If you want to employ an overseas doctor

To help employers interested in recruiting overseas doctors into service-level posts, the resources on these pages signpost to relevant information. This is a general guide based on our understanding of the relevant processes; the RCR is not expert in employment and immigration law. Your HR department should be able to advise you further on the implications of recruiting overseas doctors in respect of visas and other relevant issues. Different rules may apply to recruiting overseas doctors into training posts.

NHS Employers has produced a guide to planning successful international recruitment.​The GMC has general information on its website about employers' responsibilities when employing doctors.

Do encourage your overseas doctors to apply for membership of the RCR, which will give them a range of benefits including access to reduced rates for our CPD events, the RCR Learning e-learning hub, the journal, an ePortfolio account if they need it and keep them up to date with developments in the specialty. 

Visas, recruitment and advertising

  1. Doctors from outside the UK and EEA need a visa to work in the UK.
  2. For a locum or specialty doctor post, or similar, this will be a Tier 2 (General) visa for a skilled worker.
  3. A Tier 2 (General) visa requires the migrant doctor to have an employer sponsor. Your organisation will need to be an approved sponsor for the purpose of sponsoring the overseas doctor for a Tier 2 visa. You HR department will be able to advise you.
  4. If you are recruiting to anything other than a consultant post (but see point 9 if you are recruiting in Scotland) it is subject to the Resident Labour Market Test (RLMT). In very general terms, this means that the post must have been appropriately advertised and not capable of appointment with a UK/EEA doctor.  If this can’t be demonstrated to the required standard, a Tier 2 (General) visa will not be granted.
  5. Section 28 of the Home Office Tiers 2 and 5: guidance for sponsors sets out how to carry out the RLMT, including the advertising methods and rules.  Unless an exemption applies, all jobs must be advertised using two of the methods set out in that section of the advice.  The advice also contains other important information about sponsoring for visas.
  6. Visa applications can be rejected if important information is incorrectly entered which will lead to a delay in the doctor taking up the post. NHS Employers' Tier 2 advice sets out information about sponsoring for Tier 2 (General) visas, including a guide to Immigration and the Tier 2 recruitment process and quick guides
  7. If you are considering converting vacant locum consultant posts to anything else (such as a specialty doctor post) you should bear in mind the implications of the RLMT.
  8. However, clinical radiology consultants are on the Migration Advisory Committee’s Shortage Occupation List (SOL) for the UK and for Scotland. This means that radiologists from outside the UK and EEA can be offered a consultant radiologist post in any of the four countries, and consequently the appropriate visa, without the employer going through the process required under the RLMT.
  9. There is a separate SOL for Scotland. This includes not only consultants in clinical radiology, but also non-consultant, non-training medical staff posts and ST4 to ST7 trainees. These radiology posts can also be filled without the RLMT, but only if they are based in Scotland.  

 GMC registration

  1. Obtaining GMC registration can take some time.  We advise overseas doctors to start whatever process they are going to use at the earliest opportunity.  If the overseas doctor to whom you offer a job does not have GMC registration, it may take some months to achieve, depending on their particular circumstances.
  1. Routes to GMC Registration are set by the GMC.  The RCR has no power to vary these.
  1. There are different types of GMC registration depending on what kind of job the doctor is going to work in.
  1. Full registration on the medical register with a licence to practise is needed to work as a specialty doctor, locum consultant, in fellowship-type posts, and so on. Full GMC registration does not allow a doctor to take up a substantive (permanent) NHS consultant post. 
  1. Specialist registration with a licence to practise is needed to work as a substantive (permanent) NHS consultant.
  1. EEA and Swiss citizens, with acceptable EEA primary and specialist qualifications, may be able to apply direct to the GMC for registration on the medical and specialist registers as the GMC may recognise their qualifications automatically under European law (“automatic mutual recognition”) - GMC registration for EEA doctors.   (This may change in the future, depending on the implications of Brexit).
  1. For those who cannot register under EEA law, other options are set out on Routes to GMC Registration
  1. Sponsorship by the RCR is an exceptional route to GMC full registration and is part of our commitment to facilitate philanthropic international activity across both our faculties.  It is only potentially possible for those taking up a supervised training post for a maximum of two years, before returning to their home country.  It cannot be used to employ consultants, specialty doctors, or similar.

Job planning and development for overseas doctors

  1. The RCR has issued advice about consultant job planning which can be found on our page guide to job planning in clinical radiology.
  1. You can appoint a suitable overseas trained doctor to a locum consultant post (or anything other than a substantive consultant post) if they have full GMC registration.
  1. If you can help them prepare for their specialist registration application (CESR) while they are with you then this may turn into a longer-term benefit.  They may be offered a substantive consultant post pending their successful application for specialist registration (recognising of course that a successful application nor the length of time the applicaiotn might take can’t be guaranteed).
  1. Converting a vacant consultant post to a specialty doctor post may have benefits in expanding the pool of overseas doctors who have the skills and competence to contribute to the service at that grade, while giving them the opportunity in their job plan to prepare for an application for specialist registration and consultant practice.
  1. Specialty doctors should have the equivalent of at least four years of training, at least two of which must be in a relevant specialty, or the equivalent. See our RCR guidance for appointments.
  1. NHS employers and the BMA have issued  a UK guide to job planning for specialty doctors and associate specialists
  1. The AoMRC has issued a joint document about SAS doctor development
  1. NACT UK has issued advice about supporting “non-consultant, non training” doctors supporting locally employed doctors across the UK.  This has useful points to consider when structuring a job description for a specialty doctor or a similar post.
  1. To help an overseas doctor prepare for a CESR application it is useful to support them in consolidating areas of UK training and practice that might not be covered in the same way overseas. Each CESR application is individual to the applicant.  However, generally we find that is it useful to consider consolidating evidence in these areas:
  • MDT meetings and associated activity
  • Formal appraisal
  • Clinical audit and/or quality improvement projects, with evidence as to how and whether change was implemented
  • Active participation in other safety and quality activity such as discrepancy, clinical governance, morbidity and mortality etc.
  • Double-reporting or other experience in curriculum areas that may not have been covered in the doctor’s recent training or experience.