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HANDBOOK for Partner Institutions

International Surgical Training Programme (ISTP)

THE ISTP AND THE MEDICAL TRAINING INITIATIVE (MTI) SCHEME

The Royal College of Surgeons of England (RCS England) is one of the world’s leading medical institutions and is distinguished in

the fields of health and medical education. Its central purpose is to enable surgeons to achieve and maintain the highest

standards of surgical practice and patient care.

RCS England launched the International Surgical Training Programme (ISTP) in January 2014.

The ISTP comes under the generic Medical Training Initiative (MTI) scheme and provides a route for high quality International

Medical Graduates (IMGs) from outside the UK/EU/EEA/Switzerland to obtain registration with the General Medical Council

(GMC) and undertake training and development in UK hospital posts for a maximum of two years. The scheme was developed by

the Department of Health and operates under the Home Office Tier 5 Government Authorised Exchange (GAE) visa category. The

College is a GMC-approved sponsor of the MTI scheme.

The aim of the scheme is to:

Contribute to improving the quality of healthcare globally.

Provide IMGs with a period of training and development in the UK before returning to their home country where their

patients and colleagues can benefit from the skills and experience they have obtained.

Foster relationships between UK hospitals and their own institution.

Support the UK’s international development objectives.

If successfully appointed to an ISTP post, IMGs will undertake a range of clinical work, with the possibility of completing

placements in multiple hospitals and gaining sub-specialty experience if their application is approved for such during assessment.

As well as gaining clinical skills, IMGs will also be given the opportunity to develop a range of transferable skills such as

leadership, management, developing guidelines, conducting audit and research, and understanding clinical governance. IMGs

will be supported throughout their training by an allocated Supervising Consultant based within their employing

hospital/institution, their other colleagues and the College MTI Officer who will periodically contact them throughout their time

on the scheme.

The College is committed to providing a training opportunity which benefits the overseas surgical trainee, their home country

and the UK hospital/institution in which they will be working.

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THE ROLE OF THE COLLEGE

The College will liaise with UK hospitals/institutions to identify recognised training posts suitable for the ISTP.

The College will ‘match’ high quality IMGs with suitable skills and experience to UK training posts and will ensure that

the posts contain appropriate educational and training elements suitable for their development.

Providing the IMG meets the eligibility criteria and their interview is successful, the College will then act as their

professional sponsor and issue a Certificate of Sponsorship (CoS) enabling the IMG to obtain GMC registration and a

licence to practise within a UK recognised training post for a maximum of 24 months.

The College will liaise with the GMC on the IMGs behalf, ensuring that the registration process runs smoothly.

Support the IMG throughout their placement to ensure they are happy in their post, and receiving the adequate

training and educational development as per their contract.

Provide the IMG a certificate at the end of their training.

THE ROLE OF THE PARTNER INSTITUTION

Identify candidates (with the required skills, experience and qualifications) suitable for clinical training in the UK.

Work with RCS England to provide all necessary documentation for the candidates.

Advise RCS England of any specific requirements that the Institution or the candidates have of the training.

LOCATIONS

The location will depend on the training required, with placements identified in centres across England, Wales and Northern

Ireland.

ELIGIBILITY CRITERIA

Applicants must meet certain eligibility criteria in order to be considered for an ISTP placement. These criteria are in place to

meet legal and other requirements.

In order to be eligible for the scheme IMGs must:

A. Be working within an overseas institution which is a partner of the RCS England ISTP.

B. Be resident overseas at the time of application to the programme and have no rights of residence in the

UK/EU/EEA/Switzerland.

C. Hold a primary medical qualification recognised by the GMC (please refer to the GMC website for further details).

D. Have completed an acceptable internship (or equivalent) of not less than twelve months following undergraduate

training.

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E. Have completed at least 3 years of full-time clinical practice/training (equivalent to ST3 or above in the UK) since

obtaining their primary medical qualification (excluding internship) and including the 12 months prior to GMC

registration being granted.

There should be no gaps in employment and the GMC does not consider clinical observer-ships as clinical practice.

F. Have passed the MRCS (UK) Part A and B.

G. Achieved a minimum score of 7.0 in all categories of the International English Language Testing System (IELTS) and an

overall score of at least 7.5.

H. Acknowledge that the short-term training is for a minimum of 12 months and a maximum of 24 months and will offer

significant training and development approved by the Postgraduate School. Funding will be obtained through either a

salary provided by the employing hospital/institution, a scholarship from an institution or funding from other

organisations.

I. Not have undertaken the same programme through this College or any other sponsor of the Academy of Medical Royal

Colleges Medical Training Initiative.

J. Have a knowledge of, and intention to comply with UK GMC - Good Medical Practice whilst in the ISTP placement.

VISA REGULATIONS

The MTI operates as a sponsorship scheme under the Government Authorised Exchange (GAE) route of entry into the UK under

the Points Based System. The Royal College of Surgeons of England is a GMC approved sponsor and will act as the professional

sponsor for successful candidates by granting a Certificate of Sponsorship (CoS). The Academy of Medical Royal Colleges took on

the role of National Sponsor of the scheme in March 2010. As National Sponsor, the Academy is responsible for the issuance of

Tier 5 certificates of sponsorship to be used for visa applications.

The following principles apply to Tier 5 visas:

• The visa is for a fixed period of a maximum of 24 months

• Switching to other tiers is not permitted

• There will be no extension beyond 24 months

• Those on a Tier 5 visa are not permitted to seek alternative employment whilst under the scheme

• Applicants must be outside of the UK when the application is made

Please note: If an applicant’s partner/spouse also wishes to register for the ISTP, separate applications must be submitted, and if

successful, they will be granted separate visas.

Upon completion of the ISTP placement applicants will be required to leave the UK and will not be able to return on a Tier 5 visa

for 5 years.

The Royal College of Surgeons of England is not regulated to provide immigration information. All applicants are advised to

contact the UK Border Agency should they require additional advice.

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APPLYING FOR AN ISTP PLACEMENT

Surgical trainees wishing to apply for the ISTP must first submit the following:

ISTP application form (available from the RCS England MTI Officer) with passport photo attached

Copy of their passport

Certified copy of their IELTS results/IELTS exemption details

Registration fee

The College will assess the application which can take up to 10 working days. Successful applicants will be contacted by the MTI

Officer to attend an interview with the College Certification Panel.

THE INTERVIEW

Interviews between the applicant and the College Certification Panel will normally be held by video-conference/Skype.

The College Certification Panel will consist of representatives from the College and other expert(s) as required.

The College Certification Panel will assess the communication skills and clinical knowledge of the applicant in the interview. If

successful, the applicant will be accepted onto the ISTP register.

The College will aim to match the applicant to a potential UK ISTP placement within six months. Once the College has identified a

suitable placement, a second interview may be conducted by the employing hospital/institution.

GMC REGISTRATION AND THE TIER 5 VISA

Once a surgical trainee is offered an ISTP placement, the following will be required in order for the College to issue the

Certificate of Sponsorship (CoS), allowing the applicant to apply for GMC registration and a Tier 5 entry visa.

Certified copy of their passport.

Certified copy of their Primary Medical Qualification certificate in the original language (and translated if necessary).

Letter from the Dean/Principal of their Medical School

This must provide the dates between which they attended the medical school and confirm that their conduct was

satisfactory. The spelling of the trainees name in this letter must be identical to that on their primary medical

qualification certificate.

Certified copy of their Postgraduate Medical Qualification in the original language (and translated if necessary).

Letter from the Dean/Principal of their Post Graduate Institution

This must provide the dates between which they attended the postgraduate institution and confirm that their conduct

was satisfactory. The spelling of the trainees name in this letter must be identical to that on their primary medical

qualification certificate.

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Certified copy of their certificate of completion of internship OR a letter from their Medical School/University

confirming completion of an internship.

A Certification of Good Standing (CGS).

This form should be from the regulatory body in the country/state where the trainee obtained their primary medical

qualification and in any other countries/states they have practised in the five years preceding their application for an

ISTP placement. The CGS must be less than three months old to be accepted by the GMC and must confirm that:

They are entitled to practise medicine in the relevant country,

They have not been suspended, disqualified or prohibited from practising, and

The regulatory authority is not aware of any matters that call into question their good standing.

Signed confirmation of appointment letter from the UK hospital/institution

Equality and Diversity report (available from the RCS England MTI Officer)

Declaration of Health (available from the RCS England MTI Officer)

Placement fee

Once the College issues the CoS, the IMG will be required to begin the online registration process with the GMC, keeping the

College fully informed of developments and the GMC reference number allocated to them.

Once the registration process is complete, the GMC will send the IMG an email requesting an appointment for an identity check.

All IMGs must have this identity check and need to go to the GMC’s office, either in London or Manchester, will all original

documents. Registration will not be granted until the identity check is completed.

The MTI Officer will liaise with the IMG and the GMC to ensure that the registration process is completed smoothly.

Please refer to Appendix (A) for the Process of Appointment details.

Prior to commencing the ISTP placement, IMGs will be provided with a generic induction package, which will include information

on how the UK National Health Service (NHS) works and overall responsibilities expected by surgeons and doctors in the UK.

DURING THE ISTP PLACEMENT

The employing hospital/institution will arrange an induction programme for all IMGs upon starting in their new placements.

Under the supervision of a fully qualified consultant, IMGs on this programme will receive the same specialty medical training as

UK trainees however in most instances their training programme will be tailored to suit their educational objectives and will take

into account the type of work done by surgical trainee upon returning home. All IMGs on this programme will be supported and

assessed using the same process and principles as the Annual Review of Competence Progression (ARCP) to assess progression of

their agreed learning needs, be registered and engage with the Intercollegiate Surgical Curriculum Programme (ISCP).

All IMGs on the programme will need to comply with the Trusts requirements for Annual Appraisals.

IMGs will be supported throughout their training by their allocated Supervising Consultant based within their employing

hospital/institution, their other colleagues and the College MTI Officer who will periodically contact them throughout their time

on the scheme.

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A meeting will be arranged one month into the placement between the IMG, the MTI Officer and the Supervising Consultant to

evaluate the trainee’s performance. A formal probationary assessment will be held three months into the placement based on

feedback and evaluation forms completed by the trainee and Supervising Consultant.

Any concerns from the IMG or Supervising Consultant should be discussed with the College and it will make every attempt to

reassess and resolve the issue(s) as quickly as possible.

Consideration may be given to transferring the IMG to another hospital within the same deanery or the ISTP placement may be

terminated as a very last resort.

AFTER THE ISTP PLACEMENT

Upon completion of the ISTP placement, IMGs will be invited to the College for a ceremony during which they will be awarded a

certificate to confirm they have participated in the ISTP and demonstrated achievement of agreed competencies.

FEES

Partner Institution Based on a 3 year renewable contract

£500 per annum

Candidate registration fee Payable upon submitting an ISTP application form

£500

Candidate placement fee Payable once the candidate has been placed into an ISTP post

£2,000 (Non-GMC registered IMGs) £1,500 (GMC registered doctors)

PLEASE NOTE:

All Members and Fellows of RCS England are eligible for a 15% discount off the candidate registration and placement

fees.

These fees are non-refundable and cover the College administration expenses in relation to processing applications and

expenses incurred by the interview panels.

These fees to do not include the separate charges by the GMC and the UK Border Agency.

All surgeons will receive a UK salary as per UK trainees. This ranges from £30,002 - £47,175 depending on the grade.

Surgeons who may find it difficult to pay the placement fee can discuss payment options with the MTI Officer.

Only surgical trainees who are working within an RCS England ISTP Partner Institution are eligible to register for an ISTP

placement.

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Appendix (A)

THE PROCESS OF APPOINTMENT

International Surgical Training Programme (ISTP)

Overseas institutions identify suitable and eligible surgical trainees for registration to the RCS England

ISTP and submit application form.

Not eligible

Applicant will be given feedback from the College MTI Officer.

Eligible

Application assessed further for suitability an ISTP

placement.

Eligible

Applicant will be interviewed by the College.

Unsuccessful

Applicant will be given feedback from the College MTI Officer.

Application will not be progressed.

Successful

Applicant will be matched to an ISTP placement and their

CV forwarded to the UK hospital/institution.

Successful

UK hospital/institution conducts interview.

Successful

Applicant will be offered an ISTP placement.

Unsuccessful

The College will discuss options with the applicant.

The College MTI Officer will liaise with the applicant and

employing hospital/institution to ensure all paperwork is

received and submitted to the GMC in a timely manner.

College issues a Certificate of Sponsorship (CoS).

Once the GMC and Tier 5 visa is granted, the IMG begins

post.

Overseas institutions register as a partner of the RCS England ISTP.

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Partner Institution application form

International Surgical Training Programme (ISTP)

DETAILS OF PRIMARY AGENCY / INSTITUTION

Institution:

Address:

Country: Postcode:

Telephone number: Website:

TO BE COMPLETED BY THE PRIMARY CONTACT AT THE PARTNER AGENCY / INSTITUTION

Name:

Position:

Address:

Telephone number: Email:

Please tick this box to confirm that you will be the primary contact at the Partner Institution.

Signature:

Date:

DETAILS OF A SECONDARY CONTACT AT THE PARTNER AGENCY / INSTITUTION

Name:

Position:

Telephone number: Email:

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PARTNERSHIP PAYMENT

The annual RCS England ISTP Agency/Institution Partnership fee can be paid by bank transfer or credit/debit card. The College does not accept America Express. BANK TRANSFER Account name: Royal College of Surgeons of England Name of bank: C Hoare & Co Bank Account no: 71140010 Sort code: 15-99-00 IBAN Code (for payments outside the UK) : GB82HOAB15990071140010 Please quote the your name in the reference and email the remittance to mti@rcseng.ac.uk DEBIT/CREDIT CARD

I wish to pay by (tick as appropriate) Visa Mastercard Delta Visa Debit Maestro Card Number: Valid from: Expiry date: Three-digit security number: Issue Number (if applicable): Amount authorised to be withdraw:

Name of cardholder:

Address of cardholder:

Email address of cardholder:

Signature of cardholder: Date (DD/MM/YYYY):

TO BE COMPLETED BY THE PRIMARY CONTACT

Please tick this box to confirm that you have read the Handbook for Partner Institutions and understand the ISTP process,

eligibility criteria and the roles and responsibilities of RCS England and your institution.

Please tick this box to confirm that you understand the fees payable to RCS England, the General Medical Council and the UK Border Agency.

Please tick this box to confirm that the Partnership agreement as outlined within this document and the Handbook for

Partner Institutions is valid for three years upon receipt of the ISTP Partnership fee (payable annually) and can be modified, amended or renewed at any time during that period, with agreement of both parties. It can be terminated by either party, giving six months advance notice.

Signature:

Date:

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PERIOD OF AGREEMENT

The agreement as outlined in the Handbook for Partner Institutions will be valid for three years upon receipt of the RCS England

ISTP Partnership fee.

It can be modified, amended or renewed at any time during that period, with agreement of both parties. It can be terminated by

either party, giving six months advance notice.

RCS England is reliant on the cooperation of the General Medical Council of the UK and UK Border Agency. Any changes in

regulations could result in alterations to the ISTP agreement. RCS England is bound by the laws and regulations of the UK and

must confirm to them.

RCS ENGLAND INTERNATIONAL OFFICE

The International Office of the RCS England will act as the UK liaison and coordinator for ISTP placements.

Contact details:

Miss Erinn Middleton

MTI Officer

International Office

Royal College of Surgeons of England

35-43 Lincoln’s Inn Fields

London WC2A 3PE

United Kingdom

emiddleton@rcseng.ac.uk