Starting in the NHS as a foundation trainee VS a non trainee SHO - for IMGs only

This blog post is about starting the NHS in foundation training VS a non trainee SHO as your first job in the NHS. This is valid for international medical graduates only.

I will address this in the form of FAQs.

Please note that when I mention foundation training in this blog, I am referring to the foundation programme ( ie FY1 and then FY2 posts)- NOT FY2 LAT POSTS.


FOR IMGs WHO HAVE NOT DONE THEIR ONE YEAR INTERNSHIPS

I have not done my one year internship ( house job) from my home country. 

In this case, you will be granted ONLY provisional registration:
https://www.gmc-uk.org/registration-and-licensing/join-the-register/provisional-registration

What does this mean?

You will have to apply for the UK foundation programme:
http://www.foundationprogramme.nhs.uk/

But I have heard IMGs do not get into this?

This is not true.
Please join this group:
https://www.facebook.com/groups/IMGs.in.the.UK/
And read this:
https://www.facebook.com/notes/international-medical-graduates-imgs-in-the-uk/nazia-salmans-guideline-on-foundation-year-training/2189814987718197/

But this means I will have to give additional exams. 

Yes, this is true.

This will be very difficult. 

No, it is not very difficult. You will need additional time and will have to give the following exams:
IELTS ( OET may not be acceptable by the UKPFO - however do confirm this by contacting them if you are in any doubt- http://www.foundationprogramme.nhs.uk/content/contacts)
PLAB 1 and 2
Then get your provisional GMC registration
Situational Judgement Test
Clinical Assessment Exam
Then apply for the foundation programme. 

Will I be able to get my full GMC registration?

Once you have completed your foundation programme, you will get your full GMC license.

Do I have any other option?

No you do not. 

Why not?

Read this:
https://www.gmc-uk.org/registration-and-licensing/join-the-register/provisional-registration

THOSE IMGs WHO HAVE DONE THEIR ONE YEAR INTERNSHIPS IN THEIR HOME COUNTRIES

I have done my one year internship in my home country. What is the best pathway for me?

Give IELTS/OET
Please read the official GMC guidance here on both:
https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/evidence-of-your-knowledge-of-english

Give PLAB 1 and 2

Then get registered with the GMC 

You can then apply for jobs in the UK
This pathway is explained in detailed in the blogs here:
https://naseersjourney.com/useful-links/

What sort of job should I go for?

As mentioned in those blogs, a SHO post - equivalent to FY2/CT1/ST1. 

I have just graduated from my medical college. What should I do?

Do your one year internship. 

Why should I not go for foundation programme training?

Because of the following reasons:

Visa

In December, 2017 (for 4 months) , certificate of sponsorships were limited to doctors who had a certain pay were accepted. . 

I have explained the situation here:
https://omarsguidelines.blogspot.com/2019/01/the-future-of-jobs-in-nhs.html

Pay 

As a FY1, you will get paid almost half of what you would be paid as a SHO.
The pays are mentioned in the different blogs here:
https://naseersjourney.com/useful-links/

Recruitment

The recruitment for the foundation programme is national. If you do not do well in your interview, you may not be selected. 

Time frame:

In foundation training, you will have to give PLAB, get registered with the GMC, give your SJT, Clinical assessment exams BEFORE the opening dates for foundation training. 

Whereas for non trainee SHO posts, these are open all year and you can apply at any time. 

This is all high risk, therefore if you have the option you must do your one internship in your home country. 

Hang on! That certificate of sponsorship issue which happened in December, 2017 not only affected low pay doctors but SHOs. 

Yes, that is correct. However you never know that these rules may change. Just imagine that you have gone through the trouble of giving 2 additional exams, waiting for all that time just to find out that you cannot join because the rules have suddenly changed. 

But the rules have not changed yet.

Right now ( February, 2019), the rules have not changed however no one can guarantee what the situation in the next few months would be like. 

What if I cannot do my one year internship in my home country?

Then go for the foundation programme bearing in mind that you will need to be aware of the time frame, risk visa issues ( which so far have not occurred after April, 2018 but keep an eye out on the official document I have mentioned here:

https://omarsguidelines.blogspot.com/2019/01/the-future-of-jobs-in-nhs.html) and 

be aware that your pay will be low for the first year.

But is it not better to start at the lowest level in a new country?

No, not in this case.

Why not?

Let's take the example of a British medical graduate - they start going to the wards from their third year and by final year, stay on the wards most of the time. They shadow foundation doctors and core trainees and do procedures like bloods, cannulas, ABGs, catheters and other basic procedures. 

So by the time a British medical student graduates, (s)he is already ahead of IMGs when it comes to procedures. 

So all the more reason to go for foundation training posts. 

No, not necessarily. The PLAB exam is equivalent to foundation training:
Read this:
"The PLAB test will check that you know and can do the same as a doctor starting the second year of their Foundation Programme training in the UK."

https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab/a-guide-to-the-plab-test

Do you feel that a non trainee SHO is a good idea compared to the foundation programme?

Yes, absolutely. You will be paid better, you have less exams to give, the time for the whole process from IELTS to starting your job will be quicker, less stressful, there are plenty of oppurtunities to work on your interview skills ( it is not one interview like foundation training - you can give multiple interviews for multiple non training SHO posts). 

What about a non training FY1 post?

Why would you want to do that?

Because I do not feel comfortable working as a SHO. 

Trust me, you think that you are not comfortable but you are capable of doing so. As lomg as you ask for a period of shadowing when you start your non training post in the NHS, you will be fine. Here is a list of things to ask for before you accept a job offer:
http://omarsguidelines.blogspot.com/2015/09/what-to-do-once-your-job-has-been.html

This is a lot of reading. Can you summarize the whole thing in a few lines?

You must try to do your one internship in your home country and once registered with the GMC, apply for non training posts. 

If you are unable to do your one year internship in your home country, then you have no other option but to apply for the foundation training programme. 

To summarize, what are the core differences?

Foundation year programme ( in FY1 ) - Less pay, more stressful as you have one chance, more exams to give, may have the risk of not getting a certificate of sponsorship, more time from IELTS to securing a job in the NHS. 

Non training SHO post: Higher pay, you can apply for multiple jobs and give multiple interviews ( hence more chances to secure a post), less time from IELTS to get a post in the NHS and there are no visa risks. 

Also read the official website here and contact the recruitment team if you have any questions:
http://www.foundationprogramme.nhs.uk/