The Savvy IMG

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

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.

Table of Contents

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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:

  1. Understand the UK Dermatology training pathway
  2. Determine your long-term goal
  3. Get registered with the GMC
  4. Find a suitable job
  5. Obtain a work visa
  6. 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:

  1. Become a recognised UK Consultant Dermatologist
    • Whether you want to stay in the UK long-term or migrate elsewhere after, is up to you.
  2. Work long-term as a Dermatologist in the UK without becoming a recognised Consultant
  3. 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:

  1. CCT
  2. CESR-CP
  3. CESR

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.

Click image to enlarge

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 4 core training programmes in the UK for the CCT route:

  • Internal Medicine (2-3 years) + MRCP
  • ACCS Acute Medicine (3-4 years) + MRCP
  • Paediatrics (2 years) + 1 year adult acute medicine + MRCPCH + Alternative Certificate of Core Competences for Group 2 specialties
  • Core Surgical Training (2 years) + MRCS + 1 year adult acute medicine + Alternative Certificate of Core Competences for Group 2 specialties

It’s really up to you which one you choose depending on the type of training you wish to have.

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 3 ways to do this:

  1. 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 Group 2 Specialties
      • 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
  2. Paediatric route
  3. Surgical Route
    • Minimum of 2 years post-internship experience in Surgery
    • Minimum 1 year post-internship experience in acute adult medicine
    • Certificate of Readiness to Enter Higher Surgical Training
      • This is a document to certify you have the equivalent skills and knowledge of a doctor who has completed the official UK Core Surgical training programme.
    • Alternative Certificate of Core Competence Group 2 Specialties

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.

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 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.

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:

  1. Visit the NHS Jobs website
  2. Search “Dermatology 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.

Some universities offer Masters or MD degrees in Dermatology that you might be interested in. Here are just a few:

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 2 options:

  1. Tier 5 temporary work visa (maximum 24 months in the UK on this type of visa) – this is done through RCP OR
  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.

Dermatology residency in the UK

Core Training

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:
    • Foundation competences

These are the basic requirements. Please see each programme’s ST1/CT1 person specifications for the full requirements.

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.

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:

Specialty20152016201720182019
Internal Medicine & ACCS Acute Medicine1.701.531.411.501.43
Paediatrics1.801.651.331.301.18

(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.

For timelines, portfolio/CV requirements, and information about interviews, please visit the following links:

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

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:

  1. Adult Medicine Route
    • Minimum 2 years adult medicine including minimum 12 months managing acute medical inpatients
    • Alternative Certificate of Core Competence
    • MRCP
  2. 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.

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.

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:

 2016201720182019
Dermatology4.565.583.133.38

(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.

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

For timelines, portfolio/CV requirements, and information about interviews, please visit the following links:

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

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 (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.

  • 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.

  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.
    • All Dermatology jobs require previous training and experience. There are virtually no junior level ie. SHO level, jobs in Dermatology.
  2. 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:

Recommended first jobs if you want to become a UK Consultant Dermatologist

The most suitable first job depends on what route you choose.

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.

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.

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.

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

Recommended books

Day to day clinical references

MRCP

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:

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.

You might also like

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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Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.

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6 Responses

  1. 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

    1. 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!

  2. Hello,
    Can a Dermatologist from India get a fellowship in the UK without a CCT? Or are they eligible only for an observership?

    1. Hi! It depends on the job, most don’t require CCT. You just need to check the job description and requirements. Good luck!

  3. Will msc dermatology from king’s college London help me in building my CV for training post in dermatology

    1. 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.

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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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