Introduction
Dermatology continues to be a popular career choice for many medical graduates. With an ageing population and an increasing incidence of skin cancer, the need for Dermatologists in the UK is higher than ever.
Whether you have already trained in Dermatology overseas, or you are interested in entering Dermatology training in the UK, this comprehensive guide will discuss your options for a clinical career in this specialty in the UK.
Be aware that entering UK Dermatology training is highly competitive, however, with hard work and a clear strategy, it is certainly possible for an IMG to get a place in the UK Dermatology residency programme.
The steps to work in the UK
These are the general steps for an IMG to work in the UK as a Dermatologist:
- Understand the UK Dermatology training pathway
- Determine your long-term goal
- Get registered with the GMC
- Find a suitable job
- Obtain a work visa
- 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.
The UK Dermatology training pathway
Whether you plan to enter the UK training pathway or not, it’s important to understand the pathway so you have an idea of what it takes to become a recognised UK Consultant Dermatologist.
Dermatology training in the UK is currently 4 years long, however, to start Dermatology training, you must have a minimum of 4 years postgraduate clinical experience plus a relevant postgraduate qualification.
For UK doctors, this consists of the following:
- 2 years UK Foundation Programme
- Plus Core training (ONE of the following programmes):
- 2-3 years Internal Medicine + MRCP* OR
- 3 years Acute Medicine + MRCP OR
- 3 years Paediatrics + 1 year in adult Internal Medicine + MRCPCH**
For IMGs, it can look a little different. We’ll go into the possible alternatives a bit later.
*Membership of the Royal Colleges of Physicians
**Membership of the Royal College of Paediatrics and Childrens Health
Overview of the UK Dermatology training pathway
Exams & exit qualifications
A requirement of Dermatology training is the Specialty Certificate Examination in Dermatology (SCE Derm).
Once the exam is cleared, and the 4-year training completed, a Dermatologist is awarded a Certificate of Completion of Training (CCT). This is used to gain entry to the GMC Specialist Register and be recognised as a Consultant Dermatologist. Once on the GMC Specialist Register, one can only apply for permanent Dermatology Consultant jobs.
A note on Masters & MDs
Having a UK Masters or MD in Dermatology can look good on your CV, but these degrees are completely optional. They are not an integral part of the specialty training pathway in the UK and do not lead to being recognised as a Consultant Dermatologist.
What is 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:
- Become a recognised UK Consultant Dermatologist
- Whether you want to stay in the UK long-term or migrate elsewhere after, is up to you.
- Work long-term as a Dermatologist in the UK without becoming a recognised Consultant
- Complete a UK Dermatology 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 Dermatologist
If you want to be recognised as a Consultant Dermatologist 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:
These 3 routes differ by how much of the UK Dermatologist training pathway you complete.
CCT route
To be awarded a Certificate of Completion of Training (CCT) in Dermatology, you must complete both core training (2-3 years) and Dermatology training (4 years) in the UK.
The CCT route is best for new graduates and those who have not already completed postgraduate training in Dermatology.
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CCT route
To be awarded a Certificate of Completion of Training (CCT) in Dermatology, you must complete both core training (2-3 years) and Dermatology training (4 years) in the UK.
The CCT route is best for new graduates and those who have not already completed postgraduate training in Dermatology.
Click image to enlarge
Core training options
You have a choice of 3 core training programmes in the UK for the CCT route:
- Internal Medicine (2-3 years)
- ACCS Acute Medicine (3 years)
- Paediatrics (3 year) + 1 year adult Internal Medicine
It’s really up to you which one you choose depending on the type of training you wish to have. Before you enter Dermatology training, you need to pass the postgraduate exam relevant to the core training programme (either MRCP or MRCPCH).
Higher specialty training
Whichever core training programme you choose, you will then apply for Dermatology (4 years). You’ll need to pass SCE Dermatology in this time.
Related:
CESR-CP route
If you complete the 4-year UK Dermatology training programme, but do not complete Core training in the UK or internationally accredited equivalent, then this is known as the Certificate of Eligibility for Specialist Registration Combined Programme (CESR-CP) pathway.
However, at the end of training, you will still be awarded a CCT in Dermatology.
This route is most suitable for those who already have some postgraduate experience.
Related: CESR-CP will soon be recognised as CCT
Click image to enlarge
CESR-CP route
If you complete the 4-year UK Dermatology training programme, but do not complete Core training in the UK or internationally accredited equivalent, then this is known as the Certificate of Eligibility for Specialist Registration Combined Programme (CESR-CP) pathway.
However, at the end of training, you will still be awarded a CCT in Dermatology.
This route is most suitable for those who already have some postgraduate experience.
Related: CESR-CP will soon be recognised as CCT
Click image to enlarge
Core training alternatives
On the CESR-CP route, you can skip UK core training if you already have the equivalent experience overseas, or if you decide to obtain core training experience in the UK but outside of the official core training programmes.
There are 2 ways to do this:
- Adult medicine route
- Minimum 2 years post-internship experience in adult medicine (this must include a minimum of 12 months managing acute medical inpatients)
- Alternative Certificate of Core Competence
- This is a document to certify you have the equivalent skills and knowledge of a doctor who has completed the official UK Internal Medicine training programme.
- Having a valid Core Competence certificate confirms that you have Foundation competences as well, so no separate Foundation competence form is required.
- MRCP
- Paediatric route
- Minimum 2 years post-internship experience in Paediatrics
- Minimum 1 year post-internship experience in acute adult medicine
- Certificate of Completion of Paediatric Level 1 Competency
- This is a document to certify you have the equivalent skills and knowledge of a doctor who has completed the Level 1 Paediatrics in the official UK Paediatric training programme.
- MRCPCH
Higher specialty training
Once you complete the above requirements, you will be eligible to apply for Dermatology, along with those on the CCT route who have completed UK core training.
CESR route (AKA Article 14)
If you do not complete any part of the official UK Dermatology residency programme, you can still be recognised as a Consultant.
This is achieved by submitting proof to the GMC (ie. documentation), that you have the equivalent experience and training of someone who has completed both UK Core training and UK Dermatology training. This experience and training can be from overseas, from the UK, or a combination of the two.
If accepted, you will be awarded a Certificate of Eligibility for Specialist Registration (CESR) for Dermatology.
This route is most suitable for those who have already completed postgraduate training in Dermatology.
Click image to enlarge
CESR route (AKA Article 14)
If you do not complete any part of the official UK Dermatology residency programme, you can still be recognised as a Consultant.
This is achieved by submitting proof to the GMC (ie. documentation), that you have the equivalent experience and training of someone who has completed both UK Core training and UK Dermatology training. This experience and training can be from overseas, from the UK, or a combination of the two.
If accepted, you will be awarded a Certificate of Eligibility for Specialist Registration (CESR) for dermatology.
This route is most suitable for those who have already completed postgraduate training in Dermatology.
Click image to enlarge
What documentation do you need to provide for CESR?
The GMC and British Association of Dermatologists (BAD) have specific guidance about what documents are required for CESR. You can find the guidance here:
Related: How to become a UK specialist without entering a UK training programme
Equivalence
In the UK, all 3 pathways – CCT, CESR-CP & CESR – are viewed as equivalent. You will be recognised as a UK Consultant Dermatologist 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 Dermatologist 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 Dermatologist in the UK with decent pay and a good work-life balance.
What positions can you work in as a Dermatologist without being recognised as a Consultant?
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:
What if you eventually want to become a Consultant Dermatologist?
This is possible. Most Dermatologists in this position go through the CESR route.
Goal #3 – Complete a fellowship in the UK then return home
You may wish to gain experience in the UK through a fellowship then return home in 1-2 years. If you only plan to work in the UK for a short period of time, there are several ways to achieve this.
Apply for an established Dermatology fellowship programme
There are several subspecialty fellowship opportunities for those who have already completed their Dermatology training. You’ll need to contact the relevant departments to inquire about vacancies and application procedures.
Here are a couple of websites for these fellowships:
Find a Dermatology job on the NHS jobs website
- Visit the NHS Jobs website
- Search “Dermatology fellow”
- Apply to jobs you like and are suitable for
Fish for a Dermatology fellowship
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.
Pursue a University-affiliated postgraduate degree in Dermatology
Some universities offer Masters or MD degrees in Dermatology that you might be interested in. Here are just a few:
- MSc Clinical Dermatology – Cardiff University
- Clinical Dermatology PGDip – Queen Mary University London
- MSc Clinical Dermatology – University of Hertfordshire
- Clinical Dermatology MSc – King’s College London
These degrees have no place in the UK specialty training pathway to become a Consultant Dermatologist and are usually aimed at IMGs. Nonetheless, they are still good opportunities for further learning and to improve your credentials back home
GMC Registration for short-term training
You still need GMC registration to work in the UK as a doctor, even if you don’t plan to stay here long-term. However if you pursuing a university-based degree that does not involve patient contact, you may not need GMC registration. You’ll need to check with the university.
To gain GMC registration for a fellowship, you can use any of the 5 methods discussed below under the GMC registration section: PLAB, MRCP, MRCPCH, an overseas qualification, or MTI.
The registration you gain is permanent and will not be revoked after your fellowship ends.
Work visas for UK fellowship
To obtain a visa to work in the UK as a fellow, there are 3 options:
- Tier 5 temporary work visa (maximum 24 months in the UK on this type of visa) – this is done through RCP OR
- Standard work visa (no maximum period) – this is done through the hospital you’ll be working at
- Tier 4 student visa – if you are pursuing a University-based degree, you may need to apply for a student visa.
After completing your fellowship training and gaining UK experience, you simply return home after the job contract ends.
Dermatology residency in the UK
Core Training
CT1/ST1 - Entry requirements
The basic requirements for any of the 3 core training programmes are as follows:
- Full GMC registration by the time you start CT1 or ST1
- 24 months of clinical experience by the time you start ST1. For IMGs, this can consist of:
- OPTION A: 2-year UK Foundation Programme
- OPTION B: 1 year internship overseas + 1 year UK Standalone FY2
- OPTION C: 1 year internship overseas + 1 year UK WAST
- OPTION D: 1 year internship overseas + 1 year in any specialty whether UK or overseas (UK experience is recommended)
- Foundation competences
- FPCC (Foundation Programme Certificate of Completion) – applicable to Option A and Option B OR
- CREST (Certificate of Readiness to Enter Specialty Training) applicable to Option C and Option D
These are the basic requirements. Please see each programme’s ST1/CT1 person specifications for the full requirements.
CT1/ST1 - Restrictions
If you have more than 18-months post-internship experience in any medical specialty, you will be considered overqualified for CT1 Acute Medicine and will not be eligible to apply.
There are no such restrictions for Internal Medicine or Paediatrics.
CT1/ST1 - Competition
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 50 posts for Internal Medicine, and 100 applicants, then the competition ratio is 2.
Here are the competition ratios of the 3 programmes over the past 5 years:
| Specialty | 2015 | 2016 | 2017 | 2018 | 2019 |
| Internal Medicine & ACCS Acute Medicine | 1.70 | 1.53 | 1.41 | 1.50 | 1.43 |
| Paediatrics | 1.80 | 1.65 | 1.33 | 1.30 | 1.18 |
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.
CT1/ST1 - Further information about applications
For timelines, portfolio/CV requirements, and information about interviews, please visit the following links:
- Official website for applications to CT1 Internal Medicine or Acute Medicine
- Official website for applications to ST1 Paediatrics
- Website where you apply (Oriel) including user guide and FAQs
If you have any questions about applying for core training, please email the relevant recruitment office:
For Internal Medicine & ACCS Acute Medicine: IMTrecruitment@hee.nhs.uk
For Paediatrics: PaedsNRO@hee.nhs.uk
There are internationally accredited Internal Medicine training programmes overseas which have been approved as equivalent to the UK programme. If you complete IMT in one of these accredited overseas programmes, you will still be eligible for CCT.
Read more about JRCPTB international programme accreditation.
Dermatology higher specialty training
ST3 - Entry requirements
CCT route
- You must currently be in the final year of any one of the accepted core training programmes or have previously completed one in the past.
- Relevant postgraduate qualification (MRCP or MRCPCH)
CESR-CP route
One of the following:
- Adult Medicine Route
- Minimum 2 years adult medicine including minimum 12 months managing acute medical inpatients
- Alternative Certificate of Core Competence
- MRCP
- Paediatric Route
- Minimum 2 years Paediatrics
- 1 year acute adult medicine + Certificate of Completion of Paediatric Level 1 Competency
- MRCPCH
These are the basic requirements. Please see the ST3 Dermatology person specifications for the full requirements.
ST3 - Restrictions
One of the eligibility criteria for ST3, is that you are not already eligible for CESR Dermatology.
So if you already have extensive training and experience in Dermatology, eg. more than 10 years, it’s possible that the panel will decide you are overqualified for training. If this happens, you may be deemed ineligible for ST3 but so far we’ve not heard of this happening in real life.
ST3 - Competition
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 50 posts for Internal Medicine, and 100 applicants, then the competition ratio is 2.
Here are the competition ratios for ST3 Dermatology over the past 4 years:
| 2016 | 2017 | 2018 | 2019 | |
| Dermatology | 4.56 | 5.58 | 3.13 | 3.38 |
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.
ST3 - Succeeding as an IMG
Dermatology is extremely competitive and you’ll need a solid application to even stand a chance.
Fortunately, due to recent changes in UK immigration laws, local graduates and EU nationals are no longer prioritised for training. All applicants are given equal opportunity to apply with no restrictions on IMGs.
Related: 9 ways the new Shortage Occupation List affects IMGs dreaming of UK specialty training
ST3 - Further information about applications
For timelines, portfolio/CV requirements, and information about interviews, please visit the following links:
- Official website for information about ST3 applications
- Website where you apply (Oriel) including user guide and FAQs
If you have any questions about applying for Dermatology, please email the recruitment office – st3medrecruitment@hee.nhs.uk
GMC registration
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 MRCP/MRCPCH/Overseas qualification (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. The 2 main routes for Dermatology are PLAB and MRCP, but there are others as well.
Routes to GMC registration for Dermatologists
PLAB
The PLAB exam is set at the level of a doctor who has completed internship. It covers the basics in all specialties and is most suitable for IMGs who have not yet completed any postgraduate specialty training (residency), however, it can also be taken by trained Dermatologists. In general, PLAB is the quickest and least expensive route.
MRCP
MRCP (Membership of the Royal Colleges of Physicians) is a postgraduate qualification for doctors who have completed a residency or specialist training in Internal Medicine. If you hold MRCP, then you can bypass PLAB.
Other options
- MRCPCH – The MRCPCH (Membership of the Royal College of Paediatrics and Child Health) is a postgraduate qualification for doctors who have completed basic specialist training in Paediatrics. If you hold MRCPCH, it means that you can bypass PLAB.
- Overseas Qualifications – There are some overseas qualifications that are recognised for full GMC registration. This means means you can bypass PLAB. Eg. Diplomate of the American Board of Pediatrics – General Pediatrics, FCPS Paediatrics Pakistan etc. View the full list here
- CESR – 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 options for IMGs without PLAB, MRCP or sponsorship. You can read more about it above under the section “Become a recognised UK Consultant Dermatologist” CESR route.
Finding a suitable first job
There are 2 main questions to consider when looking for a suitable first job.
- 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.
- All Dermatology jobs require previous training and experience. There are virtually no junior level ie. SHO level, jobs in Dermatology.
- Will it lead to your long-term goal?
- There is no point working in a job that will jeopardise your long-term goal.
- It is best to clarify during interview whether a job will be supportive of your plans for CCT, CESR-CP, or CESR.
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
Recommended first jobs if you want to become a UK Consultant Dermatologist
The most suitable first job depends on what route you choose.
CCT Route
You need to make sure you meet the 12-months post-internship requirement by the start of ST1 or CT1 in order to be eligible for core training. As mentioned above, the options are Standalone FY2, WAST, or any non-training job at SHO level in any specialty.
CESR-CP Route
You need to make sure you meet the 12-months post-internship requirement by the start of ST1 or CT1 in order to be eligible for core training. As mentioned above, the options are Standalone FY2, WAST, or any non-training job at SHO level in any specialty.
CESR Route
If you have already completed Dermatology 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. GMC specialist registration is not required for locum Consultant posts, only permanent posts.
It is best to work in a department that is supportive of your plan to pursue CESR. CESR is a long and tedious path that is almost impossible to succeed without the support of your workplace. Clarify whether a department will be supportive during the interview.
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.
Recommended books
Day to day clinical references
MRCP
- Pastest Essential Revision Notes for MRCP
- Basic Medical Sciences for MRCP Part 1
- Best of five MCQS for the MRCP Part 1
MRCP PACES
SCE Dermatology
These textbooks are very expensive. Most of the time, your department or hospital library will have a copy that you can study from. I’ve listed them here anyway just so you are familiar with the titles of the recommended books.
Summary
The pathway for Dermatology in the UK is probably more complicated than you expected huh? I hope this article did a good job of explaining the major concepts and you now have a good grasp of what you need to do if you want to become a UK Dermatologist.
If you need more information, this is the most informative site to check out:
Need more guidance?
All of this may be overwhelming and difficult initially but it doesn’t have to be. Start preparing early so you have time to take things slowly and plan out each step.
Just know that if you’re really struggling, then you don’t have to be alone. We run an online course called IMGs for UK ST1/CT1 Masterclass where we simplify the whole process.
You’ll get a step-by-step video series that you can watch at your own pace, providing you with a clear winning strategy to achieve the highest application score you can and increase your chances of getting a training job.
Visit our IMG Masterclass page for more information.
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.
6 Responses
Hi I am a dr from India who has did my MD in dermatology
Will that help in getting a job as a consultant if I am to pass PLAB and SCE dermatology exam
If not what all will I need
You can apply for locum consultant jobs, but for permanent consultant jobs ie. substantive consultant, you would need to go through either the CESR-CP or CESR pathway. Good luck!
Hello,
Can a Dermatologist from India get a fellowship in the UK without a CCT? Or are they eligible only for an observership?
Hi! It depends on the job, most don’t require CCT. You just need to check the job description and requirements. Good luck!
Will msc dermatology from king’s college London help me in building my CV for training post in dermatology
Hi there, having a masters in any medically related field will add points to your portfolio. I don’t think having a masters in dermatology will specifically add anything further unless you proactively use it to gain more points by publishing papers, teaching, leading projects etc.