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The IMG-friendly specialties for training (residency) in the UK [ARCHIVED]

Ever wondered which UK specialties are "IMG-friendly"? We discuss which ones are, and how you can get your foot in the door of those that traditionally aren't. Read on to find out.

Table of Contents

International Medical Graduate friendly specialties for training residency in the UK

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The rules, guidelines and criteria for working as a doctor in the UK change frequently. Please make sure you check the latest official guidance before taking action.

UPDATED: October 24, 2019

As of October 6, 2019, all doctors coming from overseas and applying for work in the UK are automatically exempt from the Resident Labour Market Test (RLMT). This is because all jobs in the medical profession have been included in the UK Shortage Occupation List.

So now that all IMGs are exempt from RLMT, this means there are no more “IMG-friendly” specialties. Instead all specialties are now equally friendly to IMGs.

The exception to this is Public Health. Please be aware that Public Health is still subject to RLMT so the article below still applies. 

This change may not last forever. You can read more about these changes and what it means for IMGs here.

Just for your reference, I have kept the old post below so you can see how things have changed.

Pre-October 6, 2019 article

A lot of people ask whether an IMG can apply to a particular specialty in the UK. The truth is, an IMG can apply to any specialty here. The more competitive specialties just involve taking additional steps. Nothing is impossible and if you’re dedicated and determined, you can get a training job in your dream specialty, even cardiothoracic surgery!

In this post I talk about how your immigration status affects your standing in applications to a first year training post, how open or “friendly” certain specialties are to IMGs in this regard, and what you can do to improve your situation.

Important note

This post is for doctors who have not completed a training programme (residency) in their home country and want to apply to a first year training job in the UK.

If you have already completed a training programme overseas and want to work in the UK long-term as a specialist (Consultant), you can follow the CESR-CP or CESR routes described here.

If you want to pursue a fellowship in the UK then return home, have a read of this article.

Factors

To understand how a specialty can be classed as IMG-friendly, you need to understand factors that affect how available that specialty is to IMGs.

Resident labour market test (RLMT)

The priority for specialty training jobs in the UK is based on immigration rules, not where you graduated. This means that as long as you have the right immigration status, you will be considered equally alongside UK applicants. This is the most crucial concept that you need to understand as an IMG applying to UK specialty training.

The immigration rule that’s relevant here is the RLMT. Essentially it says that a visa cannot be issued to a migrant worker if there is a suitable applicant from the UK or EU. In other words: the UK prioritises their own people and the EU (for the time being, this may change with Brexit). But as I mentioned earlier, if you have the right immigration status that makes you exempt from RLMT then you can be prioritised too.

Round 1 vs Round 2

Now for specialty recruitment to be compliant with the RLMT rule, there are 2 rounds. Round 1 is where those who are exempt from RLMT are given priority for training posts. If there are any jobs leftover from Round 1, they go to Round 1 re-advert aka Round 2. This is the round where those who are subject to RLMT are given consideration.

Therefore those who are subject to RLMT ie. those who need Tier 2 visas, can usually only apply in Round 2. This forms the basis of classifying a specialty as being IMG-friendly or not because IMGs generally apply in Round 2, and not all specialties have a Round 2 due to high levels of competition.

Most IMGs are subject to RLMT but not all!

Foreign nationals can also be eligible for Round 1 if they are in certain immigration categories that exempt them from RLMT. This means they will be considered equally alongside UK & EU graduates and can apply to any specialty without restriction.

Find out if you’re exempt by checking this list.

If you are not exempt then keep reading.

Competition ratios & fill rates

You can gauge how competitive a specialty is and therefore how likely it is to go to Round 2 by its competition ratio and fill rate.

The competition ratio is the number of applicants divided by the number of available jobs. So for example, if there are 100 doctors applying for Radiology and there are 50 jobs available, the competition ratio is 2. You can find all the competition ratios for the past 5 years on the HEE website.

The fill rate is the percentage of vacancies in Round 1 that were filled. For example if there are 100 jobs available in Round 1 and 95 of these are taken up, then the fill rate is 95%. It means that 5% of the jobs were left unfilled and are therefore likely to be advertised again in Round 1 re-advert or Round 2. You can find the fill rates for the last couple of years here. Take the fill rates published on this website with a grain of salt, sometimes these are inaccurate and in reality the fill rate is a lot lower. 

Lower competition ratios translates to lower fill rates. Lower fill rates means Round 2 vacancies will arise. This gives IMGs who are subject to RLMT the chance to apply.

The opposite is true: high competition ratios translates to high fill rates. This means there are no Round 2 vacancies. Unfortunately for IMGs who are subject to RLMT, these specialties are essentially closed to them.

But don’t lose heart, there are ways around this obstacle. Keep reading till the end to find out how you can become exempt from RLMT.

Shortage occupation list

Specialties on the Shortage Occupation List (SOL) are open to IMGs because applicants are automatically exempt from RLMT and can therefore apply in Round 1.

The different groups of specialties according to IMG-friendliness

The 3 groups below are according to historical indicators of being open to IMGs such as those that have lower competition ratios, lower fill rates, and available Round 1 re-advert/Round 2 vacancies and the number of Tier 2 visas issued for training jobs in 2018.

All the specialties here are the ones that have openings for first year positions. Medical and surgical subspecialties eg. Cardiology, Orthopaedics, start from the third year (ST3) and are therefore excluded from this list. I’ll do a separate post about applying to ST3 positions. 

A. Specialties that accept IMGs in Round 1

(Most IMG friendly)

B. Specialties that tend to have Round 1 re-advert/ Round 2 vacancies

C. Specialties that tend not to have Round 1 re-advert / Round 2 vacancies

(Least IMG friendly)

GP

Core Psychiatry

For Scotland only:

Paediatrics

Anaesthetics

Obstetrics & Gynaecology

Jump to this group

Internal Medicine (previously called Core Medicine)

Paediatrics

Emergency Medicine (few spaces)

Obstetrics & Gynaecology (few spaces)

Jump to this group

Anaesthetics

Core surgery

Cardio-Thoracic surgery

Histopathology

Neurosurgery
 

Ophthalmology

Oral and Maxillo-facial Surgery

Public Health

Radiology

Community Sexual and Reproductive Healthcare (CSRH)

Child and Adolescent Mental Health Services (CAMHS)

Jump to this group

A. Specialties that accept IMGs in Round 1

GP and Core Psychiatry services are severely short staffed in the UK. Because of this, both specialties accept IMGs in Round 1 and may even accept applicants without any UK experience.

In GP recruitment, IMGs in Round 1 are still subject to RLMT so they have to wait for RLMT-exempt applicants to be placed first, but this shouldn’t phase IMG applicants too much. Because of the high number of vacancies there tends to be enough jobs to go around although you may not be allocated to your preferred geographic region.

Core Psychiatry is a little different. IMG applicants are actually exempt from RLMT as Psychiatry is currently on the UK Shortage Occupation List (SOL). For Scotland only, IMGs are also exempt from RLMT in Paediatrics, Anaesthetics, and Obstetrics & Gynaecology.

You may not need UK experience to be successful for these specialties as they are in such shortage, but it is always beneficial to have UK experience prior to starting a training job.

The requirements to apply are listed in the Person Specifications here. You can find information about how to apply through the links here under the section “Specialty Recruitment”.

B. Specialties that tend to have Round 1 re-advert/Round 2 vacancies

The fact that the specialties in this group often go to Round 2 indicates that there is a good chance for IMGs to get a spot. Competition can still be tough though so you can’t slack off with your CV. You can always try to submit your application in Round 1, but just be aware that most specialties will reject your application even before reaching interview stage if you are subject to RLMT.

Although it is possible to successfully land a job without UK experience if you have a good CV and do well at interview, I think you’ll find it beneficial to work in the UK first before applying. This will help you adjust to working in the NHS; it will also give you time to build up your CV so you have a higher chance of getting a job in a location you prefer.

Also you do not have to apply only in Round 2. You can always try to be in Round 1 by becoming exempt from RLMT. This increases your chances of not just getting a job, but getting one in your preferred location. Read the advice below to find out how.

C. Specialties that tend not to have Round 1 re-advert/Round 2 vacancies

These are the most difficult specialties for IMGs to enter. If a specialty fills all their vacancies in Round 1 with doctors who are exempt from RLMT, then that’s really the end for IMGs.

Or is it?

Remember I mentioned earlier that IMGs can also be considered in Round 1 if they become exempt from RLMT? There are 7 ways an IMG can gain exemption from RLMT in order to be considered equally alongside UK graduates. 

If I’m in Round 1 will I definitely get a training job?

No, of course not. Nothing in life is guaranteed. You still have to compete against other applicants so build up your CV and don’t waste this opportunity!

But if you are in Round 1, you are on level playing field with UK graduates and you will not be discriminated against as an IMG. This situation is the best you can hope for, it really is an incredible opportunity that you just don’t get in the US. If you are unsuccessful in Round 1, at least you know it won’t be because you graduated overseas.

Here are some ways we can help with that:

  1. Read this article for tips on improving your application to specialty training.
  2. To improve your interview skills, I highly recommend this book. Without it, I wouldn’t have gotten my Standalone FY2 job.
  3. If you want a more detailed walkthrough, be sure to check out our masterclass.

Summary

  • How IMG-friendly a specialty is has to do with how open it is to applicants who are subject to RLMT.
  • The Resident Labour Market Test (RLMT) is an immigration rule to allow jobs to be filled by UK/EU applicants first.
  • Priority for training jobs is given to those who are exempt from RLMT, not necessarily UK graduates. Some overseas graduates can be exempt from RLMT too.
  • All RLMT-exempt doctors will be considered equally for jobs.
  • Those who are exempt from RLMT are given jobs first in Round 1, if there are any jobs left vacant they go to Round 1 re-advert aka Round 2. Applicants who are subject to RLMT can apply in Round 2. Whether a specialty has a Round 2 can be gauged by the level of competition.
  • Indicators of competition include the competition ratio and the fill rate.
    • Competition ratio – number of applicants divided by number of available jobs.
    • Fill rate – percentage of jobs in Round 1 that are filled.
  • Jobs on the Shortage Occupation List (SOL) are exempt from RLMT.
  • Specialties can be grouped according to how open they are to IMGs from most open to least open
    • A. Specialties that accept IMGs in Round 1
    • B. Specialties that tend to have Round 2 vacancies
    • C. Specialties that tend not to have Round 2 vacancies
  • Being in Round 1 does not guarantee you a job, you still need to build up your CV and perform well on interview to compete with other applicants. The book Medical Interviews is essential for a good interview performance.

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.

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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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Disclosure and use of your information for legal reasons

Indicating possible criminal acts or threats to public security to a competent authority

If we suspect that criminal or potential criminal conduct has been occurred, we will in certain circumstances need to contact an appropriate authority, such as the police. This could be the case, for instance, if we suspect that we fraud or a cyber-crime has been committed or if we receive threats or malicious communications towards us or third parties.

We will generally only need to process your information for this purpose if you were involved or affected by such an incident in some way.

Legal basis for processing: our legitimate interests (Article 6(1)(f) of the General Data Protection Regulation).

Legitimate interests: preventing crime or suspected criminal activity (such as fraud).

In connection with the enforcement or potential enforcement our legal rights

We will use your information in connection with the enforcement or potential enforcement of our legal rights, including, for example, sharing information with debt collection agencies if you do not pay amounts owed to us when you are contractually obliged to do so. Our legal rights may be contractual (where we have entered into a contract with you) or non-contractual (such as legal rights that we have under copyright law or tort law).

Legal basis for processing: our legitimate interests (Article 6(1)(f) of the General Data Protection Regulation).

Legitimate interest: enforcing our legal rights and taking steps to enforce our legal rights.

In connection with a legal or potential legal dispute or proceedings

We may need to use your information if we are involved in a dispute with you or a third party for example, either to resolve the dispute or as part of any mediation, arbitration or court resolution or similar process.

Legal basis for processing: our legitimate interests (Article 6(1)(f) of the General Data Protection Regulation).

Legitimate interest(s): resolving disputes and potential disputes.

How long we retain your information

This section sets out how long we retain your information. We have set out specific retention periods where possible. Where that has not been possible, we have set out the criteria we use to determine the retention period.

Retention periods

Server log information: we retain information on our server logs for 3 months.

Correspondence and enquiries: when you make an enquiry or correspond with us for any reason, whether by email or via our contact form or by phone, we will retain your information for as long as it takes to respond to and resolve your enquiry, and for 36 further month(s), after which point we will archive your information.

Newsletter: we retain the information you used to sign up for our newsletter for as long as you remain subscribed (i.e. you do not unsubscribe).

Membership: we retain the information you used to sign up for our memberships for as long as you remain subscribed (i.e. you do not unsubscribe).

Criteria for determining retention periods

In any other circumstances, we will retain your information for no longer than necessary, taking into account the following:

    • the purpose(s) and use of your information both now and in the future (such as whether it is necessary to continue to store that information in order to continue to perform our obligations under a contract with you or to contact you in the future);
    • whether we have any legal obligation to continue to process your information (such as any record-keeping obligations imposed by relevant law or regulation);
    • whether we have any legal basis to continue to process your information (such as your consent);
    • how valuable your information is (both now and in the future);
    • any relevant agreed industry practices on how long information should be retained;
    • the levels of risk, cost and liability involved with us continuing to hold the information;
    • how hard it is to ensure that the information can be kept up to date and accurate; and
    • any relevant surrounding circumstances (such as the nature and status of our relationship with you).

How we secure your information

We take appropriate technical and organisational measures to secure your information and to protect it against unauthorised or unlawful use and accidental loss or destruction, including:

  • only sharing and providing access to your information to the minimum extent necessary, subject to confidentiality restrictions where appropriate, and on an anonymised basis wherever possible;
  • using secure servers to store your information;
  • verifying the identity of any individual who requests access to information prior to granting them access to information;
  • using Secure Sockets Layer (SSL) software to encrypt any payment transactions you make on or via our website;
  • only transferring your information via closed system or encrypted data transfers;

Transmission of information to us by email

Transmission of information over the internet is not entirely secure, and if you submit any information to us over the internet (whether by email, via our website or any other means), you do so entirely at your own risk.

We cannot be responsible for any costs, expenses, loss of profits, harm to reputation, damages, liabilities or any other form of loss or damage suffered by you as a result of your decision to transmit information to us by such means.

Transfers of your information outside the European Economic Area

Your information may be transferred and stored outside the European Economic Area (EEA) in the circumstances set out earlier in this policy.

We will also transfer your information outside the EEA or to an international organisation in order to comply with legal obligations to which we are subject (compliance with a court order, for example). Where we are required to do so, we will ensure appropriate safeguards and protections are in place.

Your rights in relation to your information

Subject to certain limitations on certain rights, you have the following rights in relation to your information, which you can exercise by writing to the data controller using the details provided at the top of this policy.

  • to request access to your information and information related to our use and processing of your information;
  • to request the correction or deletion of your information;
  • to request that we restrict our use of your information;
  • to receive information which you have provided to us in a structured, commonly used and machine-readable format (e.g. a CSV file) and the right to have that information transferred to another data controller (including a third-party data controller);
  • to object to the processing of your information for certain purposes (for further information, see the section below entitled Your right to object to the processing of your information for certain purposes); and
  • to withdraw your consent to our use of your information at any time where we rely on your consent to use or process that information. Please note that if you withdraw your consent, this will not affect the lawfulness of our use and processing of your information on the basis of your consent before the point in time when you withdraw your consent.

In accordance with Article 77 of the General Data Protection Regulation, you also have the right to lodge a complaint with a supervisory authority, in particular in the Member State of your habitual residence, place of work or of an alleged infringement of the General Data Protection Regulation.

Further information on your rights in relation to your personal data as an individual

You can find out further information about your rights, as well as information on any limitations which apply to those rights, by reading the underlying legislation contained in Articles 12 to 22 and 34 of the General Data Protection Regulation, which is available here:http://ec.europa.eu/justice/data-protection/reform/files/regulation_oj_en.pdf

Verifying your identity where you request access to your information

Where you request access to your information, we are required by law to use all reasonable measures to verify your identity before doing so.

These measures are designed to protect your information and to reduce the risk of identity fraud, identity theft or general unauthorised access to your information.

How we verify your identity

Where we possess appropriate information about you on file, we will attempt to verify your identity using that information.

If it is not possible to identity you from such information, or if we have insufficient information about you, we may require original or certified copies of certain documentation in order to be able to verify your identity before we are able to provide you with access to your information.

We will be able to confirm the precise information we require to verify your identity in your specific circumstances if and when you make such a request.

Your right to object

You have the following rights in relation to your information, which you may exercise in the same way as you may exercise by writing to the data controller using the details provided at the top of this policy.

  • to object to us using or processing your information where we use or process it in order
  • to carry out a task in the public interest or for our legitimate interests, including ‘profiling’ (i.e. analysing or predicting your behaviour based on your information) based on any of these purposes; and
  • to object to us using or processing your information for direct marketing purposes(including any profiling we engage in that is related to such direct marketing).

You may also exercise your right to object to us using or processing your information for direct marketing purposes by:

  • clicking the unsubscribe link contained at the bottom of any marketing email we send to you and following the instructions which appear in your browser following your clicking on that link;
  • sending an email to info@thesavvyimg.co.uk, asking that we stop sending you marketing communications or by including the words “OPT OUT”.

Sensitive Personal Information

‘Sensitive personal information’ is information about an individual that reveals their racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, genetic information, biometric information for the purpose of uniquely identifying an individual, information concerning health or information concerning a natural person’s sex life or sexual orientation.

Our website does not allow you to register any ‘Sensitive Information’, however if we ask for this, you will be considered to have explicitly consented to us processing that sensitive personal information under Article 9(2)(a) of the General Data Protection Regulation.

Changes to our Privacy Policy

We update and amend our Privacy Policy from time to time.

Minor changes to our Privacy Policy

Where we make minor changes to our Privacy Policy, we will update our Privacy Policy with a new effective date stated at the beginning of it. Our processing of your information will be governed by the practices set out in that new version of the Privacy Policy from its effective date onwards.

Major changes to our Privacy Policy or the purposes for which we process your information

Where we make major changes to our Privacy Policy or intend to use your information for a new purpose or a different purpose than the purposes for which we originally collected it, we will notify you by email (where possible) or by posting a notice on our website.

We will provide you with the information about the change in question and the purpose and any other relevant information before we use your information for that new purpose.

Wherever required, we will obtain your prior consent before using your information for a purpose that is different from the purposes for which we originally collected it.

Children’s Privacy

Because we care about the safety and privacy of children online, we comply with the Children’s Online Privacy Protection Act of 1998 (COPPA). COPPA and its accompanying regulations protect the privacy of children using the internet. We do not knowingly contact or collect information from persons under the age of 18. The website is not intended to solicit information of any kind from persons under the age of 18.

It is possible that we could receive information pertaining to persons under the age of 18 by the fraud or deception of a third party. If we are notified of this, as soon as we verify the information, we will, where required by law to do so, immediately obtain the appropriate parental consent to use that information or, if we are unable to obtain such parental consent, we will delete the information from our servers. If you would like to notify us of our receipt of information about persons under the age of 18, please do so by contacting us by using the details at the top of this policy.