Five steps for IMGs preparing to work in the NHS

A quick guide for international medical graduates (IMGs) joining the NHS in the UK.

More than half of the 23,838 doctors who joined the National Health Service (NHS) in 2022 were international medical graduates (IMGs), making it one of the most diverse workforces around - with more than 200 different nationalities.

Doctors come to the UK for many reasons. You might want to:

  • increase your clinical experience by treating a broad mix of patients and conditions
  • work alongside respected specialists
  • get involved in medical research
  • make the most of opportunities for training and professional development.

Whatever your motivation, moving to a new job in a new country is an exciting but scary prospect, so it's important to plan carefully to ensure you don't just practice but prosper in the UK.

Your NHS employer should provide an induction programme to help you adapt, but here are five essentials to think about right now.

1. Make sure you're eligible to work in the UK

Visit to check if you qualify for a Health and Care Worker Visa and find out how to apply.

2. Register with the GMC and get a licence to practise

The General Medical Council (GMC) is the medical regulator and maintains the official medical register of doctors eligible to practise in the UK, as well as setting professional standards and investigating concerns.

You must be registered and have a licence from the GMC to legally practise medicine and show you are keeping your skills and knowledge up to date through a process called revalidation.

To apply for full registration and a licence to practise you'll need to provide evidence of your professional skills, experience and the necessary knowledge of English through the International Language Test System or the Occupational English Test.

The GMC's online tool will help you decide how to apply. We've outlined two main routes for IMGs below.

If you're registering from a country outside the European Economic Area (EEA) or Switzerland:

  • apply via the GMC's overseas registration process. This includes taking the two-part Professional and Linguistics Assessments Board (PLAB) test to show you have the necessary knowledge and skills to practise safely and providing evidence of your practical experience after qualification
  • once registered, you'll have to work in an approved practice setting (APS) until you revalidate for the first time.

If you're registering from the EEA or Switzerland and have the relevant European qualification:

  • you don't need to take the PLAB test, provided you meet the GMC's other requirements
  • this application guide sets out how to apply for registration, including the documents you'll need.

Doctors who are starting an approved foundation year one (FY1) training post should apply for provisional GMC registration, which is available to IMGs who meet these criteria.

However, you must apply for full registration once you have successfully completed FY1 training or you won't be able to work as a doctor.

3. Join a medical defence organisation

The GMC requires doctors to have adequate and appropriate indemnity in place. Indemnity provides financial support if a patient makes a clinical negligence claim, ensuring the patient can receive compensation if they have been negligently harmed.

  • If you work in NHS secondary care, the state typically provides indemnity for clinical negligence claims. This also applies for primary care in England and Wales.
  • GPs in Scotland or Northern Ireland must arrange their own indemnity for their day-to-day clinical work.

However, there are important limits to the support provided by state. You can't rely on state-backed indemnity alone for GMC investigations, coroners' inquests or fatal accident inquiries, complaints, disciplinary procedures, or police investigations.

For support in these situations, consider joining a medical defence organisation (MDO) like the MDU. We're the UK's leading mutual MDO - meaning we're owned by and answerable to our members, not a group of shareholders.

Our doctors, lawyers and other experts are on hand if you need support and robust legal representation, but the benefits of membership go much further:

  • a 24-hour helpline to get medico-legal advice from a fellow doctor
  • learning and development resources
  • a range of discounts on products and services
  • advice on dealing with complaints, claims, the GMC and much more.

4. Learn about continuous professional development (CPD)

Whatever job you take as an IMG, the GMC says that "you must keep your professional knowledge and skills up to date".

Continuous professional development (CPD) is the term for the learning activities necessary to maintain your fitness to practise. Updating your portfolio with evidence of CPD should help you do well in your annual appraisals, which are required in order to revalidate every five years.

Your employer should cover the appraisal process in your induction but it's a good idea to review the revalidation resources on the GMC website before you start so you know what to expect.

5. Know how to access support

There's a variety of resources and professional support available to help you look after yourself and make a successful transition to UK practice.

Remember, you don't have to go it alone. It's much better for you and your patients to ask for help when you need it.

More helpful links

Information for overseas doctors - NHS careers

NHS Induction Programme for international Medical Graduates - NHS England

Welcome to UK practice - GMC workshop for IMGs

An introduction to the NHS - NHS England website

This page was correct at publication on 27/06/2024. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.