The Savvy IMG

The Savvy IMG Crash Course

It can be hard to know where to start planning your move to the UK. The process can feel daunting and overwhelming. There’s a lot to learn, and information overload can occur very quickly!

I created this very simple and easy guide so you can get an overview of the entire process in one sitting. You’ll find links to further information when you’re ready to read more.

Let’s get started!

Step 1. Determine your long-term goal

Before you can dive into the details of how to work as a doctor in the UK, you first need to know what your goal is. Once you know this, you can review your options and make an informed decision about which pathway is most suitable for you. 

The main options for IMGs who want to work as a clinical doctor are: 

  1. Become a UK Consultant or GP
  2. Work in the UK long-term without becoming a GP or Consultant
  3. Obtain short-term fellowship training then return home

Step 2. Understand the training pathway for your target specialty

Whether you want to enter UK training or not, it's extremely helpful to understand the training pathway. 

In a nutshell, UK postgraduate specialist training involves 2 years of "foundation training" + 2-3 years of "core training" + and 4-6 years in "higher specialty training". 

The path for a GP includes 2 years of "foundation training" followed by 3 years of GP training.

Learn more about how UK specialty training works in this article:

Step 3. Get registered with the GMC

The GMC is the medical authority in the UK. You need to be registered with the GMC in order to work as a doctor. There are no exceptions.

It's possible to start looking for jobs before getting GMC registration, but if you don't obtain registration on time, your job offer can be withdrawn. So we recommend getting GMC registration, or at least starting the process, before you start applying for jobs.
general medical council UK PLAB

Requirements for GMC registration

  • An acceptable medical degree
  • Proof of English proficiency
  • Proof of clinical skills and knowledge
  • +/- Proof of acceptable internship
  • +/- Certificate of good standing
  • Valid passport
  • Declaration of your activities the last 5 years
The exact requirements depend on your specific situation. Learn more in our in-depth article.

Routes to GMC registration

  • PLAB (aka UKMLA in 2024)
  • Accepted overseas licensing exam eg. USMLE, MCCQE, AMC
  • Accepted postgraduate qualification eg. MRCP, MRCS, MRCOG
  • Sponsorship eg. MTI
There may be more than one route that is applicable to you depending on your background.

Types of GMC registration

  • Provisional registration
  • Full registration
  • Specialist Register (for Consultants)
  • GP Register (for GPs)
The vast majority of new IMGs will obtain full registration with the GMC.

How much does this all cost?

If you're going through the PLAB route, it will cost between £5,000-10,000 from GMC registration to landing your first job.

We give a full breakdown of the costs and how you can save money in this article.

Step 4. Find a suitable first job

There are many different jobs for doctors in the UK, and not all jobs are created equal. It's important to choose the job that's right for you given your experience, qualifications, goals, and preferences.

3 types of jobs

  • Training jobs - Jobs that are part of a GMC-approved specialist training programme ie. residency.
  • Non-training jobs - Any job that is not part of a GMC-approved specialist training programme.
  • Locum or bank - Subtype of non-training job where you are not a regular employee of the hospital. Instead you fill in short-term vacancies arranged through an agency, usually at short notice.
The majority of IMGs will start in a non-training job at a suitable level according to experience and qualifications, and then progress to a training job if desired. 

Levels/grades of jobs

  • Junior level - Suitable for those who do not have formal postgraduate training overseas ie. have not completed a residency programme.
  • Middle grade - More suitable for those who have undergone formal postgraduate training.
  • Senior doctors - Suitable for doctors who have practised as specialists for many years.
The level you take on as a first job will depend on your previous training and experience.

NHS vs private sector

  • NHS - This is the public health system in the UK. The vast majority of doctor jobs are within NHS hospitals and connected organisations. All training jobs are in the NHS.
  • Private sector - Generally, jobs that are outside of the NHS are in the private sector.
It is advisable to start in an NHS hospital where there are better support systems and teams which make it safer for both doctors and patients. 

We personally do not recommend starting in a private hospital until you are fully familiar with how medicine is practised in the UK. This is to avoid easily avoidable mistakes that can harm patients, cost you your license and/or result in lawsuits.

Step 5. Obtain a work visa

Most IMGs will require a visa to work in the UK. There are 2 types of visas that can be used: Government Authorised Exchange visa and the Health and Care Worker visa.

Both visas will allow you to bring your family to the UK with you. This includes your spouse and children, not your parents, siblings or other relatives.

Once you successfully get a job offer, the hospital will issue you a sponsorship letter which will you allow you to apply for a work visa. So you only apply for a work visa once you have found a job, not before. You can't get a work visa then move to the UK and look for a job.

Government Authorised Exchange visa

This is a Temporary Worker Visa  most commonly used for the Medical Training Initiative or MTI programme. The maximum time you can spend in the UK on this type of visa is 24 months although you can stay longer by switching to another type of visa such as the Health and Care Worker visa.

It is meant for doctors who wish to gain experience and training in the UK then return home.

Health and Care Worker visa

This visa is the most common type of visa that IMGs use to work in the UK. 

After 5 years on this visa, you can apply for permanent residence (known as Indefinite Leave to Remain), and a year later you can apply for British citizenship.
Pathways to become a UK recognised specialist through the CCT CESR-CP and CESR routes 2
CCT - Certificate of completion of training / CESR-CP - Certificate of Eligibility for Specialist Registration Combined Programme / CESR - Certificate of Eligibility for Specialist Registration

Step 6a. Become a recognised specialist

This step is for those who wish to become a GMC recognised specialist. There are 2 types of UK specialists recognised by the GMC: Consultants and GPs.


Consultants in the UK have at least 7-10 years of postgraduate training. If you want to be eligible for a permanent Consultant job, you must be on the GMC Specialist Register. 

There are 3 routes to the specialist register: CCT, CESR-CP, and CESR. The 3 different routes differ depending on how much of the UK-based specialist training programme you complete.

Review the flowchart to see the difference between the 3 routes.


GPs in the UK are family and community medicine specialists with at least 5 years of postgraduate training. If you want to eligible for GP jobs, you must be on the GMC GP Register.

There are 2 routes to the specialist register: CCT and CEGPR. The 2 routes differ depending on whether or not you complete the 3-year UK-based GP training programme.

Review the flowchart above to see the difference between the 2 routes.

How to get into UK specialty training

If you want to become a specialist through the CCT or CESR-CP route, then you need to complete a specialty training programme. Getting into a UK training programme is highly competitive. Understand the process first, then prepare your application so you can succeed!

Step 6b. Continue working in the UK without becoming a GP or Consultant

You do not have to become a GP or Consultant. Many doctors (both locals and IMGs) are very happy working in non-training jobs for their whole career. 

It is also possible to work as a specialist without being on the GMC Specialist Register. This means you are working as a middle grade or senior doctor in your specialty, but not as a permanent Consultant. Remember, permanent Consultant jobs are only for those on the GMC Specialist Register.

Variations of the steps