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.

Important information for current MTI doctors in the UK whose Tier 5 visa is due to or has already expired and cannot return to their home country due to COVID-19 and travel restrictions        

Visas – Information from UKVI

UK Visas and Immigration (UKVI) has published guidance on GOV.UK on immigration provisions for individuals affected by travel restrictions associated with COVID-19. These changes are now in effect and full details are available here

Visa extensions

  • No individual who is in the UK legally, but whose visa is due to, or has already expired, and who cannot leave because of travel restrictions related to COVID-19, will be regarded as an overstayer, or suffer any detriment in the future.
  • Currently the position of UKVI is as outlined in the announcement from the Home Secretary on 31 March whereby a 12 months automatic extension  will currently cover those MTI doctors whose visa is due to expire before 1 October 2020:

  • The extensions will be on identical leave conditions to previously and therefore only applies to those individuals who the Trusts wish to continue sponsoring. If an applicant wishes to change route or job role a new application would be required.


May 2020: Update on changes to MTI applications processing

With the partial ease of some measures imposed in light of the COVID-19 pandemic in the UK and worldwide, we will restart the processing of all steps of the MTI application with immediate effect. Please read the below information for more details:

For current MTI applicants in Anaesthesia/ICM/Pain Medicine (at any stage of the application process)

If you have been appointed to an MTI post in the UK, we may be in a position to process all steps of the application process as detailed here.

However, please be aware that the pandemic is affecting individual hospitals differently, and whilst some UK hospitals will be able to host you in the short term, some others may need extra time before they can confirm your start. We will therefore consider MTI applications on a case by case basis and adjust the processing to hospitals’ needs/capacity. We will need the following to proceed:

  • Confirmation from your host hospital in the UK  that they have the capacity to host you as soon as you are allowed to start your post
  • Confirmation that you are able to apply for your visa and to travel from your country of residence to the UK.

What do you need to do?

You do not need do anything. If you had submitted your application and are awaiting an outcome, we will be in touch as soon as our MTI Leadership Group has reviewed your application and confirmed approval.


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
  • aligibility 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