How Does the NHS Recruitment Process Work for International Doctors? A Step-by-Step Guide

CareerPro UK Team

Oct 24

8 min read

Updated: 2 days ago

Getting an NHS job as an international medical graduate (IMG) follows a clear sequence, but each stage has its own rules. This guide covers the whole process, from GMC registration to your first day, and explains how training and non-training posts differ.

Quick answer

International doctors first gain GMC registration with a licence to practise, usually through PLAB, an acceptable postgraduate qualification or an approved sponsor. They then apply for posts on NHS Jobs, Trac or Oriel, get shortlisted against the person specification, interview, and receive a conditional offer. The employer completes pre-employment checks and issues a certificate of sponsorship for the Health and Care Worker visa. Induction follows.

Step 1: How do international doctors get GMC registration?

You cannot start work as a doctor in the UK without GMC registration with a licence to practise. If you graduated outside the UK or Switzerland, the main routes are:

PLAB test. PLAB 1 is a written exam of 180 single best answer questions over three hours, taken in the UK and several other countries. PLAB 2 is a 16-station OSCE at the GMC's clinical assessment centre. Your registration must be approved within two years of passing PLAB 2, and the GMC also requires you to have completed an internship.
Acceptable postgraduate qualification. Some UK qualifications (for example MRCP(UK) or FRCR) and some overseas ones are accepted instead of PLAB. The GMC expects the qualification to have been awarded within three years of your application being approved; otherwise you must show recent medical experience. Many overseas entries have date conditions, so check the GMC list.
Sponsorship. An organisation on the GMC's list of approved sponsoring bodies (some NHS trusts and health boards, royal colleges, universities and other bodies) assesses you and issues a Sponsorship Registration Certificate. You normally need to have practised medicine for three of the last five years, including ten of the most recent 12 months. A UK visa certificate of sponsorship is not the same thing.
Specialist or GP register. Doctors who have already completed specialist training may apply through the portfolio pathway (previously called CESR or CEGPR).

All routes also need evidence of your English. The usual standard is IELTS Academic 7.5 overall with at least 7.0 in each band, or OET (Medicine) grade B in each part. Check the GMC website before you book, as requirements can change.

Note on the Medical Training Initiative (MTI): NHS England ended the MTI scheme, which closed to new applicants on 31 March 2026. Doctors already on placements can finish them, but you should not plan a new career route around MTI.

Step 2: Training vs non-training posts – which should you apply for?

NHS doctor jobs fall into two broad groups, and they are recruited in different ways.

Training posts (foundation, core and specialty training) lead towards a CCT. In England, Scotland and Wales they are applied for through Oriel, the UK-wide portal, in fixed national recruitment rounds. You usually need three referees who supervised your clinical work in the last two years, and from 2027 you can submit a maximum of five applications per round.

The Medical Training (Prioritisation) Act 2026 now affects IMGs applying for training. Priority groups include UK and Republic of Ireland graduates, doctors who have completed or are on a relevant UK training programme (such as the Foundation Programme), and certain immigration categories such as British citizens and people with indefinite leave to remain. For 2026 it was applied at the offer stage; from 2027 it applies at both shortlisting and offer. The government confirmed in September 2026 that the 2027 rules continue the same groups. Non-prioritised doctors can still apply, but competition is much tougher.

Non-training posts are employed directly by individual trusts and health boards. Titles include clinical fellow, junior clinical fellow, trust doctor, specialty doctor and locally employed doctor. The BMA notes that eligibility for locally employed doctor roles is unchanged by the Act. For most IMGs, a non-training post is the usual first NHS job and builds UK experience for later training applications. See our guide to junior clinical fellow jobs for IMGs.

Step 3: Where do international doctors find NHS jobs, and how are they shortlisted?

NHS Jobs – the main site for trust posts in England and Wales.
Trac – many trusts advertise on NHS Jobs but send you to Trac to complete the form. Our comparison of Trac vs NHS Jobs explains the differences.
NHS Scotland – vacancies are on the NHSScotland recruitment site (apply.jobs.scot.nhs.uk).
Oriel – for training posts only.

Set up job alerts, and apply early, as doctor vacancies can close once a trust has enough applications. See how to apply for NHS jobs after GMC registration.

Applications are scored against the person specification: essential and desirable criteria such as registration, experience, clinical skills, audit and teaching. NHS Employers guidance says trusts should shortlist on merit against these criteria, not on immigration status.

To get shortlisted:

Read the person specification line by line. Our person specification guide shows how to map each criterion.
Write a supporting statement that gives evidence for every essential criterion, using the same headings. See how to write an NHS supporting statement as an IMG.
Account for your full employment history and explain any gaps honestly. Here is how to explain a career gap.
Show NHS-relevant experience where you can, such as a clinical attachment, audits or QIPs, and CPD.

Generic statements and missed criteria cause most rejections (see why NHS job applications get rejected). CareerPro UK's free supporting statement guide, free CPD courses and free Audit & QIP Ideas tool can help.

Step 4: Interviews and the conditional offer

Trust interviews for non-training posts are usually held online or in person, in front of a panel that often includes a consultant and a manager. Expect questions on:

your clinical experience and a few clinical scenarios
patient safety, escalation and team working
audit, teaching and why you want this post and this trust

Training interviews are booked through Oriel and scored to a format set by each specialty.

After the interview, the panel ranks candidates. The best-ranked suitable candidate receives a conditional offer, which means the job depends on satisfactory pre-employment checks. For sponsored candidates, NHS Employers advises trusts to confirm at this point that the planned certificate of sponsorship meets the visa points requirements.

Step 5: What pre-employment checks does the NHS carry out?

Every NHS employer in England follows the six NHS Employment Check Standards:

Identity checks
Right to work checks
Professional registration and qualification checks, including GMC registration and English language evidence
Employment history and reference checks
Criminal record checks (your trust will tell you which certificates it needs if you have lived overseas)
Work health assessments (occupational health clearance, including immunisations)

Delays usually come from slow references or missing documents, so give correct referee emails and reply quickly to HR.

Step 6: Health and Care Worker visa and certificate of sponsorship

Most international doctors come to the UK on the Health and Care Worker visa. According to GOV.UK:

You need a confirmed job offer from a Home Office-approved employer and a certificate of sponsorship (CoS). The CoS is an electronic record with a reference number, not a paper document.
Doctors fall under occupation codes 2211 (generalist medical practitioners) and 2212 (specialist medical practitioners).
You must apply within 3 months of receiving your CoS, and you can apply up to 3 months before your start date.
You usually get a decision within 3 weeks after proving your identity and providing your documents. A faster service may be available for a fee.
Health and Care Worker visa holders and their dependants do not pay the immigration health surcharge. The application fee still applies (at the time of writing, £324 for up to 3 years and £628 for more than 3 years; check GOV.UK for current fees).
If you have lived in a listed country, you will need a TB test certificate.

Your immigration status is now issued as an eVisa, a digital record that has replaced most physical immigration documents. You will use it to generate a share code so your employer can check your right to work.

Step 7: Starting work and induction

Once checks and visa are complete, the trust confirms your start date. Your first weeks usually include:

trust and departmental induction and mandatory training
a period of shadowing or supervised practice, which many trusts offer to doctors new to the NHS
a named supervisor and, in many trusts, an IMG support programme

The GMC runs a free Welcome to UK practice workshop for doctors who qualified outside the UK and have taken up a UK job within the last 12 months. It covers ethical scenarios and practical advice, and is available online or in person.

How long does the NHS recruitment process take for international doctors?

Timelines vary, but as a general guide:

GMC registration can take many months, depending on your route. Allow time for English tests, PLAB sittings and document verification.
Job searching can take weeks or many months, depending on specialty, grade, UK experience and application quality.
Offer to start date commonly takes several weeks to a few months, covering pre-employment checks, CoS, visa and relocation.

Training posts follow fixed national Oriel timelines, so plan around recruitment rounds.

Frequently asked questions

Do international doctors need a job offer before applying for a UK visa?

Yes. For the Health and Care Worker visa you must have a confirmed job offer and a certificate of sponsorship from an approved employer before you apply.

Can I apply for NHS jobs before I have GMC registration?

Some trusts accept applications from doctors whose GMC registration is in progress, but you must be fully registered with a licence to practise before you start. Check each advert's person specification.

Is the NHS recruitment process different for training and non-training posts?

Yes. Training posts are applied for through Oriel in national rounds, and UK graduate prioritisation now applies. Non-training posts are advertised by individual trusts on NHS Jobs, Trac or the NHSScotland site, and you apply to each one separately.

Is the Medical Training Initiative still an option for international doctors?

No new applications are accepted. The MTI closed to new applicants on 31 March 2026, although doctors already on placements can complete them.

What is the most common reason IMG applications are rejected?

Usually the application does not show clear evidence against each essential criterion, often because of generic statements or unexplained gaps.

If you would like your NHS application reviewed and rewritten (£35), email cvreviewexperts@gmail.com or contact CareerPro UK.

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