MTI information for Trusts

Announcement - Changes to RCEM MTI Appointment Fees from August 2021

The College is updating our MTI Scheme Appointment fee structure in order to offer a greater package of support and ultimately improve the quality of MTI Participant’s time in training within the UK.

As you will be aware, the College has not previously charged the hosting Trust for MTI placements, however, with participant numbers rising every year there is the increased responsibility to support the quality of training, education and assurance processes to ensure that this period of training and experience in the UK is as useful as possible for overseas doctors, as well the growing need to sufficiently cover the costs of administrative time spent processing applications and administering the scheme.

The fee will be £2,500 per doctor and will be charged to the Trust at the point when sponsorship is confirmed.

This fee structure will be implemented from August 2nd 2021, any new applications received after that date will be subject to this fee.

The implementation of this fee will ensure that all EM MTI Participants will receive the following:

  • RCEM Kaizen portfolio to meaningfully track their training and progress and become familiar with WPBA
  • Full RCEM Associate Membership
  • Full access to all content on RCEM Learning
  • Reduced registration to RCEM events
  • A targeted calendar of events specific to MTI Trainees
  • A centralised RCEM interview process

This change will bring the RCEM scheme in line with MTI Schemes provided by other Medical Royal Colleges and we hope you appreciate that the increased investment into the scheme will ultimately help towards its primary purpose of contributing to the improvement of the quality of healthcare in developing countries by allowing a small number of overseas doctors to access a limited period of training and development in the NHS, before returning to their home countries where their patients, colleagues can be of benefit from the skills and experience they have obtained in the UK.

MTI Placements: Academy Statement March 2021

Due to the impact of COVID-19 on Specialty Training, the Academy of Medical Royal Colleges have released the statement found here

In the light of the situation, the English Deans have made the following statement which will be on their website:

“English Deans fully support and value the MTI programme and will continue to make decisions on placements based on the published principles and national standards (AoMRC MTI Standards 2018 )

This includes ensuring that UK trainees/trainees on HEE programmes will not be disadvantaged.

In continuing this approach, Deans, together with all stakeholders and applicants, are mindful of the current additional curriculum pressures for UK trainees as a result of the pandemic. It is hoped that any impact on incoming MTI trainees affecting some specific specialities in specific geographical areas will be temporary.

The Academy of Medical Royal Colleges has made a statement on how best to manage the current temporary situation.”

Application guidance for Trusts

Trusts that are interested in hosting one or more MTI trainees within their ED that haven't hosted placements in the past, are advised to contact the Head of School of Emergency Medicine in your region to seek approval to host placements in the first instance.

Given the statement released by the Academy of Medical Royal Colleges in March, all Trusts looking to offer MTI placements must first contact the TPD/Hos and LETB/Deanery for their region to ensure enough spare training capacity is available and that the MTI Placement will not disadvantage UK trainees.

MTI trainees in Emergency Medicine can be sourced by the College or directly by the Trust, however, they must meet our eligibility criteria in order to take part in the scheme.

The Trust must provide full details of the post that they are looking to place an MTI doctor into. The post must meet the requirements of the MTI scheme, the College and the LETB/Deanery. Further guidance for Trusts can be found at the AoMRC MTI website here.

Once a suitable candidate has been identified, the Consultant from the Trust who will be supervising the trainee will be asked to conduct a telephone interview with the candidate, the College will forward an interview template for this purpose (please note that from August 2021 the RCEM will be carrying a centralised interview which will streamline recruitment).

The Trust is not required to sponsor any visa applications as visa sponsorship is provided by the national scheme sponsor, the Academy of Medical Royal Colleges (AoMRC). The Medical Training Initiative is a government authorised exchange operated under Tier 5 of the Points Based System, please see the AoMRC MTI FAQ page here.

MTI trainees should be offered an NHS induction, a trust induction and a departmental induction. They should also have access to the same training opportunities as other trainees in the department.

The RCEM MTI Application Guidance for Trusts can be downloaded here.

The full guidance on the MTI scheme can be found here.

Please note:

  • The Medical Training Initiative's primary purpose is to contribute to the improvement of the quality of Healthcare in developing countries by allowing a small number of overseas doctors to access a limited period of training and development in the NHS, before returning to their home countries where their patients, colleagues can be of benefit from the skills and experience they have obtained in the UK.
  • MTI trainees cannot fill service posts. Each post offered to an MTI participant must provide sufficient training and educational support.
  • Postgraduate Deaneries / LETBs establish the level of available training capacity to support placements under the MTI scheme in each Deanery / LETB area each year, therefore, approval of the relevant Deanery / LETB is required for each placement to confirm the placement has sufficient training and educational content and does not disadvantage UK/EEA trainees
  • It is not possible for MTI doctors to work in a substantive, honorary or fixed term NHS consultant post in the UK under this scheme - in order to do so doctors must be on the GMC Specialist register. Specialists who have not undergone a UK training programme are now able to apply for evaluation of their specialist training, qualifications, experience and knowledge to determine whether it is equivalent to the UK CCT.
  • More information can be found here:

For more information please contact

Scheme Prioritisation and Allocation

The primary purpose of the MTI is to contribute to improving the quality of healthcare in developing countries. The main intention of the scheme is to provide doctors from developing countries with a period of training and development in the NHS before returning to their home countries where their patients and colleagues can benefit from the skills and experience they have obtained in the UK.

A mechanism was introduced in January 2017, which demonstrates support for the Department for Health’s main focus, which is for doctors from the DFiD 28 and Lower Income Lower Middle Income countries to benefit from the scheme and, therefore priority should be given to developing healthcare systems.

The new criteria reflects the principles and intent of the scheme and it has been agreed that the following priority list be used.

  1. DfID 28 Countries
  2. L&LMI Countries who do not come under the DfID 28
  3. All other applications

Important changes to the prioritisation process

The current prioritising system has been working effectively but has had unintended consequences for applicants not from DfID priority and LI&LMI countries. These applications were considered at the end of each month and CoS’s allocated if there was available capacity from the monthly quota once the allocations to DfID priority and LI&LMI countries had been made. However, the overall volume of applications received, has resulted in a growing proportion of these applications being rolled over for consideration at the end of the following month.

The consequence was that these applicants could find themselves waiting up to several months to confirm an MTI placement. This delay and uncertainty understandably caused real problems for individual applicants, employers, Colleges and Deaneries. The Department of Health, Health Education England and the Academy of Medical Royal Colleges all believe that position was unsustainable and unfair to applicants. For the sake of transparency it was felt better to explicitly state that these applicants can have no guarantee or expectation of receiving a CoS, although they will not be barred from making applications.

Applicants from countries not considered DfID priority or LI&LMI countries may apply at their own risk. If there is any remaining capacity at the end of each month having processed all applications from DfID priority and LI&LMI countries, other applicants will be awarded a CoS taken in order of the receipt of their applications.

A full statement further explaining these changes to the MTI scheme, can be found at the Academy of Medical Royal College's website.