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FAQs for doctors

Answers to frequently asked questions for doctors applying for the RCOG Medical Training Initiative (MTI) scheme

MTI 2022 update

Due to the impact of COVID-19 pandemic on UK training and resultant reduction in the demand for MTI trainees in the current climate, we regret to announce the College will not be going ahead with an applications intake from prospective candidates for the RCOG MTI Scheme in 2022.

Read the full statement and FAQs

Covid-19 and and MTI

COVID-19 updates for the MTI scheme

Please read full details and FAQs


Application process

After being accepted/the MTI process

While in the UK


Covid-19 and and MTI

How is the RCOG managing the MTI Scheme in light of COVID?

As an organisation committed to providing safe and excellent care to woman and girls across the globe, we take seriously our role in helping to protect the public from the spread of the COVID-19 virus.  We are, therefore, continuing to monitor the situation daily and follow the advice and updates from the Chief Medical Officers and Public Health England (acting for all of the UK). Our guidance for both UK Employers and potential MTI applicants is constantly updated on this website accordingly. If you have any questions or concerns please contact


Should I apply for MTI during the COVID pandemic?

The pandemic is an unprecedented global situation which is constantly evolving and unfortunately we cannot predict with any certainty how this will develop over the coming weeks and months.

Doctors applying for the MTI scheme should check the latest guidance about the status of COVID-19 in the UK before deciding whether it’s practical to pursue an application in the current climate

Hospitals may be stretched, Doctors may be redeployed, self- isolation indicated and/or travel more difficult. It may also be challenging to bring your family members and children to the UK during this period with practical issues to consider e.g. schooling and also to return home for holidays. This is a personal decision and we suggest you think carefully before deciding whether it is right for you to apply for MTI 2021.


Has COVID impacted on training and education opportunities for MTI trainees?

Since reopening the MTI Scheme on 6 April 2020, we have seen COVID detrimentally impact on training and education opportunities in the NHS. A decline in elective service provision during the pandemic coupled with a drop in patient demand has resulted in a reduced workforce demand in the O&G specialty. At present we cannot guarantee training will give you full exposure to all areas of O&G and surgical exposure may be limited.


Has COVID impacted on MTI placement post numbers?

The number of placement post requests from Trusts under the MTI Scheme 2020 fell by over 20% compared to 2019. The MTI Scheme is heavily oversubscribed with applications each year, so we would ask you to be mindful of this when making your initial application and manage your expectations accordingly.

Due to the impacts of COVID on the progression of UK trainees, it is likely we will see a reduction in the number of MTI placement posts in the 2021 round. Applicants who are wait listed for the 2021 round should proceed on the understanding that we are unable to guarantee how many placements will be available. The College will be transparent with MTI applicants at all stages of the process and will provide regular updates.  



I won’t have 4 years of postgraduate training until after the deadline for MTI applications. Can I still apply?

Unfortunately no. All doctors must already have 4 years of postgraduate training and submit their Assessment of Training letter before the deadline of Friday 11 December 2020. We advise that anyone who will achieve their 4 years of postgraduate training after the deadline, waits until next year to make an application for the MTI scheme 2022.


I have more than 10 years of O&G experience. Am I eligible to apply?

The MTI scheme is developed for doctors who wish to gain more experience, training and exposure to the UK health system. The level of the offered posts (ST3-5) and focus on general core training means MTI is not appropriate for highly experienced doctors or consultants. Therefore doctors who have more than 10 years of experience in O&G are not suitable for this scheme and their applications will not be considered.

All applicants for the MTI scheme will need to detail all posts from the time of obtaining their primary medical qualifications in their employment history. Any gaps in employment (unless clearly explained e.g. maternity leave) will result in rejection of the application.


I want to obtain advanced training (e.g. laparoscopic surgery/urogynaecology). Should I apply for the MTI scheme?

The RCOG’s MTI scheme is designed to help international medical graduates to come to the UK to consolidate their core training in Obstetrics and Gynaecology and obtain the MRCOG qualification. It is not a scheme designed to provide advanced training. The posts offered under the MTI scheme therefore start at ST2/3 level (equivalent to 2nd / 3rd year of a 7 year UK training program). Please also note that COVID has impacted on training and education opportunities with elective services being cancelled in many hospitals and opportunity for surgical exposure is at present extremely limited.

However, if MTI trainees obtain the MRCOG early in the 2 years of training, they may be able to undertake Advanced Training Skills Modules (ATSM) in their areas of interest during the remainder of the 2 years. The ability to do this will depend on the presence of spare training capacity in their local hospitals to undertake these ATSMs and cannot be guaranteed. It should be noted that the tier 5 visa cannot be extended to facilitate completion of ATSMs.


I have been out of medical practice for the last couple of months, am I eligible?

Unfortunately no. The GMC (General Medical Council) will not register any doctors who have been out of full time medical practice for any of the last 12 months leading up to an application to register. All doctors must register with the GMC to be able to practice and so if they will not register you, you cannot work in medicine in the UK.


Which IELTS / OET exam should I sit?

For IELTS, we require you to sit the Academic test. You should achieve at least 7.0 in each domain of the test and you must achieve 7.5 or higher in your overall score. Please note the IELTS Indicator test is not accepted by the GMC.

For OET you must score an A or B. OET can either be paper based exam or the electronic OET@Home exam.

We cannot accept any deviations from this regulation, as it is a GMC requirement.


I am a national of one of the MTI-eligible countries, but reside and work in a high income country. Am I eligible to apply for MTI?

No, we can only accept applicants who are residing and practising in one of the MTI-eligible countries (lowlower middle-income and upper middle-income countries with a focus on DFID 28 priority countries).


I was born in a high income country, but my country of residence is now one of the MTI-eligible countries, can I still apply?

Yes, provided you meet all the other eligibility criteria.


Why does the RCOG not consider doctors from high-come countries for MTI?

The MTI scheme is a philanthropic ‘learn and return’ scheme which provides opportunities for doctors who work in low income settings to train for a fixed period in the NHS system. After completing a training placement MTI doctors will be expected to return back home and will be able to use the knowledge and skills they have gained in the UK  to improve the healthcare system in their home country. In general terms, high income developed countries’ healthcare systems do not have the same degree of need.


I have taken some contractual annual leave within the last 12 months, am I eligible?

Yes, you are eligible. Contractual annual leave does not count as a gap in your clinical experience.


I have a gap of a few weeks in the last 12 months because of changing jobs or because of COVID. Would this be acceptable?

Technically, you should have no gaps in the 12 months prior to your application in order to be eligible. However, the GMC may make an exception depending on the circumstances. If you have a gap in your clinical experience of a maximum of 5 weeks, but believe that the circumstances are exceptional, please contact the RCOG MTI Office (please include exact dates and reason for such a gap) and we will seek further advice from the GMC.


Application process

Who should fill in my Head of Department (HoD) Form?

We appreciate that doctors may be unsure as to who should fill in their HoD form if they have not been working in a hospital for a long time or if they do not have a head of department in Obstetrics & Gynaecology. If this is the case, doctors making an application should approach the most senior consultant within their department who is overseeing their training and ask for them to complete the HoD form and submit it to directly. This consultant should not also be asked to provide a reference for the doctor.


I haven’t got an Assessment of Training letter. How do I get one?

If you have completed 4 years of postgraduate training, you can apply for your training to be assessed by the Examination Department.

You must allow up to 4 weeks for your AoT application to be processed. The time is needed to allow for procedures such as application screening, verification of certificates, verification of training posts and authorisation of the final approval letter.

If you have still not heard from the Examination Department within 4 weeks of submitting your application, please email

You must obtain your AoT approval letter from the Examinations Department before the MTI deadline, to include in your MTI application. We are unable to accept late applications.

Your AoT approval letter must be included in your MTI application bundle, for the application to be considered by the assessment panel.


Can I bring my family?

Yes, many MTI doctors come with their families. They can come on a dependent visa. You should contact the UKVI (UK Visas and Immigration) for more information.


I applied to the MTI scheme last year but was not successful. Can I use any of the same forms for my application this year?

We welcome applications from those who were not successful last year. However, you must submit an entirely new application and references. You can resubmit your IELTS / OET certificate if it is going to be in-date until near the end of 2021 and you achieved the correct score, passport copy if valid until end of 2021 and AoT.


My IELTS / OET result won’t be ready until after the deadline, what should I do?

If you have sat the exam before the MTI 2021 application deadline of Friday 11 December 2020 and are awaiting your test results you will need to submit evidence with your application that you have sat the exam which must include the date of the exam. An official email from the exams board will be accepted. If you are unable to sit the exam before the applications deadline you will not be eligible to apply in the MTI 2021 round and will need to wait until the following year.

If you sat the exam before the close of applications on Friday 11 December 2020 and are awaiting the results you will need to send us your test results by Saturday 2 January 2021. If your certificate is not currently available an official email from the examinations board detailing your score will be accepted in place of the certificate. Unfortunately, we cannot accept anything else.

If we do not receive the score by this deadline or if you do not meet the minimum scoring thresholds your MTI application will be rejected.


I would like to be placed in a specific hospital / region in the UK. Is it possible to request this?

Successful MTI candidates are matched with available posts on a random basis. If however, for serious personal/family reasons you wish to be placed in a certain region or hospital around UK, please state it on your application form in the ‘Further Information’ box at the end of the document. We may be able to consider such requests, but please note that this will not always be possible and it will depend on many factors. It will not be possible to request this after you have been provisionally matched with a hospital, therefore please include such request on your MTI Application Form.


Do I need to be interviewed by my IRC Chair?

Candidates do not need to organise an interview by their IRC Chair as part of the applications process. Only those candidates whose applications are successfully shortlisted by the assessment panel in January will be required to organise an interview by the IRC Chair. Shortlisted candidates will be contacted by email in early February 2021 with further information.


What costs do I need to factor in as an MTI trainee?

You will need to cover the fee for the GMC application for full GMC registration and you will also need to cover the tier 5 visa application fee (also applicable for any dependent visas).  Also, take into account that when you move to the UK you may have to arrange your accommodation and sustain yourself for a month until you receive your first salary. At present MTI trainees must pay the healthcare surcharge (also known as the Immigration Health Surcharge) which will be reimbursed subsequently (this is currently charged at the point of making the tier 5 visa application and you then can reclaim once working in the UK every 6 months, read more here).

Currently those arriving in the UK may face additional costs in light of COVID-19 with hotel quarantine for arrivals from red list countries and self-isolation for other international arrivals and mandatory COVID testing for all arrivals to the UK. Read more around the latest regulations on Gov.UK. Hospitals may be able to help  with meeting these additional costs either through relocation allowances, salary advances or by putting MTI doctors on paid leave when they arrive to the UK (please check with the hospital what arrangements are in place for assisting you to cover these costs in advance). If you are planning to come with your family you will need to factor in the visa costs, IHS charges and COVID related expenses (hotel quarantine if applicable and COVID testing) for each person travelling.

More information on relocation fees can be found in the Academy of Medical Royal College’s MTI Relocation Guidance (PDF)


After being accepted / the MTI process

What happens if I’m pregnant during my MTI placement?

Being pregnant does not disqualify you from applying for the MTI scheme. However, you will need to consider a few issues.

While all NHS staff will be eligible for maternity leave, pay during maternity leave is dependent on duration of service. To be eligible for occupational maternity pay (OMP), the member of staff should have worked for the NHS for 52 weeks and for statutory maternity pay (SMP), should have worked for the current employer for 26 weeks before the start of the 24th week of pregnancy. Hence, a trainee that is pregnant at the time of starting their placement will not be eligible for maternity pay. You must therefore consider the financial implications of being resident in the UK without a regular income during this period of maternity leave.

In addition, as the MTI placement is for 2 years and the tier 5 visa cannot be extended beyond this time, prolonged periods of absence is likely to adversely impact on the training that the MTI doctor will receive during their placement.

If you are pregnant and are considering applying for the MTI scheme, you may choose to defer your application to a subsequent year. If having applied and being successful in obtaining a placement, you then find yourself to be happily pregnant, please liaise with the RCOG MTI office who will be able to offer individualised advice.


How long does it take to obtain a Certificate of Sponsorship needed for the application for Tier 5 visa?

RCOG will apply for your CoS at the Academy of Royal Medical Colleges as soon as we receive all the required documents. The time taken to process this will be determined mainly by the speed at which hospitals are able to send the RCOG the required signed forms. This may vary depending on the individual trust.


I need a letter confirming I have been offered a post in O&G via RCOG, how do I get one?

In some countries, employers or Home Offices request doctors to submit a letter stating they have been selected for two years to join the O&G training in the UK via RCOG. We are able to issue such letter if necessary on an individual request. If you need this document, please e-mail MTI with following details: full name, country you are coming from, name and address of the Trust you are joining in the UK, estimated start date. You should receive the letter within 5-7 working days.


When should I expect the MTI office to contact me?

The MTI unit is extremely busy and unable to answer all of the individual queries regarding application and assessment. However, we will make sure to contact the candidates when necessary and to provide all of the needed information. After submitting your application and making sure it is complete you should wait for us to contact you. You will not receive a confirmation of a receipt of your application. If your application is complete and you are eligible, your application will be taken forward to the Assessment Panel in January 2021. You will be contacted about the outcome of the assessment only if you are shortlisted for the interview stage of the process.

After your successful application is matched with a UK hospital, you will be informed. At this point you will be provisionally matched and we will put you in touch with the hospital. Depending on the hospital’s preference, you may be asked to schedule an online interview with them. It is yours and hospital's responsibility to undertake this process and the MTI office does not get involved in this part of the process. We will wait for the hospital to let us know whether they are happy to proceed with offering you a post. Should you be successful, we will send you an e-mail with next steps you need to follow. Should the hospital reject your application, we will try our best to allocate you to another hospital, if vacancies are still available at that time.

Later in the process, we will assist you with the GMC application and make sure your application for the Certificate of Sponsorship for your visa is processed as soon as possible, depending on when we collect all of the paperwork from your hospital.
The RCOG MTI will not reply to individual queries unless they are not answered on our website. Please read all of the instructions available on different sections of this website as well as the instructions we send you very carefully.


I have been informed that I am successful / waitlisted in the MTI selection process. Can I look for a job myself?

Trusts offering placements for MTI doctors have to ensure that there is spare training capacity locally before applying for an MTI trainee to be placed in their units. Only posts with sufficient educational potential will be considered by the MTI scheme as suitable. Some posts (e.g. speciality doctor posts) are not considered suitable for the MTI scheme. Trusts have to apply to the RCOG for MTI trainees with details of suitable posts. Trainees are placed in order of their ranking in the selection process.

Candidates for the MTI scheme should not try to directly contact trusts in order to obtain employment. Candidates found to be directly contacting trusts for employment will be disqualified from the process and will not be placed.


My MTI application was successful but I am no longer interested/able to join the MTI scheme, what should I do?

If for any reasons you wish to withdraw your MTI application/are unable to join the MTI scheme please email as soon as possible. We need to know in order to update our records and fill all of the posts that are being offered.


I have not heard from the MTI for a long time. How do I know what is happening?

We appreciate that it is very stressful not to hear from us for a long time. Please be assured that we will contact you as soon as it is feasible and you will be provided with all of the necessary information in time. We kindly ask you to be patient even if you have not been contacted for a long time – we are working on it.

We will contact those shortlisted but not successfully-placed in the scheme in mid-October 2021 to advise they have not been successful in this round. If they still meet all the eligibility criteria for the scheme they are welcome to reapply for the following year.

Please read the FAQs for doctors: stages of the MTI process which explains in more detail what you should do in different stages of the MTI process. We invite you to revisit this page whilst going through the MTI process.


While in the UK

How do I get an access to the e-portfolio?

In order to set up your e-portfolio as an MTI, you must either be a UK Associate Member or register join the Trainees Register. For any queries please contact


I am struggling with my work and I need guidance

We understand that relocating to a different country and working under a different system can be stressful. Please allow yourself the first few weeks/months to adapt. However, if you feel that you struggle for a long period of time and it does not seem to change, please visit our page which outlines what the RCOG can do to support you and what steps you should follow before you write to us.


I want to resign from the MTI post

Should you wish to resign from the MTI post, please let us know as soon as possible and we will process the necessary documentation. Please do not leave your post without notifying the RCOG.


Can I change posts or leave the MTI scheme before the end of the placement?

The MTI scheme matches trainees with trusts that have offered training placements under the scheme. It is intended that trainees stay in the same trust for the entire 2 years of the placement. Occasionally, the trainee may move to another hospital within the same deanery. Such a move will be agreed by the trust and the deanery and communicated to the RCOG, AoMRC and GMC.

In rare circumstances, the trainee may decide to resign the MTI placement in order to return to their country of origin for personal or professional reasons. While this is regrettable, we recognise that this may be due to circumstances beyond your control.

However, moving from the MTI placement to another job in the UK during the 2 years of the placement is strongly discouraged. The MTI scheme is designed to provide overseas doctors with structured training in the UK, which may not be provided by a non-training post.

Although MTI trainees do not contribute financially to the scheme, individual hospitals have to pay a placement fee (currently £3000/ placement) to the RCOG for each trainee that is allocated to them, which helps to cover the cost of administering the scheme.

If a trainee resigns from the MTI scheme to take up alternative employment in the UK, the employing trust may choose to recover the costs of the placement from the trainee.


Can I register for an ATSM as an MTI trainee?

Yes, you may register for an ATSM provided you have passed Part 3 of the MRCOG. Your ATSM Director will be able to advise whether there are sufficient ATSM training opportunities within your deanery. ST trainees must complete ATSMs to gain their CCT and therefore are given priority. However, many Deaneries report additional training capacity.

If you do register for an ATSM, you’ll need to complete the application process and register as a Trainee with the RCOG. If you don’t meet the criteria to register with the RCOG, your deanery  may still offer training and provide a certificate of equivalent training for your records when you complete the ATSM. However, this certificate doesn’t count towards CCT or CESR(CP).


Contact us

Please ensure that you meet all of the criteria as specified on our website. Unfortunately we cannot make any exceptions to this list and so if you do not currently meet the criteria, we would advise that you consider re-applying for the next round.

Please do not enquire as to the progress of your application. We receive a huge number of applications and we cannot respond to individuals. The time frame of assessment is stated on the website.

If you have not found the answer to your question in this list, please email


Elsewhere on the site

Working in Britain for non-UK doctors
General guidance about working and training in O&G for doctors from outside the UK
Global health work
Find out about the RCOG's work to tackle maternal mortality and morbidity worldwide