Introduction
The GMC’s 2025 workforce report found that more than two thirds of doctors joining the UK register in 2024 qualified outside the UK, and international graduates now make up 42% of licensed doctors. Securing a place on a speciality training programme in the UK is considered a milestone.
The NHS offers international medical graduates (IMGs) the opportunity to apply to these speciality training programmes so they can train in a specific speciality and work towards becoming a CCT-qualified consultant. For 2027 recruitment, the Medical Training (Prioritisation) Act 2026 means UK graduates and other priority applicants are shortlisted and offered posts first, so IMGs without priority status face much tougher odds. NHS training facilities are globally recognised for their prestige, so it is no shock that competing for a spot can be quite a daunting prospect.
To help ease any concerns and build your confidence, you’ll find below our comprehensive guide on how to secure a place on speciality training in the UK.
Key Points
- To join the GMC register with a licence to practise you need an acceptable primary medical qualification, evidence of your knowledge and skills (for example PLAB or an acceptable postgraduate qualification), evidence of your English language skills and, on the PLAB route, evidence of a completed internship.
- Most IMGs show their knowledge and skills either by passing PLAB or by holding a postgraduate qualification on the GMC’s acceptable list, such as the full MRCP(UK) or MRCS; sponsorship and specialist register routes also exist.
- UK specialty training covers more than 60 specialties; the list below shows those most IMGs ask about. Understand key differences between run-through and uncoupled specialities.
- The application process: Check your eligibility and understand the application process at each step, with commitment to speciality and self-assessment.
- All applications must be submitted through the Oriel portal.
- Interviews generally take place online through Microsoft Teams or Qpercom Recruit, so ensure you have a working microphone, camera & internet connection.
- Interviews are graded with a 1-5 point structure, with 5 being the highest score.
- Medset 12 CPD-accredited courses allow you to demonstrate knowledge and skill development in training and management.
- Learn what speciality training in the UK may be easiest, and whether it is necessary to sit the PLAB exam.
Getting GMC Registered
For IMGs wanting to secure a UK medical training pathway, you must become General Medical Council (GMC) registered. It is a necessity that all doctors in the UK register with the GMC to practice medicine.
To get on the GMC register, evidence that you are capable of practising medicine must be submitted.
Evidence should contain:
- Proof of internship
- Evidence of knowledge and skills
- Your Primary Medical Qualification (PMQ).
To showcase your development of knowledge and skills, the Professional and Linguistic Assessments Board (PLAB) is an effective option when choosing speciality training in the UK, especially if you want to secure a spot on the ST1/CT1 level. You can book PLAB 1 once you have an acceptable primary medical qualification (or have passed your final exams) and the GMC has verified your English language evidence (usually IELTS or OET); PLAB itself is not evidence of English. You can sit PLAB before completing an internship, but full GMC registration through the PLAB route requires evidence of an acceptable internship.
Holding a full postgraduate qualification on the GMC’s acceptable list, such as MRCP(UK) or MRCS, can be used for GMC registration; passing only part of an exam is not enough.
Once GMC registration is secured, many IMGs consolidate their knowledge further through a service job. Whilst not counting as part of your training, these positions allow you to understand the processes of the NHS, with hands-on experience that you can use to make your training application stand out.
Doctor training pathways in the UK
In the UK, medical training pathways are structured systems designed to assess competency and develop those who have graduated from medical school into fully qualified specialists. IMGs follow the same doctor training pathways in the UK, but can enter at different points depending on previously achieved qualifications and the GMC registration route.
PLAB Pathway
If you used the PLAB pathway to get registered, you can then apply for CT1/ST1-level service roles. Titles for training roles include Senior House Officer (SHO) or junior doctor in training.
MRCP Pathway
If you went down the MRCP pathway to registration, your non-training job can start at the ST3+ level. As a middle-grade doctor, positions include Clinical Fellow, a specialist registrar or a trust grade doctor.
CCT sign-off
For core or ST1 posts, doctors without a UK foundation certificate usually need a Certificate of Readiness to Enter Specialty Training (CREST) signed by a consultant; for higher physician posts at ST3/ST4 you need the Alternative Certificate to Enter Higher Physician Specialty Training. The CCT is awarded only when you finish specialty training.
If you choose the PLAB doctor training pathway, you will get a Certificate of Readiness to Enter Speciality Training (CREST). If you took the MRCP pathway, then you will receive an alternate certificate to enter higher physician speciality training.
For both to be signed off, you must complete the competencies on each form.
For your application, it is important to meet the experience requirements for medicine training before the deadline. Whilst many IMGs may have had medical posts overseas, it won’t score as highly despite being paired with references, because it is not an NHS establishment.
Choosing a speciality
There are two types of medical training programmes in the UK: run-through, where you apply once at the start, progressing continually to CCT without reapplying. The second type of speciality training is uncoupled, where you complete core training and then apply again for higher speciality training.
Types of NHS Medical Specialities in the UK
Speciality training in the UK with the NHS allows IMGs to choose from twenty-nine specialities:
- Anaesthetics
- Allergy
- Audiovestibular Medicine
- Cardiology
- Cardiothoracic
- Clinical genetics
- Clinical Oncology
- Clinical Neurophysiology
- Clinical Pharmacology and Therapeutics
- Core Surgical Training (CST)
- Dermatology
- Emergency Medicine
- Endocrinology and diabetes
- Gastroenterology
- Genitourinary Medicine
- General surgery
- Geriatric medicine
- Histopathology
- Immunology
- Internal Medicine Training (IMT)
- Infectious diseases
- Metabolic Medicine
- Neurology
- Obs and Gynae
- Ophthalmology (OST)
- Palliative medicine
- Paediatrics
- Pharmaceutical medicine
- Plastic Surgery
- Public Health
- Radiology
- Rehabilitation medicine
- Renal medicine
- Rheumatology
- Respiratory
- Sport and exercise medicine
- Stroke medicine
- Trauma and Orthopaedics
- Tropical medicine
- Urology
- Vascular Surgery
Beginning the application process
Once you have decided on your speciality medical training in the UK, you are ready to begin the application process.
Sections for the Higher Speciality Training (HST) application are:
- Personal
- Equality and diversity
- Employment History
- Training history and previous training details
- References
- Fitness to practice
- Declarations
- Competence and eligibility
- Evidence
- Supporting
- Self assessment
Check eligibility
If you wish to enter a higher level of training, then the MRCP is an essential doctor training pathway in the UK. The MRCP is a 3-part exam which you are required to complete during your time in speciality training. The final part of this is known as the Practical Assessment of Clinical Examination Skills (PACES).
Once completed, you will be ready to move on to ST3 level training. Higher physician training (ST3/ST4) needs MRCP(UK) Part 1 at application and the full diploma by the offer date, plus evidence of core medical competences such as the Alternative Certificate; MRCP alone does not guarantee direct entry.
If you have come through the PLAB route to GMC, it may be best to start at the ST1/CT1 level and work your way through the training. It is important to note that when applying for speciality medicine training, your registration at the GMC needs to be up-to-date. Whilst full registration does not expire, it must be revalidated every 5 years to demonstrate ongoing fitness to practice.
NOTE* Candidates must be able to demonstrate strong English language skills. Full GMC registration for an IMG should be sufficient proof.
Self-Assessment
The self-assessment section is your opportunity to showcase your skills and demonstrate your work experience, qualifications, and commitment to your chosen speciality. The maximum self-assessment score depends on the specialty, so check your own specialty’s 2027 scoring guide.
Don’t over-aim: Only include qualifications and work completed at the time of the application.
How to apply
Candidates apply to HST through the Oriel system. This is an online portal specifically designed for those applying to NHS careers.
What to do when you have submitted the application.
Once submitted, you will receive an email confirming the success of the submission. If you meet the eligibility requirements, then your application will be listed.
In order to be shortlisted, assessors will compare self-assessments and commitment to speciality sections to decide who to invite to the interviews. You can check the progress of your application on the Oriel platform.
Guide to the interview process
Interview invitation dates are set by each specialty and published on its recruitment timeline; book your slot in Oriel as soon as invitations open. Once invited, book your slot through the Oriel portal.
It is vital to book your slot in Oriel as soon as possible, as spaces fill up very quickly.
The interview
To prepare for the speciality interview, you should familiarise yourself with the framework of the questions. Many NHS interviews take place online, so ensure you have a working microphone, camera, and reliable internet connection, as well as a distraction-free environment.
The interview will usually take place on Microsoft Teams or Qpercom Recruit, but this can depend on the medical speciality. Most interviews go through a multi-station structure in which you will be asked a series of questions. In some circumstances, you will have to give a presentation.
At Medset, we focus on using the right answer frameworks to help IMGs pass their speciality interviews. Be sure to view our range of courses for the best chance at success.
How is the speciality interview in the UK assessed?
Medical training interviews in the UK award up to 5 points in each assessment area.
5 is the best score, but 3 or above is deemed satisfactory. From the scored area, your appointability status will be calculated to determine whether you will be considered for an offer.
The intention of the interview is for candidates to show consistent competence throughout all assessment areas. Appointability is awarded based on two categories: your individual interview score and the raw interview score.
Raw Interview Score
Sometimes referred to as the RIS, the raw interview score is the total of all scores awarded to you during the interview, but before any weighting is applied. In Internal Medicine Training, for example, you receive 14 marks of 1 to 5, so your raw interview score is between 14 and 70; other specialties set their own rules.
Individual Interview Score
The interviewer assigns a numerical value to each assessment area station and the candidate’s overall performance. These values are then evaluated objectively against a set of criteria and combined to determine a candidate’s suitability for a training post.
Appointability requirements
In most cases, to be considered appointable, the following must be met as a result of the interview process:
- All interview scores should be above 1 out of 5
- No more than 2 of your interview scores can be 2 out of 5
- Your RIS must be 42 or above
Please note, this is a general overview and can depend on specialist medical training in the UK.
The interviews are scored 1-5, with 5 being the highest. Candidates should aim to score at least a 3 in their interview to demonstrate consistent knowledge across all areas. Please be aware that while some candidates may be considered appointable, it does not guarantee an offer.
Stand out with a Medset course
Strengthen your application by completing a professional development course from Medset. Some specialities score a teaching course in the self-assessment and others do not, so check our points guide for your speciality. These courses are designed to develop your confidence and skills not only as a medical professional but as a leader.
Train the Trainers course
Medset’s leading Train the Trainer course is ideal for doctors and healthcare professionals wanting to extend their knowledge and develop their skills.
Written by medical professionals for medical professionals, this 12-point CPD-accredited course helps you learn to teach, assess and inspire using frameworks aligned with GMC Good Medical Practice and NHS Training Realities. Recognised for portfolios, interviews, applications and CCT.
Choose flexible self-paced online learning, or live tutor-led sessions for interactive teaching and feedback.
Medical leadership and management course
Our medical leadership and management course equips healthcare professionals and doctors with the essential skills to lead teams, deliver change, and improve NHS services.
Designed and delivered by experienced clinical leaders, this 12-point CPD-accredited course combines theory with real-world case studies for immediate clinical relevance. You’ll cover clinical leadership, communication, quality improvement and change management aligned with GMC Good Medical Practice and NHS leadership frameworks.
Our course prepares you for the next step in your medical speciality training in the UK, with portfolio-ready evidence and flexible online study with reflective exercises and CPD certification.
We have a range of resources to support IMG medicine in speciality training in the UK. From guides on specific speciality training to tips for scoring 100% on your ST3 interview, a Medset course prepares you for the next stage in your career.
Frequently Asked Questions
What is the easiest speciality for an IMG to study?
Whilst medical training in the UK is challenging, there are certain specialities for IMGs to enter. These tend to be Internal Medicine, Paediatrics, and General Practice. By utilising the resources available at Medset, IMGs can feel supported when choosing a speciality medical training in the UK.
Do I need PLAB if I already have MRCP/MRCS?
Not if you hold the full MRCP(UK) or MRCS (or another qualification on the GMC’s acceptable list), normally awarded within the last three years; passing only some parts does not replace PLAB.
