices. Work Environment and Culture - working in the NHS often involves a collaborative team approach, where multidisciplinary teams play a crucial role in patient care. This environment can foster camaraderie and support among healthcare professionals.   Common US qualifications and their recognition in the UK Whilst the UK widened its acceptance of overseas qualifications in recent years, the honest truth is that many USA-trained doctors will not have qualifications that are automatically recognised by thew GMC, the UK’s regulatory body. Anyone with USMLE that was completed prior to 2004 (roughly speaking) and after March 2019 (when the pandemic started) will not have sat the Step 2 Clinical Skills (CS), and without this important component, no USMLE qualifications will be accepted by the GMC. Step 3 is not accepted, neither is the Step 2 CSA. There is unfortunately, no bending on this whatsoever from the GMC. Beyond the USMLE, generally speaking only those holding board certification in radiology and anaesthesiology can register fairly easily with the GMC, and beyond that it is treated on a case-by-case basis. The list of GMC recognised postgraduate qualifications is always changing however, so check their website here to see if yours is on their accepted list. If you’ve not got any qualifications that are accepted, then you’ll likely need to pass either the PLAB exams or submit a portfolio for specialist registration (the CESR route as its commonly known). You can read more about PLAB here and CESR / The Portfolio Pathway here.   7 Top Tips for American-trained doctors moving to the UK! Navigating the organisation of paperwork and various application processes can feel overwhelming, but we are here to support you. Here’s a step-by-step breakdown of what to expect: 1. Understand & be comfortable with the salary difference. Consider what your earnings from working full-time in the NHS will look like in relation to your living expenses. There is no sugar coating it that you’ll earn less with an NHS post as your main point of income. It is always possible to seek out ways to boost your earnings through locum or private work in the UK, it is also crucial to know the boundaries and limitations you would face if balancing NHS work with private work, especially for consultants. Read more here to understand the dos and don’ts. If salary and higher tax is a real sticking point but you’re still keen on the move, speak to one of our team about job opportunities in Ireland and the Channel Islands. 2. Check your GMC eligibility early! To practice as a doctor in the UK, you need to be registered with the General Medical Council (GMC). This process involves several steps, and it’s essential to get it right. Check out our previous blog for a detailed guide on GMC registration and, considering the points above, make sure to understand what your eligibility is based on either your USMLE or accepted overseas postgraduate qualifications. 3. Prepare and book the PLAB Test if you need to. For US-physicians that don’t have a USMLE or postgraduate qualification that is accepted you’ll need to take the PLAB to have your registration and license to practice recognised in the UK. Check out our PLAB blog here to understand a bit about this licensing exam, and remember to check the GMC website for the most complete and up to date information regarding PLAB. 4. Search for and secure a job offer early. We will assist you throughout this process, our recruitment specialists will help match you with opportunities that align with your qualifications, career goals and preferred location. We will then set up and help prepare you for interviews, either in person or video. 5. Understand the visa and immigration process required. Securing your right to work in the UK is a crucial step. Most doctors will apply for a Tier 2 (General) visa, which allows skilled workers to live and work here. Here’s what you need. Please check this blog we made for a more detailed overview of how to complete this process. 6. Don’t stress too much about relocation – it is important to consider logistics like housing, schools (if you have children), and how to settle into your new community, and for this reason we have a whole process and team that supports each doctor with their move. We have a catalogue of promotional location packs that help you assess what an area/region is like and how it aligns with your needs and preferences. Once your visa is approved, our relocation specialist will begin their role in supporting you with your relocation. 7. Research & Preparation. Gather your documentation! It might sound obvious but, before you move, start collecting essential documents such as your medical degree, training certificates, proof of English proficiency and your CV!   We want you to feel at home, so here are a few ways we think you can achieve that.. Discover Your Community. Take time to explore your new surroundings. Engaging with local culture can ease the transition and make you feel more at home. For example, we Brits love our pubs, and it’s not just a place to drink! These beloved establishments have shaped our society and allowed for people from all walks of life to integrate and come together. Whether you’re watching your favourite sports team play on the big screen on a Sunday or partaking in a mid-week pub quiz with your mates (or colleagues), you’ll never feel alone. Join Professional Networks. As a doctor, connecting with other healthcare professionals in your area can boost you experience tenfold. Joining local medical societies or groups can provide support and networking opportunities, as well as fostering a holistic understanding of what the public might expect form you as a healthcare provider. Join Social Networks & Clubs. We know it is so important to nurture your other passions, hobbies and social batteries when your line of work is so emotionally demanding and comes home with you. There are many ways in which you can make human connections or get stuck into an activity in your area, or further afar if you fancy an adventure. Facebook is one way you can connect with locals and activity groups that reflect your interests. Inform yourself on UK guidelines and practice. The GMC and Royal Colleges have loads of content to help prepare and inform overseas doctors, so you can hit the ground running. Whilst there are many similarities, there are also lots of differences, and it pays to get ahead of yourself to avoid feeling overwhelmed once you’re in the UK. Understanding the healthcare landscape will help you navigate your new role effectively.   To summarise  For many, relocating from the USA to the UK as a doctor is a significant yet rewarding endeavour. As well as the NHS, there are lots of job opportunities for US-trained physicians in Ireland, and the Channel Islands. By understanding the acceptance of your qualifications and / or USMLE by the GMC, and partnering with IMG Connect, you can successfully navigate this transition and the UK job market and embark on a fulfilling career in healthcare in the UK. If you’re ready to take the next step or have questions about the process, reach out to IMG Connect today. We’re here to support you in making your move to the UK a seamless experience!

Many overseas pathologists wonder how UK reporting patterns are structured within the NHS. One of the key benefits of working as a histopathologist in the NHS is the use of the RCPath points system. But what does this actually mean? What is the RCPath Points System? The RCPath points system is used by the Royal College of Pathologists (RCPath) in the UK to measure the workload of pathologists. The system assigns points to different activities based on their complexity and the time required to complete them. This helps in workload planning and ensures that tasks are distributed fairly among pathologists. You can read more about the points system via the RCPath publicised document here. Here's a summary of some key features, focusing on histopathology, cytology, and autopsy practice. You can also find the most recent updates on this via the RCPath website here.   1 - 5 Minutes  1 Point  6 - 10 Minutes  2 Points 11 - 20 Minutes  3 Points  21 - 30 Minutes  5 Points  31 - 50 Minutes  8 Points   > 50 Minutes  12 Points    Points Allocation: Histopathology: Different types of specimens are assigned specific points based on the complexity of the examination. For example, simple biopsies might be assigned fewer points, while complex surgical resections would have higher points. Cytopathology: Points are allocated based on the type of cytology specimen, such as fine needle aspirations or exfoliative cytology. Post-Mortem Examinations: Autopsies are assigned points depending on the type (e.g., routine or complex cases). Workload Management: Daily/Weekly Limits: The system sets recommended daily or weekly points totals to prevent overworking and ensure manageable workloads. Job Planning: Pathologists' job plans are often based on achieving a certain number of points per session or week, balancing clinical duties with other responsibilities like teaching or research. Fair Distribution: The system aims to distribute cases evenly among pathologists by assigning points based on workload rather than just the number of cases. This helps maintain fairness within pathology departments. Adjustments: Complex Cases: Cases requiring additional time or expertise, such as those needing second opinions or further testing, may have adjusted points. Special Circumstances: Adjustments can also be made for special circumstances, such as when pathologists are in training or dealing with new techniques. What is the Purpose and Benefit of the RCPath Points System? Ultimately, every decision in the NHS is made with the aim of improving patient experience and care—a central theme of all work within the NHS. The RCPath points system benefits patient outcomes in the following ways: Standardisation of Reports and Quality: Provides a standardised way to measure and compare workloads across different institutions and pathologists. Efficiency of Reporting and Staff Workload: Helps in resource allocation, ensuring that pathologists are not overburdened and that the quality of work is maintained. Transparency Among Colleagues: Offers transparency in workload expectations and aids in discussions around job planning and workload distribution. The RCPath points system is a structured approach to ensuring that pathologists’ workloads are balanced, manageable, and fair, contributing to better patient care and job satisfaction. If you would like to read more about how staffing and workload for pathology departments are assessed and managed by the Royal College, an updated version of the RCPath Best Practice Recommendations is due for publication soon. Your IMG Consultant is happy to assist with any negotiations related to your job plan to ensure your experience is taken into account.  For more information on NHS doctor benefits and pay arrangements in the UK, take a look at our IMG Resources library.