Medical Training Initiative

Medical Training Initiative

A government authorised scheme allowing doctors from low and middle income countries to undertake anaesthesia training within the NHS for a maximum of 24 months.


Rules for entering the UK

What you must do when you arrive in the UK from abroad depends on where you have been in the 10 days before you arrive.

Before you travel to the UK you must read the government's guidance below:

Update on Immigration Health Surcharge reimbursement launch 

The Immigration Health Surcharge (IHS) is paid at the point of visa application that enables access to the NHS for most non-EEA nationals applying for temporary leave to enter or remain in the UK.
In May, The Prime Minister announced that Health and Care staff would be exempt from the IHS and in August this year Home Office and DHSC launched the Health and Care Visa which exempted applicants from the IHS. The new reimbursement scheme covers staff such as cleaners, care workers and porters and their dependents who are outside the scope for the Health and Care Visa but who work in health and Social Care.  
You are eligible if:
•    you are a non-tier 2 visa holder who has paid the Immigration Health Surcharge; or
•    you have paid the Immigration Health Surcharge (IHS); and
•    you have worked in health or social care role for at least an average of 16 hours per week since 31 March 2020
The AoMRC has created a process with the NHS Business Services Authority that will enable you to receive a refund for any payments paid since 31/03/2020 towards your IHS. To make a claim for your IHS and your dependents, you will need to complete a  survey 

Please note that the refund will automatically go into the account from which the IHS was paid.  If that account has been closed, the AoMRC has advised that no change can be made until the payment has been attempted to that account and failed, and then new account details will be accepted.

If there are any queries on this subject, please address them to

The Medical Training Initiative (MTI) is a government scheme designed to assist doctors with proven ability in anaesthesia/Intensive Care/Pain Medicine from low and middle-income countries (lower-middle-income and upper-middle-income countries), according to World Bank Definitions, and includes a focus on DFID 28 priority countries, to pursue further specific specialist training in the UK. Doctors can come to the UK for up to 24 months under the UK Border Agency’s Tier 5 immigration rules, before returning to their home countries.

The MTI scheme utilises unfilled training capacity within the NHS, to allow eligible International Medical Graduates (IMGs) to gain from opportunities on offer. The training received by IMGs on the MTI scheme will vary, however the training will follow the CCT Curriculum. The level at which, and the specific training available, will depend upon the IMGs competence, the IMGs specific interests, and training available within the placement hospital Trust. IMGs will agree their specific training objectives with their Educational Supervisor at the start of, and throughout their placement. 

Doctors who undertake training via the MTI route will benefit from world class clinical training, and also gain non-clinical skills such as medical education and leadership. These skills will be significant benefit, not only to the Doctors themselves, but also to healthcare systems and patients in their home countries. 

The MTI scheme is philanthropic in nature and not a route suitable for Doctors who intend to remain in the UK for longer than 24 months. 

The College will act as the ‘professional sponsor’ through the Academy of Medical Royal Colleges (AoMRC) who is the overarching visa sponsor and is responsible for issuing the Tier 5 Certificate of Sponsorship, which enables an applicant to apply for their Tier 5 visa. The Certificate of Sponsorship will only be issued if the application is supported by the College. The Tier 5 visa is issued for a maximum two year period.

Our role

Sponsorship from us through the MTI will equip International Medical Graduates with:

  • GMC registration: to train in the UK, doctors have to obtain registration with the General Medical Council (GMC). The normal route to registration is to pass the GMC’s Professional and Linguistic Assessments Board (PLAB) test. The GMC grant exemption from PLAB to anaesthetists sponsored by the College through MTI
  • a Certificate of Sponsorship (CoS) for a Tier 5 visa: this process is managed by the Academy of Medical Royal Colleges
  • eligibility to sit FRCA examinations
  • twelve months of free College membership: this allows IMGs to take advantage of many member benefits, including access to journals and the College's Lifelong Learning platform.


It is important to note that obtaining the required paperwork and obtaining approval can take a significant period of time. Whilst we cannot be specific about timelines as each case is different, it is not uncommon for the process of applying for an MTI position to take between three to six months. We ask that prospective MTI doctors and hosts read the information provided carefully, as providing the required information in a timely fashion will reduce processing times.

If you have any queries or require further information please contact us via or call us on +44 (0)207 092 1559