MTI Frequently asked questions for employing organisations

Please contact the relevant medical royal college that will be acting as the GMC sponsor for your doctors.

Please contact the relevant medical royal college that will be acting as the GMC sponsor for your doctors.

No. This is forbidden by the Home Office regulations for Tier 5 visas. The certificate of sponsorship must only be requested for the duration of the post linked to it. Applying for a certificate of sponsorship for longer than the duration of the post, even if there is a strong likelihood of the placement being extended, could result in the MTI doctor being in breach of their licence conditions. The Academy could also be subject to compliance proceedings by the Home Office. The Academy is reliant on employing organisations and medical royal colleges adhering to the Home Office regulations. If you are not sure what is and isn’t permitted, always contact the Academy at mti@aomrc.org.uk. Failure to do this potentially puts the whole scheme at risk.

No,  provided that the following applies for every post you want to fill:

• That the post does not disadvantage UK trainees nor adversely affect the training of existing trainees in the training location
• That the post provides sufficient educational and training content.

It is the role of the relevant Deanery to approve each post as suitable for filling by an MTI placement (i.e. that it has sufficient educational content and does not disadvantage UK trainees).

The Tier 5 visa does not have to comply with the UKVI RMLT requirement.

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 (i.e. contains sufficient educational and training 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 GMC approved sponsor that the individual is suitable.

Once a suitable applicant and post have been identified, the successful applicant will need a certificate of sponsorship for a Tier 5 Government Authorised Exchange visa. This is provided by the Academy on receipt of all the relevant documentation. The certificate of sponsorship is then used by the individual to apply for their Tier 5 visa from 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 certificate of sponsorship is valid for three months from the date of issue.

Please note, the Academy does not issue the Tier 5 Visa – we only provide the doctor with the certificate of sponsorship required for their visa application.

Before we can produce a certificate of sponsorship, we require the following documents from the GMC sponsor (royal college or NHS employing organisation):

• A completed MTI Application Form. Please ensure all questions are completed before submission
• A clear copy of the doctor’s passport
• Job offer and funding documentation [if the post is funded by the home country, please convert these amounts into Great British Pounds (£) on the MTI Application Form]
• Confirmation of GMC registration or an email inviting the doctor to complete an ID check for completion of their registration process
• Confirmation of Deanery approval of the post, signed only by one of the signatories on this list
• Data protection form signed by the doctor.

The Academy is only able to accept applications from the GMC sponsor. Applications will not be accepted from NHS employing organisations that are not GMC sponsors, or from doctors themselves. If a doctor already has GMC registration and a full licence to practise, an MTI post may be found via an NHS employing organisation or a royal college who will then process the application.

Completed application forms should be emailed with all relevant documents by the GMC sponsor to mti@aomrc.org.uk with the name of the doctor in the subject title.

Incomplete applications will be returned.

Only when we have received all the required information (see Question 8 above), will we process applications for new certificates of sponsorship according to the priority guidelines set out below,  subject to availability from the annual allowance provided to the Academy of Medical Royal Colleges by the UK Government.

World Bank Countries

Applications from World Bank Countries will be processed within five working days of acknowledgement of receipt of all required documentation.

Lower Income and Lower Middle Income Countries (L&LMI)
We will endeavour to process applications from Lower and Lower Middle Income Countries within ten working days of acknowledgement of receipt of all required documentation.

Other Countries
Applications not included in World Bank and L&LMI Countries will be processed subject to the availability of allocated certificates of sponsorship for applicants from other countries. We aim to complete these within ten working days of receipt of completed documentation.  We ask that doctors, NHS organisations and medical royal colleges keep the applicants’ work dates flexible.

No. However, there is no guarantee that this will not change in the future. Should this be required, NHS Employers have stated that proof of vaccination would be for the employing organisation to confirm.

Forms will need to be submitted to the Academy in the following circumstances.

• If an MTI doctor does not start the role for which they are being sponsored, including any reason given for their non-attendance, if known (for example, a missed flight, illness, or bereavement) – this is done by means of the Exception Report
• Within two weeks/10 working days of the MTI doctor starting their placement, send a Starters Report together with a PDF copy of the doctor’s right to work profile indicating that it is a true likeness of the doctor
• If there is an extension within same organisation – please submit an Extension Report before the original visa expires
• If an MTI doctor is going to transfer to different role within your organisation, you must submit and receive approval of a Transfer Report before the doctor transfers their placement
• If an MTI doctor is going to transfer their placement into your organisation, you must submit and receive approval of a Transfer Report before the doctor starts that placement
• When an MTI doctor’s contract of employment or contract for services, or any relevant professional registration ends– for example, if they resign or are dismissed – you must submit an End of placement Report
• If you have any reason to believe that the doctor’s conditions of leave are being breached, you must submit an Exception Report

 You will find a full list of roles and responsibilities for each of the relevant forms explained here.

If the correct paperwork is not submitted in the correct timeframes, the Academy will cease to issue any further certificates of sponsorship to the relevant employing organisation until the outstanding paperwork has been received. In exceptional cases, failure to submit the required paperwork could result in the Academy withdrawing sponsorship from the relevant doctor. This would be an action of last resort and would not be undertaken lightly.

Please note that all paperwork emailed to the Academy should be copied to the GMC sponsoring organisation so that they are aware of progress and can send reminders for paperwork if necessary.

The UKVI requires the Academy to keep a record of any absences from work. This includes annual leave and sickness absence. Your MTI doctor needs to notify their line manager of any periods of annual leave or sickness absence immediately. This does not include work-related travel.

The Academy is also required to keep a record of unauthorised absences. Unauthorised absences of more than ten consecutive working days will be reported to the Home Office (this is likely to result in the doctor losing their visa and having to leave the UK). All MTI doctors must notify their manager or medical staffing immediately if they are unable to attend work for any reason. If they are absent from work without explanation, it must be recorded as an unauthorised absence.

Please maintain an up-to-date record of contact details (including personal email address) at all times so that the doctor can be contacted if an unauthorised absence is thought to have occurred.

As outlined in Question 18 below , the Tier 5 visa does not permit taking unpaid leave (e.g. unpaid sabbatical) for more than a total of four weeks total in any calendar year (1 January to 31 December) unless the unpaid leave is due to maternity, paternity, adoption or sick leave. Unpaid leave in excess of four weeks will result in the Academy having to withdraw sponsorship for the visa. This is likely to result in the doctor losing their visa and having to leave the UK. Please note that these are UKVI regulations with which the Academy must comply.

As well as the job specified on the Certificate of Sponsorship (CoS), an MTI doctor can do supplementary work if it is:

• a job that is either:
  • on the shortage occupation list in Appendix Shortage Occupation Lists of the Immigration Rules
  • in the same occupation code and at the same level as the work for which the CoS was assigned
• no more than 20 hours a week
• outside the working hours covered by the CoS

Any such role must be included on the initial application for the certificate of sponsorship.

Yes. Doctors whose initial placement was less than 24 months are eligible to extend their Tier 5 visa up to a maximum of 24 months (including the time already taken). The doctor is free to remain in their current placement, or transfer to another NHS organisation to complete their training provided that organisation and the relevant Deanery is in agreement. In order to extend a visa, the employing organisation must complete an MTI Extension report and send it to the Academy (copied to the GMC sponsoring organisation). The report asks for the following information:

• Confirmation from the NHS organisation that the post will be funded for the period of extension, and the gross funding that will be provided
• Confirmation from the Deanery that extending the post does not disadvantage UK trainees, and that the post continues to contain sufficient education and training content
• Confirmation that all other details, such as job title, place of work etc., remain the same – or details of the changes
• Confirmation of the doctor’s current UK home address
• Confirmation of the start and end dates for the doctor’s new work placement
• A clear copy of the doctor’s Biometric Residence Permit

If the extension applies to the same post, the extension report must be completed by the current employing organisation with approval received PRIOR to the doctor starting work in that post.

If the extension applies to a different post within the same organisation, the extension form must be completed by the current employing organisation with approval received PRIOR to the doctor starting work in that post.

If the extension applies to a post in a new organisation, the extension report must be completed by the new employing organisation with approval received PRIOR to the doctor starting work in that post

Following the submission of all the above documents, doctors will be issued with a new certificate of sponsorship to be used in their visa application. Doctors are not required to return to their home countries to extend their visas. Applications for visa extensions will be treated as a priority regardless of the country of origin of the applicant.

Yes, provided that the new organisation and the relevant Deanery is in agreement.  This process is managed using the MTI Transfer Report.

If a doctor is appointed via MTI to one hospital but part of the post includes some days a month in another NHS organisation, both work addresses should be provided and will be recorded on the UKVI system.

If the post is based in the ‘home’ NHS organisation for the first part of the year followed by the remainder of the year in a different NHS organisation, the Academy will need a Transfer report from the current host NHS organisation in advance of the move. This is in to confirm the change of location and provide evidence of Deanery approval and suitable funding for the new post from the new host NHS organisation.

Yes. Immigration rules in the UK now allow applications for Tier 2 visas from within the UK.

However, the Academy strongly discourages this as it negates the intended purpose of the MTI scheme which is to ensure that the benefits of UK training are taken back to the doctor’s home country to aid that healthcare system. 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.

HMRC states that:

• MTI doctors have duties, (including any formal training within those duties) undertaken within their contract of employment that are the same as any other medical professional under a similar contract of employment.
• Any training undertaken would be part of the normal development an employee would undertake while performing the duties of the job, gaining valuable experience and enhancing their technical expertise in their role.
• For this reason, any remuneration paid in connection with the employment should be taxed in accordance with the UK’s domestic rules
• It is not possible for MTI doctors to claim benefits of the Student Article of a relevant tax treaty

As well as the routine paperwork that the Academy requires (see Question 11), there are also certain changes that we are legally obliged to report to UKVI within 10 working days of the event occurring. These are listed below and must be reported by the employing organisation to the Academy. Please note that all correspondence sent to the Academy should be copied to the GMC sponsoring organisation.

• If a sponsored worker does not start the role for which they are being sponsored, including any reason given for their non-attendance, if known (for example, a missed flight, illness, or bereavement) – this is done by means of the Exception Report
• If a sponsored worker is absent from work for more than 10 consecutive working days without permission – you must report this within 10 working days of the 10th day of absence – this is done by means of the  Exception Report
• If you stop sponsoring a worker for any reason – for example:
  • their application for entry clearance or permission is refused – please send us an Exception Report
  • you become aware they have moved on to an immigration route that does not need a sponsor – please send us an End of placement report
  • they are absent from work without pay for more than four weeks and this absence is not covered by any of the exceptions (listed below)– please send us an Exception Report
    • statutory maternity leave
    • statutory paternity leave
    • statutory parental leave
    • statutory shared parental leave
    • statutory adoption leave
    • sick leave
    • assisting with a national or international humanitarian or environmental crisis, provided you agreed to the absence for that purpose
    • taking part in legally organised industrial action

In the unlikely event that you have any information that suggests any MTI doctor may be engaged in terrorism or criminal activity, you must report this to us using the Exception Report.

All the information that employers are required to keep is detailed in the following documents:

Home Office document Workers and Temporary Workers: guidance for sponsors 

Workers and Temporary Workers: guidance for sponsors  Part 3: Sponsor duties and compliance