Entry into Training for IMGs

This article will try to cover the basic pathways for IMGs (International Medical Graduates) who wish to enter the UK’s training system. You should keep in mind that your first job in the UK will most probably be a non-training job. After having worked at a non-training post for a few months (most probably 6 to 18 months), you can apply for training. You can check your chances of finding your preferred field of training here.


IMGs who start working in the UK can be divided into three categories:

  1. Candidates who have NOT completed an acceptable pattern of internship from their home country.
  2. Candidates who have completed an acceptable pattern of internship from their home country.
  3. Candidates who have completed MRCP.


1. Candidates who have NOT completed an acceptable pattern of internship from their home country

These candidates are at the level of freshly graduated doctors, with no experience.

Therefore, the next step for them would be Foundation Program; they can only apply for FY1 posts.

It is very difficult to find FY1 posts for IMGs, since most FY1 posts are taken by local graduates in the UK. Therefore, it is always advisable to start working in the UK only after completion of an internship back home.

Entry after PLAB - I


2. Candidates who have completed an acceptable pattern of internship from their home country

These candidates are at the level of doctors who have completed their FY1.

Therefore, the next step for them would be FY2. However, getting a training FY2 post is very difficult, since most people who enter FY1, complete their FY2 training in the UK; there are almost no vacancies for FY2 training for IMGs.

So the best option would be to apply for different non-training posts at FY2/CT1 (SHO) level, which can be found very easily. After working for 3 months at a non-training post, they are eligible to get their FY2 competencies signed. However, getting competencies signed after having worked for at least 6 months might be slightly easier. Getting their FY2 Competencies signed would make them eligible to apply for Core Training.

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3. Candidates who have completed MRCP

These candidates are at the level of doctors who have completed their Core Training.

Therefore, the next step for them would be Specialty Training. However, it might not be possible to start their ST right away.

The best route for these doctors is to take a non-training (registrar) job at first. After working for a certain amount of time, they can get their Core Training competency signed and after meeting other eligibility requirements of Specialty Training, these candidates can apply for Specialty Training.

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  1. Make sure you complete your internship back home before you start applying for jobs in the UK.
  2. IMGs who have completed their internship back home, passed PLAB and registered themselves with the GMC, should take the following  route:
    a) Take a non-training job until they start training.
    b) Get their FY2 competencies signed.
    c) Works towards achieving other eligibility criteria for training jobs.
    d) Get a training job.
    e) Become a consultant.
  3. IMGs who have passed MRCP and registered themselves with the GMC, should take the following route:
    a) Take a non-training job until they start training.
    b) Get their Core Training competencies signed.
    c) Works towards achieving other eligibility requirements for training jobs.
    d) Get a training job.
    e) Become a consultant.


Useful Links


Frequently Asked Questions

1. What are non-training jobs?

These are the jobs that IMGs with an acceptable pattern of internship should apply for. There can be many different titles to these jobs, but the jobs are nearly the same. These can include:

Foundation Year 2 (FY2)
Senior House Officer (SHO)
Core Training 1 (CT1)
Core Training 2 (CT2)
Specialty Training 1 (ST1)
Specialty Training (ST2)
Clinical Fellow (CF)
Junior Clinical Fellow (JCF)
Senior Clinical Fellow (SCF)
Junior Doctor
Trust Grade Doctor

It might confuse you seeing FY, CT and ST posts among non-training jobs. These jobs arise when a hospital needs FY, CT or ST Doctors, but it is not possible for them to recruit training doctors. So they hire non-training doctors for the same posts.

Working at these jobs will not count towards your training experience. However, the job description and the salary is the same as training jobs.


2. What is the difference between a training and a non-training job?

A training job is one in which there is career progression. In a non-training job, there is no career progression. Our internship (also known as House Job in Pakistan) and specialty training jobs (also knows as Residency in Pakistan) are training jobs.


3. What is F2 Competency?

Since IMGs do not go through UK’s Foundation training, they are required to get an F2 Competency form signed by their consultant. This form can be signed by any consultant, in the UK or in their home country, under whom they have worked for at least 3 months, during the last 3 years.

This form would not make them equivalent to candidates who have completed their Foundation training from the UK, but it would make them eligible to apply for Core Training program in the second round (First round is for British and EU citizens).


4. What is an Acceptable Pattern of Internship?

At least 12 months of internship with at least 3 months in medicine and at least 3 months in surgery is considered to be an acceptable pattern of internship. Medical and surgical sub-specialties count in medicine and surgery, respectively. For example, pediatrics and OBGYN are counted as medicine and surgery, respectively.

You must also check the official link from the GMC’s website to find out the acceptable patterns of internship. You can click here to check the official GMC link.


5. Can I enter sub-speciality of my choice in Medicine?

You can visit the official ST3 recruitment website to check the number of openings for your preferred field. Go to the bottom of the page and click on your choice of sub-specialty. A new page will open. Click on Data. Check the number of openings for that field in round 2. This will give you an idea of your chances of making it to your choice of field.

You can also check competition ratios and seat availability from my post Training Availability in the UK.

Generally, entering non-surgical fields is very easy. Finding training in surgical fields require a lot of hard work and dedication in improving the CV. There is also tough competition over training spots in specialties like dermatology and radiology.

129 thoughts on “Entry into Training for IMGs

  1. Salam naseer bahi. I have completed my house job in 2009 which was 6 month in peds medicine and 6 month in dermatology in pakistan. I have no experience in Surgery.I did not have internship as required by GMC.Should i have to do in surgery?can i do 3 month more house job in surgery now? Will it be counted in internship experience?

    1. I’m not sure if 15 months of House Job with gaps will be accepted. I would advise you to check with others who’ve been in this situation.

  2. Hi Dr Khan. I would like to talk to you in more detail about applying for a core surgical training program and get your advice if possible. A brief summary, I was working as a trust SHO in Orthopedics for a year before returning to HK my home country to complete my internship here. I’ve collected the relevant competencies while I was in the the UK and an interested in applying for a surgical CT position but am finding it difficult to get the relevant info about application for round 1 in sept/October. Is there anyway to private message you to discuss further?

    Best regards


    1. I would advise you to join the Facebook group “International Medical Graduates in the UK” and post your query there. Someone will be able to help you for sure.

  3. Hello Dr.Naseer
    If I finish plab1&2 and I want to start fy1 inside uk .. Do they will require to take IELTS again and require 7.5 each ?
    Because I listen the foundation program require 7.5 each skill .. can you explain .
    Thanks in advance

    1. 1. Yes, that’s correct.
      2. Bud unless you’re British or an EEA National, it’s unlikely to find FY1 training in the UK.

  4. Hello Dr. Khan,
    I am working as a house officer in my home country Nepal. I wanted to sit for PLAB. But I am confused of whether to go for PLAB or wait and prepare for MRCP, as the ultimate goal is to become a consultant. I read about the differences between the two but asking for a personal suggestion. Thank you sir.

  5. Dear Naseer Khan,

    I am a graduate from Army Medical College Pakistan, and I am a Turkish National. Therefore applied for equivalence in Turkey. It has been more than 6 months since my graduation and I couldn’t start my house job/ internship. I am quite frustrated and I want to keep my medical experience fresh.

    I, therefore would like to try my chance in FY1. Is it impossible? When to apply?

    Kind regards,


  6. Hi Dr. Naseer.

    This blog is very informative. I’ve a confusion that
    1.what do you mean by FY1 and FY2?
    2. If i complete my housejob i.e 1year training in Pakistan. What level is it considered over there?
    3. What do we do in Pakistan that is equivalent to FY1 and FY2?
    4. Or where do i apply after passing PLAB? I want to persue cardiosurgery as future career.

  7. Hello Dr Naseer. First of all, thank you so much for your help. I am planning to work in the UK after finishing my internship in Dubai. But honestly, when I saw the IELTS requirements for the non-training FY job I was shocked. I barely managed to get the scores needed to apply for the PLAB exam. My scores were 7.5 and above in all bands, and a 7 in writing. Is there any chance for me to work in the UK with these scores? Perhaps, by applying for a SHO job or anything else directly without doing the FY2.

    Thanks in advance.

    1. You do not need to do FY training. So don’t worry about it. Everyone starts of as an SHO and then moves ahead bypassing the FY Training.

  8. Hi Dr Naseer, Firstly kudos to you for creating and maintaining a professional quality blog , all while working a full time job as a junior doctor.
    I wanted to ask you about the GP pathway. The blog entry mentions that after 6-18 months you could get your competency certificate signed and then you’d be eligible for core training.

    If I get the competency certificate signed,would i be eligible for the GP training pathway as wel;?
    And if so, typically how long are you expected to hold to training job to be competitive for the GP training posts?

    Thanking you,

    1. Thank you for visiting the website and for your kind comment! 🙂

      1. Yes, you will be.
      2. You can work as a non-trainee for as long as you like. But I feel two years is an ideal time to work as a non-trainee to get used to the system.

      All the best! 🙂

  9. Can you please find out any info about what requirements are for imgs applying for FY1?

  10. Dr. Naseer sir can you please throw some light on the MSRA exam for applying to OG training post.

    1. I am sorry, I have no idea about MSRA for OBGYN posts. But if you check their official website, you should find the relevant information. All the best! 🙂

  11. Dear Dr. Naseer,
    Thank you so much for creating this website, thats so kind of you to help others like this without even expecting anything back. You are a very kind person. I have few questions to ask from you. I hope you can help me. I am currently living in UK and I have visas to live and work here. However I have a long gap after graduating from med school in 2009, and I haven’t done my Internship either. I recently sorted my visas and preparing my ielts at the moment. If I finish plab1 & 2 and if I want to start fy1 inside UK, do you think my long gap after graduation will affect my fy1 application? Or this gap affecting me in anyway towirkas a doctor in UK? Can you please help me with this? Really appreciate your help.
    Thanks in advance
    Kind regards

    1. Yes, the gap will cause issues. But I know people with ten-year gaps who got accepted by the GMC and started working as SHOs. Your case is slightly different as you will be looking for FY1 training slots. Again, there is no harm in trying. You have the right to work without needing a visa, so that will help your case. All the best! 🙂 I would also advise you to check with others on Facebook groups who have been through the same.

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