The MTI (Medical Training Initiative) is a scheme sponsored by the Royal College of Physicians that gives the opportunity to international medical graduates to work in the UK. There are different MTI schemes, one is run by the RCP-London and another by the RCP-Edinburgh. Other Royal Colleges of different specialties have their MTI schemes as well. I came through the MTI of the RCP / London about which I am writing the article, i.e. for medicine.  The general idea of the scheme is to provide benefit to international medical graduates by gaining UK experience, and to the NHS hospitals at the same time by filling in rota gaps.


The requirements of the programme include a primary medical qualification recognised by the GMC, 3 years post qualification experience, a postgraduate qualification (MRCP (UK) Part 1, MD or other higher degree in medicine), competencies equivalent to a UK graduate at the end of their CMT, the IELTS with a minimum overall score of 7.5 and minimum scores of 7.0 in all categories.


The application process might change from time to time so I advise you to visit the MTI website for up-to-date information. Subsequently, eligible candidates will be invited to interview in Khartoum, the general structure of it is of two panels: 1. Personal assessment, here they ask you about your experience, career goals, etc. 2. Two clinical scenarios, emergency presentation and communication skills scenario. In general, they have two rounds annually and I would advise to email them and ask directly when you are ready to apply.


Generally the programme facilitates the GMC registration and provides sponsorship for Tier 5 MTI visa. During the application process, you are matched to a job at appropriate level of your experience and qualifications, based on which you can be a medical registrar or a SHO. Also you have the opportunity to choose the specialty you want to work in. Myself I have worked as a medical registrar in diabetes and endocrinology. Here I would like to consolidate a point that MTI post is a paid job, and you will get a monthly salary as per contract with the hospital.


Now let’s talk about the experience after coming to the UK and starting your first job in the NHS. First of all you need to know your goal of joining the scheme ! Is your aim to have a training programme and to gain a specialty certificate ? Or you are  required by your home country to have certain amount of time of clinical experience abroad ? Or you just want to try something different ?! Well, here are some facts you need to know that Your job as a MTI trainee shares some of the features of training, for example you have an educational supervisor, ePortfolio, and you will be attending the regional SpR training days, but formally you have no training number, and in essence it is a service job. So back to our previous question, if your aim is to gain a training programme then this is not provided by the MTI. If you are among the other two categories, then have a go and see how you find your way with the scheme !


The other question is are you getting a proof of your experience by the end of the two years? The answer is yes! Recently the RCP and the Liverpool School of Tropical Medicine have launched Diploma in UK Medical Practice, and to be awarded the diploma you need to maintain your ePortfolio, to complete a range of continuing medical education sessions, and submit a written reflection piece at the end of your placement.


Now after 16 months of experience how do I find it ? Before evaluating the academic and clinical parts of the experience, let’s make one point clear that as human being -regardless of your job- the transition from your background culture to a new different culture must be an important issue you need time to get on with. Then as a doctor, the transition from your home clinical practice that you are used to throughout your working years, to a new clinical system, must be a significant change that needs time to get on with as well. Bearing in mind these two fundamental points, I think it is quite understandable that the international medical graduates need time to settle with these “turns and twists” ! And for the same reasons I believe it is sensible to allocate the IMGs in less stressful jobs initially so that they get on smoothly and comfortably. Another suggestion to help with this “transitional period” is to define the first three months of placement as an attachment for example. From my own experience, I do not advise to start your first post in the UK as a medical registrar, as this will be very stressful and even frustrating! I would suggest to start with a SHO post and after few months you can judge if you want to change your position.


It goes without saying that having a chance to practice medicine in a different country will add much benefit to your clinical skills and enrich your clinical experience as well as your personal experience in life ! Having a job on diabetes and endocrinology -which I am interested in- has exposed me to a wide range of expertise, especially in the outpatient clinics, let alone the excitement you feel when you request a test or treatment that you read about before but never come across before !


One of the most frequently asked questions is whether it is possible to quit the scheme and find another job. The answer is yes, you can leave the scheme if you decided not to continue, and if you plan to find another job in the UK, it is again possible. It involves some logistics of switching the visa type, but it is all doable.


In conclusion, I think the MTI scheme is an excellent opportunity to enrich your clinical experience, however you need to know exactly what do you want to achieve by joining the scheme.