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Advantages of working in the UK Welcome to the start of our blog series. This series is going to guide you through the process of how to relocate to the UK and work within the NHS - providing you with the important details and the opportunity to ask questions and receive support. Our first post is aimed at outlining the fundamental advantages of an International Medical Graduate relocating to the UK and working within the NHS. Did you know that the NHS is the largest employer in the UK and Europe? It is one of the largest healthcare systems in the world as it employs over 1.5 million people to hundreds of diverse roles. However, currently there is a shortage of Doctor’s in the UK and therefore the system is continually looking to employ more clinicians. As an international doctor, no matter what speciality and area of the NHS you join, you will become part of a skilled, devoted and passionate team of people whose priority is to provide the best healthcare and treatment to their patients. Rewarding work All doctors who have worked hard to master the science and the art of modern clinical practice, create a tremendously positive impact on their patient’s lives every single day. As a healthcare professional, IMG’s will be able to satisfy their passion to help others whilst simultaneously earning a living. For most people, there are generally two common themes behind their reason for becoming a doctor. The first theme is their ability to make a positive difference to a patient’s life. Whether a patient needs pain relief or a life-threatening operation, for a doctor, to be the person who alleviates their pain or change their life is extremely fulfilling. The second theme behind a doctor’s chosen career path is their ability to develop relationships with their patients. A doctor-patient relationship can last anywhere from a couple of weeks to several decades, but nevertheless, the personal element of the relationship allows a doctor to respond genuinely and subjectively to their patients. This allows the doctor-patient relationship to develop into a genuine connection rather than the doctor simply providing a service. Training One of the principal reasons that people decide to leave their job is due to the lack of opportunities their employer offers and they yearn for a chance to gain new skills and knowledge. For the NHS, it is fundamental for their system to provide their employees with the opportunity to advance their skills and develop their careers. For all levels and specialities within the NHS, we believe that the NHS in conjunction with the Royal Medical Colleges provide some of the best medical training programs in the world. Job Stability Another advantage of being a doctor in the UK is job stability. Whilst there are people and sickness within the world doctors will always be needed. There are over 250,000 doctors working for the NHS, with over 70,000 of those receiving their primary medical qualification from abroad, and there is a continuous call for more IMG's to come and work in the UK. Furthermore, most hospitals and healthcare centres in the UK are open 24/7 which means that all healthcare professionals will always have full-time hours. But as hospitals are demanding institutions, most employees are offered overtime because of the high demand of patient’s needs. 4. Income  Healthcare professional’s salaries differ dependent on the doctor’s experience, speciality and setting. However, most doctors enjoy above-average earnings and if you are a speciality doctor you will earn a basic salary of £37,923 to £70,718. In addition to your basic salary there is a potential to earn additional income. This can be done via: Additional Programmed Activities (PA’s) Bank locums within your hospital Agency locums in surrounding areas Private work Pension and Benefits The NHS offers their employees outstanding pension packages and is one of the most generous and comprehensive schemes available in the UK. An NHS pension includes life assurance benefits, ill health benefits and voluntary early retirement benefits and a full range of other benefits. Furthermore, all NHS employees are entitled to a minimum of 27 days annual leave, which will increase to 29 days after 5 years and 33 days after 10 years’ service, plus 8 days public holidays. However, it is important to note that entitlement to Annual Leave will be determined by each individual NHS Trust. Moreover, the NHS pension scheme is one of the most generous and comprehensive schemes available in the UK. Membership of the scheme is automatic when you join the NHS and as part of the scheme, the NHS pay a contribution equal up to 14.3% of your salary towards the cost of your pension. UK lifestyle Moving to the UK can offer a life of history and culture and society full of diversity. The UK is a constitutional monarchy with a parliamentary democracy. The monarch is Queen Elizabeth II, who has reigned since 1952, which makes her the longest-serving current head of state. The UK is made up of England, Scotland, Wales and Northern Ireland. The UK’s capital and largest city is London and other major cities in the UK include Manchester, Birmingham, Leeds, Edinburgh, Liverpool, Glasgow, Cardiff and Belfast. Despite the UK being geographically small, it is extremely influential in world trade and politics. Not only is the UK influential in the economy, it possesses beautiful architecture and is well-known for its music, films, literature and football. Britain is a vastly ethnically diverse society with rising numbers of people who identify themselves as an ethnic minority. With over 1.5 million people being from an Indian or Asian group who are all spread across the entire UK. Furthermore, 26% of the NHS workforce are international Doctors and 11% European Doctors. Although it is difficult to count the number of mosques in the UK, as it is any other place of worship, research has identified over 2,000 mosques across the whole of the UK. In addition, specialist food suppliers are also nationally distributed. All major supermarkets and restaurants supply halal meat, including Sainsbury’s, ASDA, Zizzi and Nando’s. In addition, we recognise that relocation to a different country often has a large impact on family life. Therefore, we will be able to offer practical advice on family life including UK schools for your children and language classes. Schools The majority of schools in the UK are owned by the state, completely free to attend, and follow a National Curriculum. Children who are aged five to eleven will attend primary school before moving onto secondary school. Because of the decentralisation process in the UK, the schooling system can vary between different regions. Nevertheless, education for all children is compulsory for children aged five to sixteen and the school leaving age is eighteen, however the last two years are optional. The school year typically runs from the beginning of September to the end of July. Language English is the most widely used language across the world and has a large vocabulary with nearly half a million words. This is resultant of the various groups of people, nationalities and cultures that use the language. For international Doctors relocating to the UK they must first have passed the International English Language Testing System (IELTS). The IELTS is required by the UK Home Office for each category of visa applications. The test will assess all your English skills – reading, writing, listening and speaking designed to reflect how you will use English at work in your new life. However, for your family members who will not have to take the IELTS, but will want to improve their English there are a couple of different learning options for them. First, there are hundreds of language centres that are members of Accreditation UK. Or second, there are several online courses, where an individual can improve their English language skills from the comfort of their own home. Overall, there are endless advantages to relocating to the UK and working within the NHS. If you have made the decision to do so, send your CV to apply@bdiresourcing.com - and one of our Specialist Advisers will be happy to guide you. Come and say hello! Join our Facebook Group IMG Advisor. Here, you will have the opportunity to ask relocation questions, receive professional support and meet other IMG's!

Hello IMG friends! This blog post is going to provide you with an outline of the process for an international doctor who wants to relocate to the UK. Moving to the UK has many advantages, as explored in our previous blog post. However, we fully understand that the process can be complex and confusing. Therefore, this article aims to simplify the entire process and will provide a step by step guidance for an IMG who wants to relocate. You should note that the process order will differ dependent on your personal circumstance, so get in touch with one of our Specialist Recruitment Consultants at apply@bdiresourcing.com and they will be able to advise you on the best pathway to take. ---------------------------------------------------------------------------------------------------------------- Generally, below are the following steps that an IMG will have to take in order to come and work in the UK: English Language Qualification - If you are relocating from a country where English is not the native language, the UK’s General Medical Council require you to sit an English Language test. Typically Doctors take IELTS, however recently the GMC announced they would also accept the OET examination. Postgraduate Qualification – This qualification must be recognised by the GMC. To find out if you have an approved GMC postgraduate qualification contact us at apply@bdiresourcing.com, as again there are various routes to take depending on your situation. If your qualification is not recognised you will then be required to take the Professional and Linguistics Advisory Board UK (PLAB) Part 1 and 2 exams. This exam will test your English knowledge in a medical context. But for European doctors if you qualified in a European institution then your postgraduate qualification will automatically be recognised by the GMC and you will not be required to take PLAB. Job Search – For many Doctors once they have received their English language and postgraduate qualification the job search begins. Once you are at this stage get in touch with us as we will be able to pair you with a Specialist Recruitment Consultant who will be able to provide you with exclusive roles and then organise interviews for you. GMC Registration Process – Once you have an English language and post graduate qualification you will be eligible to register with the GMC for a license to practice. At this stage visit the GMC’s website and locate all the required documentation they require, then you can begin your application process and upon submitting you will be required to pay a fee. Job Offer – After you have been offered a position you can apply for a Visa to work in the UK and organise an ID check with the GMC. Relocation – When an ID check date has been confirmed, you can begin booking flights, organising accommodation and schools if you have children – all of which we can assist you on. ---------------------------------------------------------------------------------------------------------------- English Language Qualification IELTS From our experience, we believe the first step that should be taken is to ensure that you have English language testing which is approved by the GMC. The most popular language exam IMG’s tend to take is the International English Language Testing System (IELTS). The exam covers the four key language skills in general English: Listening, Speaking, Reading and Writing. Doctors must achieve an overall score of 7.5 (with a score no less than 7.0 in each section of the test). Further information on IELTS can be found on their website at: https://www.ielts.org/ OET On the 8th February 2018 the GMC announced that they would also accept the Occupational English Test (OET) as an alternative test to prove your English language skills. OET recognise that limited language proficiency is an obstacle to effective communication which affects the quality of care. Thus, OET is designed to replicate the critical tasks of the healthcare workplace setting and the test measures a Doctor’s abilities through the skills of listening, reading, writing and speaking. The score required is four B’s and the scores must be achieved at the same exam sitting. Currently we are seeing many doctors who are now attempting OET as they have struggled to reach the required scores within IELTS; however it is too early for us to give a definitive answer as to the pass rate for OET in comparison to IELTS. Nevertheless, we will be collating this information as we go along and we will then be able to advise which test is better once we have the data. It is also important to note that the OET exam is significantly more expensive than IELTS; it is limited in the number of global test centres and the frequency of exams available. Further information on the OET exam can be found here: https://www.occupationalenglishtest.org/ ---------------------------------------------------------------------------------------------------------------- Recognised Postgraduate Qualifications The next stage of the process is to ensure that you hold a GMC approved postgraduate qualification. If you hold one of the following qualifications and it has been obtained in the last three years, then it is important to note that you will not be required to sit the PLAB exams, but you will need to have an approved IELTS score. However, if your postgraduate qualification is on the list but it was obtained more than three years ago, then you will be required to submit additional evidence to the GMC, which demonstrates that the level of practice you have delivered has continued to be in line with the associated qualification. As previously mentioned, if you are unsure as to whether your qualification is recognised then do not hesitate to get in touch with us. A list of GMC approved postgraduate qualifications can be found here: https://goo.gl/jZiiRd PLAB If you do not have a recognised GMC postgraduate qualification then you will have to sit the PLAB exam. PLAB is an English language test that is focused on practicing English in a medical setting. The test assesses your ability, as a doctor, to work safely as a clinician in a UK NHS hospital. This certificate is broken into 2 exams: PLAB Part 1 is a 3 hour long exam with a paper containing 200 single best answer (SBA) questions PLAB Part 2 is a 14-station objective structured clinical exam (OSCE) Before sitting the PLAB exams you must already have successfully completed your IELTS exam, but please do not assume that because you have passed the IELTS, you will pass the PLAB. This test is harder and will more than likely require some study - there are a number of independent companies that can assist you in preparation for the PLAB exams, as well as study resources which can be purchased online. Please speak to your Recruitment Consultant for more information. ---------------------------------------------------------------------------------------------------------------- Bespoke Job Searches Although you will not be able to begin employment until you have received your licence to practice from the GMC, once you have completed your IELTS and PLAB exams (if applicable) we will then be in a position to start the job search and begin to arrange interviews for you with our clients. Many of our clients will be happy to interview and offer a position after a telephone and/or Skype interview – which means we are often able to secure an offer of employment without the need for a face to face interview and you needing to travel to the UK. BDI offer a bespoke job search so you do not have to. Part of this process for us includes: Speaking directly to Lead Consultants, Clinical Directors and Department Managers to ensure that your CV is reviewed directly by a clinician. This is because often direct applications are often disregarded by an administrator before reaching the potential employer. Provide exclusive roles: we often have access to jobs which are not actively advertised. Detailed understanding of your specialty: Our Specialist Recruitment Consultants are all trained to be knowledgeable in a wide range of niche specialties. For us it is important to know what your research interests and sub-specialties are to locate the perfect position for you to continue your professional development. We will also negotiate your salary with our client to ensure you receive the best package possible. ---------------------------------------------------------------------------------------------------------------- General Medical Council (GMC) Once you have your English Language Qualification and a hold a recognised postgraduate qualification you will be eligible to register to the GMC to receive a licence to practice which is required by anyone who wishes to practice medicine in the NHS. The GMC are responsible for protecting NHS patients and to improve medical education and practice across the UK, namely by: Deciding which doctors are qualified to work in the UK and oversee all UK medical education and training Set the standards that doctors need to follow and make sure that they continue to meet these standards throughout their careers Take action to prevent a doctor from putting the safety of patients or the public’s confidence in doctors at risk From experience registering with the GMC is the most time consuming and difficult aspect of an IMG relocating to the UK. Many Doctors will fall at this hurdle for many reasons which include; the length of registration time, fees payable and unsuitable documentation. Our first and foremost piece of advice to you as an IMG, who wants to relocate to the UK, is to contact and engage in conversation with the GMC as early as possible. The reason for this is that only they will be able to clarify whether you hold the appropriate postgraduate qualification and the appropriate documents to continue an application with them. Contact details can be found on their website via the following link: https://goo.gl/b2mASx ---------------------------------------------------------------------------------------------------------------- Cost of Registration GMC registration will generally cost £425; however, this could fluctuate dependent on your circumstance. For instance, if you have held a registration in the past and want to reinstate it, the fee is £200. Furthermore, an annual retention fee of £425 is also required and this fee can be paid via a one-off payment, quarterly or monthly. It is important to note that further fees may be applicable and a full list can be found here: https://goo.gl/hoxeHA. ---------------------------------------------------------------------------------------------------------------- European Doctors From experience the GMC registration process is generally easier for European Doctor’s, this is because the only test you are required to take is the IELTS exam. If you qualified in a European institution you will automatically hold a recognised GMC postgraduate qualification and therefore able to apply for Specialist Registration and not required to sit the PLAB exam. Furthermore, if you do not hold a Royal College postgraduate qualification then you will simply have to submit your current qualifications to the GMC as evidence of training. In addition, most European citizens will not require a Visa to work in the UK. ---------------------------------------------------------------------------------------------------------------- Visa Sponsorship After you have accepted your offer of employment the final application to be made is for a Tier 2 Visa. This step is considered simple because the employing hospital will sponsor your application and occasionally pay for it too. The Tier 2 Visa allows you to work in the UK and travel in and out of the country as you please. The Visa is supported for the duration of your employment (via extensions) and is valid whilst you work for the sponsoring organisation (i.e. if you move to work at another hospital then your new employer will need to take over sponsorship of the Visa). Despite the government citing that it takes up to three months to get your Visa, in our experience it is usually obtained by about four weeks from the point of application. With regards to close family members, they can also be granted Visa’s as part of your own application (but please bear in mind that the hospital will not carry the additional cost of this). For full details on applying for a Visa visit: https://goo.gl/RcCgiz ---------------------------------------------------------------------------------------------------------------- Relocation Process Now you have registered with the GMC, accepted a job offer and got your Visa, the next stage of the process is to arrange your travel and relocation to the UK! Once you have booked your flights then we can help arrange your accommodation. In the UK, to lease or buy a property you must view the property in person and then sign for it. Therefore, when you first come to the UK it is likely that you will have to stay in temporary hospital accommodation until you find the perfect accommodation for yourself or your family – often medical staffing will be able to arrange this once you have booked your flights. Again, BDI will be happy to help with this process and we can organise viewings of houses or apartments for you to go and visit in your first couple of weeks being here. Other points to consider once you have made the move are: Setting up a UK bank account Getting a UK mobile number National Insurance number Registering with a GP/Dentist Registering for electricity/gas/tax ---------------------------------------------------------------------------------------------------------------- To summarise, the relocation process to the UK is a complex one and the requirement of each step will differ depending on your personal circumstance, this also means that the steps can be taken in various orders. In addition elements of the process can change from time-to-time but we will be able to keep you up to date on any developments. Therefore we advise that you get in contact with one of our team, at apply@bdiresourcing.com, and we will be able to advise you on the best pathway to take in order to help you move to the UK sooner than you thought. ---------------------------------------------------------------------------------------------------------------- If you are an international doctor who wants to relocate to the UK and work within the NHS send your CV to apply@bdiresourcing.com – and we will be happy to help you. In addition, if you would like support form an online forum of other IMG’s join our Facebook Group IMG Advisor: IMG Advisor

Resident Medical Officer What is a Resident Medical Officer? In some countries, a Resident Medical Officer (RMO) is a junior doctor who is their training. However, in the UK, an RMO is a resident doctor working in a private hospital. In the UK, there are over 250 private hospitals and the RMO’s play an important role. In this article, we provide you with a list of advantages and disadvantages of being an RMO, who works as an RMO, their responsibilities and the pay you can expect to receive.   Advantages and Disadvantages Advantages Disadvantages Introduction to private practice No formal clinical training Membership of private healthcare plan Occasional loneliness and boredom Low level of stress at work Drop in salary Time to study at work No NHS pension scheme Who works as an RMO? In the past decade, there has been a large expansion in independent healthcare and medical research, and so RMO positions have been increasingly linked with research positions within various NHS departments. In this instance, the researcher will receive a basic salary on the condition that they spend at least one day of the week practicing at the private hospital. Recently, due to the shortage of doctors in the UK, private hospitals have started to recruit from overseas as it is a good opportunity for IMGs to get their first job in the UK, then find an NHS position later. For British doctors working as an RMO, they may be waiting for their preferred position in the NHS (such as a specialist register post) and have decided to work as an RMO for six months. Some doctors enjoy working as an RMO whilst they are undertaking research. An RMO position provides the opportunity for free time during and after work – which allows doctors to finish off their research projects and write papers, without the stress and high work levels found in an NHS post. Alternatively, some doctors do RMO doctors as a vocation. They are career RMOs who enjoy the low-stress element of their work and it allows them to enjoy other elements of their life, such as travelling and spending time with family and friends.   The responsibilities of an RMO The duties of an RMO can range from a house officer to a registrar. Typically, there may be a couple of RMO’s on duty in the day but only one RMO will cover the night shift. As an RMO, you will be expected to be on-site during your contracted hours in case of emergency situations, such as cardiac arrest. To apply for an RMO position a certain level of clinical experience and proficiency is expected, advanced life support is essential, and a postgraduate qualification will be desirable.   RMO’s Contract Most contracts will require an RMO to work between 24-48 hours per week with the rest of their time left free to work on their research and personal projects. Some hospitals allow RMO’s to be on duty for a whole week, alternating with 2-3 weeks off. The hospital will allow annual leave and you will sometimes find some hospitals to make a contribution towards course fees.   How much will I get paid? The pay for an RMO position is typically the same as the individuals previous NHS post. The pay is a basic salary, which includes on-calls. There may be the opportunity to do locum work at the hospital, where you can receive an additional £5-10k to your salary. If you have any questions about RMO work or are interested in working within the NHS contact us at apply@bdiresourcing.com – and we will be happy to help you.   References http://careers.bmj.com/careers/advice/view-article.html?id=422[Best_Wordpress_Gallery id="1" gal_title="All Galleries"]

For many international doctors, it is their ultimate goal to relocate to the UK and work within the NHS. The reasons for this varies from doctor to doctor but the most popular reasons are to receive the opportunity to develop their skills and education, improve their quality of living or to join friends and family who already live here. Nevertheless, some IMG’s jump straight into the process without taking the time to think about how long the relocation process takes and most importantly how much it is going to cost. It is important to know the provisional costs of relocating to the UK, as often doctors who do not research into it before becoming de-motivated once they come across how much it will cost them. Therefore, in today’s article, we aim to guide you through each stage of the relocation stage via the PLAB route with an average fee – so you know what to expect before you embark on your journey. To practise medicine in the UK, all doctors need to be GMC Registered. Therefore, when you have made the decision to relocate it is important that your first goal is to become registered, not prioritising the job search which comes at a much later stage. To become GMC registered you must have the following: Recognised primary medical qualifications English language capability Registration and licensing history Certificates of Good Standing Knowledge and Skills ID Check For more detail on each GMC Registration requirement please visit our article. As you would have already obtained your primary medical qualification we will start with the next step, which is evidencing your English language capabilities. The GMC accept two ways to evidence this via IELTS or OET English language test Cost IELTS £160 OET £349 Please note that the price of IELTS varies test centre to test centre but it is typically £160. The price of OET is the same universally. Knowledge and Skills The GMC requires all UK doctors to possess the relevant knowledge and skills in order to practise safely. To evidence this to the GMC you will need to have either a GMC approved postgraduate qualification (a list can be found here) or pass the PLAB exams. PLAB test Cost Part 1 of the PLAB test £230 Part 2 of the PLAB test £840 Flights to the UK for your ID check/relocation Popular IMG one-way flight examples (three months in advance): Country Flight Price India £450 Pakistan £350 Iraq £300 Libya £380 Egypt £250 Saudi Arabia £300 UAE £200 Average flight cost £572.86 GMC Registration Cost Registration Price Application for a full registration with a licence to practise £150 Tier 2 Visa Application Application Cost Tier 2 (General) visa application £610 NHS surcharge £200 The NHS surcharge is £200 per year for all visa and immigration applications. For example, £1,000 for a five-year visa.  For the purposes of this article, we are giving you the cost of a one-year visa. In some cases, you may be able to claim back the cost of your Tier 2 visa application and NHS surcharge, but this is dependent on your relocation package. Total Cost Exam Total OET £349 PLAB 1 £230 PLAB 2 £840 Flight for PLAB 2 £572 Flight for ID check/relocation £572 GMC Registration Cost £150 Tier 2 visa application £610 Total £3,523 Please note we have not included the cost of your undergraduate degree or postgraduate degree so the overall cost will increase if you wanted to include these in your relocation cost. Although the above figures may feel overwhelming, it is important to remember that these costs are spread out over a couple of years. For most international doctors, the process is lengthy simply due to medical and family responsibilities. Therefore, the overall price will not feel as expensive. Don’t give up on your dream! There are a lot of steps to relocating to the UK, however, with determination it is achievable. If you would like support with your relocation get in contact with us at apply@bdiresourcing.com and we will be happy to advise. Come and say hello! Join our Facebook Group IMG Advisor to gain access to frequent blog posts, the opportunity to ask questions and to meet other IMG’s.

The NHS is the fifth largest employer in the world and employs roughly 1.5 million people in the UK. Medical practitioners are also in the top five highest paid professions within the UK. The NHS is at the heart of the UK and thus their doctors are rewarded for their hard work with an extremely competitive wage. Here is what you can expect to earn at various stages of your career: Doctors salary range Level Salary FY1 £26,614+ FY2 £30,805+ Specialist Training £36,461-£46,208 Speciality Doctors £37,923-£70,718 Consultants £76,761-£103,490 GP’s £56525-£85,298 Pay for almost all directly-employed NHS staff is subject to annual analysis and recommendation by one of three pay review bodies. These recommendations are laid before Parliament, but the Government will always make the final decision on pay arrangements. There have been significant contractual changes for NHS employees in recent years and in this article, we are going to explore the NHS pay scales for each stage of your career. Junior Doctor Contract From August 2016, the Department of Health re-wrote the employment contracts for all new doctors starting in England. The new contract applies to all doctors below consultant level. So, although it is referred to as the “junior doctor” contract, this is misleading because the changes will affect experienced and senior doctors too, such as registrars. The Banding System Since December 2000, junior doctors in the UK are employed under a contract based on pay bands. This contract was designed to reduce the previously excessive number of hours that junior doctors worked in the NHS. Full-time junior doctors’ pay consists of a basic salary for the standard 40 hours worked in a week, plus a variable supplement to reflect how many more hours are being worked on average, the type of working pattern, the frequency of extra duty and the antisocial nature of the working arrangements. This is also known as on-call or uplifts. Your contracted hours will be set out in your job description attached to the contract agreed in advance between yourself and your Trust. The basic salary for each grade is set on incremental scale and under normal circumstances you will be paid at the minimum incremental point on appointment to a new grade. The bands can be summarised as such: Band Definition Salary supplement as a percentage of basic salary Band 3 For those working more than 56 hours per week on average or not achieving the required rest 100% Band 2A For those working between 48 to 56 hours per week on average, most antisocially 80% Band 2B For those working between 48 and 56 hours per week on average, least antisocially 50% Band 1A For those working 40 to 48 hours per week on average, most antisocially 50% Band 1B For those working between 40 and 48 hours per week on average, moderately antisocially 40% Band 1C For those working between 40 to 48 hours per week on average, least antisocially 20% No band For those working no more than 40 hours per week on average, between 7am and 7pm 0% Speciality Doctors and Consultants A speciality doctor and Consultant doctors contract is based upon a full-time work commitment of 10 Programmed Activities (Pas) per week. One PA has the value of four hours of work. Unless it has been mutually agreed between the Consultant or speciality doctor and the Trust to undertake the work in premium time, in which case each PA equates to 3 hours. Premium time is classified as any time that falls outside the hours of 7am to 7pm Monday to Friday and any time at the weekend or on a public holiday. Please note that depending on your speciality, as a Speciality Doctor, you will be expected to take up extra PAs. Typically, this is an additional two so you will end up working 48 hours a week instead of your contracted 40. This however, is advantageous as the extra hours will be reflected in your salary. Additional Programmed Activities (APAs) / On-call Extra programmed activities are referred to as Additional Programmed Activities (APAs) and these may be either academic or clinical. To calculate the value of an additional programmed activity will depend on: Your pay threshold, and, Whether you hold discretionary points, a distinction award or a clinical excellence award If you do NOT hold a discretionary point, distinction award or clinical excellence award, perform the following calculation: Take the value of your basic full-time pay (no other payments should be added) and divide this payment by 10. E.g. Basic salary of £69,991 per annum / 10 = APA allowance of £6,999 per annum (per APA undertaken) Click here for access to the NHS Pay Circular which informs NHS employers of changes to the Terms and Conditions for doctors. Understanding UK tax Each UK citizen has a “personal allowance” which denotes the amount we can earn without paying any income tax. If you earn more than your personal allowance, then you pay tax at the applicable rate on all earnings above the personal allowance, but the allowance remains untaxed. What is my personal allowance? Earning bracket Personal allowance Under £100,000 £11,850 £100,000 to £123,700 Decreased from £11,850 by £1 for every £2 you earn, until it reaches £0 Over £123,700 £0 What income tax band am I in? Once you know your personal allowance, anything extra earned will be subject to income tax. For 2018/19 tax year, if you live in England, Wales or Northern Ireland, there are three marginal income tax bands – at the 20% basic rate, the 40% higher rate and the 45% additional rate bracket (remember your personal allowance starts to shrink once earnings hit £100,000). If you live in Scotland, there are five marginal income tax bands from the 2018/19 tax year - the starter rate of 19%, the 20% basic rate, the 21% intermediate rate, the 41% higher rate, and the 46% additional rate. Earnings (England, Wales or NI) 2018/2019 Rate Under your personal allowance For most, £11,850 No income tax payable Between PA and PA+£34,500 (basic rate) For most, £11,850 to £46,350 20% Between PA+£34,500 and £150,000 (higher rate) For most, £46,350 to £150,000 40% Over £150,000 (additional rate) 45% Example monthly take home for a doctor’s salary Level Salary Salary after tax Monthly take home FY1 £26,614 £21,480 £1,790 FY2 £30,805 £24,330 £2,028 Specialist Training £36,461 £28,176 £2,348 Speciality Doctors £37,923 £29,170 £2,431 Consultants £76,761 £52,541 £4,378 GP’s £56,525 £40,804 £3,400 To work out your monthly take home for your specific salary please visit this site. You should also note that there is a further opportunity to increase your salary either through Bank Staff work or agency Locum work. Please visit our article on this matter for further information. If you are an IMG who is interested in relocating to the UK and working within the NHS send your CV to apply@bdiresourcing.com and we will be happy to help you. Come and say hello! Join our Facebook Group IMG Advisor, this will give you access to frequent blog posts, the opportunity to ask our Specialist Advisers questions and you can meet other IMG’s! References http://www.ucl.ac.uk/hr/ca/calculating_APAs.php

Why the NHS needs to employ more permanent doctors The NHS are currently facing a staffing crisis and consequently, they rely on expensive agency locum staff, spending 25 times as much on temporary staff than permanent staff. This trend is incomprehensible as the NHS is also experiencing severe government funding cuts. This year, on average, the UK’s healthcare system will spend over £3 billion on agency locum staff, funds that could be spent on more important Trust areas such as; the recruitment of permanent staff, medical research, patient care, drugs, equipment and increasing facility size. The inexplicably high fees paid by NHS Trusts needs to change to allow all Trusts to offer excellent continuity of care to all patients. In this article, we highlight the three focal reasons for the NHS to start employing more permanent staff over costly long-term agency locums: cost-effectiveness; staff retention; and reduced conflict. Reasons to use International Permanent Doctors Cost-effectiveness It is reported that 1 in 30 agency locum doctors earn £120 an hour, which is clearly not a sustainable method of recruitment. The most common reason for using an agency locum is simply a vacant post, other reasons include sickness, maternity, and paternity leave. However, each NHS Trust is spending nearly 25 times as much on long-term agency fees as they do on permanent positions. This amounts to paying some locum consultants £375k a year compared to a permanent senior consultant receiving just £76-102k a year. This large income disparity means that a locum consultant will often get paid 114% more than a permanent consultant, even though they are performing the same job role (albeit with reduced management responsibilities). Furthermore, although agency locum staff are hired with the aim to fill a temporary gap of employment, such as a consultant’s maternity leave – often agency locum’s can stay in a post at a hospital for several years. This is very problematic because the locum will continue to renew his contract every couple of months, and not agree to become a permanent staff member. Therefore, the obvious solution to end this significant expenditure on temporary staff is to invest in permanent staff who will only cost the Trust a one-off fee when their contract is signed. Here at BDI Resourcing, our goal is to provide the NHS with sustainable staffing solutions by providing permanent international doctors, and on average our services cost less than 10% of the cost of employing an agency locum over a 12-month period. Staff Retention Having staff who are fully trained and equipped with the appropriate knowledge and skills to perform their job efficiently is essential for a successful organisation, however, within the healthcare sector, it is especially important that this is the case. Training a permanent doctor will not only benefit your hospital financially, but it will also give doctors further confidence, resulting in better continuity of service to all patients and job satisfaction (ultimately increasing staff retention). 2.1 Empowerment and Confidence: If employees feel confident in their knowledge, skills, and training they will feel more self-assured about the job overall. Therefore, they will be more likely to take on new challenges and responsibilities within the hospital. 2.2 Continuity of Care: Research conducted by the NHS staff survey found clear and strong associations between staff abilities and how satisfied patients are. This means that a more confident and comfortable permanent doctor, over an agency locum doctor who may never have worked in the hospital before, will give a better continuity of care to patients. 2.3 Retention of Staff and Happier Working Environment: Doctors who receive training and are given the opportunity for educational development from their employer are more likely to feel satisfied with their job. In turn, this will lead to an increase in staff retention, which will benefit the whole organisation. Furthermore, having a fully-staffed department will lead to less sick days, less pressure on staff and overall a happier working environment! There are of course many benefits of an increase in staff retention and because you will no longer have to pay expensive long-term agency locum fees, you can instead use the money on investing in patients and employees. Second, is loyalty. Longstanding members of staff are inevitably more loyal than temporary staff. They will believe in the hospital, want the best for it, whilst developing a positive working relationship with peers, managers, and patients. This will make them easier to motivate, share expertise and help co-workers and to provide a better continuity of care to patients. Reduced Conflict The NHS spends over £3 billion a year and on an average day, there are an estimated 3,500 agency locums working in England and Wales. Consequently, it has been described by NHS staff that there are tense and hostile relationships between permanent members of staff and agency locum staff because of the inequality and differences in pay and/or responsibilities. This atmosphere in a hospital environment can be worrying as the focus is taken away from the excellent quality and continuity of care which is expected to be provided. Therefore, by employing permanent staff over agency locum staff – the permanent staff already employed at the hospital will feel of equal value and there will be less chance of hostility between staff. To summarise, BDI Resourcing entirely understands that short-term agency locum staff are often needed due to NHS Trust staff sickness and holiday but we are very passionate about increasing the number of permanent doctors to replace long-term agency locums. Our passion derives from two fundamental reasons: First, it is critical for NHS Trusts to start reducing their unnecessary expenditure on long-term agency locum staff, to allow them to increase their expenditure in other important areas such as increasing facility size, equipment, and medical research. Second, if NHS Trusts cut their spending on long-term agency locums and replace them with permanent doctors this will create a strong continuity of care to patients. Cost-effective health care will improve primary care as the trust will become stronger over time as doctors and patients grow to know each other better through experience, creating compassion and commitment from permanent doctors. Because of our passion to provide the NHS with a sustainable staffing solution and to save Trusts money – this year alone, we have worked with over 50 Trusts and saved the NHS over £10.5 million. So, if you are interested in using our services to help provide you with permanent doctors over costly agency locums then get in touch with us at info@bdiresourcing.com – and we will be happy to help! Alternatively, if you are an IMG who wants to relocate to the UK and work for the NHS then send your CV to apply@bdiresourcing.com and one of our Specialist Advisers will be able to provide you with tailored advice.

For long periods of time the NHS has faced workforce shortages, however, in recent years the recruitment of international doctors has been crucial in enhancing the UK health system. Research shows that over a third of doctors on the medical register gained their primary medical qualification outside of the UK. Every international doctor comes to the UK for a variety of reasons which include an increased opportunity for career development, higher standards of teaching, to pursue postgraduate training or for better working conditions and pay. Employing an international doctor on a permanent basis will improve the diversity within the profession to reflect a changing population, fill shortages in specialties and provide a fresh approach to healthcare. As an NHS hospital, there are many advantages to hiring a permanent international doctor in comparison to a locum, which are stated below. Reduced Cost The NHS locum sector spends over £250 million a month on agency costs. This is money which could go to increasing the number of hospital beds, medical research, staff well-being or staff pay. From the beginning of January 2018, BDI Resourcing has saved the NHS £10.5 million. How? We bridge the gap between supply and demand that is prevalent in many niche areas of medicine. Our solution is clear: we match top healthcare talent from around the world with top healthcare providers in the UK. We have a global reach of 12,000 potential candidates and counting. Training within the NHS The NHS prides itself on being committed to training their staff to reach full potential. This is to ensure that NHS doctors maintain and develop the knowledge and skills they require to meet the needs of their job and the service. This training can be achieved through education or skill-based learning. Development opportunities are available for all staff and clinical and educational supervisors will discuss training and development at appraisals and team meetings. The facility to offer training to international doctors has many advantages. Improved Patient Care – Doctors who are beginning their career with the NHS will be committed, eager and motivated. Training increases an individual’s loyalty to an organisation and they are more likely to want to stay with the employer. This will create a consistent and cohesive approach to patient care. A Means of Developing a Skilled, Motivated and Quality Workforce – Training will allow doctors to develop specialist knowledge and keep up to date with the latest technology and working practices. This ability to train will allow doctors to carry out their job successfully, feel satisfied with their position and stay with the NHS Trust for a long period of time. Cost Effective – Training international doctors, over employing locums for short periods of time, will be cost-effective resultant of lower overall training and recruitment costs. 3. Reduced Shortage Staff shortage is the ‘single biggest risk’ facing the NHS, with nearly three-quarters of all medical specialties having unfilled training posts and the number of applications to UK medical schools decreasing for the third year in a row. To address this workforce crisis, it is important for the NHS to maintain their ability to recruit from overseas. With 26% of NHS staff being non-British it is important that the UK has a flexible immigration system post-Brexit so it can recruit and retain enough doctors. In addition, increased employment of international doctors will create improved workforce planning this will ensure that all NHS department will not be inappropriately or understaffed. Furthermore, the recruitment of international doctors will improve staff health and well-being resultant of the reduction of pressure and stress which derives from the demands of the service. BDI Resourcing provides expert doctors We recognise that each doctor and hospital has different needs and requirements, therefore, we offer a truly tailored service to both our candidates and clients to ensure satisfaction for both parties’. When we provide an NHS Trust with a selection of candidates, they will all hold a recognised primary medical qualification, evidenced English language capability, and a GMC recognised postgraduate qualification or PLAB – meeting the requirements for GMC Registration. If you are an NHS hospital and are currently facing staff shortage issues in the following specialties then get in contact with us at info@bdiresourcing.com -Anaesthetics -Emergency Medicine -General Medicine -Paediatrics -Pathology -Psychiatry -Radiology -Surgery

Overview of the Medical Training Initiative (MTI) What is MTI? The Medical Training Initiative was established by the UK Department of Health in 2009. The scheme provides another possible route for an IMG who wants to relocate to the UK and work for the NHS. Its purpose is to allow suitable qualified overseas Doctors to undertake a fixed period of training in the UK within the NHS, before returning to their home country. As an IMG who partakes in this scheme you will greatly benefit from increased knowledge, skills and techniques learnt within the NHS and take that experience with you to use in your home country. The scheme has resulted in many government health institutions managing and running an array of programmes with varying responsibilities and quality assurance measures in place. This set of standards is placed by Health Education England (HEE), the Academy of Medical Royal Colleges in partnership with the Medical Royal Colleges and other organisations with the goal of standardising and providing quality assurance of all MTI training places. In 2018 the HEE and the Academy of Medical Royal Colleges launched a new set of standards for the MTI, which can be found here. The new standards are focused towards those who administer and approve MTI placements in line with the current guides and information for MTI’s already available. Benefits of MTI As an international Doctor who is part of the training scheme, you will be provided with speciality training and supervision by a qualified NHS consultant. When you begin the scheme, you will be given an opportunity to create a training plan which will suit your educational needs and ensure that you are offered all desired experience before the scheme ends and you return home. Royal College’s typically sponsor GMC registrations and Tier 5 Visa applications – making the process that little bit easier for you. Despite being a trainee within a hospital, you will receive the same salary as a qualified UK Doctor. However, it is useful to note that if you receive funding from your home country then you will not be provided with a salary in the UK. Disadvantages of MTI Visa issued is a Tier 5 VISA, this means that it will take 7 years to gain indefinite leave to remain in the UK as opposed to 5 years via the Tier 2 route If you already have full membership with the Royal College there is very little benefit to undertaking an MTI post as most doctors who come on this scheme are looking for UK experience prior to the final part of their Royal College Membership For senior doctors you will have to do a six-month period as an SHO in the UK, you can enter the UK system as a registrar from overseas with no UK experience if you have full Royal College Membership. MTI scheme does not make it easier to get into a training post in the UK. You have an equal chance of getting into a training post by taking a Service post in the UK for a six to twelve-month period. Required Qualifications to apply For each Royal College the requirements vary so we advise that you check your College website to find out what they require. However, the below requirements are typically found in each application: You must reside overseas at the time of applying for the MTI scheme and have no right of residency in the UK or EEA You must be practicing clinically in a GMC recognised priority country, a full list of those countries can be found here An overall IELTS score of 7.5 (with a score no less than 7.0 in each section of the test) / Or an OET result at grade ‘B’ or above achieved in each section. The results must have been achieved in a single sitting of the test and you must have achieved the score within the last two years You must have a primary medical qualification which is approved by the GMC, further details can be found here Worked in a medical practice setting for three out of the past five years, which includes working continuously in the last twelve months You must be able to demonstrate your intention to return home after finishing your two-year training scheme, with the ability to show how your training in the UK will benefit your medical practice in your home country Application Process If you meet the above criteria and want to apply to the MTI scheme then click here to access the application form and further guidance. Documents you will need: A copy of your full CV A copy of your IELTS results A cover letter which clearly specifies your nationality, preferred speciality, preferred duration and your available start date There is not an application deadline for the Medical Training Initiative as they accept applications all year round. Typically, interviews are conducted by the recruiting consultants, held over Skype rather than overseas. If an offer is made to you then you will need to start your GMC registration. The process of applying for the MTI scheme can differ dependent on your personal circumstance. We therefore advise you that the entire process can take up to six months from your interview to your first day in the post. However, the process can be accelerated if all the required documents are provided in the first instance. Will I be offered any support during my placement? During your induction to the training you will be under close supervision with a qualified NHS Consultant until you become familiar with local practices and protocols. Once both you and your supervisor believe that you are competent you will be able to begin any on-call or night-time shifts. Further support will continue to be offered after your induction period. This support includes providing you with a mentor, an ePortfolio (which will allow you to upload evidence to demonstrate your professional achievement and learning), College membership, and access to continuous feedback. If you are considering applying for the Medical Training Initiative or would prefer to relocate to the UK permanently then take a look at our GMC Registration article where we provide a break down of the different relocation routes. Get in contact with us at apply@bdiresourcing.com if you would like tailored advice and guidance on relocating to the UK and finding your perfect NHS position.

GMC Registration – What routes are available? The purpose of this blog article is to provide you with an overview of what the GMC registration process looks like and the various routes to ensure that you have a successful application. We have broken the registration process down into six categories, however, please note that each category will be covered in more detail in future articles. To legally practise medicine in the UK, all doctors must hold a valid medical license. The licence to practise is issued by the General Medical Council (GMC) and the requirement applies to all doctors in the UK regardless of whether they work for the NHS or independent sector, are national or international either on a permanent or locum basis. GMC registration will generally cost £390; however, this could fluctuate dependent on your individual circumstance. For instance, if you have held a registration in the past and want to reinstate it, the fee is reduced to £200. Furthermore, an annual retention fee of £390 is also required and this fee can be paid via a one-off payment, quarterly or monthly. It is important to note that further fees may be applicable and a full list of fees can be found here. The requirements for GMC registration in the UK will depend on a number of factors: Your nationality The country you gained your primary medical qualification Whether you or not you have completed a period of postgraduate training or an internship As the GMC registration is a lengthy process our first piece of advice is that you visit the GMC website to collate the required documents before you begin the registration process. These documents include: Evidence of your primary medical qualification Proof of identity (passport or identity card if it states your nationality) Certificates of good standing from any medical regulators you have been registered with in the last five years Employer references (and translations of them) The above documents will need to be sent within twenty-eight days of request otherwise you will be refunded the £390 you initially paid and you will have to restart your process all over again. We have broken down the GMC registration process into six steps and they are as follows: Recognised primary medical qualifications English language capability Registration and licensing history Certificates of Good Standing Knowledge and Skills ID Check 1. Recognised primary medical qualifications To be eligible to apply for the GMC registration and/or sit the PLAB test applicants must have passed all the qualifying examinations necessary for obtaining an ‘acceptable overseas qualification’ and a qualification that does not meet the criteria cannot be accepted. A list of what qualifications are recognised by the GMC can be found here. It is important to note that from 11th June 2018, once your primary medical qualification meets the GMC’s criteria, you will need to have it independently verified before registration with a licence to practise can be granted. Verification will be carried out by the Educational Commission for Foreign Medical Graduates (ECFMG) via their online system being the Electronic Portfolio of International Credentials (EPIC) service. If you are going to apply for GMC registration with a licence to practise after 11th June 2018, then visit the GMC website for further information on your primary medical qualification being independently verified. 2. English language capability If you are relocating from a country where English is not the native language then the GMC requires you to sit an English Language test. There are two types of tests available.  International English Language Testing System (IELTS) which is an academic version. Occupational English Test (OET). The GMC only accept IELTS and OET scores that are less than two years old. IELTS IELTS is the most popular language exam for IMG’s. The exam covers the four key language skills in general English: Listening, Speaking, Reading and Writing. Doctors must achieve an overall score of 7.5 (with a score no less than 7.0 in each section of the test). Further information on IELTS can be found on their website at: https://www.ielts.org/. Often one of the largest obstacles IMG’s experience during their GMC registration can be their score in the IELTS exam. That is why we work with an expert in IELTS preparation, named IELTS Advantage, who will be available to provide you with the help and support needed to allow you to pass the exam. IELTS Advantage offers test preparation guidance and documents with the advantage of studying at home for free. They work with IELTS test markers to give candidates exact feedback, so the candidate then knows what test area to focus on and to improve their score. Further information on this guidance can be found on their website. OET OET is another way to evidence your English language skills to the GMC. OET recognises that limited language proficiency is an obstacle to effective communication which affects the quality of care. Thus, OET is designed to replicate the critical tasks of the healthcare workplace setting and the test measures a Doctor’s abilities through the skills of listening, reading, writing and speaking. The score required is four B’s and the scores must be achieved at the same exam sitting. Currently we are seeing many Doctors who are now attempting OET as they have struggled to reach the required scores within IELTS; however it is too early for us to give a definitive answer as to the pass rate for OET in comparison to IELTS. Nevertheless, we will be collating this information as we go along and we will then be able to advise which test is better once we have the data. It is also important to note that the OET exam is significantly more expensive than IELTS; it is limited in the number of global test centres and the frequency of exams available. Further information on the OET exam can be found here. Sometimes, the GMC accept other evidence of your English language skills and more information on that can be found here. 3. Registration and licencing history The GMC will require you to give details of your registration or licencing for all medical regulatory authorities that you have practised or held registration or a licence in the past five years. 4. Certificate of Good Standing You will also need to provide a Certificate of Good Standing (CGS) from each individual medical establishment that you have listed. The GMC have noted on their website that often a CGS can take a while to arrive so ensure you have your CGS before you make your application. 5. Knowledge and Skills The GMC expect doctors to possess the relevant knowledge and skills in order to practise in the UK. Therefore you will be expected to have an approved GMC postgraduate qualification. If you are a European doctor and you qualified in a European institution then you will automatically hold a recognised GMC postgraduate qualification and therefore able to apply for Specialist Registration and not required to sit the PLAB exam. However, if your qualification was not achieved in a European institution but has been obtained in the last three years then it is fundamental to note that you will not be required to sit the PLAB exams, but you will still need an approved IELTS score. Nevertheless, if your postgraduate qualification is on the recognised list but was obtained more than three years ago then you will be required to submit additional evidence to the GMC, which demonstrates that the level of practise you have delivered has continued to be in line with the associated qualification. As previously mentioned, if you are unsure as to whether your qualification is recognised then do not hesitate to get in touch with us. A list of GMC approved postgraduate qualifications can be found here. PLAB If you do not have a recognised GMC postgraduate qualification then you will have to sit the PLAB exam. PLAB is an English language test that is focused on practicing English in a medical setting. The test assesses your ability, as a doctor, to work safely as a clinician in a UK NHS hospital. This certificate is broken into 2 exams: PLAB Part 1 is a 3 hour long exam with a paper containing 200 single best answer (SBA) questions PLAB Part 2 is a 14-station objective structured clinical exam (OSCE) Before sitting the PLAB exams you must already have successfully completed your IELTS exam, but please do not assume that because you have passed the IELTS, you will pass the PLAB. This test is harder and will more than likely require some study - there are a number of independent companies that can assist you in preparation for the PLAB exams, as well as study resources which can be purchased online. Please speak to your Recruitment Consultant for more information. 6. ID Check Once all the relevant documents have been submitted to the GMC they will then review your application and inform you if any additional evidence is required. When the GMC are satisfied they will invite you to attend an ID check in person at one of their offices in either London or Manchester. The check can be booked via the same portal used to make your application via the ‘My Appointments’ section. We advise you to book your ID check as early as possible because typically the dates are booked up a long way in advance and the GMC do not require you to have all your relevant documentation approved first. In addition, the GMC only offer you three months from the moment your application is successful to complete the ID check and then you will need to apply again. When you arrive at the ID check you will be expected to have your passport and other forms of ID. The GMC may request other documents; however, this information will be provided once you are invited. Once you have arrived they will take an ID photo and a copy of your signature to keep on record. The ID check usually takes around twenty minutes and once it is completed you will be added to the list of registered medical practitioners and officially GMC registered. Moreover, it has been common for international Doctors to apply for their Visa before coming to the UK for their ID check. This is advantageous because it prevents you from having to fly into the UK more than once and means you can begin looking for accommodation before starting your new role in the NHS. If you would like more information about the GMC registration, whether your postgraduate qualification is recognised or you would like some advice on taking PLAB then get in touch with us at apply@bdiresourcing.com where we will be happy to aid you.

So you have decided that the UK is for you – what is the process? Hello IMG friends! This blog post is going to provide you with an outline of the process for an international Doctor who wants to relocate to the UK. Moving to the UK has many advantages, as explored in our previous blog post; however, we fully understand that the process can be complex and confusing. Therefore, this article aims to simplify the entire process and will provide a step by step guidance for an IMG who wants to relocate. However, it is fundamental to note that the process order will differ dependent on your personal circumstance, so get in touch with one of our Specialist Recruitment Consultants at apply@bdiresourcing.com and they will be able to advise you on the best pathway to take. Generally, below are the following steps that an IMG will have to take in order to come and work in the UK: English Language Qualification - If you are relocating from a country where English is not the native language, the UK’s General Medical Council require you to sit an English Language test. Typically Doctors take IELTS, however recently the GMC announced they would also accept the OET examination. Postgraduate Qualification – This qualification must be recognised by the GMC. To find out if you have an approved GMC postgraduate qualification contact us at apply@bdiresourcing.com, as again there are various routes to take depending on your situation. If your qualification is not recognised you will then be required to take the Professional and Linguistics Advisory Board UK (PLAB) Part 1 and 2 exams. This exam will test your English knowledge in a medical context. But for European Doctors if you qualified in a European institution then your postgraduate qualification will automatically be recognised by the GMC and you will not be required to take PLAB. Job Search – For many Doctors once they have received their English language and postgraduate qualification the job search begins. Once you are at this stage get in touch with us as we will be able to pair you with a Specialist Recruitment Consultant who will be able to provide you with exclusive roles and then organise interviews for you. GMC Registration Process – Once you have an English language and post graduate qualification you will be eligible to register with the GMC for a license to practice. At this stage visit the GMC’s website and locate all the required documentation they require, then you can begin your application process and upon submitting you will be required to pay a fee. Job Offer – After you have been offered a position you can apply for a Visa to work in the UK and organise an ID check with the GMC. Relocation – When an ID check date has been confirmed, you can begin booking flights, organising accommodation and schools if you have children – all of which we can assist you on. English Language Qualification IELTS From our experience, we believe the first step that should be taken is to ensure that you have English language testing which is approved by the GMC. The most popular language exam IMG’s tend to take is the International English Language Testing System (IELTS). The exam covers the four key language skills in general English: Listening, Speaking, Reading and Writing. Doctors must achieve an overall score of 7.5 (with a score no less than 7.0 in each section of the test). Further information on IELTS can be found on their website at: https://www.ielts.org/ OET On the 8th February 2018 the GMC announced that they would also accept the Occupational English Test (OET) as an alternative test to prove your English language skills. OET recognise that limited language proficiency is an obstacle to effective communication which affects the quality of care. Thus, OET is designed to replicate the critical tasks of the healthcare workplace setting and the test measures a Doctor’s abilities through the skills of listening, reading, writing and speaking. The score required is four B’s and the scores must be achieved at the same exam sitting. Currently we are seeing many Doctors who are now attempting OET as they have struggled to reach the required scores within IELTS; however it is too early for us to give a definitive answer as to the pass rate for OET in comparison to IELTS. Nevertheless, we will be collating this information as we go along and we will then be able to advise which test is better once we have the data. It is also important to note that the OET exam is significantly more expensive than IELTS; it is limited in the number of global test centres and the frequency of exams available. Further information on the OET exam can be found here: https://www.occupationalenglishtest.org/ Recognised Postgraduate Qualifications The next stage of the process is to ensure that you hold a GMC approved postgraduate qualification. If you hold one of the following qualifications and it has been obtained in the last three years, then it is important to note that you will not be required to sit the PLAB exams, but you will need to have an approved IELTS score. However, if your postgraduate qualification is on the list but it was obtained more than three years ago, then you will be required to submit additional evidence to the GMC, which demonstrates that the level of practice you have delivered has continued to be in line with the associated qualification. As previously mentioned, if you are unsure as to whether your qualification is recognised then do not hesitate to get in touch with us. A list of GMC approved postgraduate qualifications can be found here: https://goo.gl/jZiiRd PLAB If you do not have a recognised GMC postgraduate qualification then you will have to sit the PLAB exam. PLAB is an English language test that is focused on practicing English in a medical setting. The test assesses your ability, as a doctor, to work safely as a clinician in a UK NHS hospital. This certificate is broken into 2 exams: PLAB Part 1 is a 3 hour long exam with a paper containing 200 single best answer (SBA) questions PLAB Part 2 is a 14-station objective structured clinical exam (OSCE) Before sitting the PLAB exams you must already have successfully completed your IELTS exam, but please do not assume that because you have passed the IELTS, you will pass the PLAB. This test is harder and will more than likely require some study - there are a number of independent companies that can assist you in preparation for the PLAB exams, as well as study resources which can be purchased online. Please speak to your Recruitment Consultant for more information. Bespoke Job Searches Although you will not be able to begin employment until you have received your licence to practice from the GMC, once you have completed your IELTS and PLAB exams (if applicable) we will then be in a position to start the job search and begin to arrange interviews for you with our clients. Many of our clients will be happy to interview and offer a position after a telephone and/or Skype interview – which means we are often able to secure an offer of employment without the need for a face to face interview and you needing to travel to the UK. BDI offer a bespoke job search so you do not have to. Part of this process for us includes: Speaking directly to Lead Consultants, Clinical Directors and Department Managers to ensure that your CV is reviewed directly by a clinician. This is because often direct applications are often disregarded by an administrator before reaching the potential employer. Provide exclusive roles: we often have access to jobs which are not actively advertised. Detailed understanding of your specialty: Our Specialist Recruitment Consultants are all trained to be knowledgeable in a wide range of niche specialties. For us it is important to know what your research interests and sub-specialties are to locate the perfect position for you to continue your professional development. We will also negotiate your salary with our client to ensure you receive the best package possible. General Medical Council (GMC) Once you have your English Language Qualification and a hold a recognised postgraduate qualification you will be eligible to register to the GMC to receive a licence to practice which is required by anyone who wishes to practice medicine in the NHS. The GMC are responsible for protecting NHS patients and to improve medical education and practice across the UK, namely by: Deciding which doctors are qualified to work in the UK and oversee all UK medical education and training Set the standards that doctors need to follow and make sure that they continue to meet these standards throughout their careers Take action to prevent a doctor from putting the safety of patients or the public’s confidence in doctors at risk From experience registering with the GMC is the most time consuming and difficult aspect of an IMG relocating to the UK. Many Doctors will fall at this hurdle for many reasons which include; the length of registration time, fees payable and unsuitable documentation. Our first and foremost piece of advice to you as an IMG, who wants to relocate to the UK, is to contact and engage in conversation with the GMC as early as possible. The reason for this is that only they will be able to clarify whether you hold the appropriate postgraduate qualification and the appropriate documents to continue an application with them. Contact details can be found on their website via the following link: https://goo.gl/b2mASx Cost of Registration GMC registration will generally cost £425; however, this could fluctuate dependent on your circumstance. For instance, if you have held a registration in the past and want to reinstate it, the fee is £200. Furthermore, an annual retention fee of £425 is also required and this fee can be paid via a one-off payment, quarterly or monthly. It is important to note that further fees may be applicable and a full list can be found here: https://goo.gl/hoxeHA. European Doctors From experience the GMC registration process is generally easier for European Doctor’s, this is because the only test you are required to take is the IELTS exam. If you qualified in a European institution you will automatically hold a recognised GMC postgraduate qualification and therefore able to apply for Specialist Registration and not required to sit the PLAB exam. Furthermore, if you do not hold a Royal College postgraduate qualification then you will simply have to submit your current qualifications to the GMC as evidence of training. In addition, most European citizens will not require a Visa to work in the UK (current exclusions to this include Croatian Doctors who will require a ‘Purple Card’). Visa Sponsorship After you have accepted your offer of employment the final application to be made is for a Tier 2 Visa. This step is considered simple because the employing hospital will sponsor your application and occasionally pay for it too. The Tier 2 Visa allows you to work in the UK and travel in and out of the country as you please. The Visa is supported for the duration of your employment (via extensions) and is valid whilst you work for the sponsoring organisation (i.e. if you move to work at another hospital then your new employer will need to take over sponsorship of the Visa). Despite the government citing that it takes up to three months to get your Visa, in our experience it is usually obtained by about four weeks from the point of application. With regards to close family members, they can also be granted Visa’s as part of your own application (but please bear in mind that the hospital will not carry the additional cost of this). For full details on applying for a Visa visit: https://goo.gl/RcCgiz Relocation Process Now you have registered with the GMC, accepted a job offer and got your Visa, the next stage of the process is to arrange your travel and relocation to the UK! Once you have booked your flights then we can help arrange your accommodation. In the UK, to lease or buy a property you must view the property in person and then sign for it. Therefore, when you first come to the UK it is likely that you will have to stay in temporary hospital accommodation until you find the perfect accommodation for yourself or your family – often medical staffing will be able to arrange this once you have booked your flights. Again, BDI will be happy to help with this process and we can organise viewings of houses or apartments for you to go and visit in your first couple of weeks being here. Other points to consider once you have made the move are: Setting up a UK bank account Getting a UK mobile number National Insurance number Registering with a GP/Dentist Registering for electricity/gas/tax To summarise, the relocation process to the UK is a complex one and the requirement of each step will differ depending on your personal circumstance, this also means that the steps can be taken in various orders. In addition elements of the process can change from time-to-time but we will be able to keep you up to date on any developments. Therefore we advise that you get in contact with one of our team, at apply@bdiresourcing.com, and we will be able to advise you on the best pathway to take in order to help you move to the UK sooner than you thought. If you are an international doctor who wants to relocate to the UK and work within the NHS send your CV to apply@bdiresourcing.com – and we will be happy to help you. In addition, if you would like support form an online forum of other IMG’s join our Facebook Group: IMG Advisor.

Advantages of working in the UK   Welcome to the second blog post of our series. In today’s post we explore the several advantages of an International Medical Graduate relocating to the UK and working for the NHS. The NHS is the largest employer in the UK and Europe. It is one of the largest healthcare systems in the world as it employs over 1.5 million people to hundreds of diverse roles. However, currently there is a shortage of doctor’s in the UK and therefore the system is continually looking to employ more clinicians. As an international doctor, no matter what speciality and area of the NHS you join, you will become part of a skilled, devoted and passionate team of people whose priority is to provide the best healthcare and treatment to their patients. Rewarding work All doctors who have worked hard to master the science and the art of modern clinical practice, create a tremendously positive impact on their patient’s lives every single day. As a healthcare professional, IMG’s will be able to satisfy their passion to help others whilst simultaneously earning a living. For most people, there are generally two common themes behind their reason for becoming a Doctor. The first theme is their ability to make a positive difference to a patient’s life. Whether a patient needs pain relief or a life-threatening operation, for a Doctor, to be the person who alleviates their pain or change their life is extremely fulfilling. The second theme behind a Doctor’s chosen career path is their ability to develop relationships with their patients. A Doctor-patient relationship can last anywhere from a couple of weeks to several decades, but nevertheless, the personal element of the relationship allows a Doctor to respond genuinely and subjectively to their patients. This allows the Doctor-patient relationship to develop into a genuine connection rather than the Doctor simply providing a service. Training One of the principal reasons that people decide to leave their job is due to the lack of opportunities their employer offers and they yearn for a chance to gain new skills and knowledge. For the NHS, it is fundamental for their system to provide their employees with the opportunity to advance their skills and develop their careers. For all levels and specialities within the NHS, we believe that the NHS in conjunction with the Royal Medical Colleges provide some of the best medical training programs in the world. Job Stability Another advantage of being a Doctor in the UK is job stability. Whilst there are people and sickness within the world Doctors will always be needed. There are over 250,000 Doctors working for the NHS, with over 70,000 of those receiving their primary medical qualification from abroad, and there is a continuous call for more IMG's to come and work in the UK. Furthermore, most hospitals and healthcare centres in the UK are open 24/7 which means that all healthcare professionals will always have full-time hours. But as hospitals are demanding institutions, most employees are offered overtime because of the high demand of patient’s needs. Income Healthcare professional’s salaries differ dependent on the Doctor’s experience, speciality and setting. However, most Doctors enjoy above-average earnings and if you are a speciality Doctor you will earn a basic salary of £37,923 to £70,718. In addition to your basic salary there is a potential to earn additional income. This can be done via: Additional Programmed Activities (PA’s) Bank locums within your hospital Agency locums in surrounding areas Private work Pension and Benefits The NHS offers their employees outstanding pension packages and is one of the most generous and comprehensive schemes available in the UK. An NHS pension includes life assurance benefits, ill health benefits and voluntary early retirement benefits and a full range of other benefits. Furthermore, all NHS employees are entitled to a minimum of 27 days annual leave, which will increase to 29 days after 5 years and 33 days after 10 years’ service, plus 8 days public holidays. However, it is important to note that entitlement to Annual Leave will be determined by each individual NHS Trust. Moreover, the NHS pension scheme is one of the most generous and comprehensive schemes available in the UK. Membership of the scheme is automatic when you join the NHS and as part of the scheme, the NHS pay a contribution equal up to 14.3% of your salary towards the cost of your pension. UK lifestyle Moving to the UK can offer a life of history and culture and society full of diversity. The UK is a constitutional monarchy with a parliamentary democracy. The monarch is Queen Elizabeth II, who has reigned since 1952, which makes her the longest-serving current head of state. The UK is made up of England, Scotland, Wales and Northern Ireland. The UK’s capital and largest city is London and other major cities in the UK include Manchester, Birmingham, Leeds, Edinburgh, Liverpool, Glasgow, Cardiff and Belfast. Despite the UK being geographically small, it is extremely influential in world trade and politics. Not only is the UK influential in the economy, it possesses beautiful architecture and is well-known for its music, films, literature and football. Britain is a vastly ethnically diverse society with rising numbers of people who identify themselves as an ethnic minority. With over 1.5 million people being from an Indian or Asian group who are all spread across the entire UK. Furthermore, 26% of the NHS workforce are international Doctors and 11% European Doctors. Although it is difficult to count the number of mosques in the UK, as it is any other place of worship, research has identified over 2,000 mosques across the whole of the UK. In addition, specialist food suppliers are also nationally distributed. All major supermarkets and restaurants supply halal meat, including Sainsbury’s, ASDA, Zizzi and Nando’s. In addition, we recognise that relocation to a different country often has a large impact on family life. Therefore, we will be able to offer practical advice on family life including UK schools for your children and language classes.   Schools   The majority of schools in the UK are owned by the state, completely free to attend, and follow a National Curriculum. Children who are aged five to eleven will attend primary school before moving onto secondary school. Because of the decentralisation process in the UK, the schooling system can vary between different regions. Nevertheless, education for all children is compulsory for children aged five to sixteen and the school leaving age is eighteen, however the last two years are optional. The school year typically runs from the beginning of September to the end of July.   Language   English is the most widely used language across the world and has a large vocabulary with nearly half a million words. This is resultant of the various groups of people, nationalities and cultures that use the language. For international Doctors relocating to the UK they must first have passed the International English Language Testing System (IELTS). The IELTS is required by the UK Home Office for each category of visa applications. The test will assess all your English skills – reading, writing, listening and speaking designed to reflect how you will use English at work in your new life. However, for your family members who will not have to take the IELTS, but will want to improve their English there are a couple of different learning options for them. First, there are hundreds of language centres that are members of Accreditation UK. Or second, there are several online courses, where an individual can improve their English language skills from the comfort of their own home. Overall, there are various advantages of relocating to the UK and if you have decided to do so then get in contact with us at apply@bdiresourcing.com so we can assist you in finding a job and guide you at every step during the relocation process.  

One of the most frequent and important questions we get asked by international doctors is where they fit into the UK system and what grade they can expect to work at. It is important to note that medical terminology is different from country to country, so this brief guide aims to clearly explain the UK system and give you a better idea of what grade you can expect to start at. Foundation Training In the UK the Foundation Programme is a two-year generic training programme which forms a bridge between medical school and specialist/general practice training. Foundation Year 1 (FY1 or Trust grade equivalent) FY1 enables medical graduates to begin to take supervised responsibility for patient care and consolidate the skills they have learned at medical school.  At this stage, the doctor will have provisional GMC Registration. Satisfactory completion of F1 allows the relevant university to recommend to the GMC that the foundation doctor can be granted full registration. As most IMG’s come to us after they have completed their internship year, it is rare we use this grade to employ doctors into. Foundation Year 2 (FY2 or Trust grade equivalent) FY2 doctors remain under clinical supervision (as do all doctors in training) but take on increasing responsibility for patient care. In particular, they begin to make management decisions as part of their progress towards independent practice. FY2 doctors further develop their core skills and contribute more to the education and training of the wider healthcare workforce, such as nurses and medical students. A big part of this year is determining your chosen specialist interest area upon completion. At the end of FY2, doctors will have begun to demonstrate clinical leadership and decision-making responsibilities that are essential for hospital and general practice specialty training. Satisfactory completion of FY2 will lead to the award of a Foundation Achievement of Competence Document (FACD) which indicates that the foundation doctor is ready to enter a core, specialty or general practice training programme. Most of the posts that we recruit to, at this level, are for doctors who have completed their internship year overseas and ideally have a few months of additional second-year experience. You should note that Trust grade posts are not training posts, however, most departments will sign off equivalent competency certificates to ensure that you can still apply to the next stage in their medical career. Junior Middle Grade (CMT1/2, ST1/2, Junior Clinical Fellow and SHO) At this stage, doctors have usually started to get an idea of the area that they will eventually go on to specialise in. This phase of a doctor’s career is about expanding on foundation training and moving towards specialist training. To exemplify, a General Medicine doctor will spend these two years of their career in longer rotations between several general medicine specialism’s whilst studying towards their MRCP exam. Once complete they will usually elect to continue with one specialist interest, such as Cardiology, right the way through to Consultant level. Junior Clinical Fellow and SHO equivalent positions are an excellent starting place for international doctors with a small amount of specialist training who are perhaps looking to study towards a Royal College qualification. Senior Middle Grade (ST3-8, GP Trainee, Senior Clinical Fellow and Staff Grade Equivalent, Speciality Doctor) Once a doctor has made it to this stage in their career they should have developed all the skills necessary to be ready to fully immerse themselves in specialist training for the next four to six years (depending on the length of training for the chosen specialism). Each year of progression will involve more advanced practice and autonomous working, with the emphasis moving away from training and towards becoming fully independent – and will eventually become a trainer of the next generation. Please note those who choose a career in General Practice will go through fewer years of training (typically three). Once training years are complete, doctors receive a Certificate of Completion of Training (CCT) and gain entry to either the GMC Specialist Register or GP Register. Equivalent Senior Clinical Fellow and Staff Grade vacancies are often the best starting point for international doctors who are looking to join at this level. Consultant or GP Once a doctor has completed their specialist training they will be free to work independently as Consultants or General Practitioners. For international doctors, it is worth noting that the CESR route recognises equivalent specialist training and without this, it will be impossible to enter the UK system as a permanent Consultant straight away. Thus, the most popular route is for IMG’s who do not hold CESR or CCT they will act down to a Senior Middle Grade whilst they work towards their specialist registration or alternatively take up a temporary post which will allow Consultants to work for a fixed-term without their CESR or CCT. The NHS has many different variations and it can seem quite complicated for those who are not working within the healthcare system every day. We have tried to simplify things in this article, but if you have any specific questions relating to your circumstances or would like further advice – please email us on apply@bdiresourcing.com. And if you are an international doctor who is interested in relocating to the UK and working within the NHS send your CV to apply@bdiresourcing.com and one of our Specialist Advisers will be in touch. Come and say hello! Join our Facebook Group IMG Advisor – here you will be able to ask questions, receive access to frequent blog posts and meet other IMG’s! Journey through Medical Training