IMGs seeking to work in the UK — UKFP, F2 Standalone, and the CREST pathway

The UK remains one of the most internationally consequential clinical training environments in the world, with a long-established National Health Service, a postgraduate training architecture under the Medical Education England framework, and a Royal College system that produces credentialled specialists whose qualifications are recognised globally. For international medical graduates, the UK is also one of the most pathway-complex destinations: registration depends on the General Medical Council, postgraduate training entry depends on NHS England (or the devolved equivalents in Scotland, Wales and Northern Ireland), and language and visa requirements depend on the Home Office and on UK Visas and Immigration.

Two structural changes are reshaping this pathway in 2026. First, the NHS Long Term Workforce Plan (published 2023, currently in implementation) is expanding domestic medical school numbers, which over time will shift the supply-demand balance for IMG entry into specialty training. Second, the GMC has announced a phased transition from the Professional and Linguistic Assessments Board (PLAB) examination to the UK Medical Licensing Assessment (UKMLA), which from 2024 onward also became the licensing examination for UK medical school graduates. During the transitional period, both examinations may co-exist for different cohorts; candidates should consult the GMC website at the date of application for the examination route applicable to them.

The UK Foundation Programme is a two-year postgraduate training programme that all UK medical school graduates enter, and that international medical graduates can enter through the UKFP Eligibility Office route. Foundation Year 1 (F1) leads to full GMC registration on satisfactory completion; Foundation Year 2 (F2) leads to the Foundation Programme Certificate of Completion (FPCC), which is the gateway to most UK specialty training applications.

Two sub-routes apply to international medical graduates:

Eligibility documentation for both UKFP routes is administered by the UKFP Eligibility Office and typically includes: medical school transcript and certificate; primary source verification via the GMC's accepted verification service (currently MyIntealth, formerly EPIC); evidence of English-language proficiency to GMC standards (IELTS or OET, at the levels published by the GMC); satisfactory references; and confirmation of immigration status. Applicants should consult the UKFP Office's published eligibility guidance at the date of application.

The GMC publishes a list of countries whose internship years are accepted as equivalent to UK F1 for the purposes of full registration. The criteria broadly require that the internship was a structured supervised clinical year of at least twelve months' duration, undertaken after completion of the medical degree, in posts that included a balance of medicine and surgery (and sometimes other specialties depending on the country's framework), with formal assessment.

The list of accepted countries and the specific durations and configurations required is updated periodically. Applicants should consult the GMC's "Acceptable patterns of internship" page at the date of application. Non-UK internship years that do not appear on the accepted list will not satisfy the GMC's full registration requirements; candidates in this position will need to enter via Pathway A (UKFP, including F1 if a recognised non-UK F1-equivalent year was not completed).

• Confirm GMC examination route at the time of application. The PLAB-to-UKMLA transition is in progress; the examination applicable to your cohort is determined by the GMC at the date of application, not at the date of decision. Do not rely on second-hand summaries; consult the GMC website directly.
• Verify that your overseas internship is on the GMC's accepted list before committing to Pathway B. If it is not, the entire Pathway B route may be blocked and a UKFP-equivalent application may be necessary.
• Plan English-language evidence early. IELTS and OET have validity periods. Sitting the test too early can mean expiry before a registration application is complete; sitting too late can delay GMC registration.
• For Pathway B, build UK clinical exposure before applying for Trust-Grade posts. A documented UK observership — such as the MD Acumen Primary Care Observership — strengthens the application file and demonstrates orientation to NHS systems, professional standards, and the UK clinical environment.
• Plan the visa framework alongside the clinical pathway. The Skilled Worker (formerly Tier 2) visa route is the principal pathway for non-UK IMGs entering NHS clinical employment. Visa eligibility, sponsorship requirements, and Health and Care Worker visa rules are administered by UK Visas and Immigration; clinical and immigration pathways must be planned together.

This page provides general educational pathway guidance. For the authoritative rules at the date of any specific application or decision, consult the original publishing body:

• General Medical Council — registration, PLAB / UKMLA, English-language requirements, accepted patterns of internship — gmc-uk.org
• UK Foundation Programme Office — UKFP eligibility, application calendar, F2 Standalone — foundationprogramme.nhs.uk
• NHS England — postgraduate medical education, specialty training recruitment — england.nhs.uk
• UK Visas and Immigration — Skilled Worker / Health and Care Worker visa routes — gov.uk/browse/visas-immigration
• NHS Long Term Workforce Plan — published 2023, currently in implementation — england.nhs.uk/long-term-workforce-plan
• MyIntealth (formerly EPIC) — primary source verification — intealth.org

Continue exploring the medical graduate pathways

If you are weighing the UK against international destinations, or if you want a structured UK clinical observership, the related pages below carry the relevant guidance.