• MTI ST3
  • MTI process
  • Considering
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  • joining
  • visa
  • Tier 5
  • Tier 2
  • doctor difficulty
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  • 1. What will be my approximate salary?

    This generally depends on your experience. however the average salary will be around £56000 per year . This includes your basic salary and banding for on calls. ( 40%). A good proportion of this will be taken by Tax

    This work out to about £3500 per month in hand. Remeber that expenses including accommodation will take up £2000

    The salary for a person on Tier 5 is fixed around £58,000 The salary for a person on Tier 2 is likely to depend on approved experience. Mainly academic experience is counted. You can find further information on BMA payscales and



  • 2. Will I be able to do any post graduate examinations?

    Of course. You will be able to do your MRCP/ MRCPCH. However , you may not have enough time or experience to do your Speciality examination (SCE). But what you do is only limited by your efforts.

    Often the 3 parts to MRCP will take some time and the PACES examination may take 2 attempts.


  • 3. Is there any training towards post graduate examinations?

    There is no free training but often consultants will take you around and do presentations and quiz you on your emaination and presentation technique. there are several courses locally and this can cost uyp to £500 per 4 day course. there is a PACES course run at the Trust which has to be paid for.

  • 4. What post do I join?

    Every overseas graduate joins the following scheme

    1st Month - shadow placement - This is supernumerary and allows you to observe, do all your induction, mandatory training and other personal issues (eg starting a bank account, sorting out accommodation) you will not have any night on calls. There will be 4 shadow on calls 2 at Trafford and 2 at MRI

    Month 2 - 4 This iwll be at Juniot clinical fellow level This is equivalent to Non PG registrar and will include on calls and seeing patients and making management plans. There will be a senior registrar for you to consult with

    Month 4 - 24 This will be at senior clinical fellow. This will be based on experience and seniority. You will be in charge of the take and be expected to review and give advice as well as clerk patients . There will be day and night on calls



  • 5. What is appraisal and eportfolio?
    1. Appraisal vs e Portfolio Appraisal is an annual process where you document your progress over the past year. This is a GMC mandated process to ensure that you follow the principles of Good Medical Practice set out by the GMC. Every 5 years you need to do a REvalidation which consists of 5 years of appraisals and a patient and colleague feedback. This is then signed off by your re validation officer.  In MFT the EQUINITI 360 software is used to support your appraisal. Your eportfolio is separate and is your personal folder to hold all the documents you have to support yoru career progression.This holds records of your procedures, teaching skills, case discussions and reflections. Thi is usually held on an eportfolio system.. usually the RCP ePortfolio(MTI) or NHSeportfolios(CMT) or HORUS (foundation)
      1. Appraisal and revalidation - please ring 0345 180 1405 EQUINITI revalidation Management system - Explain that you are a member of the MFT and give your GMC number and email address . they will email you the details
        1.  Your first meeting serves as your first appraisal.
        2. Your second appraisal will be in the month of your birth (eg if you join 3rd of March 2018, your date of birth is 9th of September
        3. your induction will be in March 2018;
        4. Your first appraisal will be September 2018
      2. Portfolio
        1. How do I fill my portfolio?
        2. Advice on filling your portfolio  from the AOMRC
  • 6. I will find it difficult to do nights..

    It will be challenging to get a job here without night on calls. You will start at a level lower than your current post. You will have to start off doing nights and then work your way up.

    Night on calls means that you work from 9 PM to 9.30 AM. You will have days off in recognition so that you don't do more than 48 hours per week on average. So although you are working through the night, you will have the next day to sleep. You will not do more than 4 nights in a stretch..

    However dont fool yourself to think that you will be able to start without night on calls. You must be prepared for this...

  • 7. Can I start off as a consultant

    That would be exceptional. You will need to have proven yourself to a very high standard in an academic institution. This includes publications and a verifiable advancement year on year.

    If you fit the bill, then the trust can employ you as a locum consultant provided you get GMC registration.  That is your responsibility ( To get GMC registration).To gain GMC registration, you will need the PLAB, MRCP or get sponsorship from the RCP ( MTI Scheme)..

    If you are not on the Specialist register, you can only get a locum consultantThe trust can only employ you for a year as a locum consultant and you have to gain your Consultant status by then (CESR route) In reality.. that is extremely challenging..


    In summary, there are ways around , but can be quite frustrating and cen get delayed. Are you willing to give up your practice and embark on this route with no guarantees? Willing to boldly go forward...

    In reality if you have the will and initiative you will get to where you want to be

  • 8. Can I extend Tier 5 Visa? (MTI)

    No You cant.. You have to leave the country after the 2 years are up. The Tier 5 visa is non extendable and cannot be split up into different periods. You can only apply for one Tier 5 visa during a 5 year period.

  • 9. What experience do I need for this post?

    You will need to have completed 3 - 5 years post graduation in medicine. Out of the last 5 years, you need 3 years in medicine and the last 12 months should have been in medicine.

    You need to have been in a hospital taking acute patients and been involved in patient management.

    You do not need MD/ local postgraduate degree although this would be beneficial

  • 10. Do I need the MRCP/ PLAB?

    No - You do not require either of these examinations. The Royal college will sponsor you for GMC registration.

    MRCP part 1 will be desirable


  • 11. What about IELTS examination?

    You will need to do the IELTS examination. This is the UKVI Academic version and you will need to score 7.5 on average .. Your score should not be less than 7.0 in any subcategory.

    We do not provide a certificate for you to bypass the IELTS examination


  • 12. What happens in the first month after I join?

    You will join at Junior clinical fellow level. The first month will be spent in accommodation provided by the trust. You will get an opportunity to do all your administrative work, start bank accounts, occupational health, mandatory training, and settling in.

    You will shadow 4 medical on calls 2 at MRI and 2 at Trafford.  you will be expected to clerk, take bloods and provide all assistance to the oncall team during this time.

    • 13. How many posts are available?

      We interview on Skype twice a year March and September.

      There are 12 posts  a year and we expect candidates to be able to join within 6 months of the interview.

      If this is not possible, please put a possible joining date so that we can interview you at a later date.

      Posts rotate through various specialties and you will get protected teaching days and study holidays as well as funding for courses. Please look at the published job descriptions for details.


    • 14. Accommodation - what type should I look for?

      House or house share?

      • It depends on the size of your family
      • If you are coming on your own, you may wish to rent a room in a house. you will be allowed the use of the kitchen.
      • If you are coming with family you will need to look for a 2/3 bedroom house or flat.

      Furnished or unfurnished?

      Furnished is better, and easier when you join. Furnishing a house will cost about £1500 and you will need to negotiate this with the landlord/agent. Remember, your bed may not be the best and may have been in a house with pets before. Pets are very common in this country and they may sleep on the bed. Can you buy new matresses and duvets?


      Crime is very low here and in most instances you will feel very safe. Flats generally tend to feel more safe





    • 15. What about application dates ?

      We have a March and September intake and the last date is

      28th February each year

      31 st August Each year

      Applications received after this deadline will be considered the following interview

      Please submit the following

      a) Application form on the website

      b) email full CV and passport photograph to dr.george@pab2u.com


    • 16. Why don't you respond to emails?

      I do..

      I try and deal with emails as soon as possible. However I deal with over 100 applications per year and it may be slightly delayed.

      It may be that my reply to you is languishing in your junk folder.. Please open your junk folder as well.

      Please help me by searching for information on the website first


    • 17. What posts are available?

      The posts are all at the following levels

      1. Junior clinical fellow  - These are pre MRCP and candidates will be working at non PG registrar level. You will be encouraged to complete your MRCP examination during these posts
      2.  Senior clinical fellow - These are for two categories -
        1.  Those who have completed MRCP - They will be posted in a specialty with on calls in acute medicine
        2. Those who have not completed MRCP - They will get a post in medicine with some specialty experience ( (ie clinics/ MDT)
      3. Specialty Doctor - these posts are for those who are keen to work in one area who are more keen on gaining experience and less on progression. You can of course apply for article 14 route after sufficient experience
      4. Consultant - These are for those with sufficient experience in the specialty as assessed by the employing hosiptal.
        1. Locum Consultant Overseas candidates who have been able to get GMC registration can take up locum posts (even without being on specialist register),
        2. Permanent Consultant posts are for those who have entered the specialist register either after completing an NTN post or Article 14 route.
    • 18. What is the difference between tier 2 vs Tier 5 Visas

      This list is not exhaustive and you are referred to the home office page for tier 2 visa vs tier 5 visa.



      Cost to individual

      Cost to trust


      Quality of posts

      Tier 2

      Up to 5 years

      Approx 800 per application

      Immigration skills surcharge

      Counts towards settlement

      Service posts

      Tier 5

      2 Years only (non extendable)

      Approx £250 per application

      No Charge

      Does not count towards settlement

      More educational element


    • 19. How do I plan my move?

      The move is quite daunting when you consider the number of issues to be sorted. We have put together a checklist to help you. It might be easier if you come alone for the first month and then come with family as arranging accommodation is quite difficult. The trust will usually pay for the first month of your accommodation and single airfare.. If you are coming with family, you could book a second room to help with the initial transition.

    • 20. What about flight tickets?

      You will have to pay for flight tickets and then reclaim this from the trust. ( Please ensure that when you reclaim, there is an "NT" next to it to ensure you have not been taxed on it.

      Some tips.

      • Flights with one break is the best way to travel
      • Try to arrive on a weekday. This will mean that a person may be able to meet you at airport
      • Please let the trust and your accommodation know well in advance.
      • Ensure that you book your accommodation (and pay for it if required if coming with family.)
      • Come dressed comfortably. Be aware that the temperature is 20 degrees cooler than tropical areas. You will need a thick zipped jacket in your had luggage. A suit is not sufficient.


    • 21. What happens at immigration?

      This is usually a straightforward process. You will be asked a few questions.

      • You will need to fill in a disembarkation card.
      • Join the non EU passport queue.
      • When called forward, move forward with a smile and greet the officer. Good morning or good afternoon will be sufficient. "sir" is not used often in this country.
      • Answer the questions honestly asking the officer to repeat the question if you have not heard properly.
      • Your main aim to come to the UK is to study towards your MRCP/ SCE.
      • Remember to keep you phone on silent. Do not take photographs. keep a pen handy
    • 22. Accommodation- What websites should I look for?

      Generally www.rightmove.co.uk and www.Zoopla.com are websites which advertise houses. However the timing of your move and pinning down a house will be challenging. And after a long travel to the UK you want to get into a warm comfortable house.

      Negotiate first month accommodation

      It might be easier to hunt houses once you get here. so the first month is best negotiated with the Hospital. At time of interview ensure you get furnished house for 1 -2 months paid by the hospital. Once you get here and have a house to move into, you will find it easier to rent a house as you will have a local address, a bank account and a job contract. You can negotiate hard and bargain.. given that you are going to work for the trust.

      Check with Air Bnb for local accommodation. Check on the map if local buses travel that way





    • 23. Accommodation - What distance is ok?

      It really depends on how you are planning to travel.


      Winters here tend to be very cold and dark. so travelling home after 9.30 PM may be a challenge. You could cycle if you have cycling gear. Road users are generally very considerate.


      Look for houses no more than a mile away. on right move you can look on map view.

      the alternative is to look on www.gmpte.com and look for bus routes. Then choose a house near a bus stop with a direct bus. These tend to be in

      • Stretford - 25 min bus journey on bus 245 then walk
      • Sale 40 min bus journey then wal
      • Atrincham 55 minutes bus journey then walk

      Hospital post code is M41 5SL Moorside road

      • 24. Can I do a locum job for another employer?

        Yes ....BUT

        Generally, you need to work for your employer. However, you can work up to 20 hours per week under certain circumstances..

        for full details please use the link below



      • 25. What are the types of visas available?

        There are mainly 2 types of visas

        a) Tier 2 Visa - This is a work permit and will be issued by the employing hospital. The hospital applies for a Certificate of sponsorship, which requests the home office to issue a visa

        b) Tier 5 Visa - This is an overseas exchange program where an authorized body (eg Royal College) sponsors the candidate.

        There is also a student visa for those who come to gain a university degree. The doctor can work for experience

      • 26. I am apprehensive, what after my Tier 5 expires?

        You cannot extend Tier 5 Visa. You cannot reapply within 5 years

        however you can choose to pursue the following

        a) During your 2 years as MTI , complete PLAB/ Full MRCP for your GMC registration.

        b) Apply for Clinical fellow Posts and get a job offer with tier 2 visa entitlement ( NHS Posts or Deanery posts)

        Attend interviews for these posts

        c) Get a certificate of sponsorship from the institution ( This may be the NHS Trust OR  Deanery*)

        d) Leave the country, apply for Tier 2 visa from abroad and then return.

        As I know it at present (2018) many trusts are more than willing to offer you a tier 2 visa sponsorship.

        • Deanery - If you get a deanery post - Ie National training post (eg CMT/ ST3) then the deanery becomes your sponsor.
      • 27. Do I have to pay the NHS surcharge?

        Yes you do .. This applies for all countries that do not have a reciprocal agreement with the UK for healthcare. This is a health insurance charge. This works out to approximately £200 per person per year. This is both for Tier 2 and Tier 5 Visa

      • 28. What happens with all the political uncertainty and Brexit?

        Tier 5 visa. This is a short term visa and will not be affected by the political uncertainty. You will continue to work under the same terms for your full post. The hospital has to give a guarantee that they have enough money to pay your salary for 2 years.

        The future of tier 2 visas are more difficult to predict. This is where your determination, your long term goals come in. You are the best of the best, having finished medical school and perhaps your postgraduation. You will be able to gain work long enough to work for 5 years after which you will be eligible to apply for indefinite leave to remain. The factors that you should consider are the following

        a) The NHS is desperately short of doctors and nurses.

        b) It is paying vast sums of money for locums (short term doctors)

        c) Fewer EU doctors will come to the UK over the next few years

        d) The population in the UK is getting older and need more health care

        e) There are training number which are not filled every year , year on year

        f) A large number of doctors who came here in the 70s and 80s from various different countries will retire over the next few years

        I will let you draw your own conclusions. Nothing in life is certain. Life is not without risk.

        • The person who is brave enough to play the game can win.
        • The Person who does not play the game neither wins or loses..
      • 29. How long is it valid? Can I extend this?

        Tier 5 visa is valid for 24 months from the time you join. You are not allowed to extend this visa and you will have to leave the country to change your visa status. You can only reapply for this visa once in 5 years.

        Tier 2 visa can be extended if your employer applies for a certificate of sponsorship. This can be extended for 5 years after which you can apply for indefinite leave to remain. You will need to do “life in the UK “ test

      • 30. What is the cost of the Tier 5 visa?

        The cost of the visa is £235 per year per application. This means that a family applying for this visa has to pay only this amount for the full 2 years. However if the application is made separately, you will have to pay a visa fee, each time you make the application

        In addition you will have to pay the NHS surcharge, which works out to £200 per person per year.

        This works out for a family of 4 for 2 years at £2540



      • 31. What is the cost of the Tier 2 visa?

        This visa tends to be considerably more expensive and reflects that this is a work visa. The cost is around £587 per individual per application. In addition you will have to pay the health surcharge

        For a family of 4 applying for a Tier 2 visa for 2 years this can work out to

        Visa fees £587 *4 = £2348

        Health surcharge £200*4*2 = 1600

        Total £3948

      • 32. Can I Travel to the EU for conferences on the tier 2/ Tier 5 visa?

        Yes you can.. You need a visa

        If you do not have a UK or EU passport, you wil have to apply for a visa and then travel. This is true for holidays as well. While visiting visas are not prohibitively expensive, this will mean time and expense in addition to booking your holiday.

        It is best to travel to a country with an embassy of your country, in case you need assistance.

        Look at Experiences I lost my passport

      • 33. What happens if I apply for a deanery post?


        You will need a tier 2 visa for this and the deanery becomes your sponsor. You will need to apply for the job as usual. Remember that you will need to be eligible for GMC registration which means that you either need to have the full membership or PLAB by the time you are ready to take up the post. Your application will be dealt with as per usual point system.

        If you are applying from a Tier 5 visa,

        • You can attend interview and get a job offer
        • you will then need to leave the country to apply
        • You will fall into a yearly quota for tier 2 visas usually around 20,000 per year

        If you are applying from a tier 2,

        •  You do not need to leave the country to apply
        • There is no limit for this change in visa. Tier 2 to Tier 2 is quota free
      • 34. How long a break can I take?

        You are entitled to leave as would any person who works along with you. This includes annual leave, study leave, study days, sick leave. If you need to take loss of pay leave, eg you have to look after a relative, you are entitled to only one month per calendar year after which you have to give up your visa. This can lead to some unexpected complications

        Look at experiences : My father in India fell ill.

      • 35. What about maternity leave?

        You are entitled for maternity leave as per any other employee in the organisation. Generally paid leave is only allowed if you have completed 12 months of work. This might mean that you will need alternative income to sustain yourself during this period

        Look at experiences : I fell pregnant 6 months after I joined

      • 36. Can my spouse work

        Yes your souse can work in any capacity as a dependent. This will include working as a doctor in a different hospital. You can use this fact to your advantage if your spouse is a healthcare professional. Your partner can gain a tier 2 visa and you can then change over to dependent status.

      • 37. Can I work in other Jobs to supplement my income
        • You are entitled to work extra hours with your sponsor.
        • You are also entitled to work up to 16 hours per week on average with a different organisation.

        However, be careful not to break the rules regarding European working time directive. If you work voluntarily more than 48 hours per week and you commit a mistake, you can end up in court or worse still behind bars if you are convicted of deliberate harm.

      • 38. Can I be made to do work that I am not comfortable with

        No you certainly cannot.

        You will have a supervisor whom you can discuss this with. If you are tired, feeling unwell or not at full capacity, please decline the work whether it is work you are scheduled to do or extra work. As there are fewer and fewer doctors, you may feel you are under pressure to cover that extra shift. Please do not feel obliged to.

        You may feel that you will offend your employer. However this is not the case. You must say "no " firmly very politely. If you make an error, please do not think the hospital will immediately recognise the pressure you were under.

        Options you have

        • Say "no"
        • Call and discuss with consultant on call
        • Call your educational supervisor
        • Fill in an incident form
        • Write an email to your line manager and rota coordinator


        Experiences : The Bawa- Garba Case


      • 39. I am apprehensive, what happens after my Tier 2 visa expires?

        This is where your initiative comes in. Nothing stops you from applying for jobs. In reality, there are so many vacant posts and trusts willing to sponsor you for tier 2 visa..

        If you are applying from Outside the country, you are an outsider with no UK experience or track record. If you have started off here, you will be definitely able to land a job.

        You could get a deanery post (training) or a trust post ( Non training), but this will only happen if you are in the UK.

        You should be young at heart and able to work your way through challenges. It is up to you to make it work. I have yet to hear of anyone who has left without being able to land a Tier 2 job..


      • 40. I find myself very anxious

        It is normal to feel anxious when you start. You should normally have a period of at least a month where you are on light duties. You will be given time to do your induction. 5 afternoons in the first month. This is for you to do you to do the e learning courses for you to understand the issues with working in the UK. You should have an educational supervisor and have a face to face induction. Please discuss issues with him or her.

      • 41. I am not able to get to clinics or do anything outside ward work.

        This is quite a common problem. There are many issues that need to be dealt with. The deanery trainees get preference for educational opportunities. Hence it might be a clash.

        You should not feel guilty taking one afternoon off per week to attend clinics. You should schedule this in advance. It is easier, if you discuss this with the rota coordinator and be off the ward during this time. Ensure that the ward knows you will be in clinic. You can politely but firmly mention that this is your educational session.

        However you should also remember that most of the competencies you require are ward based for getting onto deanery training. So ensure you are getting your competencies signed off.

      • 42. When can I apply for deanery posts?

        Please remember that you are not on the first list when deanery opportunities open up. You will need to apply for posts where you have a reasonable chance to get in. OR you need to work hard and get yourself to the front of the IMG line. Your main competitors are other overseas graduates (IMGs). So if you can get there you are well on your way..Remember that unlike overseas, it is not experience that counts towards a deanery post. You may have 10 years of cardiology experience. However that will count against you!

        What counts is your commitment, your understanding, your maturity , and your ability to structure discussions in a comprehensive manner, your ability to learn from mistakes and past experience. your ability to structure your path towards your goal.

      • 43. I just cant get a handle on how things work

        There are colleagues around you and you should ask. Common questions like How much leave do I have, how do I put a request for gastroscopy etc, should be things you learn from your colleagues, by asking.

        AS an adult, you should seek out information and know where to find it. All information will not be covered in your induction.



      • 44. Who is my educational supervisor

        Step 1

        This is a question to ask the doctor who does your induction. Your educational supervisor will set up a meeting in the first month to get to know you and make a plan for the next 6 months.

        Step 2

        If you do not get one allocated, Ask the consultant on the ward you work. ( this is your clinical supervisor)

        Step 3

        The next step is to find out who the clinical director of your department is and send an email if you do not have one a month after you join