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Who is involved in MTI

There are five main organisations involved in supporting international doctors on the MTI scheme.
A brief explanation of what each does for MTI is below.

The Academy of Medical Royal Colleges (the Academy) is the UK Visa sponsor for the MTI scheme.


We are responsible for issuing Certificates of Sponsorship (CoS) for overseas doctors on the MTI scheme. The CoS is an electronic record that proves that a licensed UK employer has offered a job or place of study to an international doctor.


The Academy is also responsible for keeping UK Visas and Immigration (UKVI) informed of any changes to an MTI doctor’s circumstances during their time in the UK.

Every doctor who applies to the MTI Scheme must gain written sponsorship from the relevant medical royal college (or NHS employing organisation) before applying for a Certificate of Sponsorship (CoS).


Each UK medical royal college is responsible for a different speciality within the medical field. Their work includes:

  • Improving standards in clinical practice
  • Supporting consultant and trainee doctors through education and training
  • Supporting international development in the medical field


For more information see the relevant medical royal college website.

The General Medical Council (GMC) registers doctors to practise medicine in the UK. Its purpose is to protect patients and improve medical education and practice in the UK by setting standards for doctors at all stages of their careers.


Before coming to the UK every overseas doctor who applies to the MTI scheme must register with the GMC and obtain a full licence to practise. This is done through the relevant royal college or NHS organisation during the process of applying to the MTI scheme.

The Deaneries set the annual placement capacity for the MTI scheme with Directors of Specialty Training and NHS organisations. They are also responsible for approving MTI applications sent to them via sponsoring medical royal colleges or employing organisations.


In the UK medical Deaneries are responsible for the management and delivery of postgraduate medical education and for the continuing professional development of all doctors and dentists.


This includes ensuring that all training posts provide the necessary opportunities for doctors and dentists in training to realise their full potential and provide high quality patient care.

NHS employing organisations can have a number of responsibilities in the MTI scheme, including:

  • Identifying potential MTI posts
  • Assessing and interviewing potential MTI doctors
  • Being the GMC sponsor for MTI doctors


The employing organisation is also responsible for informing the Academy about MTI doctors during their time in the UK. This includes starting in post or delays, any changes in circumstances and the end of placement. It does this via the Academy MTI scheme forms.


Employing organisations are not the sole sponsor for any doctor on the MTI Scheme. Under the UKVI requirements for Tier 5 temporary exchange scheme entry, individual employers do not act as sponsor of the applicant as they would with a direct overseas appointment. Instead, while the scheme is administered by the Deaneries and the relevant colleges, the formal process for getting UKVI approval for the applicant is handled by the Academy of Medical Royal Colleges.


Please read the NHS Employer responsibilities and reporting obligations for more information.