MTI information for Trusts

Please be aware that the MTI application process involves obtaining documentation from the applicant, the applicant's home country medical authorities, home country sponsors, home country referees, recruiting NHS Trust and sponsor, the LETB, the GMC and the Academy of Medical Royal Colleges and it can take several months from the point of application to the doctor joining the post.

Guidance can be downloaded here   

The following LETB/Deaneries have put EM posts forward for the MTI:

  • East of England
  • East Midlands 
  • Kent, Surrey & Sussex
  • London
  • North of Scotland
  • North Western 
  • Northern Ireland
  • Thames Valley 
  • West Midlands
  • Yorkshire & The Humber
If you would like to host one or more MTI trainees within your ED and you haven't hosted placements in the past, please get in touch with the Head of School of Emergency Medicine in your region to seek approval.

MTI trainees in Emergency Medicine can be sourced by the College or directly by the Trust, however, they must meet our eligibility criteria in order to take part in the scheme. 

The Trust must provide full details of the post that they are looking to place an MTI doctor into. The post must meet the requirements of the MTI scheme, the College and the LETB/Deanery.  

Once a suitable candidate has been identified, the Consultant from the Trust who will be supervising the trainee will be asked to conduct a telephone interview with the candidate (the College will forward an interview template for this purpose). 

The Trust is not required to sponsor any visa applications as visa sponsorship is provided by the national scheme sponsor (currently the Academy of Medical Royal Colleges). The Medical Training Initiative is a government authorised exchange operated under Tier 5 of the Points Based System.
MTI trainees should be offered an NHS induction, a trust induction and a departmental induction. They should also have access to the same training opportunities as other trainees in the department.

The full guidance on the MTI scheme can be found here -

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 Income 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.

Please note:

- The Medical Training Initiative is a training scheme, MTI trainees cannot fill service posts.

- Postgraduate Deaneries / LETBs establish the level of available training capacity to support placements under the MTI scheme in each Deanery / LETB area each year.

 - Approval of the relevant Deanery / LETB is required for each placement to be filled by a MTI participant, to confirm the placement has sufficient training and educational content and does not disadvantage UK/EEA trainees

- It is not possible for MTI doctors to work in a substantive, honorary or fixed term NHS consultant post in the UK under this scheme - in order to do so doctors must be on the GMC Specialist register. Specialists who have not undergone a UK training programme are now able to apply for evaluation of their specialist training, qualifications, experience and knowledge to determine whether it is equivalent to the UK CCT. More information can be found here -

For more information please contact Victoria De Witt at or 020 7400 6106 (direct line).