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General guidance and best practice




All Medical Training Initiative (MTI) application forms and reports should be submitted online.

When submitting MTI forms and reports please refer to the sections here to ensure that all your supporting evidence complies with the Academy’s Temporary Work – Government Authorised Exchange visa sponsorship requirements.


The first page of each form has additional guidance to help you complete it. A checklist of all information and documentation required is also available on the first page of each MTI form or report. We advise you check this to ensure that all the necessary information has been provided. Any omissions may cause delays.


We only accept applications from a doctor’s GMC sponsor organisation (usually a medical royal college) unless the doctor was already registered with the GMC when they applied for the post and there has been no involvement from a royal college in their application.


For new applications and extension requests, we aim to issue a Certificate of Sponsorship (CoS) within five working days of the application being submitted, in line with our prioritisation system. We also process transfer requests within this timeframe by informing UK Visas & Immigration (UKVI) of the change.


An application is only considered “submitted” once all the required information has been provided.


The CoS is used by international doctors when applying in their home country for their Temporary Work — Government Authorised Exchange visa to work in the UK for a maximum of 24 months.


Doctors can only apply to the MTI programme from outside the UK.


UKVI’s standard turnaround for Temporary Work — Government Authorised Exchange visas is three weeks, although this can vary depending on the country from which the doctor is applying. We therefore recommend that applications for new MTI placements are submitted no sooner than four weeks in advance of the placement’s planned start date.


Check on the UKVI website when preparing an application for the most up-to-date advice on visa processing timelines.


NHS employing organisations and medical royal colleges must also inform the Academy if they expect a doctor’s arrival to be delayed by 28 days or more, as these delays must be reported to UKVI within ten days of the occurrence.


The GOV.UK website has more information on NHS employing organisations’ reporting obligations for MTI doctors.