Frequently Asked Questions about the MTI programme - for MTI applicants and current doctors

Frequently Asked Questions about the MTI programme, designed for potential applicants, MTI doctors who are in the process of applying and those who are already in post.

The MTI scheme, my eligibility and how to find an MTI post in the UK

The Medical Training Initiative (MTI) is a government scheme designed to assist doctors with proven ability in Anaesthesia/Intensive Care Medicine/Pain Medicine from low, lower middle-income and upper middle-income countries (according to World Bank Definitions,) and includes a focus on DFID 28 priority countries, to pursue further specific specialist training in the UK. Doctors can come to the UK for up to 24 months under the UK Border Agency’s Tier 5 immigration rules, before returning to their home countries.

  • Working and training in the UK’s National Health Service (NHS) for a maximum of 24 months
  • Undertaking a post that has been quality assured by the RCoA. This means that the post will have an educational component in areas detailed in the job description, study leave allowance and supervision. You will enjoy the same benefits as any other doctors undertaking the same role in the UK (this includes annual leave entitlement and financial remuneration).
  • Obtaining full registration with a licence to practice from the General Medical Council (GMC)
  • Getting Tier 5 visa to work in the UK for a maximum of 24 months
  • Becoming a member of the College (12 months of free membership)
  • Accessing the Lifelong Learning Platform
  • Accessing a free MTI induction day ("New to the NHS")
  • Accessing the MTI simulation courses available across the UK
  • Eligibility to sit exams (FRCA/FFICM/ FFPMRCA)
  • Gaining technical and non-technical skills to bring back to your home country
  • Taking up leadership roles when you return to your home country

To be eligible you must meet all of the eligibility criteria set out here. If you do not meet any of the criteria, you are not eligible.

Before deciding whether the MTI is your best option, please ensure that you are fully familiar with its philanthropic aim and its requirements. For instance, if you plan to move permanently to the UK, you should consider other options other than MTI (Please check the FAQs under GMC registration for more details). You should carefully read the information about MTI on our webpages.

You have two options: find your own post by contacting hospitals or enrol in the College’s matching scheme by which we may be able to find you a post. You can find details on both routes, including useful websites to find to find jobs, here.

If you want to enrol in the College’s matching scheme, you will need to send us a copy of your CV, IELTS/OET certificate and the completed matching scheme checklist. We will then review those documents and confirm whether you have successfully been enrolled in the scheme. Our role is to accept eligible candidates to our matching scheme and provide CVs from candidates to hospitals looking to recruit MTI doctors through this scheme, and whose posts hold College MTI approval status. The shortlisting will be carried out by individual hospitals and they will contact you directly if interested, and conduct an interview with you (normally via Microsoft Teams). The appointment decision is also made by hospitals. The College are not involved in the interviewing process, and do not contribute to the outcome.

No, we are not in a position to guarantee that this would be the case. We have more candidates enrolled in our matching scheme than existing demand from Trusts. We only send your CV when hospitals approach us and request these. The recruitment process is carried out by hospitals without the College’s input.

We are unable to advise on a timeline as this depends on existing demand from hospitals and on hospitals shortlisting you for their vacant posts. We would like to reiterate that being in the matching scheme does not guarantee that we will be able to find you a post.

I have been appointed to a post in Anaesthesia, Intensive Care Medicine or Pain Medicine in the UK

We can only sponsor overseas doctors who are appointed to an approved Medical Training Initiative (MTI) post and who meet our eligibility criteria for the scheme. If you are eligible for MTI and you are not sure if the post is an approved MTI post, please check this with your hospital. Approved posts are allocated with an approval reference number (which hospitals can find in the post approval letter we email them, the number is MTI followed by three numbers, e.g. MTI122). To ensure that a post holds approval ask your hospital to provide you with their approval number. If this is an MTI post, we will be able to assist you with your GMC registration. If the post is not an MTI post, we will be unable to help, and you will need to find other routes to gain GMC registration (For further details check the FAQs on GMC Registration section).

No, we can only sponsor you if you have been appointed to an MTI post, in which case can only come under a Tier 5 visa.

The country I come from and MTI

No, we can only accept applicants who are living and practising in one of the MTI-eligible countries (low, lower middle-income and upper middle-income countries with a focus on DFID 28 priority countries)

Yes, providing that you meet the other eligibility criteria.

As the MTI has a philanthropic aim, doctors who are practising in high income countries are not eligible. The MTI scheme has the purpose of training doctors who work in low income settings and who after completing their placement in the UK would be in a better position to improve the healthcare system in their home country. In general terms, high income countries’ healthcare systems do not have that need.

I have previously sat the Professional and Linguistic Assessments Board (PLAB)

The PLAB is designed for doctors who intend to move to the UK on a permanent basis. On the contrary, the MTI is philanthropic in nature and only available for those doctors who want to come to the UK to undertake training for a maximum of 24 months and then return to their home country. Therefore, if you have sat the PLAB you would not be eligible for MTI. The following exceptions may apply to individual cases:

  • a candidate who has sat and passed part 1 of PLAB over five years ago would be considered for MTI
  • a candidate who has sat and passed part 1 of PLAB between four and three years ago would be considered providing that they provide a satisfactory reason for the change in route to GMC registration
  • a candidate who has sat and passed part 1 of PLAB within the last three years would not be accepted for MTI.

As per GMC guidelines if you have previously sat and failed any part of the PLAB Test, you will not be eligible for MTI.

My English knowledge and MTI

Two tests are accepted: International English Language Testing System (IELTS) or Occupational English Test (OET). You must provide the Global Partnerships office with your test certificate dully stamped. Provisional results will not be accepted.

Only the Academic version of the IELTS would be accepted. Your IELTS must also show that you have a score of at least 7.0 in each testing area and a minimum overall score of 7.5.

Only the medicine version of the test will be accepted. You must get at least a grade ‘B’ in each test area.

No, the scores must have been obtained in the same test and in your most recent sitting.

IELTS and OET test are valid for two years. If you have an IELTS or OET certificate which is over two years old, it will not be accepted. You will need to complete a new test to support your application.

My clinical experience

As per GMC guidance, you must have been engaged in clinical practice for a minimum of 3 years within the last 5 years when you apply for MTI. This includes the most recent 12 months. Applications showing any clinical experience gap in the 12 months prior to starting the MTI application process will be rejected

Yes, you are eligible. Contractual annual leave does not count as a gap in your clinical experience.

Technically, you should have no gaps in the 12 months prior to your application in order to be eligible. However, the GMC may accept exception depending on the circumstances. If you have a gap in your clinical experience of a maximum of 5 weeks, but believe that the circumstances are exceptional, please contact the Global Partnerships department (please include exact dates and reason for such a gap) and we will seek further advice from the GMC.

My postgraduate qualification

No, your postgraduate qualification may not have previously been assessed. If your postgraduate qualification has not been included in the list, and you meet all the other eligibility criteria, please contact the Global Partnerships team and provide us with the following details: name of postgraduate qualification, awarding body, length and details of the curriculum. We will then review the details of your postgraduate qualification and let you know whether this is suitable for MTI.

No, you must be in possession of the suitable postgraduate qualification in order to be considered for MTI.

Verification of my qualifications

The Educational Commission for Foreign Medical Graduates (ECGMG) must verify your qualifications.

Yes, the GMC will not accept your registration application unless your Primary qualification is verified, and the RCoA requires that your postgraduate qualification be verified.

To speed up the process, we allow you to submit your paperwork whilst the verification is carried out by the ECFMG. However, until we receive the verification reports from the ECGMG, we will be unable to approve your application.

Providing references

You will need to provide us with two referees (their names and email addresses) when you complete the online MTI application form. We will then email them a reference form to complete and return to us.

Your referees must know you in a professional capacity and should not be someone that you are related to. One of them must work in the hospital where you are currently employed and we expect that one of your referees has known you for more than 12 months.

No, references must be returned in the reference document emailed directly to the referees by the College. In addition, all parts of the reference form must be dully completed in order for it to be accepted.

No, references are sent to the RCoA as confidential documents and therefore cannot be shared with your UK hospital. Your hospital may also require references, and to avoid duplication of work, and if acceptable by your hospital, we would suggest that when references are requested, your referee emails them the reference they have completed for the College.

The outcome of my MTI application

The process would normally take up to 4 weeks once we have processed your application  However, please be aware that until we have received your completed references, we will be unable to process your application. Please do not contact the office within the first 4 weeks of having submitted your documentation.

The outcome letter of your application will be emailed to you. This will advise on the next steps, so please read it carefully. In the letter we will provide you with an application form link to register with the College when you are in the UK and have started your post in the NHS. The application will be verified by Global Partnerships and then forwarded onto the Membership department  ( ) so that they can register you with the College.

Please be advised that we will be unable to email your outcome letter until the MTI Trust fee payment has been received.

If we turn down your application, we will give you a reason. It is very rare for this to happen, as we will advise before processing an application if documentation/information is missing. However, we have the right to reject your application if you do not meet the essential eligibility criteria. If that is the case, you can make a request for us to re-assess the decision.

Registering with the GMC

MTI is not the only option for GMC registration. Some overseas postgraduate qualifications are accepted by the GMC as evidence that you have the necessary knowledge, skills and experience to apply for full registration with a licence to practise. You can check if your qualification is acceptable here. You can also gain GMC registration by sitting the Professional and Linguistic Assessment Board (PLAB) test. More information available here.

You should only start your application with the GMC once the RCoA has confirmed your MTI approval.

Details and the link on how to register with the GMC will be provided in your MTI approval letter.

You should apply for registration with a licence to practise through a Sponsorship with a GMC approved sponsor.

No, it is your responsibility to send the documents to the GMC. The only document that we will be sending to the GMC is the Certificate of Sponsorship for GMC registration, if this is required.


GMC Sponsorship Fee

Upper Middle Income Countries*:  £315

Lower Middle Income Countries*:  £105

Low Income Countries*:  £0

 *According to the World Bank definition.

MTI fees

MTI (on application) – High income Countries


MTI (on application) – Upper Middle Income Countries


MTI (on application) – Lower Middle Income Countries


MTI (on application) – Low Income Countries


MTI Placement Fee


No, the fees cover the administration undertaken by the Global Partnerships department to process your application and therefore cannot be reimbursed.

The GMC will have a separate fee for their application and you will also cover the visa fees. Also, take into account that when you move to the UK you may have to arrange your accommodation and sustain yourself for a month until you receive your first salary. Other expenditure may include the NHS healthcare surcharge and an indemnity insurance (which is highly recommended for doctors practising in the UK). More information on relocation fees can be found in the Academy of Medical Royal College’s Relocation Guide.

The RCoA does not have any relocation allowance for MTI doctors. Some hospitals may offer relocation allowances for overseas doctors (but this is not a requirement), so please check with them.

There are not any fees specific to your MTI placement that need to be paid to the Global Partnerships department. However, if you become a member of the RCoA, as an Associate Member you will need to pay your annual subscription as of the second year. As an MTI doctor, you will enjoy the first year of subscription free and you will be required to pay the subsequent years.

Gaining access to the Lifelong Learning Platform

In order to gain access to the Lifelong Learning Platform, you need to become an Associate Member of the College in the first instance. You will need to complete  the Application form for Associate Membership of the Royal College of Anaesthetists, Medical Training Initiative (MTI). Please complete this form only once you are in the UK and have started your post in the NHS. You will also need to ensure that the AoMRC’s MTI Starter’s Report has been completed and submitted to the AOMRC and the College. Failure to submit this report may result in the AoMRC withdrawing your CoS under the assumption that you have not arrived in the UK. 

Once you have a College Reference Number (CRN) and we receive the starter's report we will be able to create a Lifelong Learning Platform account for you.

The MTI Application Form to join the College asks for a College Reference Number (CRN), please leave this blank as this will be allocated to you by the Membership department once they process your application. You will use your CRN as your identification when you call/email the College.

Becoming a member of the College as an MTI doctor

Please complete the Application form for Associate Membership of the Royal College of Anaesthetists, Medical Training Initiative (MTI) when you are in the UK and have started your post in the NHS. The application will be verified by Global Partnerships and then forwarded onto the Membership department ( ) so that they can register you with the College.

As an MTI doctor you will enjoy the first year subscription at no cost. You will be charged the Associate Membership rate as of the second year.

Details of your benefit package can be found at

Adapting to the NHS and the UK

The Academy of Medical Royal Colleges have developed a comprehensive Relocation Guide, which you may find useful. It will also be helpful to speak to former MTI doctors / colleagues at your new hospital if you are able who will be able to give you information about relocating to the UK

Yes, we run a New to the NHS meeting twice a year. This is designed for newly-appointed MTI doctors to better understand your role and the NHS, and it also offers a fantastic networking opportunity. The dates will be published on our Calendar of Events on the website and you will also receive an email from us to inform you of dates and how to register. This event is completely free for MTI doctors approved by the RCoA (although we do ask for a deposit to save your place, once you have attended the event this will be returned to you). You can also book yourself into one of the MTI Simulation Courses run by 5 different centres across the UK. These courses are specifically designed for you and the dates, location, price and how to book can be found here.

The GMC also organises Welcome to UK Practice workshops throughout the years. This workshop makes up part of the New to the NHS meeting, so if you attend this you will not need to attend this again.

My career aims in the UK

No, the MTI is not designed for you if you intend to reside permanently in the UK. The scheme allows you to live and work in the UK for a maximum of 24 months and you before you apply for MTI, you must have clear career plans to return to your home country. You will be able to use the skills acquired in the NHS to take on leadership roles once you return to your home country. If you intend to move permanently to the UK, you will need to consider a different option.

Supervision during my MTI post

Yes, you must have an Educational Supervisor who will guide you throughout your placement in the NHS.

You should be introduced to your supervisor within the first week of starting your post in the UK.

You will meet your supervisor regularly (depending on your needs and your supervisor’s availability) to discuss your progression and learning objectives.

The main role of your supervisor is to guide you throughout your training in the UK. This includes setting your career aims and objectives and completing your 6-monthly reports.

Assessments during my MTI post

You must ensure that a six-monthly report is completed every six months and returned to the RCoA.

Normally on the Lifelong Learning Platform, but you should discuss this with your supervisor.

Apart from the 6-monthly reports, you will need to have a more formal assessment every 12 months. We call it an ARCP-like assessment as we advise supervisors that they conduct this in a similar way as the Deanery’s ARCP. We do not have a specific format for it. Some Trusts do mandate that MTI doctors complete their Trusts appraisals, and if this is the case, you will not need to have an ARCP-like assessment.


Yes, one of the benefits of being an MTI doctor sponsored by the RCoA is access to the exams.

The following links contain information on the exams:

Career and personal difficulties and financial support

The College cannot advise individual doctors on specific episodes of clinical care or medicolegal issues. Support for individual practitioners is in the domain of the medical defence organisations and the College strongly advises anaesthetists to obtain appropriate independent insurance cover and membership of a medical defence organisation. Useful links to support and wellness organisations can be found here

Contractual issues during my MTI placement

Before starting your post in the UK, you should have received and signed a contract with your Trust. The contract will detail your salary and the terms and conditions. Please ensure that you read these carefully before signing it. Signing a contract confirms that you are happy with the job description (including the duties it specifies), the annual leave given to you, the study leave allowance and your salary. If you are not happy with your salary once you have started your post, please speak with your HR department. Your Trust holds your contract and therefore the College cannot become involved in any dispute in regards to contractual issues that have been agreed pre-employment by both parties.

If you are not happy with the duties that you are asked to perform (and these are not part of your job description), discuss this with your Educational Supervisor in the first instance. If after this you are still not happy, please contact us via detailing the issues.

Please discuss this with your Educational Supervisor, if the areas of your interest are available in the department and you can be accommodated, they will arrange for you to gain experience in these.

Changing my MTI post

If you have been appointed to an ICM post, you may not be able to change to an anaesthesia post after coming to the UK without agreement from your employer. Please be aware that if you were appointed to a purely ICM post, you should not expect that once you are in the UK you will be given an anaesthesia post.

Your Tier 5 visa is linked to your MTI post and the expectation is that you complete your MTI in the hospital that appointed you. Leaving your post would result in your visa being terminated. However, in certain circumstances it is possible to change hospitals providing that:

  • an opportunity has arisen for you to take another MTI post (approved by the College) within another Trust;
  • there is a professional reason for the move, e.g. to enhance your experience in a specialised area of your interest, not offered in your current post, that would benefit your healthcare system back home;
  • before accepting the new post, you have discussed this with your current hospital and they have agreed, and the necessary notice period has been given.

In the first instance, you will need to discuss your plans with your current hospital, and once your move has been confirmed, please inform the College so that we can update our records. Your new hospital will then need to inform the Academy of Medical Royal Colleges by completing the MTI Extension and Transfer Form. (If this is not done you will be in breach of your visa conditions).

Terminating my MTI post before my original end date

You may be able to terminate your MTI post. Please first discuss this with your Educational Supervisor, your HR department and inform the College explaining the reasons. Once your resignation has been formalised, your hospital will also need to inform the AoMRC by completing and returning to the End of Placement Report.

Completing my MTI post and Certificate of Completion of MTI

Your hospital will need to complete and return to the AoMRC the End of Placement Report.

We will only be able to issue your certificate if we have received satisfactory six-monthly reports to cover the entirety of your MTI placement, confirmation of your work dates, copy of End of Placement Report and confirmation that you have returned to your home country upon completing your placement in the UK.


No, if you stay in the UK we will be unable to issue your certificate. The MTI scheme is philanthropic in nature, and the expectation is that doctors do return to their home country to put in practice the skills gained in the UK. When you apply for MTI and submit your application to the College, you are agreeing that this is your intention and therefore if you stay in the UK you have not met one of the essential requirements of the MTI scheme and hence you are not eligible for the certificate.