Medical Training Initiative (MTI)

Doctors applying to the MTI scheme must:

• Hold a primary medical qualification recognised by the UK General Medical Council from an internationally accepted medical institution. Successful applicants must have this qualification verified by the Education Commission for Foreign Medical Graduates (ECFMG) (RCPsych will advise when to do this).
• Have completed an acceptable internship (or equivalent) of not less than 12 months following undergraduate training.
• Have at least three years’ experience working in psychiatry in the last five years (including the 12 months leading up to GMC registration).
• In the last 18 months have completed one of the following tests and received the scores detailed in the most recent sitting of the test:
  • the academic version of the International English Language Testing System (IELTS), taken in person at an authorised test centre, and achieved a minimum overall score of 7.5 (and at least 7.0 in each category) 
  • the medical version of the Occupational English Test (OET) and achieved have achieved a grade B or over in each testing area.
    
• Be resident overseas at time of application and have no rights of residence in the UK.
• Have obtained, or be working towards, a postgraduate qualification in psychiatry.
• Have not previously made any unsuccessful attempts to register with the GMC (e.g. PLAB test) or exceeded the GMC’s limit on unsuccessful attempts at the PLAB test (Doctors who have failed - and not subsequently passed - either part 1 or part 2 of the PLAB test or who have previously been turned down for sponsorship by an approved sponsor are not generally considered as suitable candidates for sponsorship. If unsure, please see GMC website for clarification).
• Have not failed any examination that forms part of your psychiatric training, including between the time of application and the time of sponsorship.
• Understand that the scheme is aimed at trainees and that those in training grades will be given preference, therefore it may not be possible to interview all eligible candidates.

Applications for the MTI scheme open once a year for placements starting in August of the following year. Applications to start MTI placements will open in Autumn 2024 and will close in early 2025. If you would like to be kept up to date with application dates, please ask to be added to our mailing list by contacting mti@rcpsych.ac.uk.

To apply, you should:

• send all documents in PDF or Word format only
• submit each part of the application as one document (for example A1 should be submitted as one document, not several individual pages)
• name each file with the document number and your name (for example, "A1 Dr Forename Surname")
• submit your application in one single email
• digital signatures will be accepted.

To apply please complete the below MTI Application forms and submit them to mti@rcpsych.ac.uk.

• A1: Application Form
• B1: Reference Form
• B2: Reference Form
• B3: Reference Form
• L1: Letter of support from relevant National Psychiatric Association
• L2: Letter of support from current Employer/Institution

You will also need to submit:

• a current copy of your CV/resume
• a copy of your current, valid passport (with all details clearly legible)
• a copy of your most recent IELTS or OET certificate
• copies of your relevant educational qualification certificates

The diagram below illustrates the application process. Please note that some Employing Bodies may wish to conduct their own interview to ensure their matched doctor is suitable for the post. 

There are a number of costs associated with making a successful application to the RCPsych MTI scheme, some of these costs are:

• RCPsych Administration Fee between £250 and £550 (please see the  RCPsych MTI banding fees, this payment is due once the placement has been started)
• ECFMG fees
• GMC Registration fees
• Temporary Work – Government Authorised Exchange visa fees
• Immigration Health Surcharge (IHS) - MTI doctors and their dependents can apply for a refund of this cost through the AoMRC
• IELTS / OET test fees
• Relocation costs

RCPsych MTI induction booklet

The RCPsych MTI team have developed an MTI Induction Booklet which provides an introduction to RCPsych, your new role, the NHS and culture in the UK. We recommend reading the induction booklet before you travel to the UK as it provides lots of useful information. 

Immigration Health Surcharge refund

Doctors on the MTI scheme, and their dependents, can now receive full reimbursements of the Immigration Health Surcharge (IHS), for any period from 31 March 2020. To request a refund, complete the AoMRC IHS refund form.

Right to work checks

From 06 April 2022, all British Residence Permit (BRP) holders need to evidence their right to work using the Home Office online service. MTI doctors will need to share their date of birth and nine-digit share code with their employer to enable to employer to use the online right to work checker. 

Biometric residence permit (BPR) expiry dates

If your BRP expires on 31 December 2024 but your visa allows you to stay longer than this, please refer to UKVI guidance on this matter. 

“This has been a vast learning experience where we learn from all colleagues, consultants, MDT professionals, and most important patients. I am sure this enriched training would help me become a better clinician overall.” Dr Prashant Sahu, an MTI doctor from the 2021 cohort. 

“Six months into being an MTI Trainee: I landed in the UK as an MTI trainee for Berkshire Healthcare NHS Foundation Trust (BHFT) amidst the chaos and uncertainty of the Covid-19 pandemic. I started my role in an acute ward for adults. The first few weeks were quite challenging. I was overwhelmed with the time spent on documentation and the multidisciplinary approach to patient management. It felt like I would probably never catch up! However, I always had the necessary help and support of colleagues and the ward team. I have regular discussions about my academic and personal progress with my educational supervisor and I have been assigned an IMG tutor, who has been guiding me towards my career progression. As BHFT treats MTIs like any other trainee, I have never missed out on any teaching/learning/training/benefits received by a trainee. BHFT has also been very keen about finding the right placement for me according to my interest. I am currently placed in Geriatric CMHT with a team and consultants who have set up an example for me about efficiency and work culture. Being an MTI trainee has been a major step in my career as a psychiatrist, providing me with a new perspective and enthusiasm towards psychiatry.” Dr Shizu Singh, an MTI doctor from the 2021 cohort. 

"MTI scheme has been a great opportunity for learning and professional development. I have thoroughly enjoyed my experience working in the NHS. I have developed leadership and management skills in my various rotations which undoubtedly will help in my future career. I am proud to have contributed to the NHS while working in a difficult time during the pandemic." An MTI doctor from the 2020 cohort.

"The scheme helped in opening my eyes to other interesting and developed aspects of psychiatry practice that is not readily available in the low and middle income countries. This has helped in developing special interest in these areas." An MTI doctor from the 2019 cohort.

"I was at CT 3 level and had the opportunity to train in different rotations which enriched my experience. Also, having protected teaching time helped me involve in non clinical educational activities such as courses, conferences and audits. I was also able to pass paper A and B exams." An MTI doctor from the 2019 cohort. 

"I was very grateful for the support right from the time when I was still on my home country. I appreciated that they followed a timetable so I was not left waiting or anxious. Admin support was excellent. The guidance given the the Trust where I worked- about treating me akin to a CT3- was very helpful. I attended MRCPsych courses and was given every opportunity that a trainee was!" An MTI doctor from the 2019 cohort.

"I enjoyed the experience greatly & hope that it continues to be available. It helps the international doctors get UK experience & helps the trusts as they get very experienced doctors working in CT level posts for two years." An MTI doctor from the 2018 cohort.

"It was a great experience and I learnt a lot, interacted with others from diverse background and shared some of my knowledge and experience with others too. Thanks to MTI for the opportunity." An MTI doctor from the 2018 cohort.

• RCPsych Administration Fee - between £250 and £550 (please see the RCPsych MTI banding fees)
• ECFMG fees
• GMC Registration fees
• Temporary Work – Government Authorised Exchange visa fees
• Immigration Health Surcharge (IHS) - MTI doctors and their dependents can apply for a refund of this cost through the AoMRC
• IELTS / OET test fees
• Relocation costs

Employing bodies can benefit from the diversity and experience that MTI Fellows bring, along with their unique insight into patient care. MTI Fellows provide a valuable contribution to the UK workforce and benefit greatly from experiencing training in the NHS.

Employing bodies can apply to RCPsych to employ an MTI fellow if they have:

• vacant psychiatry training posts which cannot be filled by UK trainees
• converted ST posts
• trust posts that provide sufficient educational and training content.

MTI posts must:

• not disadvantage UK trainees
• not adversely affect the training of existing trainees in the training location,
• have approval from an authorised signatory in the local Deanery
• start at CT3 but may progress to ST level after a few months with agreement from the MTI and Employing Body.

RCPsych provides support to employing bodies throughout the entire process of employing an MTI Fellow and continues to support them throughout the MTI placement. RCPsych also provides the doctor with General Medical Council (GMC) sponsorship and coordinates the application to the Academy of Medical Royal Colleges (AoMRC) for a Certificate of Sponsorship, which the doctor uses for their Temporary Work – Government Authorised Exchange visa application.

There is an employing body administrative fee of £950 for each doctor RCPsych successfully matches with a post. The fee allows the RCPsych to continue the scheme and provide a high level of support to both employing bodies and MTI Fellows from application right through to the end of the placement.

MTI placements typically begin in August of each year. However, the RCPsych MTI team is happy to provide a more flexible approach, based on the needs of the individual employing body.

If you are interested in employing an MTI doctor, please contact MTI@rcpsych.ac.uk.

Interested employing bodies may find the following documents useful:

• RCPsych MTI Employing Body Submission Form
• RCPsych MTI Employer Guidance
• RCPsych MTI Employer Guidance: Supporting your MTI
• AoMRC MTI National Standards

Does RCPsych charge a fee to Employing Bodies? What does this cost cover?

There is an administrative fee of £950 for each MTI doctor that is successfully matched with a post within your organisation. For this fee, RCPsych will:

• manage the application process,
• interview candidates,
• match you with a suitable doctor,
• sponsor the doctor for GMC registration,
• guide you through the AoMRC application process.

We are also available for support throughout the application process and throughout the Fellow’s placement.

How do I apply for an MTI to work in my Employing Body?

Please read the RCPsych MTI Employer Guidance and submit an RCPsych MTI Employing Body Submission Form to mti@rcpsych.ac.uk.

Deanery/LETB authorisation for the post should be secured prior to submitting your application.

How do I know who my LETB/Deanery authoriser is?

The Academy of Medical Royal Colleges have produced a list of MTI Authorised Deanery Signatories who can provide approval of the post. In most cases, this is the Postgraduate Dean and Associate/Deputy Dean.

What grade should MTI doctors be employed at?

All RCPsych MTI doctors should begin their placements at CT3 level and work at this stage for at least 6 to 12 months. If the Employing Body and MTI doctor agree that the doctor has sufficient skills, experience and knowledge to work at a higher grade, they can move to an ST post after this initial period at CT3 level.

Can an MTI doctor complete on-call duties?

We recommend that Employing Bodies allow at least 4-8 weeks for MTI doctors to become accustomed to NHS systems before being put on-call. We encourage you to provide an induction plan to prepare doctors for on-calls, including shadowing colleagues who are on-call.

What salary should MTI doctors receive?

MTI doctors should be offered a contract and salary equivalent to CT3 level.

During the AoMRC application process, you will be asked to confirm that maintenance will be provided for the doctor for the first month after their arrival, up to £1270, in the event that there is an issue with their salary. 

What extra support does my MTI doctor need?

Your MTI doctor is new to the NHS and UK systems so may require a more in-depth induction than their UK counterparts. A National Induction programme has been designed to ensure that all International Medical Graduates (IMGs) recruited to the NHS are welcomed, valued and supported as they transition to UK clinical practice, we recommend consulting the guide to induction for IMGs recruited to the NHS when considering your MTI induction programme.

As well as a professional induction, your MTI doctor may also require pastoral support while relocating to the UK, this may include support with accommodation, airport transfers, collecting their British Residence Permit, opening a bank account, getting a National Insurance number, travel and more.

You should also ensure your MTI doctor is allocated a suitable educational supervisor and clinical supervisor and that they have regular meetings scheduled. Your MTI doctor is also likely to appreciate financial support with their relocation costs.

RCPsych have provided an overview on supporting your MTI which you may find helpful.

An International Medical Graduate (IMG) has applied directly to our Employing Body, can RCPsych help with GMC registration?

The only route to GMC sponsorship via the RCPsych is through the Medical Training Initiative and we are therefore unable to sponsor any doctors outside of the Scheme. If you have been in contact with a specific doctor, you can provide this information in your RCPsych MTI Employing Body Submission Form and we will take this into consideration, although we cannot provide any guarantees that the doctor will be successful in their application, or that we will be able to match them with your post.

Where can I find further information?

The AoMRC have information for Trusts and FAQs for employing organisations. NHS Employers have also provided a list of FAQs for employers based in England, although these may also be helpful for employers based in Northern Ireland, Scotland and Wales.