The Savvy IMG

Can I apply in Round 1 of specialty recruitment as an IMG?

Table of Contents

What if my internship experience is rejected by the GMC

​UPDATED: October 24, 2019

I graduated from a medical school outside the UK. Can I apply in Round 1 of specialty recruitment?

Answer: Yes.

As of October 6, 2019, all doctors coming from overseas and applying for work in the UK are automatically exempt from the Resident Labour Market Test (RLMT). This is because all jobs in the medical profession have been included in the UK Shortage Occupation List. 

Now that IMGs are exempt from RLMT, they can now apply in Round 1 for any specialty (except Public Health) and will be assessed equally amongst UK graduates.

You can read more about these changes and what it means for IMGs here.

Just for your reference, I have kept the old answer to this question below so you can see how things have changed.

Pre-October 6, 2019 Answer: It depends.

The defining difference between Round 1 and Round 2 is whether you have unrestricted right to work in the UK. This all depends on your immigration status, not where you graduated from.

The principal here is the Resident Labour Market Test (RLMT) which basically says that no UK job should be given to an overseas national if there is a suitable candidate who is a UK or EU national. Fair enough. Countries can’t justify leaving their own citizens jobless.

So in line with this rule, Round 1 of specialty recruitment is the round where UK & EU nationals are given priority for training posts. If there are any jobs leftover from Round 1, they go to Round 1 re-advert aka Round 2 which is when IMGs who need Tier 2 work visas are given consideration.

But foreign nationals can also be considered in Round 1!

As long as they are exempt from RLMT, they will be considered on equal footing with UK & EU nationals.

Applicants exempt from the RLMT will be considered for posts alongside UK/EU/EEA nationals and other settled workers. – Medical Specialty Recruitment Handbook 2019 p51.

So who are these RLMT-exempt IMGs who have the same chance as any UK/EU medical graduate in landing a specialty training post?

I’ve summarised the guidelines below and placed the different immigration categories into 5 groups to make it easier to understand.

Group 1

UK/EU/EEA/Swiss nationals and British overseas national with right to abode.

This includes those who graduated from an overseas medical school.

Group 2

Foreign nationals with the following immigration status:

  • Indefinite leave to remain (ILR) or settled status
  • Discretionary leave to remain
  • Refugee status
  • UK ancestry visa
  • Tier 1 (Graduate Entrepreneur)
  • Tier 2 in a training post (restricted to the same country eg. if your sponsor is Health Education England, you can only apply in Round 1 to training posts in England)
  • Tier 4 (Doctorate Extension Scheme) – must have completed UK Bachelors or Masters degree or currently studying and completed a minimum of 12 months towards a UK PhD

Group 3

Foreign nationals who are the partner/civil partner/spouse of any of the following and do not have the restriction “No employment as a Doctor or Dentist in Training” on their visa/BRP:

  • UK/EEA national who is resident in the UK
  • Refugee

Group 4

Foreign nationals who are the dependant of someone with the following immigration status/visa and do not have the restriction “No employment as a Doctor or Dentist in Training” on their visa/BRP:

  • UK/EU national
  • ILR
  • Tier 1 visa holder
  • Tier 2 visa holder
  • Tier 4 visa holder
  • Tier 5 visa holder
  • UK ancestry visa holder

Group 5

Foreign nationals applying to a training post on the shortage occupation list. As of December 2018 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
  • Obstetrics & gynaecology – all grades
  • Anaesthetics – all grades
  • Paediatrics – all grades

This infographic lays out the different immigration categories that are exempt from the resident labour market test. International medical graduates who are exempt from RLMT are eligible to apply in Round 1 of specialty applications and will therefore be considered alongside UK graduates.

Follow up questions

Are you sure about all this?

All the information laid out here was taken from p51-55 of the Medical Specialty Recruitment Handbook 2019. The handbook is based on the current Home Office immigration rules (correct as at August 2018) and is subject to change. If you have doubts, contact the Home Office to clarify your status.

Are there any exceptions?

You can still apply in Round 1 of GP even if you are subject to RLMT.

Who does the restriction “No employment as a Doctor or Dentist in Training” apply to?

We asked the Home Office for clarification on this. They said that the restriction applies to dependants of migrants who come to the UK through the Points-Based System (PBS). PBS covers the Tier 1 up to Tier 5 visas.

There is only one exception relevant to IMGs:

  • If you are an IMG already in the UK working as a doctor in training on a different visa that allowed you to do so, and you then apply as a dependant of someone on a Tier 1-5 visa, then the restriction will not be imposed on you when you switch visa status.

This doesn’t help most IMGs. This essentially that means that if you qualified overseas and you are coming to the UK for the first time as the dependant of someone on a Tier 1, 2, 4 or 5 visa then you will have the restriction and therefore will be subject to RLMT.

What if I am subject to RLMT?

You may still be able to hit the submit button on your application in Round 1 but it might not go anywhere. Most specialties will automatically reject your online application without allowing you to reach the interview stage.

If you’re unable to get a job in Round 1, you can always submit your application in Round 1 re-advert aka Round 2if there is one! Competitive specialties often do not go to Round 2. Also bear in mind that even in Round 2, you still have to wait for those who are RLMT-exempt to be given jobs first.

So although it is very much possible to secure a training job even if you are subject to RLMT, this is not the case for competitive specialties. Your best chance is to be in Round 1.

But how can you gain exemption from RLMT? Well, there are ways. Read about the IMG-friendly specialties and how to gain exemption from RLMT here.

We are currently contacting the national recruitment offices to find out the statistics for Round 2. We’ve asked about the number of Round 2 vacancies for each specialty and how many visas were issued. Subscribe to be notified of the data when it’s published!

You might also like

17 Responses

  1. Hi Nick and Kim! Great website.
    I just want to ask, if I’m already an IM graduate here (meaning I already finished 3 years of residency training in IM) Will that be credited in the UK or do i have to do everything all over again?

    1. Hi there, no it’s not accredited per se but what is your goal in coming to the work in the UK? Work just in IM or pursue further specialty training?

  2. From January 2021, the RLMT will be abolished.

    A new scheme will be introduced by the government requiring a points-based visa. Some of the points needed for scoring will include the job being on the shortage list.

    There are very specialities which are on the shortage list as published by MAC.

    This is good news for protection of British graduates.

    1. We’ll have to wait and see what happens! So far, no specialties were specified on the updated SOL from October 2019 despite MAC recommendations earlier in the year.

  3. hi nick an kim,
    thanks for the wonderful information and covering teeny weeny bits which canbe missed out by IMGS with scarce knowledge..
    so,scotland st3 obg is it easier to get into than the uk??
    i dont belong to any og the groups,so does that mean i am not elligible for round1 st3?

    1. Hi there, as mentioned in the article, as of October 6, 2019, all doctors can now apply in Round 1 for any specialty (except Public Health) and will be assessed equally amongst UK graduates. This can change in the future.

  4. Hi Nick,

    Thank you so much for your helpful article. I just wanted to check if you knew whether foreign nationals who have graduated from UK medical schools are also eligible for round 1.

  5. “Tier 4 (Doctorate Extension Scheme) – must have completed UK Bachelors or Masters degree or currently studying and completed a minimum of 12 months towards a UK PhD”

    I have finished my MCh (Masters) in Orthopaedics on a student (Tier 4) visa. Does that mean when I apply for training I will be included in round 1?

    1. Hi, you are eligible for round 1 if you are currently a student on a Tier 4 visa. If you have completed the course and you are no longer a student on a Tier 4 visa then you are not eligible for Round 1. Please contact HEE for further clarification. The contact details are on the useful links page. Best of luck!

  6. Hi Nick,
    Thanks for the valuable post.
    I am an IMG working as registrar in acute medicine on Tier 2 visa in the UK. It’s a non-training post. I want to apply for radiology in 2020. I know it is a very competitive speciality here. My understanding is that it’s recruitment process has only one round unlike RCP specialties. How does RLMT work in the application process in radiology?

  7. Excellent article.

    I recently graduated from med school, and will start my internship at my country soon. The speciality I want is Paediatrics.

    I was planning to follow Path B, such that I secure a first job and then look for a training job. I have a couple of questions though:

    1-If I decided to apply for Scotland, in which Paediatrics is in the SOL and is therefore excepted from RLMT, would I still need to secure a first job and then apply for round 1, or can I directly apply to round 1 once I pass PLAB?
    2-If I do apply for round 1, would it still be path B? Would I have to take FY1 or 2 in any case if I already finished my internship back home?
    3-If I look for a first job, what are my chances of getting a non-training job in Paediatrics, given that it has a low competitive rate?
    4-In case I couldn’t find a non-training job in Paediatrics, would any other field be fine if I want to get my training in Paediatrics?

    Thanks again for the info.

    1. Hi Eman, thanks for your comments. To answer your questions:
      1. Yes, since all ST1 jobs require 24 months postgraduate experience before you can start. Please read this article about eligibility.
      2. Yes. Pathway B is for those who have already completed internship overseas. You can’t apply for an official FY1 post if you have already completed internship and have full GMC registration. You can apply for FY2 and other SHO level posts.
      3. I wouldn’t know, depends on the availability of jobs and number of applicants.
      4. Yes any other field is fine. A&E is good since you’ll get exposure to paeds A&E.

  8. Thank you for your post. I am a paediatrician in my country and I want to move to the UK, unfortunately my postgraduate college is not recognised by GMC. I gathered that I need to write plab to be registered with GMC. I want to know what my training will be like in the UK. Do I have to start from ST1 or FY1 or would the training I have done be given any consideration in determining where I can start training. Can I start a subspecialty training immediately or do I need to practice for sometime. I still want to practice paediatrics and I want a training job.

Leave a Reply

Your email address will not be published. Required fields are marked *

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.
Photo of Dr Nicholas Tan