Medical Training Initiative
Key points
The scheme has closed to new applicants.
The Medical Training Initiative (MTI) scheme provides an entry route for overseas doctors wishing to train and develop their skills in the NHS before returning to their own country, with the aim of improving the quality of healthcare in lower-income countries.
The scheme is administered by the Academy of Medical Royal Colleges who issues certificates of sponsorships for local employers or colleges.
Part of the sponsorship responsibility is shared with NHS trust/boards. Employers must keep details such as the UK addresses of each doctor and submit several forms via an online system. The CoS will not be processed until all paperwork has been completed and no reminders will be sent.
The Academy of Medical Royal Colleges (AoMRC) have announced that the MTI scheme will close to new applicants with effect from noon on 31 March 2026.
Applications (including extension requests) that were already in progress by this deadline and involve a medical royal college will be granted a three-month grace period until 30 June 2026.
All MTI participants currently on the scheme will continue to be supported until the completion of their post; the Academy will continue to sponsor visas and maintain compliance for all current participants until their placement ends.
What is the Medical Training Initiative?
The Medical Training Initiative (MTI) is a scheme that provides an entry route for overseas doctors wishing to train and develop their skills in the NHS before returning to their own country. The scheme allows suitably qualified overseas postgraduate medical specialists to undertake a fixed period of training in the UK, normally within the NHS, before returning to their own healthcare systems.
The overall aim of the scheme is to improve the quality of healthcare in lower-income countries by sharing knowledge and experience, priority is given based on the category of economic standing for each country as defined by the World Bank.
The AoMRC has announced that, effective from noon on the 31st March 2026 that the MTI scheme would cease and new applicants will no longer be accepted.
Applications currently in progress will have until the 30th June 2026 for completion and participants currently employed until the scheme will be supported for the duration of their placement.
How this fits into the points-based system immigration regulations
The Government Authorised Exchange (GAE), formerly known as Tier 5, and is a sub-category of the temporary worker visa route of the Home Office immigration rules. GAE is available to any migrant – not just in healthcare, coming to the UK through approved schemes aimed at sharing knowledge, experience and best practice.
This is a rare exception where GAE schemes may bring across staff from countries on the red or amber list of the Code of Practice, because they return to their home country after the 24-month period. Doctors should return to their home countries where service users and colleagues benefit from the skills and experience, they have obtained in the UK.
The MTI scheme for doctors falls within the temporary worker sub-category of GAE. It covers all schemes and arrangements sponsored or administered by the Academy of Medical Royal Colleges and similar organisations for the training of overseas doctors and dentists. The MTI scheme offers experience and training in the UK and could enable doctors to take Royal College examinations (fellowships), together with a certificate from the postgraduate dean or college certificate attesting to the type and quality of training completed.
Some Royal Colleges do utilise different visa types as part of their overall package of support for training international medical graduates, however employers need to discuss this directly with the College they are working with as its medical staffing will be required to arrange health and care worker visa certificates of sponsorship in-house.
Time limits
Doctors’ participation in the MTI scheme is not intended to lead to settlement in the UK. MTI permits will be granted for a period of training and experience to a maximum of 24 months, after which the individual will be encouraged to return overseas.
How it works in the NHS
The Academy of Medical Royal Colleges (AoMRC) is the national sponsor for those currently employed under the MTI scheme and is responsible for issuing the Certificate of Sponsorship (CoS) for immigration purposes. The Home Office (Visas and Immigration) has authorised the Academy to undertake this role and it is the responsible body for recording, reporting and storing the documentation relating to MTI doctors in accordance with the duties of holding a sponsorship licence. The Academy also acts as a national portal for the MTI and promotes the operation of the scheme. The individual employer cannot provide a CoS to individuals on the MTI scheme.
Any doctor enquiries should be directed to mti@aomrc.org.uk
The role of the employer
The employing organisation must agree there is a role locally for the MTI applicant. They are also responsible for ensuring that the individual doctor meets the requirements of the NHS Employment Standards and Regulation prior to starting employment, including ensuring the individual has the relevant right to work documentation.
Part of the sponsorship responsibility is shared with NHS trust/boards which keep details such as the UK addresses of each doctor. For the Academy to comply with its responsibilities and maintain its sponsorship license, it requires employers to complete and submit several forms via its online system. If employers do not complete the required forms within the timeframe outlined, the CoS will not be processed until all paperwork has been completed and no reminders will be sent.
What contract should an employer issue?
The MTI contract is essentially a local matter as each post will be individually tailored to suit the needs of the doctor concerned, however employers will need to meet UK employment standards including rights to equal treatment, for example levels of pay. There are three main options for employers:
- In cases where the doctor is essentially performing the same duties as a UK training position but under MTI then it is sensible, and pragmatic, to offer pay and terms and conditions in line with these staff.
- The specialty doctor contract provides a model that can be used as an alternative if you are offering something more bespoke (that is, they are not equivalent to CT2/ST2 etc).
- The third alternative is a trust contract entirely unrelated to the existing models. For example, some doctors may come here under overseas government sponsorship (that is, paid by their home nation via the employer) and national terms and conditions might not be applicable.
MTI for dentists
The Home Office has agreed that the Faculty of Dental Surgery (FDS) of the Royal College of Surgeons (England) should administer the temporary worker visa route MTI scheme for dentistry. The Faculty accommodates the National Advice Centre for Postgraduate Dental Education (NACPDE) which is funded to provide overseas dentists with information and advice on postgraduate dental education and training in the UK. NACPDE is responsible for running the scheme day to day. For further information, please contact nacpde@rcseng.ac.uk.
Further information
We have produced some FAQs with the Academy relating to the MTI scheme.
For advice regarding a specific placement, please contact the relevant medical Royal College or Dental Faculty. Once a post is approved, employers can liaise with the Academy.
