Eligibility and funding for training in General Medical Practice
Overseas doctors are defined as those who, regardless of where they obtained their primary medical qualification, are not nationals of the European Economic Area (EEA). They commonly do not have a right of indefinite residence in the UK and do not benefit from European Community rights. Any doctor who is uncertain of his/her status under immigration and nationality law should contact:Work Permits (UK)
Immigration & Nationality Directorate, Home Office
Sheffield S1 4PQ
Telephone: 0114 259 4074
Web site: www.workpermits.gov.uk
Unless otherwise indicated, UK Immigration Rules do not apply to EEA nationals or family members of such a national who are entitled to enter or remain in the UK by virtue of the provisions of the Immigration (EEA) Order 1994. The EEA comprises the following countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Irish Republic, Italy, Liechtenstein, Luxembourg, The Netherlands, Norway, Portugal, Spain, Sweden and the UK1.
Non UK doctors entering the UK to train for general practice should check with their own competent authority or equivalent body that possession of a Joint Committee Certificate will mean that they are eligible to work in general practice in their own country
All doctors who wish to work or train in general practice in any capacity must first obtain registration with the General Medical Council.
Doctors should be aware that obtaining registration with the GMC can take some time and contact should be made with the Council well in advance of the planned date of commencement of training.
The GMC will accept a certificate of equivalent experience from the Joint Committee as a route to obtaining full GMC registration. However, applicants should be aware that overseas doctors with no experience of UK general practice will, in almost all cases, be required to undertake some training in the UK before a Joint Committee certificate of equivalent experience will be issued to them. Registration with the GMC is needed to train in hospital medicine and in general practice in the UK.
Royal college sponsorship is an alternative to PLAB for overseas doctors applying for limited GMC registration. However the Royal College of General Practitioners does not, at present, have a sponsorship scheme.
Both the hospital and GP Registrar components of the GP training programme can be done whilst a doctor holds limited or full registration2 with the GMC.
The hospital component of the GP training programme
Doctors wishing to enter the UK to do postgraduate training in the Hospital or Community Health Services (HCHS), or both, are admitted under a scheme known as ‘permit-free training’ which means that a work permit is not required as long as the doctor is training in an NHS hospital in an approved training post. The amount of permit-free time a doctor is allowed depends on the type of training being undertaken and will be subject to the doctor making satisfactory progress in training including the passing of any relevant examinations.
Doctors in basic specialist training (SHO or equivalent grades) are entitled to a maximum of four years permit-free training. A limit may be imposed upon the amount of permit-free higher specialist training allowed (Specialist Registrar or equivalent grades).
The GP Registrar component of the GP training programme
All overseas doctors who are successful in applying to a deanery for a general practice training programme or a stand-alone GP Registrar post will be funded by the NHS for the GP Registrar element of their training programme.
Permit free arrangements also apply to overseas doctors training in GP Registrar posts. Applications to the Home Office for permit-free training to cover the GP Registrar year should be made on behalf of the Registrar by the General Practice Deanery that has offered the training place.
Working as a GP in the UK
Doctors cannot occupy a training grade post whilst in possession of a work-permit, but are free to apply for career grade posts. All decisions on work-permits are made by the Work Permits Section of the Home Office.
Separate rules apply to overseas qualified doctors wishing to enter general practice as principals as this is classed as self employment. Possession of a certificate issued by the Joint Committee does not confer an automatic right of employment. Advice on the conditions to be satisfied can be obtained from the Home Office.
The Home Office has a Highly Skilled Migrant Programme which includes a priority route for GPs who wish to work in the UK. One of the criteria for entry to this programme is possession of a JCPTGP certificate of prescribed or equivalent experience or a certificate of acquired rights or specific training from another EEA Member State. For further information see the Home Office Work Permits Section web site at www.workpermits.gov.uk
The experienced overseas GP route to certification. The “accelerated route”.
The JCPTGP has an accelerated route to certification. The criteria for entry to the accelerated route are that the applicant has:
- At least five years, recent experience as a GP in a family medicine system similar to the NHS
- Has, in the last seven years, satisfactorily completed a family medicine training programme in a system similar to the NHS
- Is in possession of an EU certificate of specific training in general practice which is not recognised by the GMC because of third country nationality or PMQ.
At present all overseas doctors applying for the accelerated route must be:
- Currently registered with the GMC or
- Eligible under the GMC�s current arrangements for immediate, full registration or
- Have recently passed Part 1 and/or Part 2 of GMC�s PLAB test
Applicants will be asked to complete and submit an application form and a cover sheet which asks a short series of questions about the primary healthcare system in which they have worked. On the basis of the information provided the Committee will decide if the application is to be processed in the normal way or be referred to the National GP Recruitment Office with a recommendation that the doctor be offered a period of induction and assessment as a GP Registrar to take place contemporaneously with the Joint Committee’s full formal assessment of the applicant’s training and experience.
Assessment of the applicant during the induction period will include, as a minimum, an assessment of consultation skills and a Summative Assessment Trainer’s Report. The induction will last a minimum of three months and a maximum to be defined by the needs of the individual. The local director will be responsible for assessing the individual’s learning needs, drawing up a learning plan and advising on the maximum length of induction required.
It is possible, but unlikely, that after making its formal assessment, the Joint Committee may overturn the deanery recommendation on the length of further training and the type of assessment required of the applicant.
It may take the Joint Committee longer to complete its assessment than it takes the applicant to complete the recommended period of induction. If this is the case, there may be a slight delay in the issue of the certificate.
1. A bilateral agreement made on 1st June 2002 between Switzerland and the Member States of the EC means that postgraduate medical education undertaken in Switzerland will be treated by the GMC and Joint Committee in the same way as EEA training.
2. Doctors who train as GP Registrars in England can now do so with limited GMC Registration. At present doctors with limited registration are not able to train as GP Registrars in Northern Ireland, Scotland and Wales. Changes in regulation to bring these three countries into line with England where it is permitted, are awaited.