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FAQs for doctors

Answers to frequently asked questions for doctors applying for the RCOG Medical Training Initiative (MTI) scheme


Unfortunately no. All doctors must already have 4 years of postgraduate training and submit their Assessment of Training letter before the deadline. We advise that anyone who will achieve their 4 years of postgraduate training after the deadline, waits until next year to make an application for the MTI scheme 2022.

The MTI scheme is developed for doctors who wish to gain more experience, training and exposure to the UK health system. The level of the offered posts (ST3-5) and focus on general core training means MTI is not appropriate for highly experienced doctors or consultants. Therefore doctors who have more than 10 years of experience in O&G are not suitable for this scheme and their applications will not be considered.

All applicants for the MTI scheme will need to detail all posts from the time of obtaining their primary medical qualifications in their employment history. Any gaps in employment (unless clearly explained e.g. maternity leave) will result in rejection of the application.

The RCOG’s MTI scheme is designed to help international medical graduates to come to the UK to consolidate their core training in Obstetrics and Gynaecology and obtain the MRCOG qualification. It is not a scheme designed to provide advanced training. The posts offered under the MTI scheme therefore start at ST2/3 level (equivalent to 2nd / 3rd year of a 7 year UK training program). Please also note that COVID has impacted on training and education opportunities with elective services being cancelled in many hospitals and opportunity for surgical exposure is at present extremely limited.

However, if MTI trainees obtain the MRCOG early in the 2 years of training, they may be able to undertake Advanced Training Skills Modules (ATSM) in their areas of interest during the remainder of the 2 years. The ability to do this will depend on the presence of spare training capacity in their local hospitals to undertake these ATSMs and cannot be guaranteed. It should be noted that the tier 5 visa cannot be extended to facilitate completion of ATSMs.

Unfortunately no. The GMC (General Medical Council) will not register any doctors who have been out of full time medical practice for any of the last 12 months leading up to an application to register. All doctors must register with the GMC to be able to practice and so if they will not register you, you cannot work in medicine in the UK.

For IELTS, we require you to sit the Academic test. You should achieve at least 7.0 in each domain of the test and you must achieve 7.5 or higher in your overall score. Please note the IELTS Indicator test is not accepted by the GMC.

For OET you must score an A or B. OET can either be paper based exam or the electronic OET@Home exam.

We cannot accept any deviations from this regulation, as it is a GMC requirement.

The MTI scheme is a philanthropic ‘learn and return’ scheme which provides opportunities for doctors who work in low income settings to train for a fixed period in the NHS system. After completing a training placement MTI doctors will be expected to return back home and will be able to use the knowledge and skills they have gained in the UK  to improve the healthcare system in their home country. In general terms, high income developed countries’ healthcare systems do not have the same degree of need.

Yes, you are eligible. Contractual annual leave does not count as a gap in your clinical experience.

Technically, you should have no gaps in the 12 months prior to your application in order to be eligible. However, the GMC may make an exception depending on the circumstances. If you have a gap in your clinical experience of a maximum of 5 weeks, but believe that the circumstances are exceptional, please contact the RCOG MTI Office (please include exact dates and reason for such a gap) and we will seek further advice from the GMC.

Application process

We appreciate that doctors may be unsure as to who should fill in their HoD form if they have not been working in a hospital for a long time or if they do not have a head of department in Obstetrics & Gynaecology. If this is the case, doctors making an application should approach the most senior consultant within their department who is overseeing their training and ask for them to complete the HoD form and submit it to directly. This consultant should not also be asked to provide a reference for the doctor.

If you have completed 4 years of postgraduate training, you can apply for your training to be assessed by the Examination Department.

You must allow up to 4 weeks for your AoT application to be processed. The time is needed to allow for procedures such as application screening, verification of certificates, verification of training posts and authorisation of the final approval letter.

If you have still not heard from the Examination Department within 4 weeks of submitting your application, please email 

You must obtain your AoT approval letter from the Examinations Department before the MTI deadline, to include in your MTI application. We are unable to accept late applications.

Your AoT approval letter must be included in your MTI application bundle, for the application to be considered by the assessment panel.

Yes, many MTI doctors come with their families. They can come on a dependent visa. You should contact the UKVI (UK Visas and Immigration) for more information.

We welcome applications from those who were not successful last year. However, you must submit an entirely new application and references. You can resubmit your IELTS / OET certificate if it is going to be in-date until near the end of 2021 and you achieved the correct score, passport copy if valid until end of 2021 and AoT.

If you have sat the exam before the MTI 2021 application deadline and are awaiting your test results you will need to submit evidence with your application that you have sat the exam which must include the date of the exam. An official email from the exams board will be accepted. If you are unable to sit the exam before the applications deadline you will not be eligible to apply in the MTI 2021 round and will need to wait until the following year.

If you sat the exam before the close of applications and are awaiting the results you will need to send us your test results by Saturday 2 January 2021. If your certificate is not currently available an official email from the examinations board detailing your score will be accepted in place of the certificate. Unfortunately, we cannot accept anything else.

If we do not receive the score by this deadline or if you do not meet the minimum scoring thresholds your MTI application will be rejected.

Successful MTI candidates are matched with available posts on a random basis. If however, for serious personal/family reasons you wish to be placed in a certain region or hospital around UK, please state it on your application form in the ‘Further Information’ box at the end of the document. We may be able to consider such requests, but please note that this will not always be possible and it will depend on many factors. It will not be possible to request this after you have been provisionally matched with a hospital, therefore please include such request on your MTI Application Form.

Candidates do not need to organise an interview by their IRC Chair as part of the applications process. Only those candidates whose applications are successfully shortlisted by the assessment panel in January will be required to organise an interview by the IRC Chair. Shortlisted candidates will be contacted by email with further information.

You will need to cover the fee for the GMC application for full GMC registration and you will also need to cover the tier 5 visa application fee (also applicable for any dependent visas).  Also, take into account that when you move to the UK you may have to arrange your accommodation and sustain yourself for a month until you receive your first salary. At present MTI trainees must pay the healthcare surcharge (also known as the Immigration Health Surcharge) which will be reimbursed subsequently (this is currently charged at the point of making the tier 5 visa application and you then can reclaim once working in the UK every 6 months, read more here).

Currently those arriving in the UK may face additional costs in light of COVID-19 with hotel quarantine for arrivals from red list countries and self-isolation for other international arrivals and mandatory COVID testing for all arrivals to the UK. Read more around the latest regulations on Gov.UK. Hospitals may be able to help  with meeting these additional costs either through relocation allowances, salary advances or by putting MTI doctors on paid leave when they arrive to the UK (please check with the hospital what arrangements are in place for assisting you to cover these costs in advance). If you are planning to come with your family you will need to factor in the visa costs, IHS charges and COVID related expenses (hotel quarantine if applicable and COVID testing) for each person travelling.

After being accepted/ The MTI process

Being pregnant does not disqualify you from applying for the MTI scheme. However, you will need to consider a few issues.

While all NHS staff will be eligible for maternity leave, pay during maternity leave is dependent on duration of service. To be eligible for occupational maternity pay (OMP), the member of staff should have worked for the NHS for 52 weeks and for statutory maternity pay (SMP), should have worked for the current employer for 26 weeks before the start of the 24th week of pregnancy. Hence, a trainee that is pregnant at the time of starting their placement will not be eligible for maternity pay. You must therefore consider the financial implications of being resident in the UK without a regular income during this period of maternity leave.

In addition, as the MTI placement is for 2 years and the tier 5 visa cannot be extended beyond this time, prolonged periods of absence is likely to adversely impact on the training that the MTI doctor will receive during their placement.

If you are pregnant and are considering applying for the MTI scheme, you may choose to defer your application to a subsequent year. If having applied and being successful in obtaining a placement, you then find yourself to be happily pregnant, please liaise with the RCOG MTI office who will be able to offer individualised advice.

RCOG will apply for your CoS at the Academy of Royal Medical Colleges as soon as we receive all the required documents. The time taken to process this will be determined mainly by the speed at which hospitals are able to send the RCOG the required signed forms. This may vary depending on the individual trust.

In some countries, employers or Home Offices request doctors to submit a letter stating they have been selected for two years to join the O&G training in the UK via RCOG. We are able to issue such letter if necessary on an individual request. If you need this document, please e-mail MTI with following details: full name, country you are coming from, name and address of the Trust you are joining in the UK, estimated start date. You should receive the letter within 5-7 working days.

The MTI unit is extremely busy and unable to answer all of the individual queries regarding application and assessment. However, we will make sure to contact the candidates when necessary and to provide all of the needed information. After submitting your application and making sure it is complete you should wait for us to contact you. You will not receive a confirmation of a receipt of your application. If your application is complete and you are eligible, your application will be taken forward to the Assessment Panel in January following your application. You will be contacted about the outcome of the assessment only if you are shortlisted for the interview stage of the process.

After your successful application is matched with a UK hospital, you will be informed. At this point you will be provisionally matched and we will put you in touch with the hospital. Depending on the hospital’s preference, you may be asked to schedule an online interview with them. It is yours and hospital's responsibility to undertake this process and the MTI office does not get involved in this part of the process. We will wait for the hospital to let us know whether they are happy to proceed with offering you a post. Should you be successful, we will send you an e-mail with next steps you need to follow. Should the hospital reject your application, we will try our best to allocate you to another hospital, if vacancies are still available at that time.

Later in the process, we will assist you with the GMC application and make sure your application for the Certificate of Sponsorship for your visa is processed as soon as possible, depending on when we collect all of the paperwork from your hospital.
The RCOG MTI will not reply to individual queries unless they are not answered on our website. Please read all of the instructions available on different sections of this website as well as the instructions we send you very carefully.

Trusts offering placements for MTI doctors have to ensure that there is spare training capacity locally before applying for an MTI trainee to be placed in their units. Only posts with sufficient educational potential will be considered by the MTI scheme as suitable. Some posts (e.g. speciality doctor posts) are not considered suitable for the MTI scheme. Trusts have to apply to the RCOG for MTI trainees with details of suitable posts. Trainees are placed in order of their ranking in the selection process.

Candidates for the MTI scheme should not try to directly contact trusts in order to obtain employment. Candidates found to be directly contacting trusts for employment will be disqualified from the process and will not be placed.

If for any reasons you wish to withdraw your MTI application/are unable to join the MTI scheme please email  as soon as possible. We need to know in order to update our records and fill all of the posts that are being offered.

We appreciate that it is very stressful not to hear from us for a long time. Please be assured that we will contact you as soon as it is feasible and you will be provided with all of the necessary information in time. We kindly ask you to be patient even if you have not been contacted for a long time – we are working on it.

We will contact those shortlisted but not successfully-placed in the scheme in mid-October to advise they have not been successful in this round. If they still meet all the eligibility criteria for the scheme they are welcome to reapply for the following year.

Please read the FAQs for doctors: stages of the MTI process which explains in more detail what you should do in different stages of the MTI process. We invite you to revisit this page whilst going through the MTI process.

The Academy's point of reference is the World Bank's income countries, with those classed as low income (LI) and lower-income (LMI) countries given high priority status. Read more here:

While in the UK

In order to set up your e-portfolio as an MTI, you must either be a UK Associate Member or register join the Trainees Register. For any queries please contact .

We understand that relocating to a different country and working under a different system can be stressful. Please allow yourself the first few weeks/months to adapt. However, if you feel that you struggle for a long period of time and it does not seem to change, please visit our page which outlines what the RCOG can do to support you and what steps you should follow before you write to us.

Should you wish to resign from the MTI post, please let us know as soon as possible and we will process the necessary documentation. Please do not leave your post without notifying the RCOG.

The MTI scheme matches trainees with trusts that have offered training placements under the scheme. It is intended that trainees stay in the same trust for the entire 2 years of the placement. Occasionally, the trainee may move to another hospital within the same deanery. Such a move will be agreed by the trust and the deanery and communicated to the RCOG, AoMRC and GMC.

In rare circumstances, the trainee may decide to resign the MTI placement in order to return to their country of origin for personal or professional reasons. While this is regrettable, we recognise that this may be due to circumstances beyond your control.

However, moving from the MTI placement to another job in the UK during the 2 years of the placement is strongly discouraged. The MTI scheme is designed to provide overseas doctors with structured training in the UK, which may not be provided by a non-training post.

Although MTI trainees do not contribute financially to the scheme, individual hospitals have to pay a placement fee (currently £3000/ placement) to the RCOG for each trainee that is allocated to them, which helps to cover the cost of administering the scheme.

If a trainee resigns from the MTI scheme to take up alternative employment in the UK, the employing trust may choose to recover the costs of the placement from the trainee.

Yes, you may register for an ATSM provided you have passed Part 3 of the MRCOG. Your ATSM Director will be able to advise whether there are sufficient ATSM training opportunities within your deanery. ST trainees must complete ATSMs to gain their CCT and therefore are given priority. However, many Deaneries report additional training capacity.

If you do register for an ATSM, you’ll need to complete the application process and register as a Trainee with the RCOG. If you don’t meet the criteria to register with the RCOG, your deanery  may still offer training and provide a certificate of equivalent training for your records when you complete the ATSM. However, this certificate doesn’t count towards CCT or CESR(CP).

Stages of the MTI process

If you submitted a completed application for the MTI within the deadline, it will be forwarded to the Assessment Panel. The Assessment usually takes place in January (however the RCOG reserves the right to change the date of assessment should it be necessary).

Collecting the results and finalising the list of successful MTI candidates can be a lengthy process, so please note that there is no fixed date by which you should hear from us. The selected applicants will be ranked according to the assessment scores and put on the placement list.

We will only be able to inform you about the outcome when we have an available post that we can offer you.

We strive to contact all of the successful candidates early enough so that they are ready to start work between July to September (or later if specified by the hospital or the UKVI and visa availability).

If you do not receive any communication from the MTI office before the end of September you should consider your application unsuccessful and consider applying next year.

If you know someone who applied for the MTI has been contacted by us earlier, it does not necessarily mean you were unsuccessful. We will be in touch with you at the most appropriate and feasible time.

We accept placement post requests from hospitals from January through to September. As these posts come through they will be reviewed and then matched with an MTI applicant in order of ranking. Once we have provisionally matched the post with an MTI applicant, we send the application pack to the hospital for review. The hospital can then either choose to offer a placement post subject to performance at interview (conditional offer) or offer a placement post outright (unconditional offer).

Therefore, if you have not heard from us, it may be that your application has been sent to a hospital, and we are awaiting their decision.

A delay may also occur if a hospital decided to withdraw the placement offer for any reason. In this case, we will attempt to place you somewhere else.

We ask you to be patient, and please be reassured that you will be informed as soon as we have further information.

Once a hospital advises they would like to offer a conditional placement, RCOG MTI office will email the applicant copying in the hospital consultant and HR contact, to advise you accordingly. You should respond to this email if you wish to accept the conditional offer and liaise directly with the hospital to set up the date/time for interview.

Interviews should take place within 10 working days and the hospital will then advise MTI Office as to the outcome following interview. If accepted following interview we will send you a formal offer, if you accept this we will then send you the ‘Next Steps’ outlining what you need to do. If the hospital does not offer a post following interview the MTI Office will obtain constructive feedback on your interview performance and share with the MTI applicant within 10 working days of the interview. In this case, we will attempt to place you somewhere else provided the placement deadline has not expired.

If you are matched with a hospital and subsequently receive a placement offer, we would expect you to accept this unless there are serious personal/family/career development reasons not to do so. If this is the case, please contact the MTI Office as soon as possible to discuss your concerns and ensure we can offer this placement to another doctor on the waiting list if appropriate. Please note that if you do not accept an offer and there are not legitimate grounds for this, the RCOG will not be able to offer you another placement under the MTI scheme.

Applicants can only defer the start of their MTI placement where there are extenuating circumstances and the deferral is subject to the agreement of the hospital making the placement offer.

This process is governed by the RCOG MTI Extenuating Circumstances Policy

Please note that if there are not extenuating circumstances and the hospital does not agree to defer the start date, the RCOG will not be able to offer the applicant another placement under the MTI scheme.

If you have any queries contact the RCOG MTI Office 

Once you register with the GMC online and pay the full registration fee, the GMC will send you an email with the list of documents you are required to send. Please copy/scan these documents and send them to us via email to  as a pdf bundle.

One of the documents listed is the Certificate of Sponsorship form (CoS) from an authorised sponsor (RCOG). This document will be issued for you and we will forward this directly to the GMC, copying you into the email. You will then hear from the GMC about next steps within 2 weeks. Please follow all of the GMC’s instructions. Please note that the RCOG CoS is not the Certificate of Sponsorship you will later need for the visa application.

If you have questions regarding GMC registration, please contact the GMC directly. The RCOG is not qualified to offer this advice and does not have access to the forms. GMC registration is the applicant's responsibility.

Once you receive this email from the GMC, you will be invited to schedule an ID check. Please follow the instructions carefully and forward this email to us. If you are unsure about the date you are planning to start work, check with the hospital. For most doctors, this is in the first two weeks of August, but it is not uncommon to start later. Schedule your appointment accordingly. The majority of MTI doctors have their ID checks a few days before/after their start date.

Your next step will be applying for the visa. In order to apply for the visa, you will need a Certificate of Sponsorship (which is not the same CoS that the RCOG issues for the GMC). The visa sponsorship is issued by the Academy of Medical Royal Colleges (AoMRC). Please note that AoMRC have introduced a ticketing system, which means there may be an additional delay in obtaining your CoS. This is a Home Office regulation regarding the limit of CoS issued each month.

In order to receive the Certificate of Sponsorship, the Academy requires specific documentation from the RCOG. These forms are filled by your employer (hospitals and Deaneries). It can take considerable time for the hospitals to complete and return these to the MTI. Please be patient and reassured that we are doing everything we can to speed this process up. We ask you to please refrain from contacting us about the CoS during this time, as we are not able to reply to these queries.

Once we have received all the required documents, we will include you in the CoS email request to the Academy. There is nothing you are required to do at this stage.

Before applying for the Tier 5 visa using the CoS, please check it for any spelling mistakes or errors, and ensure all details match with those in your current passport. If you spot a mistake, please let us know by emailing  and we will request the CoS be amended accordingly. We are not responsible for errors on your visa and we will not be able to help if you submit an incorrect CoS.

Once the CoS is corrected, please use this to apply for the visa using the CoS. For any questions regarding visa application please contact the visa advisor in your country or UKVI. The RCOG is not qualified to give visa advice.

Contact us

Please ensure that you meet all of the criteria as specified on our website. Unfortunately we cannot make any exceptions to this list and so if you do not currently meet the criteria, we would advise that you consider re-applying for the next round.

If you have not found the answer to your question in this list, please email