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Are you overqualified for UK specialty training?

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UK specialty training eligibility and experience limits for international medical graduates

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UPDATED: March 7, 2023

You may have heard of “experience limits” when it comes to applying specialty training (residency) in the UK. What it means is that if a doctor has already exceeded the stated limits of experience, they will be deemed overqualified and therefore ineligible for training in that specialty. Or if a doctor has too much experience, they will be penalised in their application score or they will not be given priority for places.

In this article we answer some common questions about the limits according to the current guidelines. 

The experience limits for ST1 or CT1

The specialties that have strict experience limits are for first-year posts ie. ST1 or CT1. As of 2023, these are the specialties with strict limits of experience. If you exceed these limits, you will be deemed ineligible to apply.

SpecialtyMaximum experience permitted
Anaesthetics ACCS CT1/Anaesthetics (core anaesthetics) CT118 months in Anaesthetics
Cardiothoracic surgery18 months max. combined in the following specialties: Cardiac &/or Thoracic surgery, Congenital Cardiac Surgery and Cardiothoracic Transplantation by the closing date of the application
Neurosurgery24 months clinical experience (in any specialty) with no more than 12 months combined experience in Neurosurgery, Neurology, Neuro-radiology, and Neuro-intensive care
Obstetrics & Gynaecology24 months in Obstetrics & Gynaecology
Ophthalmology18 months in Ophthalmology or Medical Ophthalmology by the interview date
Radiology18 months in Radiology
Surgery (core surgery)18 months in surgical specialties (Ophthalmology and Obstetrics & Gynaecology not included)

*If you don’t complete any part of the UK Foundation programme, then up to 12 months of surgical experience will be considered equivalent to the Foundation years and therefore exempt from the limit.

The timing relates to the start of training which is usually, but not always, in August. So if you’re applying for August 2023, you should not reach these limits before then.

Please note that the specialty limits tend to change from year to year. So it’s always important to make sure you are looking at the latest person specifications for the specialty.

Experience limits for ST3/ST4

There does not appear to be any strict maximum experience limits for ST3 or ST4 level training posts so you can still apply even if you have a lot of experience.

However, many surgical specialties usually have a desired maximum experience requirement. This means that the limits are imposed when there are too many applicants. If there are too few applicants, then the limits may not be imposed.

Also, in many surgical specialties, having a lot of experience can be a disadvantage in the application score because the more experience you have, the less points you get.

Examples:

Specialty Maximum experience desired
Obstetrics & Gynaecology ST3 60 months in Obstetrics & Gynaecology
Anaesthetics ST3 48 months in Anaesthetics or Intensive Care Medicine
General Surgery ST3 48 months in General Surgery
Vascular Surgery ST3 48 months in Vascular Surgery
Paediatric Surgery ST3 12 months at ST3 level (registrar level or above) in Paediatric Surgery, General Surgery, or Urology
Trauma & Orthopaedics ST3

No desired maximum experienced stated however the longer you’ve worked after internship, and the more experience you already have in Orthopaedics, the less points you will get in your application.

You can review the application score calculations here.

ENT ST3

No desired maximum experienced stated however if you have less than 5 months or more than 30 months experience in ENT, then you will get 0 out of 20 points in this section of the application.

You can review the application score calculations here.

 

If your specialty is not listed here, you can check what the maximum desired experience is in the Person Specifications of that specialty.

What counts towards the experience limits?

Any clinical experience anywhere in the world as a doctor after internship, outside of the official UK Foundation Programme up until the start date of the training programme is counted. This includes the following:

  • Residency overseas
  • Postgraduate training overseas
  • Non-training jobs overseas
  • Non-training jobs in the UK at any level (FY1, FY2, SHO, registrar, junior clinical fellow, senior clinical fellow, trust grade, LAS, locum appointment for service etc)

Some specialties exempt the first 12 months after internship from the experience limits however most specialties do not. To avoid disappointment, it is recommended that you do not exceed the experience limits through non-Foundation Programme jobs as much as possible.

What does not count towards the experience limits?

  • Medical school rotations
  • Internship rotations
  • Observerships
  • Clinical attachments
  • Official FY1 rotations in the UK/Maltese Foundation Programme
  • Official FY2 rotations in the UK/Maltese Foundation Programme ie. Standalone FY2

Example

Doctor AB wants to apply for Obstetrics ST1 2020 which starts in August 2020. The experience limit for Obstetrics is 24 months by the start date.

He is applying in Round 1 which is in November 2019. He has completed 4 months of Obstetrics during a 12-month internship, and has 20 months of experience in Obstetrics after internship by the time he is applying in November 2019.

As of November 2019 (time of application), he is considered to have 20 months experience in Obstetrics. The 4 months Obstetrics experience during internship does not count towards the limit. 

If he continues to work in Obstetrics for up to 4 months after submitting his application, he will still be eligible for ST1 since his experience is 24 months in total which is still permitted.

If he continues to work in Obstetrics for more than 4 months after submitting his application, he will no longer be eligible for ST1 since his experience will exceed 24 months.

Why don’t all specialties have a limit?

In general, I’ve noticed that specialties with low levels of competition do not have experience limits. The specialties that don’t currently have any experience limits at ST1/CT1 level are:

  • Community sexual reproductive health
  • Emergency medicine ACCS
  • General Practice
  • Histopathology
  • Internal medicine
  • Paediatrics
  • Public health
  • Psychiatry
At ST3/ST4 level, most medical or psychiatric specialties do not have experience limits while almost all surgical specialties do.

What happens if you exceed the limits?

You can still become a UK recognised Consultant, but through a different route. 

So if you are barred from applying for year 1 of training due to the experience limits, and you still aim to become a UK recognised Consultant, then you have 2 options:

  1. Enter training at a level beyond ST1/CT1 (usually ST3) and become a Consultant through the CESR-CP route (you will still be awarded a CCT in most cases) OR
  2. Don’t enter any formal training but prove that you have the equivalent skills and knowledge some who has completed formal UK training and become a Consultant through the CESR route.
If you are unable to enter ST3/ST4 level, then your next option to become a UK recognised Consultant is through CESR.
 

In the UK, CCT, CESR-CP and CESR are all equally accepted for entry to the GMC Specialist Register and therefore recognition as a Consultant. This is not always the case overseas. If you plan to migrate after completing your UK training, check with the medical authority of that country whether CESR is accepted.

You can read more about how the CESR pathway works here.

Related: CESR-CP soon to recognised as CCT

How strict are these limits?

Pretty strict. The specialties that impose experience limits tend to have more than enough applicants, so they have no problem rejecting applications from those who have exceeded the limits.

Does the first year after internship count as FY2 and therefore excluded from the limit?

It depends on the specialty. The rules for this are a grey area so it’s best you contact the recruitment office for your desired specialty directly so you have an official response.

Does CREST convert your experience to Foundation modules?

We’ve asked several recruitment offices this, and the answer so far has been no. Having CREST or your F2 competencies signed does not make your post-internship experience a Foundation module. Therefore, it does not remove your experience from the limit.

This is based on our correspondence with several recruitment offices. If you would like to verify or try to get a different answer, you can try asking them yourself. We have listed the contact details for all specialty recruitment offices on our Useful Links page.

To avoid disappointment, it is recommended that you do not exceed the experience limits through non-Foundation Programme jobs as much as possible.

My final advice

Avoid exceeding the experience limits as much as possible if you want to enter UK specialty training! 

If it’s not possible to enter UK training due to overexperience, then you can consider the CESR route instead, you can read about CESR here.

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Looking for a step-by-step guide?

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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.

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77 Responses

  1. Hello, I am an IMG from South America, I did pediatric residency in the USA x 3 years after doing the USMLEs but now I would like to do Cardiology in the UK. Can I used my pediatric residency to get GMC registration and from then start internal medicine training to do cardiology afterwards. Please explain me the process.

    1. Hi there, you can’t use residency to get GMC registration although you can use the USMLE provided you have no significant clinical gaps since passing it, and you meet the criteria for internship. You can then then apply for jobs including Internal Medicine Training.

  2. Hi ,
    If I have 36 months of experience in nuclear medicine will it be considered as overqualified for radiology training at ST1 level ?

  3. Hi there, I have graduated medicine in 2019. I did one year post graduation internship and then worked two years as a resident doctor in Anesthesia and Intensive Care. During this time I finished my GMC registration and I am going to start my job in UK as clinical fellow in Intensive care medicine (ST3 equivalent job but non-training) this August. I have two questions;
    1- Am I overqualified for this branch or any other branches (surgical branches or ophthalmic surgery)
    2- If I apply for ophthalmology, what are my chances to get into this specialty in my first attempt considering the clinical experiences that I have. Do I have to have any experience in ophthalmology to be eligible for applying for ST1?

    1. Hi doctor, thanks for your questions!
      To answer:
      1. No
      2. Your chances all depend on your application score. Past work history doesn’t really matter to some extent. If you do well on the MSRA, have a good portfolio score, and do well in interview, then you have as good a chance of anyone else regardless of past experience. You don’t need any ophthalmology work experience to be eligible for ST1, but you do need to demonstrate interest by doing clinical attachments, passing the exams etc.

      For our general tips to improve your application to specialty training, please see this article: https://thesavvyimg.co.uk/8-tips-to-succeed-when-applying-for-uk-specialty-training/

      If you need any further guidance for CT1/ST1 applications, we do have a premium course that explains every detail in a step-by-step manner which you may find useful. You can read more about it here https://thesavvyimg.co.uk/masterclass

      Best of luck!

  4. Hi Nick. I am currently 24 months in Radiology training in my home country. I intend writing the FRCR 1 next year. Do I have any chances of continuing residency training in the UK with FRCR 1? If any what do I need and which level do I apply.
    Thank you

    1. Unfortunately no, you won’t be able to apply for training but you can become a consultant through the CESR route.

      If you’re looking for one-to-one guidance for your specific personal circumstances, I would recommend booking a general guidance session (40 mins). For more details, please visit our page here.

      https://calendly.com/drkimberlytan
      I hope to speak to you soon so we can come up with a plan and timeline that works for you.
      Kimberly

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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.
We have scoured the official guidance to put these posts together, but we can make mistakes! If you spot anything that is incorrect, please get in touch and we’ll put it right.
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