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MTI Employer responsibilities and reporting obligations to the Academy of Medical Royal Colleges

For the Academy to issue a Certificate of Sponsorship (CoS) to an MTI placement the NHS employing organisation must comply with specific reporting duties, including the return of the following documents (the relevant medical royal college may also need to be copied into the correspondence).

Starters report

The MTI Starters report must be submitted within ten working days of the doctor starting work. It must be submitted with the following documents:

  • A PDF copy of the doctor’s right to work profile signed and verified as a true likeness by their NHS employer. Employers can perform the right to work check on the website after the doctor has applied for and received a share code. The employer will need the doctors share code to carry out the right to work check.
  • A Data protection consent form signed by the doctor. A new copy must be provided with each form.
    Please do not re-submit the form that was used with the doctor’s initial MTI application.

Exception report

The Exception report notifies the Academy of any changes in the doctor’s circumstances.

The NHS employer is responsible for reporting any exceptions to the Academy within ten days of the occurrence, such as:

  • If a doctor fails to start work within 28 days of their agreed start date shown on their CoS.
  • Extended absences from work of more than four weeks without pay (beyond the existing statutory exceptions, such as parental leave).
  • A doctor moving to a different role within the same place of employment.
  • Changes to a doctor’s salary and/or working hours.
  • If a doctor wishes to undertake any supplementary/locum work
  • Statutory maternity or paternity leave.
  • Changes to a doctor’s UK residential address.
  • Information which suggests that the MTI doctor is breaching the conditions of their leave.
  • Information suggesting criminal activity or other activities in contravention of the doctor’s visa conditions.

End of placement report

Note: do not use if a doctor is transferring to a new Trust/Board but remaining on the MTI scheme

The End of placement report:

  • Must be submitted within ten working days of a doctor leaving the MTI scheme, regardless of the circumstances.
  • Should not be submitted if a doctor is only transferring to another trust and remaining on the MTI programme.


If an MTI doctor’s initial visa was issued for less than 24 months and their employer wishes to extend their placement, a completed Extension application must be submitted to the Academy. The form must be submitted with the approval of the doctor’s GMC sponsor and local Deanery no sooner than four weeks before the expiration date of their visa.

Please note that a Temporary Work – Government Authorised Exchange visa cannot be extended beyond 24 months from the date the doctor entered the UK. If a doctor has already been issued a 24-month visa, an extension is not possible.

The following additional documents must be submitted to the Academy with an extension request:

  • Extensions of any length must be authorised by the local deanery within six months of the new work start date. This will be the day after the doctor’s current visa expires
  • A new Data protection consent form signed by the doctor
  • For overseas-funded posts, documentary evidence confirming that the funding will cover the period of the extension.

Note: The doctor’s NHS employer will need to conduct a new right to work check after an extension has been issued.


If an MTI doctor wishes to transfer to another NHS organisation, a completed transfer form must be submitted to the Academy. This must be approved by both the doctor’s GMC sponsor and the Deanery for the region to which they are transferring.

It is imperative that a transfer request form is submitted before the doctor transfers, as it must be approved by the Academy first. Any doctor who transfers to a new employer without the Academy being properly notified may be breaching the conditions of their visa and risks having their sponsorship withdrawn.

Please do not submit an End of Placement report for doctors who are transferring to a new Trust/Board but will remain on the MTI scheme.

**CoS Suspensions for non-compliant employers **

Please note that due to the importance of our obligations to UKVI, we will place hospitals on a CoS Suspension if they fail to supply the appropriate paperwork detailed here within the stated timeframes. This suspension will mean that we will not produce any further Certificates of Sponsorship for the suspended hospital until they submit all outstanding paperwork.

Further information can be found on the MTI Forms section.