Information for European Economic Area nationals (EEA)
As an EEA national (or non-EEA national with EC rights) who has qualified in an EEA member state you will have reciprocal rights to work within any country of the EEA and therefore you are treated the same as a British national when applying for posts in the United Kingdom. This may be in the form of a training post or you may be applying for a permanent consultant post if you already have your Certificate of Completion of Training (CCT).
General information
Royal College of Obstetricians and Gynaecologists (RCOG)
The RCOG is a postgraduate Institute for doctors specialising in Obstetrics and Gynaecology. It is not a University or a hospital and does not train people directly. The RCOG administers examinations, approves hospital training programmes, organises scientific meetings and courses, and is responsible for education and standards. Some of these responsibilities were initially taken over by the Postgraduate Medical Education Training Board (PMETB) but are now under the umbrella of the General Medical Council (GMC), with whom the RCOG works closely.
National Health Service (NHS)
The NHS (in England and Wales) was established in 1948 and is the means by which health care is delivered to the population free of charge at the point of delivery. It is funded through general taxation. The provision of health care is divided into two main sections – primary and secondary care.
Primary care is provided by general practitioners (GPs) in the community. It is not possible to get secondary care without initial referral from a GP, except for emergency treatment.
Secondary care is provided in a hospital setting. All referrals are made by a GP and each patient is allocated to a particular consultant (specialist) who will retain overall responsibility for the care provided to that patient, whether as an inpatient or outpatient, until such time as the patient is discharged. Within hospitals, doctors work in multidisciplinary teams, which will include medical staff such as consultants, doctors in training, namely Foundation Trainees and Specialty Registrars (StRs), doctors who are not in training posts, such as Staff Grades and Associate Specialists, nurses, midwives, therapists, allied healthcare professionals and a range of scientific and technical staff.
Registration with the General Medical Council
Registration with the General Medical Council (GMC) is mandatory before undertaking direct patient care. There are four forms of registration:
Provisional registration
This is for doctors who have an acceptable undergraduate degree and are in Foundation Training Year 1.
Full registration (FR)
EEA nationals with qualifications from their own country will get reciprocal full registration, as will an EEA national who has had his qualification accepted by another EEA Member State. EEA nationals are not required to take the PLAB test or other English language test.
Specialist registration
This is for doctors who have completed specialist training and are on the Specialist Register.
General Practice registration
This is for doctors who have completed training in General Practice and are on the General Practice Register.
Choosing to pursue training or a career in the United Kingdom
Medical training is a highly competitive field and there will always be more doctors seeking to undertake training than there are places available. It is important that you are very clear about what it is you wish to do and to plan accordingly.
If you wish to come to work in the UK, you should ensure that you are registered with the GMC (www.gmc-uk.org ).
Clinical attachments
Doctors must arrange observer status/clinical attachments themselves by writing directly to hospitals, as there is no formal mechanism for organising these through the RCOG. Hospital addresses are given in the Health Services Year Book and the Medical Directory, which are available for consultation at most British Council offices. You should approach an appropriate clinical director perhaps through help from UK-based colleagues or write directly to the Clinical Director in the hospitals to which you wish to apply. Doctors should expect a large number of negative responses, since only a few hospitals will be in a position to take doctors for clinical attachments. Please note that, if not registered with the GMC, doctors undergoing clinical attachments may not touch or assist in the treatment of patients. Doctors should also be aware that some hospitals may charge a fee for observer attachments.
Appointment to hospital posts in the UK
By law, all appointments to hospital posts funded by the NHS in the UK must be by open competition. All training posts within the United Kingdom are advertised in the classified section of the BMJ.
Foundation Year I & II
All UK medical graduates must undertake the two-year Foundation Programme of postgraduate training before applying to specialty training. The Foundation programme comprises a series of modules in different specialties, each lasting between three and six months. There is a wide variety of modules, including a 'Women's Health' module in Obstetrics and Gynaecology. All Foundation Trainees are expected to attain a series of generic competencies, whatever specialties their training is based within.
Specialty Registrar posts (ST1 to 7)
After Foundation Training, application for further postgraduate training in a particular specialty or group of specialties is possible.
All doctors entering postgraduate specialty training must have completed 24 months of experience since gaining their primary medical qualification, whether in the UK or beyond. All applicants for Specialty Training Programmes must provide evidence of completion of Foundation programme competences. If one is applying from the EEA for entry into Specialty Training, and you have not completed the UK Foundation Programme within the last three years, you will need to submit alternative evidence by asking a consultant who has supervised you for at least 3 months during the last three years to attest to your achievement of foundation competences. You will be required to produce an ‘Alternative Certificate’, completed by the doctor who has overseen your medical training after qualification, confirming that you have had the equivalent training to the Foundation Training Programme in the UK. Details of the Alternative Certificates and entry requirements for Specialty Training are contained within the Modernising Medical Careers (MMC) website.
In Obstetrics and Gynaecology the length of the standard training programme is 7 years but training may be longer if a trainee spends additional time undertaking research or choosing to do subspecialty training in the latter years of training (see below).
Entry into training posts is through online application and subsequent competitive interview. Obstetrics and Gynaecology is popular with many high quality applicants. The process is overseen by the RCOG but the posts themselves are awarded by the individual regional Deaneries which oversee all postgraduate training throughout the country.
The advertisements for the posts are usually in early November with online application at the end of November and into December. The Deaneries interview shortlisted applicants in the early spring. Posts commence between August and October. There is information about the recruitment process here.
Specialty training consists of a seven-year training programme, with the MRCOG Part 1 taken before ST3 and MRCOG Part 2 before ST6, followed by two years of special interest training during ST6 and 7. During training, you are expected to keep a logbook and record of work done. The training programmes are based in the Deanery to which you are appointed, with a planned rotation through different hospitals within the Deanery to ensure an appropriate range of training opportunities. You do not necessarily have a choice of which hospitals you go to, although the Training Programme Director in your Deanery will endeavour to cater for your preferences.
Other jobs that may be advertised are fixed term specialist training appointments (FTSTA), which are locum appointments for the equivalent of ST1 and ST2 jobs. They give the equivalent training but do not actually carry a training number. These jobs usually only last for six months or maximum of one year. If you are subsequently successful in getting a National Training Number the training acquired in FTSTA can be accredited towards the total time for training, after agreement with the supervising Deanery.
Similarly, locum appointment for training (LAT) posts may be advertised, which are usually at ST3 equivalent level or above. Likewise, these jobs are usually only for six months to a year, do not carry a National Training Number but do provide training that can be accredited towards CCT if you gain a National Training Number at a later date. LAT posts will normally require possession of the MRCOG Part 1.
Within Specialty Training, once you have been awarded a National Training Number and have completed basic training in ST1 and 2, you will do a minimum of three years intermediate training in obstetrics and gynaecology (ST3-5). This training will be assessed against an appropriate core curriculum with an Annual Review of Competency Progression (ARCP) organised by your regional Deanery. If you have satisfactory assessments and have passed MRCOG Part II you will progress into Years 6 and 7 (ST6 and ST7) where you will continue to be assessed against an advanced training curriculum. You will also be expected, in those final two years, to develop your special interests by undertaking a number of Advanced Training Skills Modules (ASTMs). These ASTMs will be a variable length but will all have their own logbooks and curriculum, to be undertaken in addition to the general advanced training curriculum and logbook. Subject to satisfactory assessment you will get your Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration (CESR) at the end of Year 7. Please refer to the General Medical Council and MMC websites for information about CCT and CESR.
Some trainees will choose to do subspecialty training with the aim of specialising more deeply in one particular area of obstetrics or gynaecology; subspecialty subjects at present are: maternal and fetal medicine, urogynaecology, reproductive medicine (including infertility), sexual and reproductive health and gynaecological oncology. These subspecialty programmes are normally for three years, with one year being involved in research. It is possible at present to get exemption from the research year if you have done sufficient research to get a relevant MD/PhD or at least two relevant peer review papers. Exemption from the research year is at the discretion of the Subspecialty Committee of the RCOG. Posts for subspecialty training are advertised in the British Medical Journal (BMJ). The RCOG has a worldwide list of recognised hospitals for subspecialty training. Subspecialty training is assessed annually, with assessment interviews at mid-term and in the final year. Each subspecialty has a specific curriculum and logbook. Completion of subspecialty training enables application to consultant posts practising in this subspecialty only, with little or no involvement in general Obstetrics and Gynaecology, but does not guarantee progression into a subspecialty-only post.
Many hospitals will have on-call married accommodation for which a commercial rate is charged. Food provided in hospital canteens has to be paid for at the time of consumption.
Clinical Fellows/Trust Grades
Many hospitals do have middle-grade registrar jobs but these are not officially training jobs and are not, therefore, officially recognised or reviewed by the deaneries. These jobs are often identical to the StR jobs with identical rotas and experience. They can therefore be used for clinical experience, but if used towards a training programme abroad would need to be approved with your own training authority. These jobs are advertised by the hospitals themselves in the BMJ in the normal way and have variable starting dates and lengths of contracts. If you do a clinical fellow/trust grade job you need to check these will be recognised for training in your home country.
EEA nationals undertaking CCT training in their own countries
EEA nationals who have undertaken a period of recognised training towards a CCT in their own country can apply through open competition for transfer to the UK and be placed in the appropriate year of training for their experience. On completion of training, they will obtain a UK CCT or CESR. (Note however that the numbers of posts in the UK at ST3 and above are very few and the competition is fierce).
Additionally, if you have already obtained a CCT from an EEA country you may apply for subspecialty training post in the UK. It is always important when applying for these posts that you have the appropriate registration documents and have already contacted the General Medical Council in the United Kingdom for registration to work as a doctor.
Glossary
EEA National
The European Economic Area includes the following countries: Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the UK.
FTSTA = Fixed Term Specialist Training Appointments
LAT = Locum Appointment for Training
ST1, ST2, ST3 etc. = Specialist Training Year 1, 2, 3
CCT = Certificate of Completion of Training
CEST = Certificate of Equivalence of Specialist Training
Useful Addresses
The General Medical Council (GMC)
Regents Place, 350 Euston Road, London NW1 3JN
Tel: 0845 357 3456 or +44 161 923 6620 (if from outside the UK)
Email: registrationhelp@gmc-uk.org
Website: www.gmc-uk.org
The GMC deals with all issues relating to medical registration and can provide advice relating to PLAB and IELTS. Since April 2010, the GMC has also been responsible for setting requirements for training and approving training programmes across all specialties.
The British Medical Association (BMA)
BMA House, Tavistock Square, London WC1H 9JP
Tel: 44 (0) 20 7171 4499
Website: www.bma.org.uk
This is the main professional association and trade union for doctors in the UK. Doctors can join once registered or eligible for registration. The BMA offers advice to members on matters including contracts and employment issues and has a wide range of committees including those dealing with consultants, non-consultant career grades, junior doctors (i.e. doctors in training), and international affairs.
Immigration and Nationality Directorate
Apollo House, 36 Wellesley Road, Croydon CR9 3RR
Website: www.homeoffice.gov.uk
Deals with all aspect of immigration. Individuals are however advised to resolve immigration issues in their own country wherever possible.
Useful Websites in the United Kingdom
NHS Professionals
www.nhscareers.nhs.uk
NHS Careers page for international healthcare professionals
UK Foundation Programme Office
www.foundationprogramme.nhs.uk
Modernising Medical Careers
www.mmc.nhs.uk
Medical Careers Information
www.medicalcareers.nhs.uk
London Deanery (Overseas Dean)
www.londondeanery.ac.uk
West Midlands Deanery
www.wmdeanery.org
British Medical Association (Careers)
www.bma.org.uk