The National Health Service (NHS)
The United Kingdom (UK) has one of the most revolutionary and progressive healthcare systems in the world. Whether you’re working for the National Health Service (NHS) or a private healthcare provider, you can be sure that you are part of a national workforce who not only provide first-class care, but who are making history each and every day.
The UK lifestyle offers a fantastic wealth of activities and opportunities not only in employment but also recreationally. Steeped in history, the UK offers the perfect mix of vibrant, modern cities and a wealth of countryside landscapes – from the snowy mountain ranges in Scotland and the rolling Oxford countryside to the sandy shores of the West Country.
The NHS was founded in 1948 to provide healthcare free at the point of use to the entire UK population. Since the creation of the NHS there have been significant changes in the structure and funding of NHS healthcare. It still covers the whole of the UK population and is still mostly free at the point of delivery.
Exceptions to this include outpatient dental treatment, some health appliances and sight testing, for which patients are expected to pay in part, or fully, themselves. Patients also pay a fixed amount for drugs prescribed in primary care, although there are exemptions or reductions for certain groups, such as children, the elderly, the unemployed, those on low incomes and some patients with chronic conditions. There are no charges for seeing a doctor or for treatment in hospital.
The private medical sector is small. Just over 11 per cent of the population have some private healthcare insurance, but the cover provided can be limited and the private sector relies heavily on the support provided by the NHS. Most doctors in the UK practise in the NHS, even if they do some private work as well.
Healthcare structure in the UK
The NHS is funded mainly through general taxation and national insurance contributions, which all employed people and employers are required to pay. Health service provision has been devolved, resulting in slightly different systems within the four nations comprising the UK – England, Northern Ireland, Scotland and Wales.
Staff working in the NHS are employed by the hospitals. Most doctors are employed under the terms and conditions of service negotiated nationally by the Bristish Medical Association for NHS employed medical staff, but not all employers are obliged to apply them.
The Department of Health for England is the Government department responsible for the management of health and social care services to the people of England and sets the overall policy on health issues. In July 2010 plans were introduced by the Government to reform the NHS. The resulting Health and Social Care Bill is still being discussed and debated in Parliament.
The responsibility for developing strategies for local health services and ensuring high quality performance did rest with 10 strategic health authorities (SHAs) which also managed the NHS at a local level. Each SHA was then split into different types of NHS Trusts that run different services in particular areas: acute trusts, ambulance trusts, care trusts, mental health trusts and primary care trusts (PCTs). NHS Trusts are independent with their own boards of directors.
In 2004 foundation trusts were also introduced. These are run by local managers, staff and members of the public and are tailored to the needs of the local population. They also have more financial and operational freedom than other NHS Trusts. As part of the NHS reforms the aim is that all Trusts become Foundation Trusts in the future.
The Health and Social Care Act will introduce changes in how services are commissioned; Strategic Health Authorities and Primary Care Trusts will be disbanded, new GP consortia will commission the majority of services locally and every GP practice will be required to become part of a consortium. The changes to the NHS are extremely detailed and are constantly being updated. Visit our definitive section on NHS reforms on our website and stay up to date.
The administration of the Northern Ireland HSC (Health and Social Care) lies with the Department of Health, Social Services and Public Safety (DHSSPS). Health and personal services are provided as an integrated service by four health and social services boards (Eastern, Northern, Southern and Western). The boards commission and purchase services for their areas. HSC Trusts provide health and social services within commissioning arrangements agreed with the health and social services boards.
With the exception of the regulation of the professions and legislation on abortion, decisions on health legislation are taken by the Scottish Parliament in Edinburgh. The Scottish Government Health Directorate is responsible for the leadership of the NHS and implementing health and wellbeing policies.
There are 14 area NHS boards in Scotland responsible for planning and delivery of health services. Hospital divisions are responsible for the delivery of secondary care and Community Health Partnerships, which encourage closer working between primary care and social services, are responsible for providing services in local communities.
For more information visit the NHS Scotland website.
The National Assembly for Wales has strategic responsibility for the NHS in Wales. Seven local health boards deliver secondary and primary care.
For more information visit the Welsh Assembley Government website.
You need to be on the UK medical register before you can do any clinical work or write prescription drugs in the UK.
The General Medical Council (GMC) holds the medical register. The GMC is the regulatory and disciplinary body for the medical profession and it keeps the UK specialist and General Practitioner registers.
If you want to work in the UK make sure you do the following:
Arrangements differ depending on where you are from.
If you are from the EEA registration can be relatively simple.
If you are from outside the EEA the procedures for registration can be more complex
This information below is strictly for Doctors outside of the EU, if you are a European doctor please scroll down to the heading titled ‘’Knowledge of English – European doctors’’
Information on training opportunities, the application process and the competition for training posts is available on the NHS Specialty Training website.
The Overseas doctors training scheme (ODTS) and International sponsorship scheme (ISS) are dual-sponsorship schemes administered by the medical royal colleges in the UK.
They were launched to provide highly-skilled overseas-qualified doctors with structured and supervised specialist training in postgraduate training posts in the UK.
Doctors who qualified in, or are resident in the EEA are not eligible. ODTS/ISS graduates are expected to return to their own country on completion of the agreed period of training.
To be considered for one of the Royal colleges ODTS/ISS schemes (the names of these can vary), you will need to have been recommended to the relevant Royal college in the UK by a sponsoring organisation in your own country.
The sponsors overseas must satisfy the Royal college that they can personally vouch for you with regard to your professional expertise and competence in English. In addition, the sponsor must satisfy the Royal college that suitable employment will be arranged for you on your return.
Each college has its own criteria for selection of candidates for sponsorship under the schemes, but some general rules apply.
You must possess a qualification which is acceptable for full registration in the UK.
In addition, you will normally be required to have obtained a postgraduate medical qualification in the specialty in which you wish to train in Britain and have at least two years’ clinical experience in medicine or surgery gained at postgraduate level. However, for details of requirements specific to your specialty you should contact the relevant royal college.
Please note – competition for places on the ODTS/ISS is very high and some colleges are ceasing to run such schemes, especially in light of the recent changes to the immigration rules for postgraduate doctors and dentists and due to withdrawal of funding.
It is very important you check the current situation with the appropriate individual royal college.
There are different routes one take in-order to get a chance to work in the UK NHS, to name a few I have put a list below. (These contain different routes one can take) PLAB Professional and Linguistic Assessments Board (PLAB) test.
The PLAB test is the main route by which International Medical Graduates (IMGs) demonstrate that they have the necessary skills and knowledge to practise medicine in the UK Complete the PLAB Part 1 & Part 2. (This usually is the longer, more conventional way for overseas doctors who do not hold a post graduate qualification. The PLAB is a route taken by doctors who are not EU citizens, it can take up to a year to complete.
More details on the PLAB test- click here
If you are entering Britain to sit the PLAB test (see section on regulation for more information) you should request leave to enter the UK for the purposes of taking the PLAB test.
This does not entitle you to work in the UK.
If you are subject to the immigration rules you may be admitted to the UK for a period of six months to take the PLAB test, and extensions may be granted by the UKBA, with the maximum amount of leave an individual can be granted being 18 months.
On passing the PLAB test, you may apply to the Home Office for permission to remain in the UK to undertake a clinical attachment, or for permission to switch to a Tier 2 (General) visa if you have an offer of employment.
If there are still vacancies on the Foundation Programme after the recruitment process, then vacancies may be advertised.
If a vacancy is advertised and there are there are no suitable applicants from the UK or EEA, then the post can be offered to doctors outside of the UK/EEA and a Tier 2 (General) visa may then be obtained. But be warned, places are heavily oversubscribed so make enquiries before making plans to come to the UK.
What you should do
Overseas doctors are strongly advised to complete their pre-registration year in their own country. This is because posts are designed to complement UK undergraduate medical training and the number of posts is linked to the number of UK graduates. This means that opportunities are limited.
In addition, most overseas doctors will need to complete the IELTS and PLAB tests successfully before being granted limited registration by the GMC. Please note that the PLAB test assesses basic medical competence and an ability to communicate in English for suitability to work at F2 levels.
The MTI scheme allows International Medical Graduates (IMGs) to come to the UK for a maximum of two years to train within the National Health Service (NHS). IMGs benefit greatly from the knowledge, skills and techniques learned within the NHS and can use them to improve the level of patient care in their home country on their return. In addition, UK hospitals who provide a placement for IMGs benefit from increased workforce capacity and the skills and knowledge that IMGs can share with their UK colleagues. During the placement, IMGs follow a similar assessment process to UK trainees. The expectations of IMGs in terms of their performance and targets should be based on the same standards as UK trainees at ST2 level initially, until, with support from the hospital, they move to ST3–4 level for the majority of their placement. The MTI process contains several steps and involves many parties. It requires the continuous cooperation between applicants, the MTI Lead, hospitals, the GMC and the Academy of Medical Royal Colleges. Efficient communication between these parties reduces the risk of delays in placing MTI doctors.
There is an initial fee for registration and an annual fee to remain on the register. You will need to contact the GMC to find out which category of registration you can apply for and how much it will cost.
It is now a legal requirement to be registered with the GMC and to hold a licence to practice. The licence is issued by the GMC and is virtual – it is an online record which is held on the medical register. The licence to practice is part of the UK’s regulation system called Revalidation.
Doctors have to demonstrate to the GMC every five years that they are up to date and fit to practise, although they will have to demonstrate they are up to date throughout the five year period.
The revalidation process is based on ‘Good Medical Practice’ which sets out the principles and values on which good practice is founded, including the duties of doctors registered with the GMC. The revalidation process started in 2012 and the GMC expects to revalidate most doctors in the UK for the first time by March 2016.
We have guidance on revalidation which is more relevant to doctors once they are established in the UK. Even if you are new to the UK it gives a useful background to the subject and a helpful overview of how the process as it relates to your working life.
Who needs to provide evidence of knowledge of the English language?
All doctors who practise medicine in the UK must have the necessary knowledge of English to communicate effectively so they do not put the safety of their patients at risk. Communicating includes speaking, reading, writing and listening.
Whether we ask you to give us evidence that you have the necessary knowledge of English depends on a number of things.
The Occupational English Test (OET) is an international English language test that assesses the language and communication skills of healthcare professionals who seek to register and practise in an English-speaking environment.
It provides a valid and reliable assessment of all four language skills – listening, reading, writing and speaking – with an emphasis on communication in medical and health professional settings.
OET tests international health practitioners in the following 12 professions:
OET is recognised and trusted by more than 40 regulatory healthcare bodies and councils in Australia, New Zealand, Singapore, Dubai, Namibia, UK (NMC) and Ireland (NMC). Many organisations, including hospitals, universities and colleges, are using OET as proof of a candidate’s ability to communicate effectively in a demanding healthcare environment. In addition, OET is recognised by the Australian Department of Immigration and Border Protection for a number of visa categories, including work and student visas.
(Occupational English Test, as an alternative to the International English Language Test System (IELTS) –click here for details
IELTS is an English Language test administered by the British Council, IDP Education Australia and Cambridge ESOL. It is run in over 100 countries. You can find out more on the IELTS website at http://www.ielts.org
For us to accept your IELTS certificate, it must meet our criteria.
Your IELTS certificate is valid for two years. Your certificate must be valid on the day you sit PLAB Part 1.
If you have obtained the required scores in the academic version of the IELTS test over two years ago, you may be able to prove to us that you have maintained your English language skills.
You can do this by submitting your original IELTS certificate showing that you got the required scores and one of the following:
If you supply a reference we will keep this for our records.
Please note that achievement of IELTS for the purpose of applying for registration with the GMC may not be acceptable evidence of your English language skills for the purpose of obtaining a UK Visa. We recommend you visit the UK Visa and Immigration website to check their requirements.
You will need to book this in yourself. For us to accept your IELTS certificate it must show:
IELTS certificates are valid for two years. If you are taking the PLAB test, it must be valid on the day you sit PLAB part 1. Or If you are applying for registration with a licence to practise it must be valid when we approve your application. Please note that achievement of IELTS for the purpose of applying for registration with the GMC may not be acceptable evidence of your English language skills for the purpose of obtaining a UK Visa. We recommend you visit the UK Visa and Immigration website to check their requirements
Primary medical qualification taught and examined in English
Post Graduate Qualification This is one I see most common in Asian or Middle Eastern doctors who hold qualifications such as the MRCEM Part A, B & C. ‘’The Royal College of Emergency Medicine’’. Once all parts of this qualification are successfully completed it allows the doctor to apply for their IELTS English exam, pass it with an overall 7.5 minimum score and apply for their GMC immediately after. The GMC registration after the IELTS is complete should take an average of 6-8 weeks. There are many other post graduate qualifications that are accepted by the GMC and the one I have put above is just an example. To check the list of other post graduate qualifications and see if you are eligible please click this link which will take you to the official GMC website and have a list of acceptable qualifications
You may also be able to show us you have the necessary knowledge of English if your primary medical qualification has been taught and examined in English. In this case you would need to send:
For more information on Post Graduate qualifications click here
You will then need to apply for your GMC registration. Here is a link to the website to guide you through it. After you have successfully completed your IELTS. It will then take you roughly 6-8 weeks to get your registration. If you are a Non EU doctor this will give you time to interview for a post, get a job offer and the hospital can sponsor you a COS (Certificate of sponsorship) for a Tier 2 VISA once your GMC Is complete.
When you apply for registration with a licence to practise (or your first licence if you’ve previously held registration), the GMC need to be satisfied you have the necessary knowledge of English to communicate effectively so you do not put the safety of your patients at risk before we grant your licence. Communicating includes speaking, reading, writing and listening. They will look at the information in your application and may ask you to give us evidence that you have the necessary knowledge of English. You can read their detailed guidance, including the legislation which gives them the powers to ask for evidence and the types of evidence they may accept, for background and more information.
If they ask you for this evidence, and:
See the list of universities from which they WILL NOT accept English language evidence. click here
Please note that above applies only if your PMQ is less than two years old at the point of application. OR
Note: The following information is intended as a general guide only, and should not be used as a sole source of information.
Any International medical graduate (IMG) coming to the UK must satisfy UK immigration requirements. These are handled entirely separately from registration matters.
Please note that being granted a particular type of registration has no influence on a doctor’s immigration status and does not mean that you will automatically be allowed to remain in the UK.
Immigration law is very complex and doctors should seek detailed advice from UK Visas and Immigration or from a licensed immigration adviser.
Doctors who are still overseas can seek advice from the British High Commission, Embassy or consulate.
Rules for nationals of European Economic Area (EEA) member states and Swiss nationals
Doctors who are citizens of the EEA, with the exception of Croatian nationals, and Switzerland can enter the UK freely and work here without any restrictions.
Rules for doctors with specific entry rights
Doctors from beyond the EEA may have specific rights to live and work in the UK, for example as the spouse of an EEA national or because they have commonwealth ancestry rights. Doctors who think that they may have such rights should seek advice from the UKBA or the British representative overseas.
Rules for non-EEA doctors
Doctors who do not have any rights to live and work in the UK must satisfy immigration requirements appropriate to their reasons for coming to the UK. The various immigration processes can take time so you must factor this in when applying for posts.
UK Visa Cap Lifted – click here
Employers must apply for a Certificate of Sponsorship and will usually be required to show that no suitably qualified resident worker is available to do the job. The process is simplified if the post is considered a shortage occupation. Once you have been issued with a Certificate of Sponsorship you will be able to apply for a Tier 2 (general) visa. This is the permission that you will need to stay in the UK and this visa will be specific to a particular post or job. If you then move to another job you would have to make a new application for leave. After a continuous period five years spent on a Tier 2 (General) visa you can apply for indefinite leave to remain (permanent residency) in the UK.
Note: The above information is intended as a general guide only, and should not be used as a sole source of information.
Source : General Medical Council (UK)
It is important to note that under the Immigration and Asylum Act 1999, all organisations and individuals giving immigration advice must be authorised by the Office of the Immigration Services Commissioner (OISC). Lists of advisers can be found on the OISC website.
Remember, if you feel uncomfortable about taking part in something you have been invited to do, just say no, you will not cause offence.
Overview One of your primary concerns when moving to the UK is where you will live. If accommodation is not provided by your employer, the information provided here will help point you in the right direction.
Can You Live in the UK?
You must check your immigration status as you may not be permitted to live in the UK. If you are not currently in the UK, you should contact your nearest British Diplomatic post. You will be given detailed advice about your rights concerning living and housing in the UK.
Types of Accommodation
When looking for housing in the UK you have many options, but some of these can be expensive. You must remember to look carefully at what you can realistically afford.
Guest Houses / Bed and Breakfast These are often expensive and would ideally suit short-term stays.
Private Landlords To find listings of available properties try looking at: – Local newspapers – Notice boards in community centres – Local shops – Post Offices –
Cost of living in United Kingdom is 0.69% lower than in United States (aggregate data for all cities, rent is not taken into account). Rent in United Kingdom is 15.71%lower than in United States (average data for all cities). For a guideline on the cost of your daily/ weekly expenses click here
If you are not used to the grades of doctor in the UK they can at first seem confusing. However, the main differences lie between the grades that lead to a Certificate of Specialist Training and those that do not. Consultants lead the teams of doctors and all other grades are supervised by a Consultant. Click here
click here for further information.
click here (England) for further information
click here (Wales) for further information
click here (Northern Ireland) for further infromation
Education in England is overseen by the United Kingdom’s Department for Education and Department for Business, Innovation and Skills. Local government authorities are responsible for implementing policy for public education and state-funded schools at a local level.
From the age of 16 there is a two-year period of education known as “sixth form” or “college” which typically leads to A-levelqualifications (similar to a high school diploma in some other countries), or a number of alternative qualifications such as BTEC, theInternational Baccalaureate or the Cambridge Pre-U.
Higher education often begins with a three-year bachelor’s degree. Postgraduate degrees include master’s degrees, either taught or by research, and the doctorate, a research degree that usually takes at least three years. Universities require a Royal Charter in order to issue degrees and all but one are financed by the state via tuition fees, which cost up to £9,000 per academic year for English, Welsh and European Union students.
Feel free to visit our jobs section to find the latest vacancies as per your grade & specialism. We are here to help you progress your careers.