Medical Training Initiative (paediatrics) - guidance for applicants

The MTI(p) scheme provides paediatricians from outside the UK / European Economic Area two years of high quality postgraduate training in the NHS. Graduates can use this experience to improve patient care in their home countries, and UK hospitals benefit from their skills and knowledge. If you're interested in joining the scheme, please review the eligibility criteria and full guidance below.
Last modified
14 November 2023

Who is MTI(p) for?

This scheme is suitable for doctors who are:

  • currently in training in developing nations outside UK/EEA
  • looking for a two-year training fellowship in the NHS that is quality assured by the RCPCH
  • not already registered with the GMC.

It is not suitable for doctors outside training and:

  • from EEA nations
  • at UK consultant or equivalent level
  • looking to work beyond two years in the UK or to enter run-through paediatric/paediatric sub-specialty training.

You can see the full eligibility criteria below. If you are still unsure, you can contact us with our short form. You can also explore other opportunities in the UK for overseas paediatricians.

Important notice for potential applicants

Before an MTI(p) sponsorship application can be opened, the RCPCH team will need to carry out a screening process. This ensures both the post and applicant are suitable/eligible for the scheme. The screening process involves checking the job description, a post submission form, the CV, and English language scores of the appointed doctor.

It is only once these documents have been approved by RCPCH that an application will be opened. The screening process should take 5 working days but may take slightly longer during very busy times.

Prospective start dates should be no less than 3 months from the point at which the screening process takes place. We cannot guarantee start dates as this is an open ended process, parts of which are in the hands of other stakeholders we work in partnership with. In rare circumstances applications may take up to 6 months.

It is very important that applicants should stay in their clinical role until the GMC registration stage is complete. There are strict GMC rules around continuous clinical practice (see eligibility criteria below) and any employment gap of 4 weeks or more (uncontracted leave) will mean the RCPCH cannot act as sponsor.

What is MTI(p)?

International Medical Graduates (IMGs) learn from experienced consultants within the UK national health system. They use their experience to improve the level of patient care in their home country on their return. In turn UK hospitals benefit from the skills and knowledge that IMGs can bring.

Successful applicants are given Royal College sponsorship for GMC (General Medical Council) registration and are recommended for a Tier 5 Visa. The RCPCH facilitates this process.

As of April 2017 the Department of Health (DoH), Health Education England (HEE) and the Academy of Medical Royal Colleges (AoMRC) agreed arrangements for processing visa applications for MTI: priority is given to applicants from countries identified as World Bank Low Income and Lower Middle Income Countries (LI & LMI).

What type of posts are offered?

Posts are usually offered at a 'middle grade' level, equivalent in standard to Level 2 of the UK Specialty training programme. After a period of up to six months induction at a more junior level (ST3), it is expected that candidates will progress to spend the remaining 18-21 months working at a more senior level (ST4-5).

There are increasing opportunities to train at Level 3 (ST6-8) after an appropriate induction period.

You can see our current list of approved MTI(p) posts.

Step 1 – Eligibility

To be eligible for MTI(p) sponsorship, you must make sure that you are of the appropriate level of experience described above and meet the following requirements:

  1. You must be overseas at the time of applying and have no right of residency in the UK/EEA.
  2. You must be practising clinically in one of the priority countries as defined by the Academy of Medical Royal Colleges. (If your country does not appear on this list then sponsorship may be possible on a case-by-case basis; you should clarify with the MTI(p) team.)
  3. You must demonstrate the necessary competence in the English language as evidenced by one of the following. Results for both tests are valid for two years, the minimum scores must be attained in one sitting, and they must be obtained in your most recent sitting. *If your most recent test results are within six months of their expiry date when beginning an application, you may need to provide an updated set of results at a later time.
    1. Pass the International English Language Testing System (IELTS) Academic examination with a minimum score of 7.0 in each category and an overall score no less than 7.5
    2. Pass the Occupational English Test (OET) Medicine test with a minimum grade of ‘B’ in in each testing area
  4. You must hold a primary medical qualification accepted by the GMC. As part of your application, this will need to be pre-verified by the Educational Commission for Foreign Medical Graduates (ECFMG). This process is carried out by a third party, working on behalf of the GMC and is not under the control of the RCPCH.*
  5. You must hold a three-year minimum postgraduate qualification in paediatrics that is accepted by the RCPCH OR full MRCPCH.
  6. You must have been in direct clinical practice for a minimum of 36 out of the last 60 months. Observerships and pure research positions do not count towards this.
  7. You must have been in direct clinical practice for the whole of the last 12 months. Observerships and pure research positions do not count towards this. If you have any employment gaps beyond four weeks in this period you should clarify with the MTI(p) team on your eligibility status.
  8. You must demonstrate an intention to return home after the two-year maximum training period, with a consideration of how your time spent training in the UK might benefit your patients and colleagues at home.
  9. Cannot have attempted and failed any part of the PLAB examination within the last three years prior to point of application.

Step 2 – Applying for a post

Eligible candidates can apply for suitable jobs found on the NHS Jobs website or as advertised on our approved MTI(p) posts webpage. You may also find suitable positions by searching on the BMJ jobs board.

Any post with sufficient and achievable training potential can in theory be converted to a post for the MTI(p). These may be advertised as clinical fellowships or Trust-grade posts. Once they go through our quality assurance process then sponsorship can be arranged. This is a brief but important process where our MTI(p) clinical champions across the country check the post for suitability of training, induction processes, appointment of an independent educational supervisor, salary levels, protected study leave and so on. More details can be found on the Trust guidance page.

Sometimes doctors will apply and interview for a post, receiving an offer before the post has been quality assured by the RCPCH. This is not a problem; however, the approval process must be completed before any progress can be made.

Any posts advertised on our approved posts webpage have already been quality assured with regards to training and support for MTI doctors.

Once you have interviewed for a post and that post has been approved for MTI(p) sponsorship, you should inform the RCPCH MTI(p) team on and provide us with the following:

  1. An up-to-date copy of your CV, listing all of your qualifications and giving a detailed breakdown of your work history over the past five years, including any gaps
  2. Contact details for the medical staffing/human resources team member at your host hospital/Trust/Health Board who can provide us with more information on the post you have been offered
  3. A job offer letter (if you have been provided with one)

The RCPCH team will then check these documents to make sure you are eligible for sponsorship. We may ask you some additional questions at this stage. Provided all is satisfactory, a formal application for sponsorship can begin.

The proposed start date for the post should be at least six months from the point of application.

Step 3 – Application for sponsorship

The RCPCH team will give you an ‘application pack’ to complete, together with guidance, and will support you in completing this. The application pack consists of important documents we must receive before we can progress your application any further. These items must be provided in the form of clear, scanned colour copies.

At the same time your host Trust will be given its own application pack or ‘Trust pack’ to complete. This involves providing the College with additional important documents that we will need to progress the application further.

Alongside this, the trust will begin an Academy of Medical Royal Colleges (AoMRC) request form for visa sponsorship and will send you a link to complete a Data Protection Consent Form. You will also be asked to add your passport to this form at a later stage.

The application process usually takes at least two months. Please be aware that the host Trust may sometimes take longer than this to complete their documents and this should be no cause for concern. The RCPCH team will liaise and keep both parties informed during this process.

Please note that applications cannot be progressed to the next step until all the documents from both candidate and Trust have been supplied to the College team.

As of 15 October 2018, the RCPCH no longer charges application fees. Instead all MTI(p) doctors are expected to enrol as Associate members.

Step 4 - Review

All of the documents are reviewed by the RCPCH team with help from the College MTI(p) regional champions. This will ensure that both you and your post are suitable for MTI(p) sponsorship.

If your postgraduate qualification in paediatrics is not already on our list of approved qualifications, you will have already been asked to provide the relevant curriculum/syllabus as well as a contact from the issuing institution (usually a head of department.) Our assessors will then establish whether the postgraduate qualification meets the sponsorship requirements, examining the curriculum and assessment methods carefully.

The RCPCH team will work with all stakeholders to resolve any issues with documentation as quickly as possible.

The review process usually takes 10-15 working days.

Step 5 – Acceptance letter

If the above review process is successful, then you will be issued an acceptance letter from the RCPCH, offering you GMC sponsorship and a recommendation for a Temporary Work - Government Authorised Exchange Visa Certificate of Sponsorship (CoS).

This letter also includes instructions on how to begin your registration with the GMC via our sponsorship pathway.

Step 6 ­– Applying to the GMC (General Medical Council)

It is only at this point that an application with the GMC should begin. You will be given full instructions on how to take this forward.

The GMC will request a certificate of sponsorship from the College, as well as a few other key documents. These documents will already be available as they form part of your application pack.

Provided your application is successful, the GMC will offer you provisional registration, and ask you to complete an identity check.

This step usually takes around 3-4 weeks but is variable.

Step 7 ­– Applying for a Temporary Work - Government Authorised Exchange Visa CoS

The offer of provisional registration with the GMC is a requirement for a Temporary Work - Government Authorised Exchange Visa Certificate of Sponsorship, so it is only at this point that we can place a request for one. Certificates are issued by the Academy of Medical Royal Colleges (AoMRC), who act as the overarching visa sponsor for the MTI scheme.

Certificates of Sponsorship usually come through within 10 working days, but in rare instances can take longer and will be sent to the RCPCH team, who will forward it to you as soon as possible.

Step 8 – Applying for your visa, entering your post and beyond

Once you receive your Certificate of Sponsorship you will be able to apply for your visa, enter the UK, attend your GMC ID check and take up your post. This concludes the application for sponsorship.

However, the College will continue to support you during your time spent in UK training under MTI(p).

  1. We provide you with access to a web-based ePortfolio which you will use to evidence your development.
  2. Through our network of regional champions, the College offers workshops for MTI(p) trainees, covering areas such as adjusting to UK clinical practice, improving communication skills and boosting confidence.
  3. There is an annual symposium for all MTI(p) doctors, which includes presentations from trainees and senior clinicians. This event provides an excellent opportunity to network with your fellow MTI(p) trainees across the UK.
  4. We also act as an impartial advisor in the very rare instances in which difficulties arise or expectations are mismatched. You are free to approach us with complete confidentiality and will work hard to resolve issues. Similar support and guidance is provided to Trusts as well.



  • *Please note that for MTI(p) applications, you will only need to have your primary medical qualification pre-verified by ECFMG - your post graduate qualification does not need to go through this process. You should start this process as soon as your eligibility has been confirmed by the RCPCH Team and you have been formally offered a post, that has been approved for the MTI(p).