The Savvy IMG

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

The immigration barriers that once made it difficult for IMGs to enter UK specialty training in competitive fields have just been removed! Find out how this affects you.

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shortage occupation list

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Back in May 2019, the Migration Advisory Committee (MAC) recommended that all doctors be added to the UK Shortage Occupation List (SOL). We all thought this would take a couple of years to become a reality, but as of October 6, 2019, this will be official! 

Any occupation on the SOL is considered automatically exempt from the Resident Labour Market Test (RLMT). If you’ve been following this website, you know that RLMT was a huge barrier that IMGs needed to be overcome in order to be eligible for training posts in competitive specialties such as Surgery or Radiology, and formed the basis of the IMG-friendly specialties.

But now that barrier has been knocked down, so all IMGs are eligible to apply for training jobs in any round, at any level, in any specialty including core training and higher specialty training

The only exception is Public Health. If you are applying for a training job in Public Health, RLMT rules still apply. It is a competitive specialty so you must be exempt from RLMT in order to be considered for a job. Read more about RLMT here.

The Medical Specialty Recruitment Applicant Handbook 2020 reflects these changes on Page 11 and Page 50 which I’ve copied below:

From 6 October 2019, all medical practitioners have been added to the Shortage Occupation List in the UK. This means that all medical practitioners are exempt from the Resident Labour Market Test (RLMT) and can apply for any specialty in any recruitment round, subject to eligibility.  Page 11

All medical practitioners are now on the Shortage Occupation List and are therefore exempt from the RLMT….Applicants exempt from the RLMT will be considered for posts alongside UK/EU/EEA nationals and other settled workers. Page 50

What does this really mean and how will this affect you as an IMG applying for UK specialty training? 

After careful analysis of the situation, here’s what we think. Of course, we’re not fortune-tellers so what actually happens can be quite different!

1. Competition will go up

Now that anyone can apply, it’s inevitable that many will! This change opens the doors for hundreds, even thousands, of highly qualified IMGs who want to apply for specialty training in the UK. 

The recruitment offices are likely to be inundated with applications over the next couple of years but will not have the capacity to review every application or interview every applicant. They will naturally need to introduce ways of cutting down the number of applicants which leads me to number 2.

Related: Comprehensive IMG guides per specialty

2. Expect a new shortlisting process

Some specialties already have a shortlisting process in place, while others don’t. Due to the increased number of applicants as a result of these changes, we may see the introduction of new and stricter shortlisting criteria. 

We can’t say for sure what the criteria will consist of, but judging from the current shorlisting processes, it can include any of the following:

  • A higher cut off score in the Multi-Specialty Recruitment Assessment (MSRA)
  • A higher portfolio score requirement at the time of application
  • A combination of the above
  • Something completely new

We’ll have to wait and see how things unfold. 

If you need to prepare for the MSRA, Kimberly recommends the E-medica SRA Crammer course which helped her score well and get her Ophthalmology job in London. Use the code Savvyimg for £20 off the MSRA Crammer Course.

3. There may no longer be a Round 2 for ST1/CT1

Round 2  (aka Round 1 re-advert) for ST1/CT1 only exists in some specialties because the specialty is unable to find enough suitable applicants from Round 1 and therefore not all training posts are filled. 

Highly competitive specialties manage to fill all their training jobs in Round 1, therefore they don’t have a Round 2.

This year, there may be more applicants in Round 1 than previous years so it’s possible that all training jobs are filled in Round 1. This would mean that there may not be a Round 2 this year for specialties that usually have it such as Paediatrics, and Internal Medicine.

If you were planning on applying in Round 2, I would say apply in Round 1 now because there may not be a Round 2! Prepare your portfolio, keep improving it even after you’ve submitted your score, do your best at interview, and you can still get a job. 

If you don’t get a place in Round 1, and there is a Round 2, then you can reapply with your better portfolio score, and with your interview experience. Both will increase your chances of succeeding on your second application!

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

4. ST3/ST4 applications are also open to all

If you have already completed some training back home and have your core competencies signed, you will now be able to apply for higher specialty training at ST3 or ST4 level and be considered equally amongst UK graduates. Those competitive specialties like Cardiology, Dermatology, Plastic surgery, and Ophthalmology are now within reach! 

Related: CESR-CP will soon be recognised as CCT

5. Your portfolio is more important than ever

Now that your immigration status isn’t holding you back, there really is no excuse. If you don’t get into training with these new rules, it means that your application was not good enough. So don’t waste this chance to show your worth! 

Check out our top 8 tips on improving your application to UK specialty training.

If you need extra guidance in doing this, check out the IMG Masterclass where we go into more detail and guide you through it step by step.

The general rule is: analyse the person specifications for the specialty you want to apply for, research the scoring criteria, and develop your portfolio accordingly.

6. Preparation for the interview is paramount

If you make it past shortlisting, then the only thing between you and your dream is the interview. A strong portfolio and regular practice will give you the confidence to do well and achieve success. 

Interview season for those applying in Round 1 will be from the end of December to February. Make sure you’re ready! 

The Medical Interviews (Amazon link) book is a staple for UK doctors preparing for interviews so definitely get your copy now!

7. Visa fees will be reduced

The cost of a Tier 2 work visa on the shortage occupation is almost 25% less compared to occupations that are not on the SOL. It’s not a huge amount but if you have a family to bring over to the UK, every little helps! 

Related: An Essential Guide to the UK Standard Visitor Visa for PLAB and Clinical Attachments

8. The rules can change

The Shortage Occupation List is regularly reviewed so any changes are not permanent. This is the time to work hard and work smart, not rest back thinking you’re solved. The current rules represent a window of opportunity that you should take advantage of while you can!

Also, local graduates who previously had little to worry about when it came to IMGs taking up training posts, may now find that they have no job security for specialty training. Objectively speaking, this is a genuine concern for local graduates and there may be some changes to the rules if these concerns are raised.

Related: UK internship (Foundation Programme) open to all IMGs for 2020

9. Have a back up plan

If you’re not quite ready to apply for training this year, it’s important to have a backup plan to remain eligible for Round 1 as the rules can still change. Review this article about how you can be exempt from RLMT and eligible in Round 1.

It’s also worth noting that RLMT may be abolished altogether in 2021, but we don’t yet know what immigration rules will replace it. Again, we’ll have to wait and see and develop a strategy accordingly.

Related: Career options in the UK for IMGs 2020


These are exciting times for IMGs who dream of pursuing specialty training in the UK! 

The changes with the SOL opens doors, but also brings new challenges of increased competition. There is also the chance that local graduates and UK/EU settled workers will block the equal treatment of IMG applicants in future years in order to retain their job security.

Everything mentioned above is our analysis and speculation. We hope this gives you some ideas about how to plan for the future but we can’t know how things will turn out for sure, so it’s important that you are aware of what’s happening and remain flexible with your strategy. 

Bottom line?

Remain vigilant to any changes, stay committed to your vocation, keep working on your application (portfolio & interview skills +/- MSRA), and have a backup plan

Related: 8 ways the UK has made it easier for IMGs in the past 2 years

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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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.


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.


9 Responses

  1. Hello
    So if i am currently in a non training job and have my GMC registration via sponsorship lasting for 5 years
    Here are my questions
    1) if when this year ends i apply to a CESR-CT ST3 intensive care after chrckin entry requirements ehat kind of visa will i have since the skilled worker visa i hold now will end when my non training job ends

    2) if during my training ny GMC registration time ended what can i do ? Knowing that o dnt have PLAB and i will be toward the end of my specialty CESR-CCT training

    1. Hi there, GMC registration via sponsorship doesn’t expire. Every doctor with GMC registration and a license to practice needs to go through the revalidation process every 5 years to show they are up to date. This is the same for the PLAB, or MRCP route. If you pass revalidation, you keep your registration and license.
      1. It will be a Tier 2 work visa, most likely the health and care visa subtype.
      2. Your GMC registration won’t end. If you are in training, your GMC registration and license renews automatically every year as long as you pay the fees. Hope that’s clear! Best of luck!

  2. Hi Nick
    Am an mbbs graduate from India with 7years experience in gp practise. I have completed my ielts with band 7.5 and individual 7. Can I get into gp training program directly without going through plab

    1. Hi there, you need GMC registration to work as a doctor in the UK so unfortunately no, you can’t start GP training without PLAB because PLAB is required for GMC registration. With your experience you’re sure to do well in PLAB! Best of luck!

  3. Good Day doctor!

    I passed the local boards last September 2017 in the Philippines, I gave birth and did not undergo any training specialties. My husband is currently working as a nurse at Cambridge and we are planning to migrate as a family to UK. I will be taking my IELTS this October and will apply for PLAB once I am eligible. I am worried that my portfolio is not competitive enough. Are there ways to improve it? Do i need to attend some trainings while I am waiting for my results? I am hoping for your positive response. Thank you and Godbless!

    Best Regards,

    Cyrine Cunanan, MD

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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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