The Medical Training Initiative (MTI) is a national scheme designed to allow a small number of doctors to enter the UK from overseas for a maximum of 24 months, so that they can benefit from training and development in NHS services before returning to their home countries.

Through the MTI, trainee doctors from countries outside the European Union are offered the opportunity to learn from experienced consultants within the UK national health system. From April 2017 the Department of Health, Health Education England and the Academy of Medical Royal Colleges agreed changes to the arrangements for processing applications for MTI Certificates of Sponsorship (CoS) from applicants from countries other than those identified as Department for International Development (DfID) priority countries or World Bank Low Income and Lower Middle Income Countries (LI & LMI).

New applications from countries not considered DfID priority or LI&LMI countries will be placed on a revised waiting list and will be processed only if and when there is capacity at the end of each calendar month. While we do not turn away applications for doctors based in other countries, applicants from these countries and employers will need to recognise that the waiting list may become quite long and reduce only slowly. This means that these applicants may be better off finding alternative routes for employment and immigration through Tier 2 entry.

The MTI team is available to respond to telephone queries from individual doctors at the following times each week:

Tuesday 14:30 – 16:30
Friday 11:00 – 13:00

After extensive consultation, Health Education England and the Academy of Medical Royal Colleges launched new standards for the Medical Training Initiative in February 2018. They are aimed at those administrating and approving placements and will sit alongside and complement guides and information which are already available on this site.

They set the benchmark for the minimum requirements of MTI schemes which last more than 6 months, are aimed at doctors and are for use across the whole of the United Kingdom. Recognising the variety of MTI schemes, the standards aim to give flexibility for the allocation of responsibilities, where more than one organisation is involved in providing the scheme. It is expected that organisations and individuals will work together to ensure the standards are met.

If you do have a query about the MTI programme or an individual application, 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.

You can also contact the relevant Trust or Royal College, who is processing your MTI application, for information that you may require. 
Please check with the Trust or Royal College responsible for submitting your application whether they have done so before chasing your application with the Academy, as we may not yet have received the application.

Thank you for your patience.

The MTI Scheme was established by the UK Department of Health in February of 2009 as an immigration category under the Tier 5 Government Authorised Exchange (GAE) class of the points based immigration system. The Tier 5 GAE permits entry to the UK for overseas nationals coming to undertake exchanges or educational initiatives sponsored by government departments.

The Academy of Medical Royal Colleges took on the role of National Sponsor of the scheme in March of 2010. As National Sponsor the Academy is responsible for the issuance of Tier 5 certificates of sponsorship to be used for visa application. Additionally, the Academy plays a role an integral role in promotion of the scheme..

The Academy of Medical Royal Colleges is also an ‘A-Rated Sponsor’. This means MTI applicants will not be required to provide evidence of £945 in a savings account as part of their Tier 5 visa application.

The prioritisation and allocation criteria were updated in January 2017 to reflect the Department of Health’s main focus for doctors from the DFiD priority and L&LMI countries to benefit from the scheme and, therefore giving priority to developing healthcare systems; the new criteria reflects the principles and intent of the scheme, more information can be seen on the Prospective Applicants page.