The Savvy IMG

How to rank preferences for UK training jobs as an IMG

Preferencing is an important process that can affect whether you get the training job of your dreams, or end up gritting your teeth through a job you hate. In this article, we discuss some of the common misconceptions of IMGs when it comes to the preferencing process, and clarify the truth about how to get the job you want.

Table of Contents

Some of the questions we answer here include:

  • How many jobs should you include in your preferences?
  • What should you base your preferences on?
  • What happens if you preference incorrectly?
  • Will you be considered for a job/location that you do not include in your preference list?
  • Should you include jobs in your preference list that you don’t actually want at all?

What is preferencing?

Preferencing is the part of the application process for a training job where you are given the opportunity to rank which regions of the UK or which specific jobs you would like to be considered for.

How does preferencing work?

There can be a 2-step or 1-step preferencing process.

In the 2-step process, you first rank which regions of the UK you want to work in. For example, if there are 7 regions available (London, East of England, Thames Valley, Midlands, Scotland, Northern Ireland, Wales), you need to rank these in order of preference. That’s the first step. Once you are assigned to a region, the second step involves ranking the hospitals in that region.

In the 1-step preferencing process, you rank specific jobs with fixed rotations and hospital placements. For example, for Standalone FY2, you will be given a list of let’s say 300 jobs. The list will consist of something like this:

  • Job 1: A&E / GP / General Surgery @ Hospital 1
  • Job 2: Respiratory Medicine / Psychiatry / A&E @ Hospital 2
  • Job 3: OBGYN / ENT / GP @ Hospital 1
  • etc until job 300

You will need to pick which jobs out of these 300 you want to be considered for, and rank them in order of the ones you prefer the most.

Related: Standalone FY2: Your chances as an IMG and how to optimise your application

The most common misconception about preferencing

There is a very rampant misconception amongst IMGs that there is some special way to rank job preferences that will increase your chances of getting a post. This is completely untrue.

Here’s the truth: 

Your chances of getting a post depend on 2 things:

  1. Your rank
  2. How many jobs you include in your preferences, NOT how you arrange them.

Is this different to what you’ve been told?

Just think about it, if there are 300 jobs and your rank is 350, it doesn’t matter how you arrange your preferences. If you don’t somehow get bumped up to the top 300, you will never be considered for a job. 

How you arrange your preferences does not bump you up the list. The only thing that bumps you up the list is if someone who ranked above you drops out.

Related: What IMGs need to know about applications to specialty training (residency) in the UK

Why is rank important?

Once your portfolio and interview score are tallied up, you’ll get your final application score. All the application scores will be sorted with the highest score on top and the lowest score at the bottom. The highest scoring applicant will be rank 1, followed by everyone else.

The higher your rank, the higher your chance of getting your most preferred job.

That’s because jobs are allocated according to rank. So if you do well in your portfolio and interview score, you will be rewarded with a higher rank and therefore a higher chance of getting your dream job.

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

So, how many jobs should you include in your preferences?

Whether you get a place or not depends on you including enough preferences in your list for your rank.

If you are rank number 1, then you only really need to include one job in your preference list because you get first pick. Essentially, whatever you choose will go straight to you.

However, if there are 600 jobs, and your rank is 500, but you only include 200 jobs in your list, then there is a very real chance that you won’t get a place.

We recommend that you include as many jobs in your preference list as your rank as a minimum. 

Eg. if your rank is 50, include at least 50 jobs. You should probably include more just in case; you don’t want to end up without a job because you didn’t include enough on your list.

If you don’t know your rank yet and preferences are already open, you may want to include all jobs to maximise your chances of getting a job.

Related: 12 essential items for IMGs working in the NHS

How do you maximise your chance of getting your dream job?

This is where how you arrange your preferences comes into play. Just remember this: your chances of getting a specific job, now depends on how you arrange your preferences. 

Where does your rank come in all of this?

The allocation of job offers goes like this:

  • Rank number 1 will be given their topmost preferred job.
  • Then rank number 2 will be given their topmost preferred job, if their top is not available because it’s already taken by rank number 1, then rank number 2 will be given the second job on their list.
  • Then rank number 3 will be given their topmost preferred job. If their top job is taken by rank number 1, they’ll give be given the second job on their list. But if the second job on their list has been taken by rank number 2, then they’ll be given the 3rd job on their list.
  • And so on and so forth until all the jobs are taken.

Keep in mind that everyone will arrange their preferences differently. So it’s possible that someone who is rank 19, will still get their top preference if it was not taken by rank 1-18.

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

What happens if you arrange your preferences incorrectly?

Example 1

Let’s say you really want a job in Manchester, but you think it’s too competitive so you rank Birmingham above Manchester to increase your chances of getting a job.

Here’s what will happen: you will never get a job in Manchester as long as there is a vacancy in Birmingham.

Even if there are 10 jobs available in Manchester, you won’t get one if there is even one job left in Birmingham because you ranked Birmingham above Manchester.

Example 2

You really want a particular rotation at a specific hospital but you think lots of other applicants want the same job. So you rank another job higher instead and put your most desired job at number 2 or 3.

This means that even if you rank number 1, you will never get your most desired job because you put another job first.

In fact, someone who ranked below you will get that job instead of you because they put it higher on their preference list.

Example 3

For instance, your rank is quite low, in fact you are lower than the number of available jobs. There are 300 jobs available and your rank is 310. Well, the first step is to rank at least 310 jobs to maximise your chances of getting a job. I would even recommend ranking them all. Let’s say you do that.

Next, you need to think about how to arrange your preferences. Well someone told you that because you have a low rank, you only have a chance with the less competitive jobs. So instead of ranking your most preferred job on top, you put your least preferred job on top thinking this will increase your chances of getting a job. Based on our discussion above, you already know that’s not true.

Now if 10 people in the top 300 drop out (this can happen), then their jobs will become available again and you now have a chance to get a job! If both your most preferred and least preferred job both become available because of applicants dropping out, which job do you think you will go to you? I think you know the answer by now, it will be your least preferred job.

So you see, you can really shoot yourself in the foot if you approach preferencing with incorrect notions!

So, how should you rank your preferences?

Your actual preference ie. put your most preferred jobs on top, and your least preferred jobs at the bottom.

And how should you NOT rank your preferences?

You should not base your preferences on factors that do not play a role in you getting a job. These include:

  • Perceived competition
  • Number of available places
  • What your rank is

If you’re new to the country, what should you base your preferences on?

It’s really a personal decision, but here are a few things we suggest you take into consideration:

  1. Location – rural vs. urban, cost of living, proximity to preferred recreational activities eg. coastal vs inland, countryside vs. city.
  2. Reputation of the hospital, department or deanery – you can ask for reviews on Facebook, check out the website Junior Reviews, or explore the GMC National Training Survey.
  3. Hospital type – teaching hospital vs. district general hospital, secondary vs. tertiary centre for your specialty etc.
  4. Your future career goals – does the job have rotations in the subspecialty that you want to pursue in the future? Are you interested in working with a particular Consultant or at a specific hospital? Then place those jobs on top.

Will you be considered for a job/location that you do not include in your preference list?

No. If you don’t include a particular job or location in your preference list, you will never be considered for that job or location.

If you want to be considered for a particular job or location, then you must include it in your list. If you do not, then even if there are 10 jobs left, you will still end up without a job if you did not include any of those 10 in your preference list.

Should you include jobs in your preference list that you don’t actually want at all?

If there is a particular job or region of the UK that you know you won’t be willing to work in, it may still be worth including in your preference list, as long you rank your most preferred jobs above it. This means there is still a chance that you can be upgraded to your preferred job if someone else drops out.

However, upgrades are not guaranteed.

So if you don’t get upgraded, you can simply reject the offer. 

Related: Can I reject a job offer I previously accepted if I get a better offer?

Wait, what are upgrades?

When you are given a job offer, you can accept it as it is, or accept it with the option to upgrade. You can also hold it, meaning you need time to think about it, or you can hold it with the option to upgrade.

This means that if someone drops out of a job that is higher on your preference list, it can be given to you.

Are preferences set in stone?

Some specialties will allow you to adjust your preferences up until a certain date. Check the rules for your specialty before submitting your list of preferences.

Take home messages

  • The lower your rank, the more jobs you need to include in your preference list.
  • Rank all jobs if you want to have the highest chances of getting a place.
  • Put your most preferred jobs at the top of your list.
  • Never rank a job that you don’t want above a job that you actually do want.

There were some complex topics in this article! We hope we have done a good job of explaining them. Please let us know if anything is unclear or if you have any questions.

Some things are difficult to explain through text alone! We include this topic in our IMG Masterclass where I explain everything with audio-visual support including diagrams and more examples. If you’re looking for more insight into the application process for training jobs, you might want to check out the IMG Masterclass to make your life easier. 

Or if you’re up for it, you can do all the research yourself through the official websites. We link all the important sites you might need in your research on our Useful Links page.

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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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