The Savvy IMG

Become a Radiologist in the UK: A comprehensive guide for IMGs

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Introduction

As a technologically-dependent field, Radiology is one of the most exciting specialties in medicine. Innovation is fast-paced and you need to be ready to keep up!

Whether you are already a specialist overseas, or just starting out in your journey to a career in Radiology, there’s a path to the UK for you here in this comprehensive IMG guide.

If you are interested in entering Radiology residency in the UK, be aware that it is very competitive. However, with hard work and a clear strategy, it is certainly possible for an IMG to get a place in the UK Radiology residency programme!

The steps to work in the UK

These are the general steps for any IMG to work in the UK:

  1. Determine your long-term goal
  2. Get registered with the GMC
  3. Find a suitable job
  4. Obtain a work visa
  5. Start work

It is possible to do steps 2 & 3 simultaneously depending on the type of job. It is also possible to interchange steps 2 and 3 by finding a job first, and obtaining GMC registration after you’ve received a job offer as long as the employer agrees to this in advance.

We also have a short course where we explain how it is possible to get into UK training in 2 years time. Enrol now for free.

Determining your long-term goal

Before you can set out on our journey, you really need to determine your long-term goal. This is the step that many IMGs skip and end up taking a sad long winding road.

So before you continue reading, pause for a minute to answer this question: what do you want to get out of coming to the UK?

There are 3 main choices when it comes to clinical work:

  1. Become a recognised UK Consultant Radiologist 
    • Whether you want to stay in the UK long-term or migrate elsewhere after, is up to you.
  2. Work long-term as a Radiologist in the UK without becoming a recognised Consultant
  3. Complete a UK Radiology fellowship/gain UK experience then return home

What is the answer for you?

By answering this question early on, you can save yourself the wasted time and money spent following a pathway that does not lead to your end-goal.

Other options

Of course, there are other options such as pursuing a career in research, medical education, pharmaceuticals, hospital management etc. However, these careers are not covered in this article. This article, and the entire Savvy IMG blog for that matter, deals mainly with clinical careers.

How to reach your long-term goal

The good thing about the UK, is that the pathways are flexible and there are a lot of options. But that is also why it is so confusing.

Here I’ll go through each of the 3 possible long-term goals in more detail.

Goal #1 – Become a recognised UK Consultant Radiologist

If you want to be recognised as a Consultant Radiologist in the UK, and be eligible to apply for  permanent Consultant posts in the NHS, you need to be on the GMC specialist register.

You can enter the specialist register via 3 possible routes:

  1. CCT
  2. CESR-CP
  3. CESR

These 3 routes differ by how much of the UK Radiology residency programme (specialty training) you complete.

CCT route

CCT Radio UK GradsIf you complete the full 5-year UK Radiology training programme, you will be awarded a Certificate of Completion of Training (CCT) in Radiology. This means you start from specialty training year 1 (known as ST1)*.

*If you have more than 18 months experience in Radiology after internship anywhere in the world, you are overqualified for ST1 and cannot pursue the CCT route. To become a Consultant, you must pursue either the CESR-CP or CESR routes described below.

Related: Are you overqualified for UK specialty training?

Before you can start UK Radiology training, you need 24 months clinical experience. This includes 12 months of internship, and 12 months post-internship. Your experience can be in any specialty.

If you have not completed internship overseas, then your only option is to join the 2-year UK Foundation Programme as a first job.

If you have already completed internship overseas, the most suitable first jobs for this route include non-training FY2, Standalone FY2, WAST, or any SHO level post in any specialty. Any of these jobs will help you gain the 12-months post-internship experience required before starting ST1 Radiology.

Please take note, you do not need to have any work experience in Radiology in order to apply for ST1 Radiology. Besides, there are rarely any Radiology jobs for those without prior experience.

CESR-CP route

If you complete less than 5 years of the UK Radiology training, then this is the Certificate of Eligibility for Specialist Registration Combined Programme (CESR-CP) route.

However, the problem is that there is no national process to apply for Radiology training other than at ST1 level. It might be possible to apply for ST2 or ST3 through individual hospitals, but this is quite rare and not a reliable path.

According to new GMC rules, those on the CESR-CP route still need to complete at least 4 years of UK training in Radiology in order to be awarded a CCT. If you complete less than 4 years of UK Radiology training then you will be awarded CESR, not CCT.

Related: CESR-CP will soon be recognised as CCT

If you already have more than 18 months of experience in Radiology, you can apply for non-training ST1, SHO, or junior clinical fellow posts. There are very few jobs like this available. 

If you have more than 3 years of experience, you could apply for specialty doctor, senior clinical fellow, and registrar posts. There are more jobs like this available.

Through any of these posts, you can work on the requirements needed to apply for ST3, however as mentioned above there is no national application process for ST3 it is more realistic and more likely that you end up pursuing the CESR route. Please see below.

CESR route (AKA Article 14)

CESR Radio IMGsIf you do not complete any part of the official 5-year UK Radiology residency programme, you can still be recognised as a Consultant by providing proof (ie. documentation), that you have the equivalent experience and training.

This experience and training can be from overseas, from the UK, or a combination of the two.

CESR stands for Certificate of Eligibility for Specialist Registration.

If you have already completed Radiology training overseas, you can apply for posts such as senior clinical fellow, registrar, and specialty doctor. 

If you have worked as a specialist for many years, you can even apply for locum Consultant jobs.

Through these posts, you can work on the documents you need for CESR. It’s critical that you find a department that will support your plans to apply for CESR. I recommend making your goals clear at the job interview.

The GMC and Royal College of Radiology (RCR) have specific guidance for the requirements for CESR. You can find the updated list of requirements here:

Related: How to become a UK specialist without entering a UK training programme

Equivalence

In the UK, all 3 routes are seen as equivalent. You will be recognised as a UK Consultant Radiologist via any of these 3 routes.

But please be aware that this may not be the case overseas. Some countries do not accept CESR as equivalent to CCT, so if you plan to migrate after becoming a UK Consultant, be sure to check with the medical authority of that country first.

Goal #2 – Work long-term as a Radiologist in the UK without becoming a recognised Consultant

Not all doctors aspire to work as a Consultant, the responsibilities are significant and some doctors find the role unattractive.

If you don’t want to become a Consultant, rest assured that you can still work as a Radiologist in the UK with decent pay and a good work-life balance.

You can apply to any position you feel you are qualified for according to your previous experience and the job description. Potential job titles include clinical fellow or specialty doctor.

It is also possible to apply for locum consultant jobs. Locum consultant posts do not require you to be on the GMC Specialist Register.

Whatever job you start with, you can always seek promotion with the same employer or apply for more senior positions as you gain more experience.

Related:

UK doctor titles 101

The best first jobs for overseas doctors in the UK

This is possible. Most Radiologists in this position go through the CESR route.

Goal #3 – Complete a fellowship in the UK then return home

Many doctors wish to gain experience and training in the UK in order to better serve their patients back home. If this is something you’re interested in, there are a couple of ways to do this.

There are some hospitals that provide fellowship training in Radiology and the subspecialties. These are aimed at doctors who have already completed some Radiology training.

Here are the main ones:

Check the website for the application procedure. Keep in mind that the availability of positions varies from year to year so definitely check them out early on.

If there aren’t any vacancies, you can find others by simply searching “RADIOLOGY FELLOWSHIP UK” on Google.

  1. Visit the NHS Jobs website
  2. Search “radiology fellow”
  3. Apply to jobs you like and are suitable for

If there is a specific Consultant who you would like to do a fellowship with or a specific centre that you would like to gain experience at and you can’t find a job opening anywhere, it’s worth sending a direct email to inquire about a possible fellowship.

Be sure to include a well-formatted up-to-date CV and a convincing cover letter about why you want to work with them and how you can be an asset to them as a fellow.

You still need GMC registration to work in the UK as a doctor, even if you don’t plan to stay here long-term.

To gain GMC registration for a fellowship, you can use any of the methods mentioned above: PLAB, FRCR, MRCS/MRCP, or RCR Sponsorship (MTI).

The registration you gain is permanent and will not be revoked after your fellowship ends.

To obtain a visa to work in the UK as a fellow, there are 2 options:

  1. Tier 5 temporary work visa (maximum 24 months in the UK on this type of visa) – this is done through the RCR MTI OR
  2. Tier 2 standard work visa (no maximum period) – this is done through the hospital you’ll be working at

After completing your fellowship training and gaining UK experience, you simply return home after the job contract ends.

Radiology residency in the UK

Let’s talk a bit more about the UK Radiology training programme.

It is 5 years in duration and each year is numbered. The first year is termed ST1, each year the number goes up until the final year ST5. 

You will be paid a salary while you are training.

Related: How much do doctors in specialty training (residency) earn in the UK?

Programme structure

The first 3 years cover basic Radiology training, the final 2 years are dedicated to a subspecialist interest in Radiology.

Throughout the 5 years you will be vetting radiology requests, interpreting images, performing ultrasounds and radiology-guided procedures, and attending teaching sessions and conferences. Most placements will also include some evening, nights and weekend work.

In most programmes, you will rotate to a new hospital every 6-12 months for all 5 years.

Related: How specialty training (residency) works in the UK: A complete beginner’s guide 

Exams

The official exam for Radiology in the UK is the FRCR. There are 3 parts to this exam. All parts must be passed by the end of the 5-year training programme.

  • First FRCR Exam– this exam has 2 modules: anatomy and physics. Trainees are expected to pass both modules by the end of ST1. 
  • Final FRCR Part A – This is a written exam of 2 papers taken on the same day. Each paper contains 120 multiple choice questions and lasts 3 hours each. Trainees must pass Part A by the end of ST3.
  • Final FRCR Part B– This exam is more practical. It involves reporting images, and discussing cases with the examiners. Trainees must pass Part B by the end of ST4. 

How to apply for UK Radiology residency

Applications open once a year and are submitted through the website Oriel. The exact dates are released each year but the general timeline is as follows:

NovemberApplications open
JanuaryMulti-specialty recruitment assessment (MSRA test) – the top 600 scorers will be invited to interview.
FebruaryNational interview + Portfolio scoring
MarchResults are released
August-OctoberStart of training

 

Take note: in the UK residency application process, you make a single application for the whole UK. You do not apply to individual hospitals.

If you want to learn more about how residency applications work in the UK, check out this essential guide: What IMGs need to know about applications to specialty training in the UK

The entry requirements for UK Radiology specialist training

The main entry point for Radiology is ST1. Here are the basics of what you need to know. 

ST1

  • Full GMC registration by the time you start ST1
  • 24 months clinical experience by the time you start ST1
    • This includes 12 months of internship + 12 months after internship.
    • You do not need to have any work experience in Radiology in order to apply.
  • F2 competences or CREST (Certificate of Readiness to Enter Specialty Training)

These are the basic requirements. Please see the ST1 Radiology person specifications for the full requirements.

If you have more than 18-months experience in Radiology after internship anywhere in the world, you are considered overqualified for ST1 and will not be eligible to apply.

Competition is typically expressed as a ratio. This is calculated by the number of applicants divided by the number of available posts.

Eg. If there are 300 posts for Radiology, and 900 applicants, then the competition ratio is 3.

Here are the competition ratios for Radiology ST1 over the past 5 years:

 20152016201720182019
Radiology3.714.283.823.753.63

(Source)

I would consider a competition ratio of less than 2 as having low to moderate competition, between 2-4 as highly competitive, and a competition ratio of more than 4 as extremely competitive.

ST2/ST3/ST4

If you have more than 18 months experience in Radiology, then you might be thinking of applying for Radiology training at ST2, ST3, or ST4 level. In that case, you can read the requirements here:

Please keep in mind that there is no national process to apply for Radiology training at ST2, ST3 or ST4 level.

You might be able to find individual jobs at certain hospitals, but this is quite rare and not a reliable path. These jobs also tend to last for only 12 months (known as Locum Appointment for Training or LAT posts) so you have to look for another job each year.

So if you have more than 18 months experience in Radiology, you’ll need to strongly consider the CESR route.

Is it difficult to get into UK Radiology training?

Radiology is considered highly competitive and used to be essentially closed to IMGs unless you found a way to work around the immigration restrictions. 

However, as of October 2019, immigration laws changed in a way that meant that UK graduates are no longer prioritised for training posts. This means that IMGs will be considered equally alongside UK graduates and the only determining factor of success, is the application score. So it’s definitely possible with a good strategy and hard work!

At the time of publication, 9% of Radiology trainees are IMGs but with the new rules, this can go up.

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

How do I improve my chances of success?

Although Radiology is competitive, it’s not impossible. To succeed with your application, you’ll need to maximise your application score.

There are 3 components to the application score:

  • The Multi-Specialty Recruitment Assessment (MSRA)
  • Your CV/portfolio
  • Your interview performance

Do well in each of these areas and you will have a decent chance of landing a spot.

Related: 8 tips to succeed when applying for UK specialty training

Further information about applications

If you have any questions about applying for Radiology in England, Scotland and Wales, you can use this contact form. For Northern Ireland, you can email specialty.nimdta@hscni.net.

GMC registration for Radiology

So now you’ve decided on your long-term goal, you need to think about how you’re going to gain registration with the General Medical Council (GMC).

The GMC are the medical authority in the UK. To work as a doctor here, you need to be registered with them. There is no exemption to this no matter how much experience you have or where you come from. Every doctor working in the UK needs GMC registration.

How do you obtain GMC registration?

You’ll first need to create a GMC online account. You can find instructions on how to open an account here.

You’ll then need to submit an application for full registration. These are the requirements for an application:

  • Proof of English proficiency (IELTS, OET or other)
  • EPIC verification of your medical degree
  • +/- EPIC verification of your FRCR/MRCP/MRCS certificate (if you have one)
  • +/- Internship certificate (if going through the PLAB route)
  • +/- Certificate of good standing (if you are registered as a doctor anywhere else in the world)

Read more about the requirements for GMC registration in detail here.

On top of the above requirements, you need to provide proof of your clinical skills and knowledge. There are several options to do this for Radiology:

The PLAB exam is set at the level of a doctor who has completed internship. It is most suitable for IMGs who have not yet completed postgraduate training in Anaesthesia, however, it can also be taken by those who are already specialists. In most cases, it is the quickest and least expensive route.

These exams are aimed at doctors who have completed a residency or specialist training in Radiology. If you pass FRCR, then you can bypass PLAB.

Either of these exams can also be used to bypass PLAB and gain GMC registration. If you’re planning to apply for UK Radiology residency AKA specialty training, then they also add points to your application.

You can gain GMC registration without PLAB, FRCR or MRCS/MRCP if you can obtain sponsorship through the Royal College of Radiology. It’s a lengthy process which you can read more about on the RCR website.

The GMC accepts some international qualifications for registration. If you have any of the these, then you can bypass PLAB. Eg. Fellowship of the American, Canadian, South African, Australian/New Zealand Colleges of Radiology, Sri Lankan MD in Radiology etc.

If you have already been practising as a specialist for many years, you can try applying for direct recognition as a Consultant via the CESR route. This is a difficult and tedious process that can take years to complete, but it’s an option for IMGs who do not go through any of the other routes mentioned above. You can read more about it below under the section “Become a recognised UK Consultant Anaesthetist”

Finding a suitable first job

There are 2 main questions to consider when looking for a suitable first job.

  1. Do you have the right training and experience for the job?
    • You will find detailed information about the roles and responsibilities of the job in the job description. Read these carefully to decide whether you are suited for the post.
    • Most Radiology jobs require previous training and experience.
  2. Will it lead to your long-term goal?
    • There is no point working in a job that will jeopardise your long-term goal.
    • Read below to figure out the overall pathway and for tips on what a suitable first job would be in each pathway.

Related:

The best first job in the UK for overseas doctors

10 ways to prepare for your first job in the NHS as an IMG

12 essential items for IMGs working in the NHS

Visas and immigration

Most IMGs will need the General work visa (Tier 2). With this type of visa, you can bring your family to the UK as well. Family means spouse and children. It does not include parents, siblings or other relatives.

After 5 years in the UK on a Tier 2 visa, you can apply for permanent residence AKA Indefinite Leave to Remain (ILR). After one year with ILR, you can apply for British citizenship.

In short, the majority of IMGs who come to work in the UK, can gain British citizenship within 6 years.

Disclosure: There are some affiliate links in the article above. This means that at no additional cost to you, we may earn a commission if you make a booking or purchase by clicking on the link. We only recommend products and services that we use ourselves or have proven success amongst IMGs.

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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.

free

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.

free

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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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