MTI questions fall under the following three areas.  Scroll down to see all questions in each area.

  • Considering an application
  • Making an application
  • During an MTI placement

If, after looking through the information available on our website, you have further questions, the most effective way to contact us is to email:, with the full name of the doctor interested in, or applying for, an MTI placement in the email subject.


ENT UK  can help you with finding out about making an MTI application in your Specialty. Details can be found on the ENT UK website.

The MTI scheme for dentistry placements is run by the National Advice Centre for Postgraduate Dental Education (NACPDE). Further information can be found on the NACPDE website.

Or you can contact them at:

Admission to the MTI is through the Medical Royal Colleges (or through the small number of other bodies that the General Medical Council (GMC) accept professional sponsorship from). Applicants will need to satisfy the following criteria:

  • United Kingdom Visa and Immigration (UKVI) Points Based System criteria for a Tier 5 Government Exchange Scheme Visa
  • GMC criteria for non-PLAB (Professional Linguistics Assessment Board) route registration
  • Any additional Medical Royal College (or other GMC sponsoring body) criteria for sponsorship (refer to the relevant Medical Royal College for further information)
  • Must not have been on a MTI placement in the last five years

Yes. International Medical Graduates (IMGs) do require GMC registration to work under the MTI scheme.

The Medical Royal Colleges are the most common sponsoring bodies of MTI candidates and provide verification to the GMC that an MTI candidate is suitable for GMC registration.

The sponsoring Medical Royal College assessment and verification means that candidates are not required to take and pass a Professional Linguistic Assessment Board test (PLAB). The non-PLAB route to GMC registration is a key feature of the MTI scheme. Only certain bodies have been approved by the GMC as being able to undertake this assessment, more information can be read on the GMC website.

Yes. The appropriate Deanery and employing Trust will still be involved in the MTI placement and visa application process.

To be awarded a certificate of sponsorship for a Tier 5 Visa, the following requirements need to be met:

  • Confirmation that the post is suitable for MTI (sufficient educational content and does not disadvantage UK graduates)
  • Confirmation of eligibility for GMC registration.

However, the specific placement offered may not be suitable for an MTI placement (and therefore Tier 5 Visa). If the role is purely observing it may not be considered to have sufficient educational and training content. You should ask the Trust offering the placement to confirm with their relevant Deanery if the role is suitable for an MTI placement. If it is, the Trust ought to be able to help you with the steps required for getting a Tier 5 Visa.

An MTI clinical toxicology placement is most likely to be sponsored by one of the Royal College of Physicians (London, Edinburgh, Glasgow). However, to progress towards a Tier 5 visa, the following requirements will also need to be met:

  • Confirmation that the post is suitable for MTI (sufficient educational and training content and does not disadvantage UK graduates)
  • Confirmation of eligibility for GMC registration.

No. Under the Tier 5 Government Authorised Exchange, workers must be funded to the National Minimum Wage Act requirements for their skill and training level. This funding can come from any source, except the applicant’s personal funds, e.g. the employing UK Trust, a foreign employer or UK/foreign government grants and scholarships. An IMG must be able to provide evidence of an external source of funding for their post.

Yes. However, the IMG must return to their home country in order to apply for their Tier 5 Visa. It is also worth noting that the IMG will need to check if they are also required to apply for GMC registration. If so they must comply with the GMC Recency of Practice Rule, if they don’t already have GMC registration.

Yes, providing that:

  • The post they are in is agreed by the appropriate Deanery as an MTI post*
  • The MTI application process is then followed.

*Students might find it difficult to meet the GMC registration requirements relating to length and recency of medical practice.

MTI Tier 5 Visas are granted for a maximum period of 24 months, after which the individual will be expected to return home. Participation in the MTI will not lead to settlement in the United Kingdom. It is important to note that there is no prospect of a career in the UK via this route.

The MTI Tier 5 Visa scheme requires that you leave the UK after the two year period. If you then choose to go to another country rather than your home country, your ability to do this would be governed by the entry requirements of your chosen destination country.

The 24 month maximum length of a Tier 5 visa cannot be broken up into different periods with gaps in between, whether with same or different Host Trust. Although technically there is no UKVI rule against the number of Tier 5 visas applied for and the period between them, it is a Department of Health rule with regard to the MTI scheme that participants cannot reapply within 5 years.

No, there is no limit for how many MTI posts a trust can have at any one time.

There is no rule on this. It is the role of the relevant Deanery to approve each post as suitable for filling by an MTI placement (have sufficient educational content and not disadvantage UK trainees). Part of their consideration should be whether the role first requires UK advertising. Tier 5 does not have the UKVI RMLT requirement.

An MTI placement does not have to be an unfilled salaried training post (although many are). But it does have to be approved by the relevant Deanery as appropriate (e.g. contain sufficient training and not disadvantage UK trainees) for an MTI placement. The relevant Royal College is also likely to need to assess the post as part of providing professional sponsorship.

Each time a new individual is placed in an MTI post the following is required for the Academy to process a Tier 5 Certificate of Sponsorship:

  • Confirmation from the appropriate Deanery that the post is a suitable MTI role (e.g. contains sufficient educational content and does not disadvantage UK trainees). Obtaining this confirmation might be streamlined if the post is established as a specific MTI post.
  • Confirmation from the appropriate Royal College (or other GMC approved sponsor) that the individuals are suitable. This is usually via a letter of sponsorship from the Royal College, who would also then manage obtaining GMC sponsorship for the applicant.


The process varies according to the specific process run by each Medical Royal College (or other GMC sponsor). Some Medical Royal Colleges become involved once a potential Host Trust and/or UK Supervising Consultant and a potential participant have already made contact with each other to agree a placement in principle. Other Medical Royal Colleges run specific recruitment drives to find suitable participants.

Once a suitable applicant and post have been identified, an application for a Certificate of Sponsorship for a Tier 5 Government Exchange MTI Scheme Visa needs to be made via the Academy of Medical Royal Colleges. The Academy issues a Certificate of Sponsorship which the individual uses in applying for their Tier 5 visa in their home country. Once the Tier 5 visa has been granted, the MTI participant is able to enter the UK and take up their MTI post.

The Academy of Medical Royal Colleges is only licensed by the UKVI to issue Certificates of Sponsorship (CoS) for Tier 5, Government Approved Exchange Scheme (MTI) Visas. To satisfy the Department of Health requirements for the MTI scheme and UKVI Sponsor licence arrangements, and to complete the required mandatory information on the UKVI system for each CoS, the Academy requires the individual data items detailed here.

Provision of the individual data items to the Academy should be made by submitting the following documents:

  • Completed MTI form (Parts 1 and 2)
  • Copy of passport
  • Offer letter / Funding letter with gross amount to be paid clearly stated
  • Copy of Sponsorship letter from Royal College
  • Copy of GMC registration or email inviting applicant to ID check.

This depends on the specific arrangements between the sponsoring Medical Royal College and the Academy of Medical Royal Colleges. The relevant sponsoring Medical Royal College should advise Trusts.

Once we have received all the required information, we will endeavour to process applications for new Certificates of Sponsorship according to the guidelines set out below, all subject to availability of allocation slots from the yearly allowance provided to the Academy of Medical Royal Colleges.

DFID Countries:
Applications from DFID Countries will be processed within five business days of acknowledgement of receipt, subject to availability of allocated Certificates of Support to the Academy.

L&LMI Countries:
We will endeavour to process applications from L&LMI Countries Applications within two weeks of acknowledgement of receipt, subject to availability of allocated Certificates of Support to the Academy.

Other Countries:
We will endeavour to process applications from Other Countries not included in DFID and L&LMI Countries within a period of three weeks, subject to availability of allocated Certificates of Support to the Academy.

A Certificate of Sponsorship (CoS) is valid for three months from the date of issue by the Academy of Medical Royal Colleges.  Any associated application for a Tier 5 Visa must therefore be made within this three month period. The dates of validity are shown on the electronic copy of the Certificate of Sponsorship.

Having the GMC’s approval (subject to attending an ID check) is essential to work as a Doctor in the UK and for the Academy of Medical Royal Colleges to provide a Certificate of Sponsorship. The Academy certifies, amongst other things, that the applicant is of sufficient professional standing to take part in the MTI. If the invite to attend an ID check expires before the CoS is used for a Tier 5 Visa this will not mean that the Tier 5 Visa application is refused by the UKBA. However, the applicant runs a risk that, for some reason, the GMC will not provide approval at a second time of asking and without approval the individual will not be able to take up their MTI placement. Any expenditure, including visa fees, will be lost.

Yes. Internal Medical Graduates applying for a MTI Tier 5 Visa can concurrently apply for dependent visas for their immediate family members.

No. It is implicit in the Certificate of Sponsorship so there is no need a separate letter.

MTI placements live in the UK during the period of the Visa and so do not need the box ticked. They are still able to travel overseas for leisure / work / domestic purposes.

The UKBA guidance states that this box should only be ticked ‘if the migrant is based outside the UK and wishes to enter the UK on a regular basis’ during the period in question. It should not be ticked for ‘migrants who will be living in the UK and wish to travel overseas for leisure, domestic or work periods.’


In order to extend a visa, the following is needed by Academy:

  • Confirmation from the Host Trust that the post will be funded for the period of extension and what gross funding will be provided
  • Confirmation that all other details (post title, job description, place of work etc.) remains the same – or details of appropriate changes.
  • Confirmation of the Doctors current UK home address (not the original home country address).
  • Confirmation of the start and end dates needed for the Visa extension.

There is a fee for the visa. You need to refer to the UKVU website for the latest information on prices. You can apply for a Visa extension online, by post or in person at one of the seven UKVI Public Enquiry Offices (Belfast, Cardiff, Croydon, Glasgow, Liverpool, Sheffield, Solihull).

If the only role available to you at the end of your current post is an honorary (i.e. non-funded) role, this would not meet the requirements for issuing a Tier 5 MTI Visa extension and the Academy would not be able to issue you with a Certificate of Sponsorship.

A requirement of issuing the original Tier 5 Visa, and any visa extension within the maximum 24 month period, is for the related post to be funded. In order to issue a Certificate of Sponsorship for use in applying for a Tier 5 Visa or visa extension, the Academy (sponsors of the MTI scheme) have to see evidence that the post is funded and certify to this on the UKBA system.

Yes. An MTI Participant can leave the UK on an intermittent basis, for example for holiday or domestic reasons. However, prolonged absences will be scrutinised by border officials and may result in the withdrawing of their Tier 5 Visa.

An MTI participant can choose to end their MTI placement and return to their home country at any time should circumstances require this. If this occurs, the Host Trust should complete and send an Exception Report to the Academy who will inform the UKBA and the Tier 5 Visa will be withdrawn.

Yes an MTI participant can change posts during the period of their Tier 5 Visa. However, they must inform the relevant Medical Royal College prior to changing posts to ensure that the College is still able to sponsor them in their new post. The College will want to know the reasons for leaving the original post prematurely. Details of the new post (job description, rota, salary, consultant contact) along with Deanery approval (educational and training requirements) of the new post must also be sent to the Academy of Medical Royal Colleges to approve before the change is made. This would normally be done by the new Host Trust. The current Host Trust should send an Exception Report stating the individual is leaving their current post. The Academy will then update details on the UKBA system.

If the post entails most of the time in the ‘home’ Trust and for example one or two days a week/month in another Trust, both work addresses should be provided and can be recorded on the UKVI system.

If the post entails for example eight months in the ‘home’ Trust followed by four months in another, the Academy would need an Exception Report from the current Host Trust in advance of the move to advise of the change of location and evidence of Deanery approval and provision of funding for the new post from the new Host Trust.

The answer to this will depend on the home country in question and what arrangements they have with the UK. The HMRC website should provide information on agreements between countries, or alternatively the individual concerned can telephone them and ask.

The official NHS policy is that an individual would not be eligible (unless they are being paid by a UK employer (e.g. a NHS Trust)) until they have resided in the UK for 12 months. After that time, they are eligible. However, in MTI placement instances it is possible that they might be considered a ‘volunteer’ in the health service as they are not receiving UK pay. Interpretation of the rules is down to the NHS Trust in question where the individual is wishing to use the NHS services. Policy on use of NHS services can be found on the Department of Health website.

No. The Tier 5 regulations state that those on a MTI Tier 5 Visa can change employment but only up to the maximum 24 months stay – they cannot move to a Tier 2 Visa.

The objective of the MTI scheme is to assist in building healthcare capability outside the UK, particularly in developing countries, and is not to be seen as a route to UK-based employment. Under the Tier 5 and MTI rules, a MTI participant can only:

  • Stay in the existing role – which can be extended up to a maximum stay of 24 months
  • Move to another acceptable MTI post (the Academy has to confirm this before a move is made) – for a duration up to the maximum stay of 24 months.

An MTI participant could return to their home country after their Tier 5 Visa expires and then seek employment in the UK under a Tier 2 Visa, but this would be outside the remit of the Academy and the MTI scheme.