Can I start the Foundation programme on my Tier 4 medical student visa?
If you are an international graduate of a UK medical school, and you want to start Foundation training, you will need to apply for your new Tier 4 visa to cover your time on the Foundation Programme.
This application needs to be made in advance of beginning the Foundation programme, even if you have time remaining on your visa.
UK Visas and Immigration (formerly the UK Border Agency) has confirmed to the UKFPO that doctors who have applied for extensions to their current Tier 4 leave to remain, may start their Foundation Programme before their new leave is granted, unless their original Tier 4 visa was granted between 1 October 2009 and 22 July 2010.
If your visa was granted between those dates, you will be able to start the Foundation Programme only once you have received your new Tier 4 visa.
Those granted under the rules between 1 October 2009 and 22 July 2010 are restricted to studying only with their current Sponsor. Therefore you must wait until your new leave is granted before starting the Foundation Programme.
Those with leave granted at other times may start the Foundation Programme with the following conditions:
- You must still have leave to remain
- You must have submitted an application to the UK Visas and Immigration (formerly the UKBA) for your new visa
Your new Tier 4 visa will enable you to complete the two-year Foundation Programme.
The reason a new Tier 4 visa is needed is because a change of sponsor is required and slightly different Tier 4 rules apply to postgraduate doctors.
At present, the UK Foundation Programme Office (UKFPO) provides sponsorship for doctors on the Foundation Programme. The UKFPO will issue you with a Confirmation of Acceptance for Studies (CAS) at the end of your course. You will only be able to make your Tier 4 application once a CAS has been issued to you.
The UKFPO will provide all the necessary information for you to make your application.
Advice for Tier 4 visa non-UK or non-EEA nationals who are not graduates of a UK medical school
You need to apply for a new Tier 4 visa for the Foundation Programme as your sponsor will change from being your university, to the UK Foundation programme. You can do this as soon as you receive your Confirmation of Acceptance for Studies (CAS).
Check the UKFPO website
Read more about study visas on Gov.UK
Read Home Office policy guidance on Tier 4 visas
I am at a medical school outside the UK and want to do Foundation training in the UK
Doctors from non-UK medical schools are not eligible to apply for Tier 4 sponsorship so cannot undertake the Foundation Programme in the UK on a Tier 4 visa and cannot be sponsored by UK Foundation programme Office.
Non-UK/-non-EU doctors should visit or contact the Home Office for information on other types of visas. In very rare cases, some doctors have been sponsored by the employer on a Tier 2 visa, although this is very rare.
I am already in the Foundation programme what happens next?
If you are coming to the end of your Foundation Programme, your Tier 4 visa will expire at the end of Foundation Year 2.
At this point, you will be able to switch to Tier 2 (General) which is the visa for skilled workers in the UK however you will only be able to do this if you are in the UK before your student visa (your Tier 4 visa) expires.
The normal Tier 2 requirements will apply, except for the Resident Labour Market Test. In order to switch into Tier 2 (General) you will need an offer of employment from a UK sponsor, but you will be eligible to apply for jobs on an equal basis with UK and EEA applicants.
Applying for specialty training
How do I apply for specialty or core training at the end of Foundation Year 2?
If you are in Foundation year 2 and wish to apply for specialty training, the following rules apply:
- Graduates of a UK medical school can apply for a job with a UK Visas and Immigration licensed Tier 2 sponsor – there is a list of licensed sponsors on the UKVI website
- Graduates of a UK medical school can only switch to Tier 2 if they are already in the UK and they apply for a Tier 2 visa while still in the UK and before their student visa (Tier 4 visa) expires
- You need to have an offer of a skilled job from a licensed sponsor and be paid at least £30,002 per year, if you are applying for jobs at specialty or core training level. There are different pay thresholds for higher grades. In all cases, if you move to part time working, you should take advice to ensure your pay does not fall below the relevant threshold as you may then lose your visa
- Graduates of a UK medical school must meet the normal criteria for Tier 2 but the Resident Labour Market Test requirement will be waived
- Graduates of a UK medical school switching as set out above will not be subject to the limit on Tier 2 migrants
- If you are a graduate of a UK medical school and switch from Tier 4 to Tier 2 (general) you will be able to sponsor new dependants on the same terms as other Tier 2 migrants, once you have switched into Tier 2
- You will be required to show maintenance funds of £945 in order to switch into Tier 2
- You will need to show an additional £630 for each dependant
- You will need to pay the health surcharge when making your Tier 2 application
Read the current Gov.UK guidance for Tier 2 (general) visas
Applying for specialty training posts
Applying if you are on a visa
There are two rounds of application for specialty training in the UK: Round 1 and Round 2.
It is important to note that competition for this training is fierce and many of the training posts will be allocated in Round 1.
If you are on a visa, the decision about your eligibility to apply for training in Round 1 or Round 2, depends on your immigration status and the type of visa you have.
Can you apply for specialty training on a Tier 1 visa or if you are the dependent of someone on a Tier 1 visa?
To be eligible to apply for specialty training (including GP) you will need to be able to work without restriction in the UK.
If you are on a Tier 1 Dependent visa with a restriction on your visa which says you must not work as a doctor or dentist in training, you will have to change your visa status to Tier 2.
You will have to leave the UK to do this and will have to apply for specialty training from outside the UK.
This means you will not be able to apply in Round 1 unless the job is exempt from the resident labour market test.
Tier 1 visas have been phased out.
Read more about Tier 1 visas
Can you apply for specialty training if you are on a Tier 2 visa or are the dependent of someone who is?
There are special rules for graduates of UK medical schools on the Foundation Programme who are applying for specialty training – see above.
If you are already on a Tier 2 visa but not a graduate of a UK medical school, you may be able to apply for specialty training in Round 1 if:
- the post you are applying for is on the shortage occupation list. Currently, only certain training posts in Scotland are on the list. Check the list, or
- you are already on a Tier 2 visa and applying to continue training with the same sponsor. So if you are applying for specialty training but are already working for that employer or sponsor you can apply in Round 1; or
- you are continuing your training with the same national training number. Your national training number is the number you are given when you start specialty training, so this would only be relevant if you have started specialty training and are applying to return to it after an out of programme experience; or
- you are applying for GP recruitment, when applications from those subject to the resident labour market test may be accepted in Round 1 if there are not enough suitable UK or EEA national (settled status) candidates for the posts.
Other non-UK or non-EEA nationals, who need a Tier 2 visa to work in the UK, are subject to the Resident Labour Market Test, and will not be eligible to apply in Round 1. However, they will be eligible to apply in Round 1 re-adverts and in Round 2.
Round 1 re-adverts are purely a re-advert for ST1/CT1 and won’t include ST3. Round 2 is for ST3 and above only and does not include ST1/CT1 recruitment.
Therefore, everyone is eligible to apply in Round 1 re-adverts and Round 2, whether subject to the resident labour market test or not.
Further information is in the specialty recruitment guidance under the heading Right to work in the UK.
Special rules for graduates of UK medical schools on the Foundation Programme
If you are the dependent of someone on a Tier 2 visa, and you do not have a restriction on your visa which says no employment as a doctor or dentist in training, then you can apply for specialty training, but there are certain rules which apply and you should get advice.
If you are the dependent of someone on a Tier 2 visa and you do have a restriction on your visa which says no employment as a doctor or dentist in training, you will have to change your visa status to Tier 2 to apply for specialty training.
You will have to leave the UK to do this and will have to apply for specialty training from outside the UK. You will not be able to apply in Round 1 unless the job is exempt from the resident labour market test.
Can you apply for specialty training if you are on a Tier 4 visa or the dependent of someone who is?
Advice for Tier 4 visa graduates of UK medical or dental schools on the Foundation programme
If you are a non-UK or non-EEA national, you are on the Foundation Programme and hold a Tier 4 visa, you can apply for specialty training in Round 1, provided you have had continuous immigration status in the UK since you graduated.
However you will need to switch in the UK from Tier 4 to Tier 2 status to apply for the specialty training.
All Tier visa holders on the Foundation Programme can apply for Specialty training and be exempt from the Resident Labour Market Test. This a one time exemption when you switch from Tier 4 to Tier 2.
Advice for Tier 4 visa Non-UK or non-EEA nationals who are not graduates of a UK medical school
You can apply for specialty training if you meet all these criteria:
- You are currently on a Tier 4 visa and you have passed and will be awarded a UK Masters or UK Bachelors degree
- You have the correct registration from the GMC that allows you to practice legally as a doctor in the UK
- You were previously on a Tier 2 visa before you switched to Tier 4 (for example, you were working but then stopped to do a Master’s degree) and it is 12 months since you were last on a Tier 2 visa.
If you meet all these criteria, once you get confirmation you have passed your degree, you will be allowed to apply under Round 1, as you will be exempt from the Resident Labour Market Test.
Advice for dependents of someone on a Tier 4 visa
If you do not have a restriction on your visa which says you must not work as a doctor or dentist in training, then you can apply for specialty training, subject to certain conditions but you should get advice.
If you are the dependant of someone on a Tier 4 visa and you have a restriction on your visa which says no employment as a Doctor or Dentist in Training you will need to switch to your own Tier 2 visa.
You won't have to leave the UK to do this. However, you will not be eligible to apply in Round 1. Instead you will only be able to apply in Round 2 as you will need to satisfy the Resident Labour Market Test.
Need more help?
Read the NHS handbook on applying for specialty training
Information on Tier 2 sponsorship
There are currently single sponsors for trainee doctors on visas in England, Scotland and Wales. Unfortunately, a single sponsor is not yet available in Northern Ireland.
Find out about Tier 2 sponsorship available in the UK
Applications for GP training
General Practice will consider and assess applications from non-UK and non-EEA applicants who are subject to the RLMT in Round 1, although offers will not be made until after all UK and EEA candidates have been exhausted following a second round
And don't forget...
If you are a BMA member you can call first point of contact and talk to someone about your issue.
Free phone 0300 123 1233
To be eligible for a Tier 2 visa you will need to meet what are known as attributes.
What are attributes?
But maintenance rules often change so don't get caught out.
Make sure to check the UK visas and Immigration regularly
NHS Employers offers guidance for international medical graduates on working and training in the NHS
Take a look
Core and Specialty training
Why do I need to pay the health surcharge if I am already in the UK?
From 6 April 2015, all nationals from outside the European Economic Area (EEA), coming to the UK for longer than six months to work, study or join family, will be required to pay a health surcharge as part of their visa application.
The surcharge will also be payable by non-EEA nationals who are already in the UK and apply to extend their stay.
Why do I have to pay the health surcharge for a minimum of three years when my training programme is only for two years?
At the moment all applicants for Tier 2 (general) leave to remain, are required to pay a minimum of three years health surcharge on the UK Visa and Immigration Service (UKVI) online system.
This means that instead of paying £400 as before, using the online option will result in paying £600 however the UKVI will refund any overpaid health surcharge fees once leave is granted.
Read the UKVI guidance on partial refunds
See more information on the health surcharge
Timing it right
We are aware that each year there may be delays in visa processing, which can have a major impact on your training and employment opportunities.
That's why it's important to make sure you know what you should be doing and when you should do it.
Use our guidance to make sure you stay on track