Royal College of GPs calls on Home Secretary to remove the barriers for international GPs

The Royal College of GPs has written to the Home Secretary, Shabana Mahmood MP, calling for urgent action to address the barriers International Medical Graduates (IMGs) who have completed their GP specialty training in the UK, are facing trying to secure work in the NHS.

It is urging the Government to grant GPs from overseas, who have completed postgraduate medical training in the UK, the right to apply for Indefinite Leave to Remain (ILR). Currently, this option is not available to most IMGs as GP specialty training only last three years – two years short of the five years required in the country to apply for ILR. As such, upon qualification, they can only work in GP practices that have a licence to sponsor them to continue working in the UK. A recent RCGP survey of 493 general practice managers found that only 29% of practices currently offer visa sponsorships.

In a separate survey by the College and BMA of 521 GPs and GP Registrars who either need or had recently secured a visa to work in the UK, it was revealed that:

• 71% said finding a job in a practice that could sponsor their visa was difficult or very difficult 
• 44% found the visa application process and associated paperwork difficult or very difficult 
• 61% said that if their difficulty finding a GP job due to visa issues continues or had continued, they would make plans to leave the country.

General practice is facing a workload and workforce crisis and is in dire need of more qualified GPs in order to meet growing patient health needs. As of Octber 2025, the number of fully-qualified, full time GPs in England is only 462 more than at the end of 2019, while the number of registered patients has increased by over 3.7 million.

The RCGP is concerned that whilst the Government has pledged to gradually increase the number of UK medical school places, this won't address the present shortfall in GP numbers needed as it takes at least 10 years to fully train a GP.

In the letter, the College cautions the Home Secretary that planned immigration reforms, as they stand, including an increase of the Immigration Skills Charge (ISC) by 32% , could have significant financial consequences for GP practices and patient care.

It argues that if practices have to pay a higher rate of ISC , the added cost, when combined with other financial strains, would place practices under serious pressure and act as a deterrent for GP practices to secure sponsorship licences.

At the time the letter was sent (in September 2025) the College also raised concerns about proposals to double the time required to apply for ILR from five to ten years. It has since been confirmed that this would not be the case for doctors, the timeframe for whom would remain at five years. Whilst the College has described it as ‘encouraging’ that this will not be extended, it is still pushing for this to be reduced to three years.

The letter calls on the Home Secretary to use the reforms to make GPs from overseas eligible to apply for ILR as soon as they complete their GP specialty training in the UK.

Professor Kamila Hawthorne, Chair of the Royal College of GPs, said: "GPs from overseas are an integral part of general practice and we must ensure that they are supported, valued, and encouraged to stay working in the NHS post-qualification.

"Currently IMGs who have undergone specialty GP training in the UK – at expense to the UK taxpayer - have to jump through hoops in order to stay working in the NHS as they need to secure work in a surgery able to sponsor them. There's a real possibility that this could become even harder with current proposals for immigration reform.

“This is not only stressful for impacted GPs, but it makes no sense given the investment the UK has put into their training, to risk losing talented GPs, who want to continue working in the NHS at a time we desperately need them. We know that many feel they have no choice but to leave the NHS or in some cases the country when they can’t secure work. It’s such a waste.

"The College's previous calls on the Home Office to address this issue resulted in a four-month extension for IMGs on completion of training to help find appropriate sponsorship. Whilst this provided some respite, these IMGs are still restricted as to which jobs they can apply for - and we have heard that there is a lot of variation between ICBs as to how many practices in their patch hold the necessary sponsorship licenses.

"The UK needs to train more doctors, but we must also ensure that our colleagues who come to the UK to train and work in our health service are supported, valued, and encouraged to stay so that our patients receive the care they need and deserve. With a backdrop of some much pressure, the last thing we should be doing is discouraging trained professionals from working in the NHS."

Further information

Read our full letter

The GP Visa and Employment Survey is an online survey conducted between 12 June – 18 July 2025 by the RCGP in collaboration with the BMA aimed at capturing the experienced challenges with employment and visa processes of GPs who require a visa to work in the UK. The survey’s sample size was of 521 respondents.

The Practice Managers Survey is an online survey of GP practice managers, recruited via the RCGP practice manager mailing list and promoted through the Practice Managers Association, between 16 June – 7 July 2025. The survey’s sample size was of 493 respondents.

RCGP press office: 0203 188 7659
press@rcgp.org.uk

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.