This post is out of date as of October 6, 2019. It remains published here for historical information purposes only, and should not be used to make future plans.
For the change in immigration law that made IMG-friendly specialties a thing of the past, please see the article: 9 ways the new Shortage Occupation List affects IMGs dreaming of UK specialty training
UPDATED: August 17, 2019
The advantage that UK medical graduates have over IMGs is that they are exempt from the Resident Labour Market Test (RLMT). RLMT means that employers eg. NHS hospitals, have to make sure there are no suitable applicants who are already settled in the UK before they can sponsor an immigrant on a visa. Therefore UK graduates are prioritised through exemption from RLMT.
But IMGs can also gain exemption from RLMT, and once exempt, IMGs will be considered equally alongside UK graduates.
You will not be rejected for specialty training based on your nationality or where you graduated once you are exempt from RLMT.
So here I have listed 7 ways you can gain exemption from RLMT and be considered alongside UK graduates. These are all based on the rules listed in the 2019 Medical Specialty Recruitment Handbook and are applicable for training jobs at ST1/CT1 level and above.
1. Apply for a shortage specialty
As of January 2019 these are the training positions on the list for the whole UK:
- Emergency medicine – CT3, ST4-7
- Psychiatry – CT1
These are the training positions on the list for Scotland only:
- Radiology – CT3, ST4-7
- Psychiatry – all grades except CT1
- Paediatrics – all grades
- Anaesthetics – all grades
- Obstetrics & Gynaecology – all grades
Posts beyond CT1/ST1 require prior experience to apply. All requirements to apply for each grade will be listed in the relevant person specifications here.
2. Apply for Standalone FY2
A standalone FY2 post is a training job within the official UK Foundation Programme. It’s called “standalone” because it is just one year of the 2-year programme. Standalone FY2 lasts for 12-months starting each August and being in it allows you to apply to a first year training post (CT1/ST1) in Round 1.
This is because Standalone FY2 is a training post therefore if you require a visa to work in the UK, your sponsor will be a government organisation such as Health Education England (HEE) instead of an individual hospital. Scotland, Wales and Northern Ireland have their own counterpart training organisations.
When you come to apply for another training post like CT1/ST1, you will not make a new visa application for the new job. Instead you will simply be extending your visa with the same sponsor rather than making a new application. This exempts you from RLMT and makes you eligible to apply in Round 1.
Keep in mind that you will only be considered in RLMT-exempt for ST1/CT1 applications when you apply during your FY2 year. After FY2 you will no longer be exempt. This means you should have been working on your portfolio even before you start Standalone FY2 so you will be ready for applications almost immediately (FY2 starts in August, Round 1 of applications open in November).
Also you will only be considered RLMT-exempt in the same UK nation you are an FY2 in. Eg. If you are an FY2 in England, you will be exempt from RLMT when applying to ST1/CT1 posts in England but subject to RLMT for positions in Scotland, Wales and Northern Ireland.
What else you should know
Standalone FY2 is most suitable for those who plan to apply to a first-year training post (CT1/ST1). It is not an appropriate career move to do FY2 then apply for ST3. Although there doesn’t appear to be any specific rules against this, bear in mind that ST3 jobs have requirements that will not be satisfied through FY2.
3. Apply for WASTThe Widening Access to Specialty Training scheme is essentially an alternative to FY2 aimed specifically at IMGs. The programme also lasts 12 months and awards you a Certificate of Readiness to Enter Specialty Training (CREST) which is required for application to CT1/ST1.
Similar to Standalone FY2, the visa sponsor for WAST is a government organisation – specifically HEE (England). Again this exempts you from RLMT and makes you eligible for Round 1 of applications.
What else you should know
4. Apply for a training post in a less competitive specialty first
Let’s say your target specialty is specialty X but it doesn’t go to Round 2. You can apply to a less competitive specialty first, let’s call it specialty Y, and then apply to specialty X the following year.
By doing this you basically use specialty Y as a stepping stone to get to specialty X because as mentioned in number 2 and 3 above, being in a training job with a government sponsored visa makes you exempt from RLMT when applying for another training job.
Now this is not something I necessarily advocate as I don’t believe that any specialty should be a “used” to enter another, but if viewed the right way there are several advantages to this route.
You must maintain sponsorship with the same visa sponsor between the 2 training jobs to be exempt from RLMT.
If you quit specialty Y before you start specialty X and you either change visa sponsor between the 2 jobs or your visa sponsorship with specialty Y ends before your sponsorship with specialty X starts, then you will no longer be exempt from RLMT and your job offer may be withdrawn.
You will also only be considered in Round 1 for the same UK nation you are in for your training job. Eg. If you are a trainee in England, you will be in Round 1 when applying to ST1/CT1 posts in England but in Round 2 for positions in Scotland, Wales and Northern Ireland.
5. Study for a higher degree in the UK
The current specialty recruitment handbook states that those on a Tier 4 student visa studying a UK Masters or PhD are eligible to apply for Round 1. Those on the Tier 4 Doctorate Extension Scheme are also eligible for Round 1.
Having a higher degree attracts additional points during specialty recruitment so aside from helping you reach Round 1, it can give you a competitive edge amongst other applicants. But don’t do an additional degree for the sake of it. Consider whether you really want to pursue further education and how it might benefit you overall.
To be exempt from RLMT, you must complete the Masters degree in the UK, or complete 1 year towards a PhD by the time you are offered a job which is usually around March.
6. Await Indefinite Leave to Remain (ILR)
After 5 years on a Tier 2 visa you will be eligible to apply for ILR. This is permanent resident status in the UK and means you will be able to live and work here without restrictions ie. you will be exempt from RLMT for the whole UK pretty much forever.
But five years is a long time to “wait”. During that time you will most likely be working in non-training jobs and if you work in the same specialty you want to apply to for too long, you can actually be disqualified from applying to a first year post.
So if you want to be more proactive in your career, you may want to consider acquiring your CT1/ST1 and CT2/ST2 experience and competences through non-training jobs, and work towards applying for ST3 instead.
There are 2 pathways on the alternative route:
- CESR-CP – this is where you use your experience in non-training jobs to demonstrate equivalence to core training then apply to ST3 posts while subject to RLMT OR
- CESR – this is when you use your experience in non-training jobs to demonstrate equivalence to the whole training programme and apply directly for specialist registration as a Consultant. This can take longer than a training programme but it is a possibility.
7. Marry your RLMT-exempt partner
Many IMGs move to the UK to be with their beloved. If that person happens to be exempt from RLMT because they are a UK or EU national or have ILR, then this privilege may extend to you as their partner/civil partner/spouse provided your visa/BRP does not have a specific restriction that states “no employment as a doctor or dentist in training.”
Obviously don’t arrange a marriage just to become exempt from RLMT! That’s called immigration fraud my friend.
Just know that if you are moving to the UK to be with your partner, it doesn’t mean you have to be disadvantaged as an IMG. I would hate for any doctor to think that their medical career has to come to an end when they move here just because they’re not aware of this.
With this type of exemption you will be exempt from RLMT throughout the UK every year.
If I am exempt from RLMT and apply in Round 1, will I definitely get a training job?
No, of course not. Nothing in life is guaranteed. You still have to compete against other applicants so build up your CV and don’t waste this opportunity!
But if you are in Round 1, you are on level playing field with UK graduates and you will not be discriminated against as an IMG. This situation is the best you can hope for, it really is an incredible opportunity that you just don’t get in the US. If you are unsuccessful in Round 1, at least you know it won’t be because you graduated overseas.
I’ll go over the many ways you can build up your CV in a future post. As always, subscribe so you don’t miss it!