Some international doctors training in Scotland face being left with no option but to leave the UK due to issues with visas and sponsorship – at a time when the country is in desperate need of more clinicians.
The problem is mostly affecting GP trainees who wish to remain working and living in Scotland following their training.
Currently foundation training – the first two years of a doctor’s training after they graduate medical school – falls under a Tier 4 visa for university study. Once their foundation training is complete, they move on to a Tier 2 skilled-worker visa, which grants them indefinite leave to remain (ILR) in the UK after working here for five years.
However, because the length of GP training is normally three years, this current rule leaves those trainees two years short of achieving ILR once they complete their training. While NHS Education for Scotland (NES) sponsors GP trainees while they are in training, this ceases when their training is complete and another sponsor is then required.
Eric is a second year GP trainee in Dundee, who could potentially lose his right to remain working in the UK when he completes his training next year.
He said: “Seven years ago, I came to Edinburgh as a transfer student from Malaysia to continue my clinical training. After I graduated from medical school and completed foundation training in Edinburgh, I moved to Dundee to pursue my postgraduate specialty training in General Practice.
“I now have a home in Dundee, and I wish to work and live here once I complete my GP training. However, in order for me to work without restriction as a non-UK citizen, I will need an Indefinite Leave to Remain – and in order to be eligible to apply for that, I must have held a tier 2 visa for at least five years. I was granted a tier 2 visa when I entered my GP training in August 2020, having held a tier 4 visa prior to that while I was studying and completing my foundation years.
“This means I will not be eligible to apply for ILR after I complete my GP training next year as I will be two years short. In other words, I could lose the right to remain in this country once I am a qualified GP.”
Unless he is able to find a practice that offers visa sponsorship, his options to remain in Scotland as a GP will become extremely limited.
He added: “I am given only two weeks grace period after completion of training to find a practice that can sponsor me to remain in Scotland for at least another two years on my current visa – currently there aren’t many practices which do this and there is already a significant number of international medical graduates (IMGs) in Scotland facing similar issues, so I will have to compete with them for visa sponsoring practices.
“There is a very real possibility that I may have to leave Dundee, or even Scotland, to look for jobs.”
Chair of the BMA’s Scottish GP Committee, Dr Andrew Buist, said: “Eric’s story is a huge concern, and we know there are many others out there affected by this too. We are desperately short of GPs as it is, so the last thing we need is to be in a position where fully qualified clinicians are being left with no choice but to leave Scotland because of an issue with the terms and conditions of their visa.
“We have proposed to the Scottish Government that they create fellowship posts for these trainees so that they can work as qualified GPs in Scotland, while remaining employed, and therefore sponsored, by NES for visa purposes. However, in the meantime I would encourage any practice finding it hard to recruit a GP just now to consider applying to become a visa sponsor to ensure these much-needed doctors are not forced to leave Scotland. A full-time GP trainee spends three years learning about the local healthcare service and the population – it would be a great loss to the community if the locally trained trainee had to leave, particularly in those already hard-to-recruit areas.”
Notes to editors
From this year, all international foundation year trainees will apply for a Health and Care visa instead of remaining on their tier 4 visa. It is expected that this will add the two FY years to the three GP training years and solve the problem for anyone starting foundation training from this year onwards – the affected cohort is anyone completing their GP training over the next four years.