Life and work in the UK Overseas qualified doctor

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A quick guide to clinical attachments for IMG doctors

A junior doctor takes notes on a ward round. Hands only

Clinical attachments are a useful way for IMGs to get a taste of the working lives of doctors in the NHS by observing a consultant in a relevant specialty but without having the responsibility of patient care.

Read our guidance to find out what a clinical attachment entails, how to apply for one and what you can expect after the attachment is finished.

However, please note this information is intended as a guide only, and is not definitive. You will need to confirm with each hospital Trust as to their own rules and requirements.


Read more below

  • What is a clinical attachment?

    A clinical (observer) attachment will help you prepare yourself for working in the NHS.

    It allows you to gain an overview of medical processes and systems in the NHS, by observing a consultant in a relevant speciality at work.

    During the attachment, you are not given any responsibility and are not able to make clinical decisions or give clinical advice.

    After a set period observing the consultant, you may start to take on some limited clinical duties. This will be following a risk assessment, and at the discretion of and under the overall supervision of the supervising consultant.

    Duties are generally limited to:

    • observing consultations
    • participating in patient administration (clerking)
    • taking patient histories
    • physical examinations (under direct supervision)
    • observing surgery

    Read GMC guidance on clinical attachments


    Is a clinical attachment required for GMC registration and working in the NHS?

    It is not a requirement for GMC registration or working in the NHS. However, you may find the experience usefully contributes towards showing that you meet the standards of competence, care and conduct which are expected of doctors. For more detail on standards see the GMC’s Good Medical Practice

    The BMJ article A model for clinical attachments to support international medical graduates provides a good overview of the benefits of undertaking a clinical attachment for international medical graduates applying for registration in the UK


    Are all clinical attachment programmes the same?

    No. Clinical attachment programmes will differ from one hospital to another. Clinical attachments can also be called clinical (observer) attachment programmes,visiting professional programmes and clinical placement programmes.


    How much does a clinical attachment programme cost?

    The fee for a clinical attachment will vary from one programme to another. Current fees range from £400 upward. Please note you will also be responsible for your own living costs.


  • Who can apply to do a clinical attachment?

    You will need to meet the following conditions to be able to take a clinical (observer) attachment:

    • Successful completion of a criminal records check or similar endorsement. Further guidance is on the Gov.Uk website
    • Documents giving your proof of identity as requested by human resources at the Trust.
    • If you are not a native English speaker, you will need an IELTS certificate at level 7.5 or an equivalent level of English that you can demonstrate. See our guidance on English language testing
    • Occupational health clearance from the NHS trust providing the clinical attachment programme.
    • Attendance at the doctors' induction day before the attachment commences, if applicable.
    • Satisfactory references from referees cited in the application form.


    What immigration status do I need to come to the UK to do a clinical attachment?

    Generally, international medical graduates from outside the EEA need a standard visitor visa to come to the UK.

    A standard visitor visa lasts for six months maximum, during which you can take the PLAB 2 test and complete the clinical attachment.

    Find out more about the standard visitor visa


  • Where can I find one?

    There is no UK-wide mechanism for finding a clinical (observer) attachment programme.

    You can search the internet for clinical attachment programmes including NHS hospitals and post graduate deaneries in your search. This should show the NHS Trusts currently offering clinical (observer) attachments programmes.

    Alternatively, you could try asking any friends or family working in an NHS hospital if they can introduce you to a consultant in your specialty who would be willing to provide a clinical attachment in their team.

    For a list of NHS hospitals in the UK please see the following:

    England and Wales


    Northern Ireland


    When should I undertake a clinical attachment?

    This will depend on the individual clinical attachment programme.

    Some clinical attachment programmes accept applications when you have passed the PLAB 1 examination and are preparing for the PLAB 2 examination. Some will only accept applications after you have passed the PLAB 2 examination and are preparing to apply for GMC registration.

    See GMC guidance on Professional and Linguistic Assessments Board (PLAB) test


  • How do I apply for one?

    When you find an NHS Trust offering a clinical (observer) attachment, complete the application form as instructed by the individual NHS Trust or Postgraduate Deanery offering the clinical attachment programme.

    We suggest that you include the following details in a letter requesting a clinical attachment:

    • your personal details
    • your reasons for wanting to complete a clinical attachment
    • a brief outline of your medical background, your career ambitions, why you are interested in this department/field in particular and what you hope to get from the clinical attachment
    • your level of clinical expertise and your previous work experience in health
    • whether you are applying for GMC registration and what stage in the process you have reached (i.e. whether you have taken/passed the IELTS (international English language test), PLAB 1 or PLAB 2)
    • We recommend also attaching a current CV including medical exams and work experience, a copy of your learning objectives, and details of referees.


  • What comes after a clinical attachment?

    The experience you gain from the clinical attachment will be relevant to your GMC application for registration as this will ask for details of all your work experience from the last five years both medical and non-medical.

    When the GMC receives your application the consultant who supervised your clinical attachment will be asked to complete a report on the standard of practice observed during your attachment. See the GMC Clinical attachment report form

    Find out more about the GMC registration process


    Finding a job

    When you have your GMC registration and licence to practice, the next step is to look for a job.

    The British Medical Journal and British Dental Journal carry job advertisements and the NHS has a dedicated recruitment website

    NHS Jobs includes those jobs not filled by UK and EEA doctors, which means that immigration sponsorship is more likely to be available for those posts.

    See the rest of our extensive guidance in Life and Work in the UK which is tailored to IMG doctors and more general advice

    Read our careers help for overseas doctors

    See our general guidance on applying for a job


    Creating a medical CV

    Writing a good CV (curriculum vitae), filling in job applications and attending job interviews can be uniquely challenging for international medical graduates seeking employment but we have lots of useful guidance to assist.

    See our tips for your medical CV


  • Further help and resources