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6 things that don’t matter when applying for UK specialty training (residency) and 4 things that do

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what matters when applying for uk specialty training residency

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Updated: November 12, 2019

There are a lot of misconceptions that IMGs have about applying to UK specialty training (residency). These are often based on things that are important for residency applications back home, or residency applications in the US, but you’ll be pleased to know that many of them are not applicable to the UK. I hope this article will set the record straight on a few issues.

What doesn't matter

#1 Your PLAB score

Although a high PLAB score may make you feel warm and fuzzy inside, the truth is – nobody else cares. Ouch, I know. But unlike the USMLE, your PLAB score is not used in any way, shape or form, to select applicants for specialty training. It is simply a licensing exam to gain GMC registration to practise as a doctor in the UK. 

So leave your PLAB score out of your CV, and concentrate on other areas of your application that actually matter.

Related: What you need to know about PLAB

What doesn't matter


Postgraduate exams are tough! Just passing them is recognised as an achievement, so raw scores are not taken into account. Having a higher score than the next applicant will not gain you any advantage in your application, so don’t focus on scoring the highest possible, focus on learning the material well and developing your skills and knowledge as a specialist.

What does matter

#1 Your interview score 

Successful applicants for specialty training are selected based on their total application score. For most specialties, the biggest component of this score is the interview performance, followed by the portfolio. 

So if you want to do well in your application, find out all you can about the interview, then practise, practise, practise! Most specialties publish the format and content of the interview in advance so be sure to check it out.

What does matter

#2 Having a well-rounded portfolio

Most specialties score your portfolio as part of your total application score. The different domains typically include things such as research, teaching experience, quality improvement, leadership, publications, presentations, etc. 

You will score more by having achievements in all domains rather than excelling in a single domain. Unfortunately, having world-class achievements in research will not offset a lack of teaching experience, or make up for not completing a quality improvement project.

Be sure to find out how your specialty scores the portfolio and what domains are included. For competitive specialties in particular, you’ll want to score highly in all domains. 

We have an IMG Masterclass that is all about how to achieve this, be sure to check it out!

What doesn't matter

#3 Your Aunt/Uncle/family friend who is an NHS Consultant

UK specialty training applications are highly objective. Your portfolio and interview are marks based on a standardised scoring framework. Applicants are selected on this basis alone. 

The interview panel scoring your performance is usually made up of Consultants from across the region or even across the country. The panel members will interview hundreds of applicants in a day. Their scoring sheet will have your applicant number but no personal details like your name, your age, or where you graduated. There is literally nowhere for connections to put in a good word or ask for favours.

Although some doctors may see this a bad thing, I would advise you to see it as an opportunity. This objectiveness means that the son or daughter of a prestigious professor cannot gain an unfair advantage in the application process, and you have just as good a chance as anyone if you work hard and prepare well.

What doesn't matter

#4 Letters of recommendation (LORs)

This seems to be an extremely important component of US residency applications, but not so much in the UK. 

In UK applications, letters from Consultants are only used as evidence to confirm any achievements you’ve claimed in your portfolio. They generally say, “Dr X organised and led a quality improvement programme that…” or “ I confirm that Dr Y presented at the departmental meeting for…”

They do not need to comment on your suitability for the specialty you’re applying for, your overall career progression, your character, or anything else. The selection panel will determine all of this at interview and award marks according to the official scoring framework.

What does matter

#3 Your work references

Although LORs don’t play much of a role in selecting successful applicants, they do have some importance once you actually land a training job.

When you are successful in securing a job offer (congratulations!), the references you listed in your application form will be contacted. A positive reference will mean your job offer moves forward, while a poor reference can result in your offer being withdrawn. So do make sure you work hard in your previous job and select your references carefully.

It is always best practice to let your Consultant know beforehand that you would like to put them down as a reference. You will get an idea about what they are likely to say in your reference form by their reaction. If they feel you are not ready for training and decline to provide a positive reference, then that’s a good time to discuss any performance issues. Work with them on how to resolve any problems so they will be happy to give you a positive reference. 

What does matter

#4 Your immigration status 

I talk about this a lot here on the blog because it’s the number one thing that IMGs need to understand when it comes to applying for training in competitive specialties. If you have the right immigration status, you have the opportunity to apply for any specialty. 

So what’s the right immigration status? Anything that is considered exempt from RLMT.

RLMT stands for Resident Labour Market Test. It’s an immigration rule that basically says a foreign national cannot work in the UK unless no suitable applicant from the UK or EU can be found for that specific job. Therefore those who are settled UK residents are given priority.

IMGs need to gain exemption from this rule in order to be eligible for competitive specialties like Surgery or Radiology. 

What if you don’t have the right immigration status?

Fortunately on October 6, 2019, all medical jobs were added to the Shortage Occupation List which means that all IMGs can now be considered exempt from RLMT. This opens up many doors for IMGs to apply for training jobs in even the most competitive specialties!

Related: 9 ways the new Shortage Occupation List affects IMGs dreaming of UK specialty training

What doesn't matter

#5 What country you graduated from 

Once you are eligible to apply for specialty training, your place of graduation does not play any role in your application. Your application will only be judged on the content of your portfolio, and your performance at interview. Some specialties will also include the score from the Multi-specialty Recruitment Assessment (MSRA). 

So if you are eligible to apply and failed to secure a training spot, then unfortunately that means your application was not good enough that year. It will have nothing to do with the fact that you’re an IMG.

What doesn't matter

#6 Your age

Age is not taken into consideration at all when applying for UK specialty training. There is no upper age limit when it comes to postgraduate training. We posed this question to Health Education England:

I’d like to ask please if there is an upper age limit when applying for UK specialty training. 

I understand that age discrimination is illegal but what about mature students who want to enter ST1/CT1 in their 60’s or those who want to retrain in a new specialty at that age? Is there a limit with applying and proximity of age to stage retirement age?

I’d be grateful for your guidance.

This was their response:

Thank you for your email.

 There is no upper age limit to apply for any specialty. When applying for training you’ll be assessed on your eligibility and ability for the post applied.

Harriet Maclennan
Recruitment Officer

There you have it in black and white: an applicant of any age can apply for UK specialty training. So don’t be held back by a self-imposed limitation about age!


The important factors when it comes to applying for UK specialty training (residency) differ from other countries. Being familiar with what matters and what doesn’t will help you focus your efforts and avoid wasting time and energy on activities that will not bring you any closer to your training job. I hope this article has helped you develop your strategy for your application.

6 things that do not matter when applying to uk specialty training

  1. Your PLAB score
  2. Your postgraduate exam scores
  3. Having “connections”
  4. Letters of recommendation (LORs)
  5. What country you graduated from
  6. Your age

4 things that do matter when applying to UK specialty training

  1. Your interview score
  2. Having a well-rounded portfolio
  3. Your work references
  4. Your immigration status

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Looking for a step-by-step guide?

Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.


Looking for a step-by-step guide?

Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.


4 Responses

    1. High academic achievement can get you extra points in your application, but it’s only one part of the score. Low grades have no bearing on an application ie. you do not lose points for low or average grades as long as you pass.

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Meet the Team

Hi, we’re Drs Nick & Kimberly Tan, the two IMGs behind The Savvy IMG. We write comprehensive guides, create courses, and provide one-to-one guidance to help other overseas qualified doctors on their journey to the UK.
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