COVID-19 Update for International Medical Graduates

Please find below an update from the College regarding regarding the status of the MTI Scheme. COVID-19 Response for RCEM MTI Applications

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. As National Sponsor of the MTI, the Academy of Medical Royal Colleges (AoMRC) is responsible for the issuance of Tier 5 certificates of sponsorship to be used for visa application.

The Royal College of Emergency Medicine’s International Sponsorship Scheme offers Emergency Medicine training opportunities within the MTI by providing successful applicants with sponsorship for full GMC registration without the need to take the Professional and Linguistic Assessment Board (PLAB) test and matching successful applicants to training posts. Posts are available for between 6 and and a maximum of 24 months and at the end of their training period in the UK, trainees must to return to their home country in line with the primary purpose of the scheme.

You can read further information about the scheme at the AoMRC's MTI web page here

Important information on 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 2017, which demonstrated support for the Department for Health’s main focus of supporting developing healthcare systems, which is for doctors applying from the DFiD priority and Low & Lower middle income countries to benefit from the scheme by receiving priority over all other applications.

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

Important changes to the prioritisation process

The prioritising system had worked effectively but had unintended consequences for applicants not applying 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 priority applications has been processed. The overall volume of applications received, had resulted in a growing proportion of applications from the 'other applications' category 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 this 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 priority category applications - other applicants will be awarded a CoS taken in order of the receipt of their applications. When there is no spare capacity, applications will be be placed on a waiting list held by the Academy of Medical Royal Colleges where a substantial wait is likely and no placement is guaranteed.

Please read the full statement from the Academy of Medical Royal Colleges further explaining these changes to the MTI scheme.

Important changes to GMC application process

From 11 June 2018, applicants will need to have their primary medical qualification (and acceptable postgraduate qualification, if they have one) independently verified by the Educational Commission for Foreign Medical Graduates (ECFMG) before the GMC can grant registration with a licence to practise.

Please read the full guidance from the GMC website here.

Applicant guidance

You can download the full application RCEM sponsorship guidance in PDF format here .

The full AoMRC MTI guide can be found here


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. (Please note from 11 June 2018, applicants will need to have their primary medical qualification independently verified before the GMC can grant their approval - the full guidance can be found at the GMC website.)
  • 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 (orRCEM 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 the scores were met all in the same test that was taken within the last 2 years.
    Have achieved a grade of at least 'B' in each testing area (speaking, listening, reading and writing) of the Occupational English Test (OET). You must be able to provide an OET certificate that shows that you took the medicine version of the test, that you got those grades in the same test within the last 2 years, your candidate number, that you obtained the grades in your most recent sitting of the test.
    Full guidance regarding English Language tests/evidence accepted by the GMC can be found at 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, full guidance on this can be found at the GMC website

Points to consider before you apply

  • Participation in the scheme is dependent on an appropriate post being available. The likely time-frame for the application process is approximately 4 months, however, as they are dependant on many different factors it 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 of Emergency Medicine 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 of Emergency Medicine, 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 by the Academy of Medical Royal Colleges is only provided to those that successfully register 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.

How to apply

Please contact an application pack.

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