The MTI Scheme Has Closed

The Medical Training Initiative was, for years, one of the most straightforward ways for an international doctor to get GMC registration and work in the NHS. It has now closed. This guide explains what the scheme was, what happens if you are on it and what your options are if you were counting on it.

What the MTI scheme was

MTI was a two-year sponsorship scheme that gave a limited number of international medical graduates a route into the NHS. You worked in a UK hospital under a named consultant, earned the same salary as an equivalent UK doctor and returned home at the end with the experience.

It ran on a Government Authorised Exchange visa, previously called the Tier 5 temporary worker visa. The big draw was sponsored GMC registration - you didn’t need to sit PLAB. Several Royal Colleges offered it, the Royal College of Physicians being the largest.

Who it was for

MTI was never right for everyone. It suited doctors who wanted UK experience for a couple of years and intended to build their long-term career back home. It did not suit anyone looking to settle in the UK, because none of the two years counted towards British residency.

It also had limited numbers with The Royal College of Physicians, the largest provider only having a few hundred places nationwide. You needed a recognised primary medical qualification, an appropriate postgraduate qualification, three years of post-graduate experience and evidence of your English. Priority went to doctors from low-income and lower-middle-income countries.

I am on an MTI placement now. What happens to me?

Nothing changes. You keep your placement and finish your two years as planned. The Academy has confirmed it will carry on sponsoring your visa and handling compliance until you complete.

A few specifics worth knowing:

• Your visa stays valid. The Academy remains your sponsor through to the end of your placement.
• Extensions are closed. An extension only went ahead if it was fully submitted and approved by noon on 31 March 2026. Nothing is being accepted now.
• Transfers between Trusts are still possible, handled case by case during the wind-down.
• Your Immigration Health Surcharge refund is unaffected. The existing refund process continues.
• The Academy MTI team is still your point of contact and the scheme runs until the last participant finishes.

The one thing to plan for is what comes next. Your MTI years do not count towards indefinite leave to remain so if you want to stay in the UK you will need to switch to a different visa - usually the Health and Care Worker visa. Start that conversation early rather than in your final few months.

What are my options now?

If MTI was your plan then you have three realistic routes to GMC registration. None of them is closed by numbers the way MTI was.

1. The PLAB test - The most common route by far. You sit PLAB 1, then PLAB 2, then apply for registration. It takes longer than sponsorship did but there is no cap on places and you’re not competing for a limited number of spots. Note that you must pass PLAB 2 within two years of passing PLAB 1.
2. An acceptable postgraduate qualification - If you already hold a qualification on the GMC’s accepted list - MRCP(UK), MRCS, MRCEM, MRCPCH, FRCR, FRCPath or MRCOG among others - you can use it in place of PLAB. Many doctors who were eligible for MTI already hold one of these, so this is often the quickest option.
3. Sponsorship by another approved body - MTI was the best known sponsored route but not the only one. The GMC keeps a list of approved sponsoring bodies, including Royal Colleges, NHS trusts and universities, who can issue a sponsorship certificate.

Which one is right depends on your specialty, your experience and how quickly you want to move.

Questions and answers

Is the MTI scheme definitely ending?

Yes. It closed to new participants at noon on 31 March 2026. Applications already in progress with a medical royal college had a grace period until 30 June 2026.

Will this affect my current placement?

No. Current participants are fully supported to complete their placements as scheduled.

Can I extend my MTI placement?

Only if the request was fully submitted and approved by noon on 31 March 2026. No requests are being accepted after that.

Will my visa still be valid?

Yes. The Academy continues to sponsor visas and maintain compliance for everyone on a placement until they finish.

Can I move to another Trust?

Transfers are still possible and are being handled case by case during the wind-down.

Will I still get support from the Academy?

Yes, including visa sponsorship and general scheme support. The Academy MTI team remains the main point of contact.

Am I still eligible for an IHS refund?

Yes. The existing refund process continues during the wind-down.

Can new doctors still apply?

No. The scheme is closed to new applicants.

Will there be a replacement scheme?

NHS England has said it will review future options and engage with the Royal Colleges, but there is no confirmed replacement at this stage.

How long will the scheme carry on?

Until everyone currently on a placement has completed it.