Surgical Jobs in the NHS for IMGs: Junior, Middle Grade and Specialist

If you are an international medical graduate who wants to work in surgery in the UK, the first question is simple: which level of job can you apply for? This guide splits NHS surgical jobs into three levels and explains, for each one, how much clinical experience and surgical experience you usually need, and which courses and exams help.

Quick answer

Most IMG surgeons start in a non-training post. Junior level (FY2, SHO, CT1–CT2, ST1–ST2) usually needs about 12 months' experience after internship. Middle grade (ST3+, registrar, specialty doctor) usually needs 4+ years, 2+ in surgery, and MRCS. Specialist posts need 12+ years, 6+ in your specialty.

Junior level

Job titles: FY1–FY2 level, SHO, CT1–CT2, ST1–ST2, junior clinical fellow and trust grade doctor.

Clinical experience: usually at least 12 months after your internship. Core-level posts (CT1–CT2 / ST1–ST2) often ask for 1 to 2 years, and some ask for part of it to be in the NHS.

Surgical experience: little or none is needed for FY2-level and junior clinical fellow posts. For core-level posts, placements in one or two surgical specialties help. If you want to apply for Core Surgical Training (CT1), note that you must have no more than 18 months of surgical experience.

Courses and exams that help: MRCS Part A (or studying for it), a Basic Surgical Skills course, and a trauma course such as ATLS or the European Trauma Course.

Middle grade

Job titles: ST3–ST8, registrar, senior registrar, senior clinical fellow and specialty doctor.

Clinical experience: usually at least 4 years after qualification.

Surgical experience: usually at least 2 years in surgery, often at ST1–ST2 level or above, recorded in a logbook validated by your supervisor. Senior posts may ask for set numbers of operations you have performed independently.

Courses and exams that help: full MRCS (usually expected at this level), ATLS, CCrISP (Care of the Critically Ill Surgical Patient) and courses in your specialty, such as laparoscopic or endoscopy skills courses.

Specialist level

Job titles: specialist (the senior non-training grade) and, later, consultant.

Clinical experience: at least 12 years since your primary medical qualification.

Surgical experience: at least 6 years in your specialty, which can include experience from overseas, with a strong logbook showing independent operating.

Courses and exams that help: FRCS (often expected for senior posts), advanced courses in your subspecialty, and leadership or management courses. To become a substantive consultant without UK training, you also need to join the GMC specialist register through the portfolio pathway.

What to show in your supporting statement

Whatever the level, surgical shortlisters look beyond your operating. For each of these, give one short, real example:

Teaching. Who you taught, how you taught them, and what feedback you got. Free course: Teaching Skills.

Leadership and management. For example, organising a rota, leading the team on call, or improving a process on the ward. Free course: Leadership & Management.

Audit and quality improvement. A completed audit or QIP, ideally with a re-audit that shows change. Free course: Audit & QIP step by step, plus our Audit and QIP Ideas tool.

Research. Presentations, publications, or critical appraisal of papers. Free course: Research & Critical Appraisal.

Communication. Consent discussions, breaking bad news, working with the MDT. Free course: Communication Skills.

Reflection and professionalism. What you learned from a difficult case or a complication. Free courses: Reflection, Appraisal & Revalidation and Understanding Good Medical Practice.

Our free CPD courses for doctors cover each of these areas. Every course shows you how to write that criterion in your supporting statement and gives you a verifiable certificate of completion for your portfolio. Browse all free CPD courses →

Need help putting it together? Read our guide on how to write an NHS supporting statement as an IMG, or contact CareerPro UK to have your surgical application checked before you apply.

Which level are you?

Internship done, little surgical experience: apply for junior level posts.

Four or more years of experience, two or more in surgery, MRCS passed: apply for middle grade posts.

Twelve or more years of experience, six or more in your specialty: apply for specialist posts.

Keep a logbook from your first day in surgery, and record every course you attend. If you would like your surgical application checked before you apply, contact CareerPro UK.

Requirements vary between hospitals and change over time. Always check the job advert before you apply.

Frequently asked questions

Can IMG doctors get surgical jobs in the NHS?

Yes. Most IMG surgeons start in non-training posts such as junior clinical fellow, trust grade SHO, senior clinical fellow or specialty doctor, chosen to match their experience.

Do I need MRCS for a surgical job in the UK?

Not for most junior posts, where MRCS Part A is helpful but optional. At middle grade (ST3+, registrar or senior clinical fellow), full MRCS is usually expected.

What courses help with a surgical application?

A Basic Surgical Skills course, a trauma course such as ATLS or the European Trauma Course, and CCrISP help, along with MRCS and specialty skills courses at middle grade.

Can I apply for Core Surgical Training as an IMG?

You can, but you must have no more than 18 months of surgical experience, so many experienced IMG surgeons aim for non-training posts and later ST3 instead.

Last reviewed: October 2026. Read how we research and update our guides.