Step by step guide to the GP International

Induction Programme (England)

There are several steps you will need to undertake to be able to register and work as a GP in the
NHS. This is a summary to help you understand all the steps required under the GP International
Induction Programme in England. For eligibility criteria please see the GP NRO website.

Summary of Registration Requirements

1. The first thing you should do is ensure is that your GP specialist medical qualifications are able
to be registered with the UK General Medical Council (GMC),
2. To work as a GP you will need to be on the GMC’s GP Register with a Licence to Practice (LtP)
but this is not required at the initial application to the programme.
3. If you gained your GP qualification outside the UK, the next step depends on the country where
you gained this qualification:
a. If in an EEA country, the GMC is likely to accept the qualification, but you will need to
apply to them to assess this.
b. If in Australia, Canada, New Zealand or South Africa, you will need to apply for a
Certificate of Eligibility General Practice (CEGPR), but there is a “streamlined route” to
achieve this.
c. If from any other country, you will need to apply for a full CEGPR.
4. Once you have confirmation that you can be included on the GMC GP Register with a LtP, you
will need to register with the National Recruitment Office (NRO) for the GP International
Induction Programme; following this you will be directed to the Health Education England (HEE)
local Educational Lead. This may take a little while to organise and to arrange a review
appointment.
5. You will need to be eligible to work in the UK and may need to apply for a Skilled Worker visa
(previously known as a Tier 2 visa) and will need an identified a GP practice to act as your
employing sponsor. Guidance on this will be provided by the local HEE team.
6. To start a placement you will also need to apply for and be included on the Medical Performers
List (MPL) with conditions or undertakings permitting you to participate in the Placement.
7. NHS England and NHS Improvement team North West (previously Cheshire and Mersey
NHSE&I) lead on all applications to the MPL on behalf of the local NHSE&I team. Upon
satisfactory completion of the IIP you will be transferred to the local NHSE&I team where you
work.
8. The MPL application includes a lot of checks; these will include an Occupational Health check
which needs to include an Exposure Prone Procedure clearance, a Disclosure and Barring
Service (DBS) check and you may also require a Police Check, and two clinical references.
(See below)
9. You will need to register for an NHS Email address; you can usually only do this when you have
an identified IIP placement in a GP practice.

You should plan to start these applications at about the same time as you register for the
MCQ unless you wish to have a deferred start of 6 or more months.

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To register for the International Induction Programme

• You should register with the GP NRO as soon as you know you want to undertake the
International induction Programme or need advice about it
• Visit the GPNRO website and download the registration form and send this to the GP NRO at
this stage you do not need to be registered with the GMC.
• They will send your form to the appropriate local Health Education England team where you
wish to be for your placement and future work.
• Once the local HEE lead has approved your application, you will be sent a link to complete the
self-test (Module 1). This will need to be completed prior to your interview.

If you are applying to Northern Ireland, Scotland or Wales please see their websites for
further information and advice (see links on x page)

The local HEE team for the IIP will contact you to arrange a review with the HEE Educational Lead
and include access to the self-test (Module 1).

(If you have not heard anything within 5 working days please let the NRO office know)

• Following the review with the HEE Educational Lead, which may be by phone, Skype or in
person, they will be able to advise you on the next steps in your application process. This may
include
a. Advice that you should undertake an unpaid Observation Placement in a GP practice: this
can be arranged by the HEE Educational Lead. You do not need a Skilled Worker Visa for
this.
b. Approval to apply for the IIP Learning Needs Assessment (LNA) route or
c. Advice on what further requirements you may need to meet (i.e., CEGPR etc) before you
can undertake the IIP
• The HEE Educational Lead will inform the NRO of the agreed outcome plan
• The NRO will arrange access to the on-line educational modules and Associate Membership of
the RCGP for 12 months

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Learning Needs Assessment route

• Once the NRO have been informed that you will be taking the LNA route you may register to sit
the MCQ in a UK based Pearson Vue test centre or an approved Overseas test centre.
• Once registered the NRO will notify the North West NHSE&I team of your application
• Registered with the Fourteen Fish Portfolio (14FP)
• The MCQ assessment must be passed for entry to the Programme, and up to four attempts are
permitted.
• Dependant on your MCQ result you may be also required to undertake the Simulated Surgery.
• North West NHS England team will contact you to start and process a formal application to be
included in the national MPL if you plan to proceed with the programme.
• This should usually be at the same time as you have been accepted for the MCQ, but please be
aware the MPL application can take up to 3 months, or occasionally longer especially if checks
are required from outside the UK.
• There is limited financial support to help with formal application.

To sit the MCQ -

• You must be registered with the GP NRO and

• Have been approved by the HEE Educational lead (CV, career review etc.)
• Register for the MCQ
• You can then also register with the e-LfH, RCGP and Fourteen Fish websites and start to
access the e-Learning modules
• Take the MCQ in an approved test centre (in a number of approved UK and worldwide sites)
• It is important you only apply to sit this when you have undertaken adequate preparation using
the on-line resources and are familiar with NHS GP
• There is an option for an Observation Placement if you are in the UK prior to sitting the MCQ.

MCQ band outcomes

There are two parts to the MCQ: The Professional Dilemma’s (PD) paper (this is a situational
judgement test) and The Clinical Problem Solving (CPS) paper. In the PD paper only a pass is
required in order to proceed. The CPS paper will give one of five possible outcomes:

• Band 5 outcomes will be able to enter the short one-month placement Programme and you may
not have to take the Simulated Surgery subject to agreement by NHSE&I. Approval by the
NHSE&I Medical Director is subject to completion of a satisfactory “Short End of Placement
report”.
• Band 4 will be able to enter a 3-month placement Programme and you may not have to take the
Simulated Surgery subject to agreement by NHSE&I. Approval by the NHSE&I Medical Director
is subject to completion of a satisfactory “Full End of Placement report”.
• Band 3 outcomes will need to book to sit the Simulated Surgery having agreed this with the HEE
Educational Lead and will normally be expected to complete a placement of up to 6 months.
 Approval by the NHSE&I Medical Director is subject to completion of a satisfactory “Full End of
Placement report”.
• Bands 1 and 2 need to arrange an on-line appointment to review the outcome and to consider
your Learning Needs and how this can be achieved. They will need to re-sit (max 4 attempts
allowed) and pass the MCQ (a pass in the Professional Dilemmas paper and minimum band 3 in
the Clinical Problem Solving) before they can progress further with the Programme.
• If you obtained a Band 2 at the MCQ, it is recommended that you should only re-sit after 3
months to allow sufficient time to review your learning, if you obtained a Band 1 it is
recommended that you should allow at least 6 months before re-sitting the MCQ.

To sit the Simulated Surgery (for doctors who achieved a Band 3 outcome in the CPS and a
pass in the PD paper of the MCQs)

• You must have passed the CPS MCQ at Band 3 and the PD paper
• Have approval to sit the Simulated Surgery by the HEE Educational lead
• On the day you sit the Simulated Surgery you must have approval or have evidence of
application to be on the GMC register with a Primary Care Qualification (i.e. an EEA graduate or
CEGPR holder): this will require a UK based face to face check with the GMC
• Formal evidence you are in good standing (part of GMC registration)
• Take the Simulated Surgery in the RCGP headquarters at 30 Euston Square, London or virtual
due to government pandemic guidelines.
• There is a short briefing video to help inform you about the Simulated Surgery.

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International Induction Programme Placements

To undertake the clinical placement (short or standard)

• Have an approved IIP placement arranged through the local HEE Educational Team
• Have passed the MCQ and Simulated Surgery (usually does not apply to Bands 4 & 5 MCQ
outcomes)
• Have full GMC registration
• Be on the GMC GP Register with a current Licence to Practise
• If you do not hold Rights of Residence in the UK you will need to hold a Skilled Worker Visa and
have the offer of employment by a sponsoring practice
• Be in good standing (no Restrictions, except for the requirement to complete the IIP)
• Have completed Basic Life Support training
• Have completed Safeguarding training for Children to Level 2 and Adults (e-LfH) to start in a
placement but must be level 3 (adult and children) by the end of the placement in order to
practice independently
• Be on the NHSE Medical Performers List (MPL) with the conditions or undertakings that you
undertake and complete the IIP (requires DBS, police checks and occupational health among
other things that take time and face to face checks). The NW NHSE&I team will inform the local
NHSE&I team to where your placement will occur; this is usually in the same area as your HEE
team who will have set up your placement in an approved supervising practice.
• Have “top up” medical indemnity (there is funding support for this while in the Programme)
• Complete the e-LfH mandatory modules for Safeguarding level 2 for children.
• Document your learning and experience in the 14F P

To successfully exit the Programme and gain full entry to the MPL without conditions or
restrictions

• Have successfully completed the IIP placement

• Have a satisfactory Workplace Based Assessment, End of Placement report (includes an on-line
Multi-Source Feedback and Patient Satisfaction Questionnaire) which has been submitted to the
NW NHSE&I team along with any other required evidence (they should have evidence of all
your assessments already but important you check what they need)
• Completed safeguarding training for children to Level 3
• Completed the mandatory e-LfH module on GP induction
• Start your portfolio preparation for an early formal NHS Appraisal in the placement: this will be a
MPL requirement on exit from the IIP placement, usually after 3 to 6 months
• Received confirmation from NHSE&I local team where you plan to work that you are included on
the MPL without conditions

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Requirements for the MPL Application

Apply to the North West NHSE&I Team

• Download and complete the application form which must be sent to the Lead NW NHSE&I team,
all applicants will have access to a dedicated account manager who will be available to support
them with their application for inclusion on the performers list

Occupational Health Check

• Applicants must provide an occupational health screening ‘fit to practise’ declaration from a Safe
Effective Quality Occupational Health Service (SEQOHS) accredited occupational health
provider (or one that is seeking accreditation). A list of accredited SEQOHS providers is
available on the website.
• This must also include an Exposure Prone Procedure (EPP) clearance
• A fee will be payable and applicants should contact them in good time to arrange an
appointment as the service does get booked up.
• If you cannot access a SEQOHS provider, NW NHSE&I will normally accept Occupational
Health clearance from an NHS Occupational Health provider, but please check with them first.

Disclosure and Barring Service

• You must provide an up to date enhanced DBS certificate and have registered for the online
update service.
• You must register for the online update service within 19 days of DBS certificate being issued or
you can register at the time of making the DBS applications (you will need the number of your
application form.) There is an annual fee and you should opt for this to be automatically renewed
each year.
• If you have worked abroad in the last 5 years you will also need to obtain a Police Check from
this country. This can be requested through the Embassy of the country where you worked.
• If you do not have a current DBS certificate and registration for the online updates when you
apply for the MPL then you will need to have another DBS check.
• This is the most common cause for delay with applications for the MPL and you should start the
DBS application process at the earliest opportunity, usually when to apply to take the MCQ.
• You will be able to re-claim some of the costs of this from the NRO, please see the Funding
page on the NRO website
• Alternatively, a list of the umbrella bodies recommended by the Home Office for supporting
applicants with their DBS application is available.
• The NW NHSE&I team may be able to advise you of appropriate local links for both the
Occupational Health Check and a local Umbrella body for the DBS check

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References
• The references required by HEE will normally be accepted for your application to join the MPL
• The Health Education England (HEE) Programme requires that you provide two Clinical
references covering the last two years.
• Please ask your referees to complete the Clinical Reference form (download from the GP NRO
website) and return it to the HEE local lead who is managing your IIP application
• If you have no recent clinical referees a full explanation as to why this is the case and the names
and addresses of two alternative referees should be provided; please ask them to complete the
Non-Clinical References form
• They should not be sent to the GP NRO.
• References will need to be provided as part of your application to the IIP and to the NHSE&I
MPL
• Copies of these two references will be sent to the NW NHSE&I local team by the HEE Lead
along with confirmation of your registration and application for entry to the Programme.
• Please note: That NW NHSE&I may request additional references if these are deemed
insufficient for the purposes of a MPL application.

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Child and Adult Safeguarding

• For an application to the MPL for an IIP placement you are required to have completed level 2
but during the placement will need to attain Safeguarding level 3
• Unless the applicant is in an agreed training programme agreed by the GMC or is in a
placement under the IIP, applicants to the medical performers list are required to provide
evidence of child protection training at level 3, as a minimum, otherwise attainment at level 2 will
be accepted at the point of entry with the requirement to have achieved level 3 as a minimum at
CCT or completion of the programme.
• You must also have training in Adult Safeguarding

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Basic Life Support

• You are required as the very minimum to hold a UK BLS certificate or higher

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January 2021