MTI in Psychiatry by Dr Amit Chougule

My Journey towards MTI Psychiatry post in the UK


I completed my post-graduation in Psychiatry from India in 2017. I was one step away from becoming a consultant Psychiatrist in India. One fine day I came across an advertisement for an NHS job on a WhatsApp group. It was about recruitment by NHS Wales trust in collaboration with British association of Doctors of Indian Origin (BAPIO).

My dream since my adolescence of working in the UK which I had consciously supressed due to financial, career and familial reasons resurfaced. After reading the advertisement in detail I was acknowledged with the fact that there is new route for training in the UK for international medical graduates known as Medical training Initiative (MTI).

It does not require PLAB or Royal College exams nor any hefty fees for training. All it requires is 3 to 4 years of post-graduate experience in India, a good CV and clearance of IELTS exam for proving your proficiency in English language. I had no excuse to supress my dream anymore and the journey began.

Getting the CV ready:

First step in the process was to forward your CV to the recruitment team. The process of learning new skills and competencies started even before starting the job with the NHS. First skill was about writing an impressive CV and unfortunately, we are not trained in India to write a CV. I started with google search and asking my colleagues and seniors about preparing a good curriculum vitae (CV). I spent 7 days in preparing my CV. Most important points while preparing CV for NHS jobs is be honest, don’t mention any skill which you are not confident about, explain all gaps with an honest explanation for the gaps and structure your CV the way they expect in the UK.

Invitation for the interview:

I received a mail that I was shortlisted for the interview at Mumbai. Unfortunately, there is scarcity of sources which provide guidance in this area. Also, I learnt an important aspect of NHS interviews. They give almost equal priority for ethics, team work and good clinical practise as for your speciality knowledge. So, someone who has excellent knowledge about his speciality but doesn’t do good on ethics and in the area of good clinical practise, has less chances of getting selected for the Job. The interview is structured and generally theme of questions asked to the candidate is similar, though the exact question may differ.

The Interview:

  • Usually it starts with “Take us through your CV”. Here you are expected to describe your CV in 3 to 5 minutes.
  • Then most commonly in Psychiatry there will be one question on risk assessment based on a clinical scenario.
  • Then there will be questions on Psychological and social interventions and one on medico legal aspects of Psychiatry.
  • This will be followed by questions related to GMC good clinical practise and ethics.
  • Most common question will be about the reason for choosing this job and relocation to the UK.
  • Then the interview will end by asking the candidate if he/she has any questions for the interviewing team.

Long anxious wait and the Good news:

After the interview the wait began for the results. Finally, after 2 months I got the long-awaited news about my selection. One month after that around December 2017 I got my Job offer letter. I was given a post of Senior clinical fellow in mental health. The salary was equivalent to what a UK trainee will receive with similar post graduate experience. They also offered excellent relocation package. Undoubtedly, it was an offer which one cannot refuse. I signed the appointment letter and mailed them back.

The routes available to get the MTI Post:

Someone who is planning to apply for MTI should understand that there are two routes to get into MTI training.

Route A:

Route A is through Royal college of Psychiatrist. Through this route the candidate applies to the Royal College of Psychiatrist, London and RCPsych conducts interview and matches the candidate with the trust.

Route B:

I took route B where trust conducts interview and requests the Royal college to provide certificate of sponsorship for the candidate, if the candidate fulfils the trusts criteria and completes all the documentation required by the trust commonly known as the “ Trust Package”

The Trust package:

So, the trust gave me a list of documents which I should submit to the trust after which the trust can send my application to Royal College for certificate of sponsorship.

Two most important and time-consuming documents which the trust expects are:

  1. IELTS test score certificate
  2. Police clearance certificate/ Good standing from police

Clearing the IELTS:

  • According to my experience the process gets delayed as many candidates are not able to clear IELTS. One should start preparing early for the IELTS exam. Usually 6 to 8 weeks preparation is minimum period required for clearing IELTS.
  • Do not underestimate IELTS specially after listening to your non medico friend’s wo have cleared the exams. For all other fields the score required is low which is around 5.5 or 6. To score 5.5 or 6 is quite easy. But to score 7 its very difficult. So, give a good try. Take IELTS tuitions if available in your city, Android apps are available, you tube has good videos for IELTS preparations.
  • The score required is minimum 7 in all modules and overall score of 7.5 in IELTS academic exam. This is GMC requirement and there is no exception for this score.
  • Other option is to take OET which is acceptable for GMC registration.

Police clearance certificate:

Police clearance certificate may take 2 to 6 weeks and has to be applied in the passport office. Some candidates get it from local police superintendent office which is acceptable.

The Royal College Package:

Once you submit the trust package, the trust evaluates all the documents and sends an application to the Royal college for approval. My application was sent to Royal College of Physicians and surgeons Glasgow (RCPSG). RCPSG then sends a list of documents which they require before considering the application for certificate of sponsorship (COS).

I had all the documents except the two most important documents.

  1. The verification of my medical credentials by EPIC
  2. Good standing certificate from all the medical councils I am registered in India.

EPIC Verification:

  • These two words will haunt you for at least 2 months during the process. It’s quite a complex and frustrating process.
  • EPIC stands for electronic portfolio of international credentials which is a service provided by Educational Commission for Foreign Medical Graduates (ECFMG).
  • It may take 30 to 90 days to finish the verification. It is again a requirement for GMC registration.
  • The process is explained in detail on EPIC website. It took almost 60 days to finish the process. Though Royal college and GMC requires only verification of your primary medical qualification, I also got my post graduate qualifications verified. It is a one-time process and your credentials get verified for lifetime and can be sent to medical councils all over the world.

CGS from medical council:

Every medical council has its own process to issue the certificate of good standing (CGS). Its only valid for three months. You will need them also for GMC registration. If you are not able to reach GMC registration stage within three months, you have to reapply and get a new one for GMC.

The frustration and the uncertainty due to delay in the process:

Almost everyone goes through this phase of uncertainty and frustration.

Royal college clarifies with the trust if they have any queries about the candidate’s skills and competencies or about the job profile that is offered to the candidate. These requirements and paper work delayed my process by almost 8 months. This was a very difficult time. The uncertainty was killing. The paper work was frustrating. Also, NHS had a staffing crisis which delayed the process further.

During these 8 months I thought about giving up on my UK dream many times. Infact, there was a time when I gave up and started with other career plans in India. My parents, my wife and my friends, my consultant and my work place colleagues were a solid support during this time.They all encouraged me not to give up on my dream. Furthermore, during this time, I came in contact with Dr Raja Adnan Ahmed on Facebook he helped remarkably to keep my hope alive.

I just couldn’t stop thinking about UK. I came across a motivational phrase on fb which said “If you cannot stop thinking about something, you should definitely go for it”. Another one was “while taking a major decision during uncertainty, if you are prepared for the worst that can happen, then you should go ahead with the decision”. This way I kept the hope alive for around 8 months.

“That email from Royal College”:

Finally, I got the most awaited email from the royal college saying that your application has been accepted and they will soon issue a certificate of sponsorship for GMC registration. I was ecstatic. The Royal college clinical assessor evaluates all the documents from the candidate and the trust. The meeting usually takes place once in a month. After the assessment the assessor confirms if the candidate fulfils the criteria for certificate of sponsorship and once approved the certificate is issued within 2 weeks.

Thus, since the time of interview, it took around 17 months to get my certificate of sponsorship. This wait taught me many lessons of life and being a Psychiatrist definitely helped me survive the stress that comes with the wait and uncertainty.

GMC Registration:

It took 3 weeks for GMC registration. My advice will be to start reading GMC guidelines for registration right from the beginning of the process so that you can make changes in your application in case there are any changes in the GMC requirements.

All IMG’S should keep reading the step by step process of getting the GMC Registration via the sponsorship route. Read it multiple times and if you get to know that you don’t fulfil any requirement then start working towards that while the process of getting COS is going on.

Finally got a mail for GMC Id check after getting provisional registration with the GMC.

Certificate of Sponsorship (Cos) from AOMRC:

Once I got an email from GMC for Id check, my trust submitted an application for Cos from AOMRC which stands for association of medical royal colleges. AOMRC issues a Cos for tier 5 visa. Luckily, I got this Cos within 1 day.

Application For Tier 5 Government Authorised Exchange Visa:

Best part of MTI is that AOMRC is a A-rated sponsor and they usually agree as a guarantor for your maintenance. So, you don’t have to show any money in your saving account and also the candidate requires only two documents namely the Cos from AOMRC and a TB Clearance certificate for tier 5 visa application. My wife got a tier 5 dependent visa. She is allowed to work on that visa in the UK.  Visa process was smooth and got my visa in 3 weeks.

The big Leap:

I reached UK on the 1st April 2019, twenty months after my interview. After four months of working in the UKwhen I ask myself,

“Was the wait of 20 months for the UK MTI fellowship worth it?

I always get only one answer “Oh! Hell Yes”

Help and guidance for prospective MTI candidates:

I am humbled and honoured by all the help I got during my journey. I can now say that if I hadn’t received help at certain points, I would have never made it to the UK. So, I started whatsapp group for prospective MTI candidates with an aim of providing guidance and help in order to make their journey smooth and stress free. Glad to announce that we have around 46 members in the group and around 10 candidates have successfully started their MTI post in the UK. Anyone who is planning for an MTI post can contact me via facebook, whatsapp or email.



Whatsapp: +44 7471964883

Facebook pages that are really helpful for international medical graduates who are planning to relocate to the UK:

  1. Psychiatry training in the UK
  2. IMG Advisor
  3. BDI Resourcing
  4. MTI UK
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