Information for trainees

The Royal College of Emergency Medicine is one of the Medical Royal Colleges taking part in the Medical Training Initiative (MTI). The MTI is a government authorised exchange under Tier 5 of the Points Based System allowing overseas trainees to obtain training in the UK for up to two years. The Royal College of Emergency Medicine’s International Sponsorship Scheme offers Emergency Medicine training opportunities within the MTI.

Successful applicants can obtain full GMC registration without taking the Professional and Linguistic Assessment Board (PLAB) test.

The Royal College of Emergency Medicine matches successful applicants to training posts. Posts are available for between 6 and 24 months. At the end of their training period in the UK trainees have to return to their home country.

Scheme Prioritisation and Allocation

The primary purpose of the MTI is to contribute to improving the quality of healthcare in developing countries. The main intention of the scheme is to provide doctors from developing countries with a period of training and development in the NHS before returning to their home countries where their patients and colleagues can benefit from the skills and experience they have obtained in the UK.

A mechanism was introduced in January 2017, which demonstrates support for the Department for Health’s main focus, which is for doctors from the DFiD 28 and Lower & Lower middle income countries to benefit from the scheme and, therefore priority should be given to developing healthcare systems.

The new criteria reflects the principles and intent of the scheme and it has been agreed that the following priority list be used;

1. DfID 28 Countries
2. L&LMI Countries who do not come under the DfID 28
3. All other applications

Important changes to the prioritisation process

The current prioritising system has been working effectively but has had unintended consequences for applicants not from DfID priority and LI&LMI countries. These applications were considered at the end of each month and CoS’s allocated if there was available capacity from the monthly quota once the allocations to DfID priority and LI&LMI countries had been made. However, the overall volume of applications received, has resulted in a growing proportion of these applications being rolled over for consideration at the end of the following month.

The consequence was that these applicants could find themselves waiting up to several months to confirm an MTI placement. This delay and uncertainty understandably caused real problems for individual applicants, employers, Colleges and Deaneries. The Department of Health, Health Education England and the Academy of Medical Royal Colleges all believe that position was unsustainable and unfair to applicants. For the sake of transparency it was felt better to explicitly state that these applicants can have no guarantee or expectation of receiving a CoS, although they will not be barred from making applications.

Applicants from countries not considered DfID priority or LI&LMI countries may apply at their own risk. If there is any remaining capacity at the end of each month having processed all applications from DfID priority and LI&LMI countries, other applicants will be awarded a CoS taken in order of the receipt of their applications.

A full statement further explaining these changes to the MTI scheme, can be found at the Academy of Medical Royal College's website.

Applicant guidance 

A downloadable document with the full scheme information can be found here

We currently have a number of Trusts that are actively seeking placements to be filled as soon as possible, please email for further details -


To be eligible for sponsorship you must be one of the following:
  1. a current trainee in an overseas Emergency Medicine training programme (You should have the support of your training programme director for your plan to spend a period of time training in the UK)
  2. a consultant who has completed a specialist training programme in Emergency Medicine (You should have the support of your employer for your plan to spend a period of time training in the UK)
  3. a consultant who has trained in a specialty other than Emergency Medicine with at least 12 months experience in Emergency Medicine (You should have the support of your employer for your plan to spend a period of time training in the UK)

Candidates must:
  • Not (normally) hold EEA citizenship or EEA rights of residency.
  • Hold a Primary Medical Qualification acceptable to the GMC for full registration.
  • You will be asked to provide details of your registration and licensing for all the medical regulatory authorities of any countries where you have practiced or have held registration or a licence in the last five years. You will need to provide Certificates of Good Standing (CGS) from any country you have practiced or been registered or licensed with since you were granted provisional registration. To read more about this please visit the GMC's registration and application webpages
  • Have been in continuous medical practice for all of the most recent twelve months leading up to your application (please note that clinical attachments and observerships are not counted as medical practice therefore cannot be counted within these twelve months)
  • Have completed at least three years postgraduate training including an internship. This must include at least one year in an Emergency Medicine training programme. 
  • Have an institutional sponsor in their home country specifying the post they will return to.
  • Provide evidence of satisfactory progression through training. Acceptable evidence would be documentation of passing any required postgraduate exam, a logbook or training portfolio (if applicable), evidence of clinical governance activity, appraisal documentation. Evidence should cover both generic Emergency Medicine and acute specialties. Any evidence should be validated by the overseas sponsor.
  • Be certified in at least one life support course - ATLS, APLS or ALS (or RCEM recognised equivalent).
  • Have achieved a minimum score of 7.0 in each section (speaking, listening, reading and writing) of the academic module of the IELTS (International English Language Testing System) and an overall minimum score of 7.5. You must be able to provide a test report form that reflects that this test was taken within the last 2 years. More information regarding Knowledge of English Language can be found on the GMC website.
  • Provide contact details of two referees. If you are a trainee these should be your current educational supervisor and one other Emergency Medicine specialist currently or recently involved in your training. If you have already completed your specialty training you should get two references from doctors currently supervising you. Your referees will be contacted directly by the Royal College.

A full assessment of your eligibility can only be made once all of your evidence has been received. 


Copies of documents that are not in English must be submitted with an accurate translation, see GMC guidelines for further information on this. 

Points to consider before you apply;

  • Participation in the scheme is dependent on an appropriate post being available. The likely time-frame for the process is approximately 3-4 months, however, as they are dependant on many different factors they can take up to 6 months.
  • Sponsorship for GMC registration under the College's International Sponsorship Scheme is only provided for those making an application for an approved MTI post from 6 to 24 months. 
  • Doctors who have failed the PLAB are not eligible for sponsorship. The MTI is not a route to permanent UK employment. Once a participant has completed their placement, they must return to their home country.
  • The Royal College will only recommend successful applicants to the GMC for full registration.
  • The GMC must be satisfied that the doctor has been selected under quality assurance arrangements designed to safeguard the interests of patients and to provide support for the trainee before granting registration.
  • Once your application has been approved by the Royal College you will need to complete the application for registration on the GMC website and read the GMC guidance on what evidence should be provided to support the application.
  • Visa sponsorship is only provided to those that are successful in their application for GMC registration.
  • If successful, you will need to produce original documentation to the GMC at an ID check when you arrive in the UK, to confirm your registration before you start your post. Information can be found on the GMC website.


The Medical Training Initiative is a government authorised exchange operated under Tier 5 (Temporary Worker) of the Points Based System. The Academy of Medical Royal Colleges will issue a certificate of sponsorship for each successful applicant. This certificate supports application for entry to the UK under Tier 5. Please see 'Scheme Prioritisation and Allocation' above. 

Please note that changes to the IELTS requirement from UKVI from April 2015 will not effect the Medical Training Initiative. These changes relate to those applying for Tier 1, 2 or 4 visas where there is a proof of English Language requirement. Sponsorship for these visa Tiers are not available within the MTI. 

Administration Fee

The fee for the administration of an individual application is £115 for applicants based in lower and lower middle income economies (as defined by the World Bank), and £215 for all other countries.
You will be charged the fee when your application has been accepted.

Please note that the GMC's Registration application fee is a separate fee and is payable to the GMC directly on submitting your application.

Application Pack

Application forms can be obtained from Victoria De Witt (email:  

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