The Savvy IMG

Once I hold full MRCP or MRCS I can skip core training, right?

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What if my internship experience is rejected by the GMC

Updated: October 28, 2020

Answer: Unfortunately, no.

This appears to be quite a common misconception. Many IMGs are under the impression that they can “skip” core training in medicine or surgery and apply directly to higher specialty training at ST3 level if they pass one of the Royal College membership exams. Unfortunately, this is not completely true.

To be eligible to apply for any ST3 post you need to fulfill the eligibility criteria. Exams are only one of those criteria. The other main criteria are:

  1. Clinical experience
    • Evidenced by completion of the relevant UK core training programme OR
    • Evidenced by time spent in clinical practice (in the UK or overseas) and/or a portfolio
  2. Alternative certificate of competence

The specifics of these criteria can be found in the relevant person specifications. I’ve provided an example for a medical specialty and a surgical specialty below.

ST3 Cardiology entry criteria


  • MBSS or equivalent medical qualification
  • MRCP (Membership of the Royal College of Physicians)


  • Full GMC registration
  • Achievement of Foundation competences or equivalent. This includes 24 months clinical experience (12 months internship and 12 months post-internship).
  • Completion of a UK approved Core Medical Training programme OR Alternative certificate of core competence

Career progression

  • 24 months’ experience in medical specialties (including at least 12 months in the care of acute medical in-patients)
    • Foundation level experience (first 24 months clinical experience) cannot be counted here. Therefore you should have a total of 48 months clinical experience equivalent to FY1, FY2, CT1 & CT2.

ST3 General surgery entry criteria


  • MBSS or equivalent medical qualification
  • MRCS (Membership of the Royal College of Surgeons)


  • Full GMC registration
  • Achievement of Foundation competences or equivalent. This includes 24 months clinical experience (12 months internship and 12 months post-internship).
  • Completion of UK approved Core Surgical Training programme OR Certificate of Readiness to Enter Higher Surgical Training

Career progression

  • Completion of the relevant competencies in General Surgery as described in the Core Surgical Training curriculum. This can be demonstrated through a log book or portfolio.
  • There is no stated minimum number of months of experience however you need to complete all the competences which will usually take 24 months (equivalent of core surgical training). It may be achieved in less time.

So although you may have passed the exam, if you don’t have the right experience or documentation, it won’t be possible to completely skip UK core training.

Follow up questions

If I have done the equivalent training overseas, can I have the certificate signed by my Consultant overseas?


If I have done the equivalent training overseas, I have the certificate, and I have the relevant logbook/portfolio, can I apply directly to ST3?

Technically yes, however it is not advisable to start work in the UK in a training role at this senior level without prior work experience in the NHS or a similar health care system. Expectations at this stage are high and you are being closely monitored. Poor performance can lead to failure to progress in training or removal from the training programme.

It is generally best to apply for a non-training job first to gain NHS experience then apply for ST3+. 

Further reading

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44 Responses

  1. Hi, I graduated from an European medical school with a MD (thesis was part of my undergrad.) As part of the person specification for ST4 recruitment, can I claim points for my MD under the postgraduate qualifications for a masters level degree?

    1. Hi there, unfortunately no. The criteria states that “To score yourself for an MD it should meet the UK definition of an MD: A supervised research degree for students already registered with the General Medical Council, is studied full time over 2 years or 4 years part time awarded a doctorate if your thesis is judged to represent an original contribution to knowledge in your chosen area.” So essentially it needs to be a research degree that takes 2-4 years to complete AFTER your medical degree. If it’s part of your medical degree, then it’s not considered an additional degree. I have the same qualification like you, the MD is the PMQ, not an additional degree.

  2. Hey, I graduated 2016 from Pakistan took the USMLE route and did about a year and half of research before applying for residency. I matched for surgery residency and completed 2 years in May 2022 but could not find a job for year 3 and complete training. I am thinking of going to the UK. Am I eligible for ST3 positions with only 24 months of post graduate training? I did not complete an internship in my home country. Im thinking of taking MRCS part A next year in May and starting work as a medical officer in the mean time.

    1. Hi Mahnoor, well done for matching to surgery in the US! Unfortunately no, you would not be eligible for ST3 in the UK with only 2 years postgrad experience. You might not even be eligible for full GMC registration if you have not completed an internship which included 3 months of medicine and surgery… There is a lot to cover in your comment and I’m afraid I won’t be able to give you the detailed response you need to really develop a plan.

      For one-to-one guidance for your specific personal circumstances, I would recommend booking a general guidance session (40 mins) or even specialty guidance session (60 mins).

      I hope to speak to you soon so we can come up with a plan and timeline that works for you. We wish you all the best!

  3. Hi Nick,
    I have completed my MBBS and MS Obstetrics and gynecology from India. I’m currently preparing to give mrcog. After clearing part 2, can i apply for job without gmc registration? Because requirements for part 3 states 4 years of work experience and i have only 3 years. How do I add up another year?

    1. Hi there, I’m afraid you can’t work in the UK without GMC registration. You’ll need to continue work back home for another year in order to meet the requirements for MRCOG. All the best!

  4. I have completed my MBBS 2019 and complete my internship in 2020 in INDIA .iam planning todo MRCS IN UK .

    1. It is possible to do my MRCS in UK ?
    2. Duration of MRCS IN UK?
    3. After completing MRCS, i can return to India ?

    1. Hi there! You can get MRCS just by passing the exams, which does require gaining any UK experience.
      If you plan to work in the UK and enter UK surgical training, that would be something very different.

      There is a lot to cover in this comment and I’m afraid I won’t be able to give you the detailed response you need to really develop a plan on this platform.

      For one-to-one guidance for your specific personal circumstances, I would recommend booking a general guidance session (40 mins) or even specialty guidance session (60 mins). For more details, please visit our page here.
      I hope to speak to you soon so we can come up with a plan and timeline that works for you.

  5. Dear NICK
    I have an MBChB from University of Freestate in South Africa, I have 11 years working experience, finished my two years internship in 2013 in South Africa. I have been working in general medicine for 11 years. I have passed FRCSA -Neurosurgery last year through the CMSA ( The Colleges of Medicine South Africa). I would like to apply for Specialty Training for NeuroSurgery in the UK. Can my FRCSA- Neurosurgery exempt me from writing PLABs. Please advice me.

    1. Hi there, only the qualifications listed on the GMC list here will be accepted as an alternative to PLAB
      Unfortunately, it looks like FRCSA – Neurosurgery is not on that list. If you require further clarification, we recommend contacting the GMC directly for advice. Their email address is and the phone number is +44161 923 6602. They are open Monday to Friday 8 am–5.30 pm and 9 am–5 pm on Saturday. You can also send them a message on FB messenger, they usually reply within a day or 2.

  6. I graduated in 2014 , and have a total of 5 years of post graduate experience , 1 year back home and 4 years in the nhs in FY2 labelled trust posts . How much of my work experience will count as IMT equivilant for the purpost of ST3 recruitment processs , if any ?

    1. It should all count towards the experience requirement but you also need to complete the alternative core competences certificate. If you have done everything on the form and your supervisor is happy to sign it, then you don’t need any further experience. However, if you haven’t done everything on the form and your supervisor is not happy to sign it, then you’ll need further experience just to get everything done. Hope that makes sense, best of luck! Hope it all works out.

  7. I have a degree of interbal medecine (3 years post grad) and a degree in respiratory /critical care (3 years) from outside the UK and currently i am working at NHS outside national training as a clinical registrar .
    If i want to apply for st3 respiratory i will need a consultant from the UK only to sign the alternative core competence but in the new version they say that the signatory should also tick these :

    In addition I confirm that I have personally reviewed the applicants portfolio and it contains evidence of:
    ☐ A minimum of 500 acute medical consultations
    ☐ A JRCPTB approved multiple consultant report from at least 4 consultants
    ☐ A minimum of a multisource feedback with 12 responders with satisfactory reports
    ☐ A completed quality improvement project
    ☐ Curricular based completed learning outcomes for geriatric medicine
    ☐ Curricular based completed learning outcomes for critical care medicine
    ☐ Educational supervisor reports that explicitly ascertain that the trainee has achieved all of the clinical CiPs identified within the IMT curriculum with specific reference to clinical CiP 1

    Is this mandatory ? I do have these consultants from abroad but no official portfolio ot will be difficult to get the documents

    1. Hi there! If the form requires it then yes, I would think it is mandatory. Please contact the ST3 recruitment office to confirm. Hope it all works out!

  8. Hi . Post Md in medicine and MRCP how advisable is it to enter ST3 once requirements are met? And regarding alternate certificate of core competence , it can be signed by the consultants from my MD course?

    1. Hi! It’s really a personal choice depending on your career goals. If you want to enter training and become a Consultant, then apply, otherwise don’t. As long as you meet all the criteria in the form, you can have it signed overseas, although I would not recommend starting ST3 as your first job in the UK. It’s much more advisable to get some UK experience before starting ST3. Please see this article

  9. Good day to you

    Need couple of clarifications?

    1. I Finished B.S pharmacy in Manila, PH on 2012 (Pre-Med)
    I Finished M.D (Doctor of Medicine) in Cebu , PH on 2016
    2. Working in KSA currently in ICU since then
    3. Finalizing my MRCP degree (Only PACES left)

    My aim is to complete CCT in ICM
    For me to join ICM training as ST3, as you mentioned, I need the eligibility:
    A. GMC registered after MRCP
    B. Alternative Core Competency Certificate

    1. Can I sign my ACCC by my chairman here in KSA who happens to have MRCP also?
    2. How can I use my 5 yrs experience in ICU in KSA to join ST3 level training?

    Please help me with your kind knowledge
    Thank you

    1. Hi there!

      1. If you have done everything on the form and meet all the other criteria, then yes.
      2. You need to meet the eligibility criteria in terms of experience, if your ICU experience meets the requirements then you can apply. Please see the person specs for ICM ST3 for the experience requirements.

      Best of luck!

      1. Hi . Post Md in medicine and MRCP how advisable is it to enter ST3 once requirements are met? And regarding alternate certificate of core competence , it can be signed by the consultants from my MD course?

        1. Hi, it’s really up to you whether you want to apply for ST3 training. You’ll need to think about what your career goals are and what you hope to gain by joining training. The certificate can be signed overseas provided you meet all the requirements. Please download the form and review the contents carefully. Best of luck!

  10. Hello,
    I completed my PMQ in 2019, did internship in 2020. I plan to
    1. sit MRCS instead of PLAB
    2. use MRCS to apply for GMC registration
    3. Apply for Stand alone FY2 as I prepare to apply for CST 1

    Question: Can I get Stand alone FY2 training position having gotten GMC registration with MRCS instead of PLABs?


  11. I am working as Non training grade . I had alternative certificates that I competent core training . I have a chance to do as IMT Tranee this year.Can I apply palliative ST 3 training if I am in CT1 training?

  12. Hi,
    Thank you for this informative post.

    I did my undergraduate training in the UK, completed AFP foundation training completing my MRCS and am interested in going overseas to complete core CST competencies, then return to the UK for ST3 T&O.
    I assume I need the Certificate of Readiness to Enter Higher Surgical Training, ISCP portfolio during this time, but does it make a difference which country I go to (i.e. in terms of GMC recognition) of where I gained those competencies?

    Many thanks

    1. Hi there! If you’re referring to getting CCT at the end, then currently, no. As long as you complete at least 5 years of T&O in the UK you should get a CCT. No idea if that can or will change in the future though. Hope I’ve understood your question correctly.

  13. Hi, I have done MS in Orthopaedics from China in 2012 and since then working ,and have recently passed MRCS, can i apply for ST3

    1. Hi, you also need the Certificate of Readiness to Enter Higher Surgical Training. Once you have that and you apply for GMC registration, you would be eligible to apply for ST3. Please check the person specifications for the full list of requirements. All the best!

  14. I have done MBBS from India and an MD in Pulmonary Medicine (Respiratory) which is a 2 year program again from India. I also have my MRCP. Am I qualified to apply to ST3? And if not then what is the best option here. And please do tell how long will it take. Number of year wise. Thanks.

    1. Hi there, you need the alternative core competence form to be eligible. No one can say how long it will take in terms of years. If you get your certificate signed and do well in the applications, it can take 1 year. If not then it can take many years or you may not get a place in training. Please see the ST3 recruitment website for full details about the application process (link in our useful links page). Best of luck!

  15. I completed my mbbs from Bangladesh and entered residency directly after internship without doing my foundation year 2. Can i be eligible to apply for st3 training provided i complete mrcs examination.

  16. Hello Nick, really appreciate your efforts here!
    I have completed my MBBS and 12 months of internship in Pakistan. I want to work in Ireland for the next year as a SHO and get done with my MRCS! Will that 12 months of working as a SHO in Ireland be counted in the 24 months of clinical experience required for CT1?

  17. hi Nick,

    I am a Malaysia with a Malaysian medical degree from the International Medical University, Malaysia. I’ve only done the paedtric and orthopaedic posting , which is 2 out of 6 postings required to complete internship in Malaysia. I quit my internship in March 2020 and am now keen to move to the UK and work in the medical field. How can i do that? Thanks.

    My e mail address is : and



  18. Hi ,
    I have completed mbbs from India and has 6 years experience in critical care field. I also completed mrcp UK and got a job offer as ST3 level registrar post in general medicine. Is it possible for me to get into intensive care medicine training by getting core competencies certified while working in the general medicine non trainee job ?

  19. I have completed my surgery three in india and given mrcs and passed both exam now how shall i apply to uk i want to study further uk and work as consultant in uk i want to study either hepatobiliary or cardiothoracic surgery and do i have to wait to get in cardio thoracic or hepatobiliary surgery or i can apply directly in those fields and i have obtained my gmc registration

  20. A training in radiology at ST3 requires “36 months’ experience after full GMC registration.” How can I fulfil this if I finished a 5 year residency overseas, got a full GMC registration, and am currently doing a standalone FY2 to achieve foundation competence?

    1. Hi, apologies we have only seen your comment now! The requirement is for experience after full GMC registration OR EQUIVALENT. The equivalent here means after internship since internship is a requirement for full GMC registration. So if you have done 5 years of residency overseas (60 months) presumably after internship, then you already have 36 months experience in Radiology after the equivalent of full GMC registration. Foundation competences are not required to apply for training jobs at ST3 level. We hope everything has worked out. Best of luck!

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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.
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