Changes to postgraduate training

A short history of UK Training

Post Graduate training in the UK, its structure, duration and focus have changed over the years. There also has been issues with immigration with the lack of trainee doctors to staff hospitals. Doctors have found it difficult to establish here but once you establish, the career path is smooth.

1. Pre 1997

The training structure was largely unstructured with many doctors getting trapped at the level of “Junior Registrar”. Progression to senior registrar was dependant on your supervisor and guide who would determine that you had done enough to progress. There was a lot of unfairness, variation and lack of progression. Many doctors fed up with lack of progress took up other specialities , general practice and left the country. The Calman report in 1997 changed this 

2. Calman Report

The Calman report in 1997 exposed many of the flaws in postgraduate training structure and made the process more fair with a streamlined progression towards consultant grade once you had a “National Training Number” This was reserved for UK graduates but the law was interpreted variably and many foreign graduates suddenly were offered numbers. A large number of foreign graduates came to the UK on the “permit Free Training” which would not entitle you to right of settlement ( Citizenship). You were allowed to apply after 10 years of being in the UK.


Due to skills shortage in the UK , the government introduced the “highly skilled migrant Programme” which would allow you to come and work (but not train) in the UK. This visa was dependant on the point system which has been inherited  but the Tier 2 visa Scheme. Due to lack of UK graduates applying for NTN posts, many HSMP candidates successfully got NTNs and have become consultants and GPs.  


4. Current situation

There has always been reservation of UK jobs for UK/ European candidates and this continues to be the case. It is right of every country to dictate who gets the jobs on offer and to reserve its government funded jobs for its citizens. Hence for a foreign graduate, a training post will only be offered if there are no local graduates for the job. The current situation is that you can be offered a job if no local/EU graduate has been found suitable for the Job despite two advertisements. The Hospital then has to offer you a sponsorship letter.

5. Progression

In reality, there are so many vacant posts that if you are IN THE RIGHT PLACE AT THE RIGHT TIME  you will get a post. You will be on tier 2 visa for 5 years while you complete MRCP and work towards an NTN,. You will be eligible for apply for right of indefinite residence after 5 years on Tier 2 visa and at that time you will be on par with a UK graduate.

However even during your tier 2 status you can apply for NTN/ CMT and if there is a vacant post, you will be offered the post. In reality there are so many vacant posts and you will get in. So be prepared to maximise your potential for being offered a job. Get all your exams, sign off your competencies, show commitment towards your speciality and I guarantee that your chances of a chosen post graduate speciality is VERY HIGH.


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