The Savvy IMG

Less Than Full Time (LTFT) training for IMGs in the UK

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One of the benefits that drew us to a career in the UK was the support for work-life balance for doctors. Many other countries simply do not entertain doctors who need to work part-time for any reason and because of this, it’s common for these doctors to have very long clinical career gaps while they care for children or family, or pursue non-medical interests.

In the UK, there is far more understanding for an individual doctor’s situation and there are provisions for doctors in specialty training to work part-time while remaining on the pathway to becoming a Consultant or GP. But there are some restrictions for doctors working in the UK on a Tier 2 visa to work part time.

This article explores the current restrictions to help you understand whether you can work part-time, and how much you can reduce your work hours.

What is Less Than Full Time (LTFT) training?

This is when you work part-time while remaining in your training job. Full time means working between 40-48 hours per week on average and is considered 100%. 

Any LTFT plan is expressed as a percentage and refers to the percentage of full time hours you work per week. You can do 80%, 70%, 60% or 50%. The lowest percentage any trainee can work while retaining their training number is 50%.

Doctors usually apply for LTFT for reasons such as caring responsibilities (children or ill family members), personal disability, or ill health. But you can also apply for LTFT for other reasons such as training for national/international sporting events, being a member of a national committee, pursuing an additional degree, or simply for work-life balance.

What happens when you go LTFT?

There’s a lot to know about LTFT but I wanted to give you a quick overview of what to expect. Here are some of the things that will happen once you work LTFT.

  • You will be able to state specific days of the week you don’t work depending on your needs.
  • You will work less hours per week.
  • In most cases, your training will be proportionately extended and will take longer to complete. To calculate this, divide the remaining years you have left by your percentage.
    • Eg. If you 2 years left to go and you work 50% LTFT, then 2 years divided by 0.5 = 4 years to finish. If you have 3 years left to complete training and you work 80%, divided 3 years by 0.8 = 3.75 years left.
  • You will have proportionately fewer on calls.
    • Eg. If you work 60% LTFT then you will only do 60% of the on calls.
  • Your salary will be proportionately lower.
    • The calculation for this is complex calculation but for a very rough idea, 80% LTFT means 80% pay of a full time colleague working on the same rota. For a better explanation, please see this BMA guide on LTFT pay.
  • You will have proportionately less annual leave and less study leave.
    • Eg. If the annual leave allowance is 27 days + 8 bank holidays and you work 50% LTFT, then your annual leave allowance is 23.5 days + 4 bank holidays.
  • You have the same entitlement to maternity leave (52 weeks) and paternity leave (2 weeks).
  • You will still have an ARCP every calendar year ie. every 12 months, not every training year.

Can IMGs on a Tier 2 visa apply for less than full time training?

Yes, provided you meet the minimum salary and weekly hours requirement appropriate to your visa situation. These are all explained in detail below.

“I’ve heard that IMGs on a Tier 2 visa can only go as low as 80%”

We’ve heard that too, and it seems roughly right but doesn’t tell you the whole picture.

To understand how low you can go LTFT as a Tier 2 visa holder, there are several factors to consider. These include:

  1. Whether your HEE sponsored Tier 2 visa was issued under the Resident Labour Market Test (RLMT) or the Shortage Occupation List (SOL)
  2. The number of hours you work each week
  3. Your annual salary
  4. When your visa was issued
  5. If you’re switching to a Tier 2 visa from a Tier 4 visa
  6. Your age

How do these factors affect your application for LTFT?

1. Whether your HEE sponsored Tier 2 visa was issued under RLMT or SOL

This determines whether you will have to work a minimum number of hours per week. There is a minimum requirement of weekly hours if you were issued a visa under the SOL.

2. The number of hours you work each week

If your visa was issued under SOL, then you need to work more than 29 hours per week. It is further stated in the HEE Tier 2 FAQ that these hours do not include on-call hours.

If your visa was issued under RLMT, then you do not need to work for more than 29 hours per week as long as you meet the minimum salary requirement.

Was your visa issued under RLMT or SOL?

Before October 6, 2019, only certain specialties would have been issued Tier 2 visas under SOL. Most visas would have been issued under RLMT.

However, due to the SOL change, all new visas issued after October 6, 2019 should now be issued under SOL.

If you need to clarify whether your visa was issued under RLMT or SOL, you can simply email the Tier 2 team of your UK nation.

The contact details can be found here:

Related: 9 ways the new Shortage Occupation List affects IMGs dreaming of UK specialty training

3. Your annual salary

According to the HEE Tier 2 FAQ, only your basic salary will be considered in the calculation. This means it excludes on-calls, London weighting, and LTFT allowance.

Related: How much do doctors in specialty training (residency) earn in the UK?

4. When your visa was issued

This influences the minimum salary requirement.

  • If your Tier 2 visa was issued after 5th April 2017, then the minimum annual salary requirement is £30,000.
  • If it was issued between 24 November 2016 and 5th April 2017, then the minimum is £25,000 for the current duration of your visa, but £30,000 for any extensions.
  • If it was issued before 24 November 2016, then the minimum salary threshold is £20,800.

5. If you’re switching to a Tier 2 visa from a Tier 4 visa

This also influences the minimum salary requirement.

If you’re switching to a Tier 2 visa from a Tier 4 visa, and your Tier 2 Certificate of Sponsorship (COS) is for 3 years and 1 month or less, then the minimum salary threshold is £20,800.

If your COS is for more than 3 years and 1 month, then the minimum salary threshold is £30,000.

6. Your age

This is the final factor that determines the minimum salary requirement.

If you are less than 26 years old and you are switching from any other visa type other than Tier 4, then the salary threshold is significantly lower at £20,800. This allows you to work at a lower LTFT percentage.

If you are 26 years old or older, then the salary threshold is still £30,000.

Examples of “other visa types” might include Tier 2 dependent or Tier 5 (MTI).

So, how low can you go?

We’ve done the calculations based on the current guidelines published for Health Education England (HEE) and the salaries listed in the 2016 Junior Doctor Contract in England. Presuming our calculations are correct, this is what we concluded. 

(Please note, we created these categories to simplify the rules for you. These categories are NOT used by HEE or the Home Office.)

Category 1

This category is applicable to you if the Tier 2 visa for your training job was issued under the Shortage Occupation List. In that case, you must work more than 29 hours per week AND meet the minimum salary requirements.

Because you must work more than 29 hours per week, and meet the minimum salary requirement:

  • It is not possible to go LTFT as an FY1 or FY2 unless you fulfil one of the following:
    • You are switching from a Tier 4 visa and your Tier 2 visa is for 3 years and 1 month or less, OR
    • You are switching from any other type of visa and you’re younger than 26 years old. 
    • In these cases you may be able to go down to 80% LTFT.
  • If you are CT/ST1-2 level, you should be able to as low as 80% LTFT.
  • If you are CT3/ST3+, you can go as low as 75% LTFT.
    • Most of the time, LTFT percentages are in increments of 10 so it’s more likely that you will apply for 80% LTFT.

Category 2

This category is applicable to you if you meet the following criteria:

  • Your Tier 2 visa for your training job was issued under RLMT, AND
  • Your Tier 2 visa was issued after 5th April 2017,  OR
  • Your Tier visa was issued between 24 November 2016 and 5th April 2017 and you are applying for an extension,  OR
  • You are switching to Tier 2 from Tier 4, and your CoS is for more than 3 years and 1 month,  OR
  • You are switching from any other type of visa to Tier 2 and you are 26 years old or above.

The minimum salary requirement for this category is £30,000 therefore:

  • It is not possible to go LTFT if you are an FY1 or FY2.
  • If you are CT/ST1-2 level, you can go as low as 80% LTFT.
  • If you are CT3/ST3+, you should be able to go as low as 65% LTFT.
    • Most of the time, LTFT percentages are in increments of 10 so it’s more likely that you will apply for 70% LTFT

Category 3

This category is applicable to you if you meet the following criteria:

  • Your Tier 2 visa for your training job was issued under RLMT, AND
  • Your Tier 2 visa was issued before 24 November 2016, OR
  • You are switching to Tier 2 from Tier 4, and your CoS is for than 3 years and 1 month or less, OR
  • You are switching from any other type of visa to Tier 2 and you are below the age of 26.

The minimum salary requirement for this category is £20,800 therefore:

  • If you are an FY1, you can go as low as 80% LTFT.
  • If you are an FY2, you can go as low as 70% LTFT.
  • If you are CT/ST1-2 level, you can go as low as 55% LTFT.
    • Most of the time, LTFT percentages are in increments of 10 so it’s more likely that you will apply for 60% LTFT.
  • If you are CT3/ST3+, you should be able to go as low as 50% LTFT.

Category 4

This category is applicable to you if you meet the following criteria:

  • Your Tier 2 visa for your training job was issued under RLMT, AND
  • Your Tier 2 visa was issued between 24 November 2016 and 5th April 2017 and you still have some time leave left on your visa therefore you are NOT applying for an extension.

The minimum salary requirement for this category is £25,000 therefore:

  • It is not possible to go LTFT if you are an FY1
  • If you are an FY2, you should be able to 80% LTFT.
  • If you are CT/ST1-2 level, you can go as low as 70% LTFT.
  • If you are CT3/ST3+, you should be able to go as low as 55% LTFT.
    • Most of the time, LTFT percentages are in increments of 10 so it’s more likely that you will apply for 60% LTFT

Our calculations and conclusions are only a rough guide and the final decision lies with the Tier 2 team of the UK nation you will be working in so make sure you contact them to discuss your situation!

Also, Scotland, Wales, and Northern Ireland may still be using the old Junior Doctor contract and therefore the salaries and calculations will be different. Again, we advise you to contact them directly for advice.

You can find the relvant contact details here:

Does LTFT have any implications for Indefinite Leave to Remain (ILR)?

Unfortunately, we’re not too clear on this as immigration is not our area of expertise. The way we understand it, Indefinite Leave to Remain has a minimum requirement for both salary and weekly hours, but how this applies to doctors and occupations on the SOL is confusing.

For definitive advice, we recommend consulting an immigration expert. Immigration rules constantly change so asking IMGs who applied for Indefinite Leave to Remain recently may end up with you receiving unknowingly outdated advice. Definitely consult an immigration expert.

How do you apply for LTFT?

Each deanery will have a different application process. Check your deanery website or contact them directly to find out what the process is.

For any application, you will need to provide documentation of your reason to go LTFT. Your deanery will tell you what documents you need to provide.

Need more information about LTFT?

When it comes to salary requirements and eligibility for LTFT on a Tier 2 visa, you need to contact the Tier 2 team of the UK nation you are working in. You can find the contact details here.

Other resources

Again, for any questions about LTFT and Tier 2 visas, it’s best to contact the Tier 2 team of the UK nation you are working in. Their contact details can are listed here.

Conclusion

It is possible for an IMG on a Tier 2 visa to work less than full time in a training job subject to various visa-related restrictions.

After taking all of these restrictions into account, most IMGs starting a training job in England for the first time this year should be eligible for 80% LTFT at CT/ST1 level, and as low as 65% at ST3 level for RLMT issued visas, and 75% at ST3 level for SOL issued visas. This will vary for Scotland, Wales and Northern Ireland.

Our conclusions are only a rough guide and the final decision lies with the Tier 2 team of the UK nation you will be working in so make sure you contact them to discuss your situation! The contact details can be found here.

If we receive or find any further information that contradicts our understanding, we will update this article as soon possible. Likewise, if you notice anything that’s incorrect in our understanding of the rules, please do not hesitate contact us.

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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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