FAQs about the MTI (for Trusts)

MTI doctors may need extra support to adapt to the new country and new healthcare system. Some may struggle at first with settling in, particularly because of the cultural differences and communicating with their colleagues and patients (and understanding the local accent) may be difficult for them. The RCoA strongly recommends that the following steps be taken to support new MTI doctors:

• Organise a comprehensive induction
• Inform the relevant trust staff that the MTI doctor is new to the NHS and therefore they may ask a lot of questions and will require their colleagues to be patient and speak slowly and clearly
• Identify a colleague who is happy to be a ‘mentor’ to the trainee
• Arrange a sufficient period of shadowing
• Provide essential information often taken for granted such as the NHS and trust management structure
• Arrange separate IT training sessions
• Ensure that study leave number of days and funding is equivalent of UK anaesthetists in training
• Release the MTI doctors from the trust when requested so that they can attend the New to the NHS Meeting held at the College

No, MTI doctors must be supervised and must be assigned an Educational Supervisor who must meet them regularly to provide advice, set objectives and review progress against objectives. They will also complete their assessments.

You will be required to submit a 6-monthly report to the RCoA for each doctors. Failure to do that will result in not having more posts approved for MTI.

While we insist that, in most instances, MTI doctors should be treated the same as their UK anaesthetists in training counterparts, we would be concerned if MTI doctors are asked to cover acute areas in other specialties due to the following

• Unlike their UK counterparts (UK trainees have a 7-year programme and will have completed a 2-year foundation programme in which they will have been exposed to other acute specialities in the UK), MTI doctors would not have the generic experience of working in UK hospitals in different specialties as they come from different training backgrounds.
• MTI doctors are in the UK for a very limited time with specific training objectives. For them to be diverted to other acute specialities would dilute the training in anaesthesia/ICM and pain medicine they have come here for.
• The concept of winter pressures implies reduced staffing in areas such as Emergency Departments and Acute Medical Units. MTI doctors should not work in these areas unless they are fully trained to do so, have had a proper induction and an on-site clinical supervisor. These preconditions are highly unlikely to be met where there are staffing shortages.

Therefore, and given the concerns outlined above, our view is that MTI doctors should in most cases not be asked to cover areas in other specialties. However, if the individual doctor and the education supervisor agree that the post is educationally valuable and training is being maintained, the doctor would be able to undertake other duties.

It depends on the individual ability. The RCoA’s IAC should be used as a framework to measure competence (MTI doctors normally take 6 weeks to receive their IAC). Putting an MTI doctor on on-call will also need the endorsement of the Educational Supervisor.

Yes, we have an MTI Leadership Group made up of experienced consultants who would be able to provide advice. Please contact them through the International Training team.

This would depend on the nature of the issue. We would advise that the performance issues are discussed with the MTI doctor in the first instance, and when possible, mechanisms are put in place to support doctors in difficulty. If following these, no improvement has occurred, and deemed necessary, you should speak to your HR department so that they can apply the HR procedures relevant for each case. If you think that your MTI doctor could put in risk a patient, the doctor should not be allowed to practise until the issue is resolved. Remember to keep the RCoA posted on the issues, as our MTI leadership Group may be able to provide you with further advice.

Complete the Application for a visa extension and return it to the AoMRC (and inform the Global Partnerships team at the RCoA)

No, MTI doctors can be in post for a maximum of 24 months and the Government Authorised Exchange visas cannot be extended beyond that. The expectation is that on completing their MTI placement, MTI doctors return to their home country to put in practice the skills gained in the NHS.

Please complete the Transfer form and send it to the AoMRC (and inform the RCoA).

You will need to let the AoMRC know by completing the End of Placement form. Please also keep the RCoA informed. You will also need to ensure that all the six-monthly reports to cover the entirety of the doctor's placement have been sent to the RCoA so that we can issue them with a Certificate of Completion of MTI.