The Savvy IMG

Will your internship be accepted for full GMC registration?

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An overview of the issue

If you are applying for full GMC registration through the PLAB route, you will need to provide evidence of internship.

Submitting your internship documents can often feel like presenting your case before a judge. The GMC’s judgement will affect your journey to the UK and can quickly put an end to your dreams if they do not rule in your favour.

Many IMGs face problems in the following areas relating to having their internship accepted:

  1. A gap between graduation and internship
  2. Gaps during internship
  3. Not having rotations in both medicine and surgery
  4. Internship of less than 12 months

In this article, we’ll review the GMC requirements and how these issues can be addressed.

Related: The 4 types of GMC registration

Can The Savvy IMG tell you if your internship will be accepted?

Unfortunately, no. Nobody can tell you 100% that your internship will be accepted.

For this reason, I am unable to answer any messages about whether your internship will be accepted.

Not even the GMC can provide any assurances, but you can contact them to discuss your situation. They can advise you of your options for full registration, but will not be able to give you a final decision. This can only be made once you submit your full application. This means completing all the requirements first including IELTS/OET, PLAB, certificate of good standing etc.

So, what should you do?

You will need to read this article in full and use your professional judgement. Any potential issues with your internship will need explanations and potentially documentation. These are often accepted by the GMC provided you have valid genuine reasons.

You may also find it helpful to post in one of the many IMG Facebook groups to see if anyone has had their internship accepted with a similar pattern to yours. However, bear in mind that this is not a guarantee that yours will be accepted. Every application is different and assessed on a case-by-case basis. You can find a list of relevant IMG groups here.

Ready to find out whether your internship is likely to be accepted?

Let’s review the criteria. The first set of criteria is known as Pattern A.

What are the requirements for Pattern A?

  1. Approved supervised training post – honorary posts, observerships, or clinical attachments are not accepted
  2. Minimum of 12 months duration – this relates to the calendar dates, there must be 12 months from the start date to the finish date
  3. Continuous and uninterrupted – meaning no gaps during internship
  4. Occurred either immediately before or immediately after graduation – meaning no gaps between graduation and start of internship
  5. If the internship was between 12-18 months, there must be at least 3 months in medicine and 3 months in surgery
  6. If the internship was longer than 18 months, there must be at least 6 months in medicine and 6 months in surgery

Those mentioned above are the official requirements however some leeway is permitted in the areas that IMGs have the most problems with.

Potential problems with Pattern A

1. You have a gap between graduation and internship

In general, the longer your gap between graduation and internship the more difficult it is to have it accepted. 

However, valid and genuine reasons for gaps with accompanying documentation tend to be accepted.

Cases that have been accepted in the past according to the experience of other IMGs include:

  • Maternity/paternity leave
  • Carer responsibilities (looking after children or sick family members)
  • Approved period of research
  • Approved period of additional training, education or other clinical experience outside of the internship programme
  • Problems involving the internship programme itself that led to an unavoidable gap outside of the doctor’s control
  • Preparing for exams (postgraduate exams, USMLE etc)

The most important thing in any case is that there is evidence surrounding any gap. Formally approved gaps must have supporting documentation.

2. You have gaps during internship

The GMC allows 5 weeks of annual leave for a 12 month period of internship plus an additional 20 days absence. It’s not stated what the additional 20 days absence can be for but acceptable reasons are probably things like sickness.

For any other prolonged absence you will be asked to provide evidence. Cases that have been accepted in the past according to the experience of several IMGs include:

  • Maternity/paternity leave
  • Carer responsibilities (looking after children or sick family members)
  • Approved period of research
  • Approved period of additional training, education or other clinical experience outside of the internship programme
  • Problems involving the internship programme itself that led to an unavoidable gap outside of the doctor’s control

Again, the most important thing in any case is that there is evidence surrounding any gap. Formally approved gaps must have supporting documentation.

3. You do not have rotations in both medicine and surgery

Your rotation does not need to be specifically labelled “internal/general medicine” or “general surgery”. Branches of internal medicine and branches of general surgery are accepted.

Fulfills the requirement for a rotation in medicine

Fulfills the requirement for a rotation in surgery

Cardiology, respiratory medicine, renal medicine, gastroenterology, neurology etc.

General surgery, orthopaedics, urology, plastic surgery, breast surgery, ENT etc.

If you do have rotations in both medicine and surgery but they are less than 3 months, the GMC accepts allied medical specialties for medicine and allied surgical specialties for surgery. These are the ones I am sure of:

Accepted as a medical rotation

Accepted as a surgical rotation

Paediatrics

Emergency medicine

Anaesthetics

ITU/ICU

Obstetrics and gynaecology

Ophthalmology

If any IMGs have experience of having anaesthetics or ITU/ICU accepted as surgical specialties since they do technically involve caring for surgical patients, please do let us know through our contact form so we can update this ASAP.

4. Your internship is less than 12 months

This is a difficult one because the GMC is clear that an internship should be of at least 12 months duration. I’m afraid I am unable to provide any further advice on this issue.

If any IMGs have experience of having their internship accepted even if it was less than 12 months, please do let us know through our contact form so we can update this article ASAP.

What if your internship doesn’t meet the Pattern A criteria?

All is not lost as none of these rules are set in stone. The GMC will review all your evidence and give you the opportunity to provide documentation relating to any issues before coming to a final decision. 

You can read the official GMC document that officers at the GMC use to evaluate internship and assess your own situation.

If your internship really does not fit Pattern A, there is a reason it’s called Pattern A – there is another pattern that can be used: Pattern B.

What are the requirements for Pattern B?

  1. Minimum of 24 months duration
  2. Continuous uninterrupted postgraduate experience – clinical attachments and observerships not accepted. Honorary (unpaid) posts wherein you are engaged in active medical practice may be accepted.
  3. Supervised post at a hospital – the hospital must be recognised as suitable for medical teaching and training, and must be regulated by the relevant government authority
  4. At least 3 continuous months in a medical specialty
  5. At least 3 continuous months in a surgical specialty

As with Pattern A, gaps may be accepted for similar reasons as listed above.

We contacted the GMC to clarify the issue of honorary posts. This is what they said:

“Honorary posts and clinical attachments generally consist of research or observing, and our guidance says: “The postgraduate medical experience has to have been undertaken in a public hospital that meets the standards for regulation within its jurisdiction and has established supervision, safety and governance systems in place.”

Therefore we would not normally expect honorary post evidence to be submitted under Pattern B. But, if you state that the honorary contract experience took place in a public hospital, you can submit it for assessment. Although, we couldn’t confirm whether it is acceptable until your application has been submitted and assessed.

We would not consider clinical attachments or observerships to include medical practice and they would not be considered for evidence in Pattern B.”

What if your experience does not fit either Pattern A or Pattern B?

If you apply for GMC registration without fitting either of the 2 patterns, there are 2 possibilities:   

  1. Your application is rejected and you need to apply for provisional registration instead of full registration.
  2. You will be referred to the Registration Investigation (RI) team who will examine your application in more detail.

If you are referred to the RI team you will be given the opportunity to provide evidence related to the questionable aspects of your application. You can also submit further evidence and a cover letter detailing why you have the up-to-date skills and knowledge to be granted full registration. The RI team can either accept this and grant you full registration, or reject this you’ll need to apply for provisional registration.

If the RI team does not grant you full registration you may be able to appeal and may even seek legal assistance. There are cases where full registration has been granted after a long appeals process and through solicitors.

What if your experience is rejected?

If your experience is not accepted then your application for full registration will be rejected. In this case there are 4 options:  

    1. Apply for provisional registration and FY1 (UK internship) through the UK Foundation Programme.
    2. Complete the requirements for Pattern B overseas then reapply for full registration.
    3. Obtain an accepted postgraduate qualification (PGQ) and reapply for full registration.
    4. Apply for full registration through the sponsorship route.

You can read more about each of these options in detail here.

What about gaps after internship?

Gaps after internship are rarely a barrier to GMC registration. However, if you have a long clinical gap, you may need to submit a statement and additional paperwork to show that you are clinically up-to-date.

Take home message

If your internship doesn’t fit the GMC requirements, it doesn’t mean that it will be automatically rejected. Genuine valid reasons with supporting evidence and documentation are usually accepted.

If you do not have a genuine valid reason for the issues in your internship or do not have suitable documentation, then your internship may be rejected. However this is not for certain, the GMC will decide once they receive your application in full.

I am unable to assess your internship and provide any assurances as to whether it will be accepted. I’ll need to refer any messages of this nature back to this article.

Further Reading

Find out the rest of the requirements for GMC registration here.

After GMC registration, what’s next? Find the steps for your specific pathway by taking this quiz.

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.

free

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.

free

179 Responses

  1. Hello, I have two months of general surgery and one month in neurosurgical ICU in my internship .
    I want to check if neurosurgical ICU will be accepted as surgical rotation?
    Thank you
    Lilly

    1. Hi Lilly,

      Thank you for your question. The neurosurgical ICU rotation you completed during your internship may be considered as a surgical rotation, but it may not be. If you’ve done any rotations in Obstetrics, those would definitely be counted as surgery. You may also find it useful to ask IMGs who have recent experience with that in one of the IMG Facebook groups,to see if someone with a similar rotation has had it accepted for surgery in the past. All the best!

  2. Hi Nick, first of all, nice post, very it’s very clear, but, however, I’ve got a few questions about my personal situation. I’m from Mexico, my MBBS program lasts 7 years, 5 years, 2 and half years of basic medical sciences and 2 and half years of clinical rotations in all the specialties and sub-specialties; then 12 months of internship, divided into 6 rotations of 2 months of length each one: G&O, Paediatrics, Internal Medicine, General Surgery, Emergency Medicine, and Family Medicine, then, we’ve to do something called ‘Social Service’ by 12 months in primary medical care or research, in fact I’m actually doing my social service. The question is, my pattern of internship meets the criteria of 3 months of “Medicine” and 3 months of “surgery”?

    1. Thank you for the positive feedback! Regarding your question, based on the information you provided, it seems that your pattern of internship meets this requirement.

  3. Hi i graduated in 2011, did my pre graduate internship back in 2010. After that i applied for Plab 1 in 2013 but could not make it. In 2014, i started applying for UK study visa and got a place in MSc Public Health in 2015, completed that in 2017. Additionally, i did another master degree in UK that ended in 2019. After that Covid 19 outbreak started and i was stucked and had some personal problems as well. In 2021, i started preparing for OET got it done after three attempts. After that i appeared fro Plab 1 in november 2022 and passed it. Now i am due for Plab 2 on august 2023. Considering my circumstances, will i be able to get full
    GMC registration? Your reply would be highly valuable.

    1. Congratulations on passing your PLAB 1 and OET. Passing PLAB 1 is a significant step towards achieving full GMC registration. As long as you pass all your PLAB exams, it looks like it should work out for you.

  4. Hi,I am Dr.Ali,have done MRCP,my internship is 5 months General Medicine,2 months neurology,3 months Paediatric Medicine and one year Anesthesia.Is this pattern acceptable for GMC registeration

    1. Hi Dr. Ali, it looks like you don’t have any surgical rotations. I’m afraid it may not be accepted by the GMC.

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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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