Starting out in the UK

General practice, or primary care, is often described as “the bedrock of the NHS”, dealing with around 90 per cent of all patient contacts.

As a generalist, a GP needs to have a high level of understanding across the full range of medical and surgical specialties and the skills to provide appropriate care in a safe and cost-effective way. Many GPs also now lead multi-professional teams to provide integrated services for patients that were historically provided in secondary care.

GPs deal with a wide range of health problems and will treat patients throughout their lives. 

Their work involves:

• Providing both regular and reactive health promotion
• Making accurate diagnoses and risk assessments
• Dealing with multi-morbidity
• Coordinating long-term care
• Addressing the physical, social and psychological aspects of patients' wellbeing throughout their lives

They are also involved in deciding how health and social services should be organised to deliver safe, effective and accessible care to patients in their communities. 

You can read about life as a GP and a typical day in general practice on the NHS website. 

The salary of doctors in the UK depends on their training level and experience. The NHS pay scale is used for public sector roles.

GPs in the UK, enjoy a rewarding and varied career that offers unrivalled flexibility, with the option to fit the job around other major commitments, such as having a family. It also provides the opportunity to decide to be wholly a generalist or to develop skills in a specific area as a GP with an extended role.

Adjusting to working in the UK can feel challenging, but with the right guidance, preparation and support, you can settle confidently into NHS general practice. A range of resources is available to help you understand both the professional and cultural aspects of working in the NHS. 

For example:

• The GMC runs a free online workshop, Welcome to UK Practice. This session helps doctors new to NHS practice, or new to the country, to understand the ethical issues that will affect them and their patients on a day-to-day basis.
• The King’s Fund is also a great source of information relating to the NHS, offering insight, reports and analysis on a number of topics
• The BMA website offers practical advice on what to expect in your first 90 days in the UK.

GPs can move between many different roles and locations throughout their careers and build flexible working patterns around the needs of their patients as well as their personal lives.

Several websites advertise GP vacancies including RCGP jobs which will give you an idea of the variety of roles on offer. These are explained on our Career Options page which includes tips and advice. 

• Read about why Dr Jodie Blackadder-Weinstein chose GP and her portfolio career. 
• If you prefer podcasts, explore the GP+ Careers podcast, where GPs share their experiences of varied and fulfilling career paths.

If you do not hold a UK primary medical qualification, there are six ways you can obtain full registration with a licence to practise:

• A pass in the Professional and Linguistic Assessments Board (PLAB) test
• Sponsorship by a GMC approved sponsor – The RCGP is not currently an approved sponsor
• An acceptable postgraduate qualification
• A Relevant European Qualification
• A Recognised Specialist Qualification
• A Portfolio Pathway application

These assess whether you have the required knowledge and skills to practise medicine safely. Whichever route is followed, you must hold an acceptable primary medical qualification.

There are five possible pathways you can take to apply for entry to the GP Register.

• GP specialty training in the UK
• Combining previous experience with GP specialty training in the UK
• A Portfolio Pathway application for doctors who have not completed UK GP specialty training 
• Holding a Relevant European Qualification
• Holding a Recognised Specialist Qualification

For more information about these pathways please visit our Pathways to GP registration in the UK page and use our Pathfinder tool [Interactive or PDF] to help you find the most appropriate pathway for you.

If you hold an MRCGP [INT] accredited qualification you are eligible to make a Portfolio Pathway application. However, holding MRCGP [INT] does not mean a Portfolio Pathway application is more likely to succeed. Applicants must demonstrate the standard across the 13 capabilities of the UK GP curriculum and every application is evaluated on individual merit.

While examinations accredited for MRCGP[INT] meet the rigorous standards set by the RCGP, passing the examination does not confer the right to practise as a GP in the UK. The curriculum on which the MRCGP[INT] examination is based is unique to the country it was developed for and is therefore different from the GP curriculum in the UK.

Once you are on the GP register, before you can practise independently in the NHS, you will need to complete the GP International Induction Programme (IIP) which is designed to induct overseas qualified GPs into the workforce. You will be included on the National Medical Performers List after completing your induction which will enable you to start working.

GP induction programmes provide a safe and supported route for qualified GPs to join NHS general practice. Induction programmes in the UK have slight variation from nation to nation.

• England
• Wales  
• Scotland
• Northern Ireland

While completing your induction, you are eligible to receive a free year of RCGP Associate membership which includes many benefits. All you need to provide to qualify is proof of registration on an induction programme.

A Skilled Worker visa allows you to come to or stay in the UK to do an eligible job with an approved employer. This visa has replaced the Tier 2 (General) work visa.

As a doctor working in health or adult social care, you are eligible to apply for the Health and Care Worker visa, which is a subcategory of the Skilled Worker visa. It’s cheaper to apply for and you do not need to pay the annual immigration health surcharge. You must have a job offer in the UK which includes an offer to join a specialty training programme and be granted a licence to practise by the GMC.

There is a four month grace period on Skilled/Health and Care Worker visas for GPs at the end of their training. This is intended to allow you to have extra time to secure work with an employer and arrange sponsorship with them.

• If you started your training in August 2023 or after this, your additional four months will automatically be applied.
• If you started your training before August 2023 you will need to apply for the extension. 

You should contact your local training body visa team for details on how to apply. Here are some initial pointers:

You cannot apply more than one month before your current visa is due to expire (the end date on your BRP card or visa). Applications submitted too early will be rejected by the Home Office.

Make a Skilled Worker Visa application (using the health and care route) via the UKVI website.

• Please note you will need to pay the associated visa application fees at this time, but will be refunded later  

As part of this application, you will need to use the Certificate of Sponsorship (CoS) number currently issued to you for your training – or the most recent one if you’ve had an extension before your CCT date.

• Your CoS number is located on your previous CoS
• Add the start date as the day after your visa expires 
• Add the end date as your start date plus 4 months 

The Home Office will then ‘hold’ your application for a period 4 months.  Please note they will not assess your application and you will not be given a decision or a new visa. Your application will just be placed in a holding position so that your stay in the UK will not be curtailed and you will not be asked to leave.

The 4-month visa extension or grace period is not an alternative to securing sponsorship with your next employer after completing your training and you will not be given a new visa. This scheme is only to allow you to legally remain in the UK while you are looking for employment and waiting to start work.  If you have already secured employment and sponsorship with a new sponsor by the end of your training, you will not need to apply for the extension.

If your visa is due to expire at the end of your training, this information should help you to plan ahead, so that when you complete training and gain your CCT, you are in the best possible position to move smoothly into a role as a qualified GP.

Good to know

• Plan ahead as far as possible so that you can move directly into a job without delay.
• You should think about this early in your ST3 year and talk to your local NHS links.
• It's quicker if you can secure a job with a practice which already has a sponsoring licence, but this can be applied for if the practice doesn’t have it and is willing to get it.
• It may be worth double-checking your CCT date is accurate with your deanery (who can confirm this with the RCGP GPSA team) to ensure the correct timing of your application.
• General practice jobs are on the shortage occupation list, so a Resident Labour Market Test (RLMT) isn't required.
• You must have a confirmed job offer before applying for your visa.

Applying for jobs

• Check the RCGP Jobs board
• Talk to your Educational Supervisor and Training Programme Directors, as they may be able to signpost you to local opportunities and initiatives to support you if you are due to complete training
• Find out which practices in the area you are planning to work can sponsor Health and Care Worker visas. Your Local Medical Committee (LMC) should be able to provide more information on this.

• To apply for your CoS you will need passport details, your address, details of your job, etc.
• If you have a job offer from a practice which already holds a licence for Skilled Worker visa sponsorship, they will be able to apply for your CoS straight away.
• If you have a job offer from a practice which isn’t already a sponsor, they will have to be prepared to apply to become a sponsoring practice and complete this process before you apply for your CoS. Securing a licence can take around 8 to 12 weeks so allow enough time for this.

More information and support for practices:

• UK visa sponsorship for employers on GOV.UK
• Employer Helpline: 0300 123 4699
• businesshelpdesk@homeoffice.gov.uk
• Once the sponsor licence is granted, the practice can apply for your CoS.
• When you have been assigned a CoS you must apply for your visa within three months but cannot apply more than three months before the start date of the job listed on the certificate. See certificates of sponsorship on GOV.UK.

Gov.uk/Home Office

• Health and Care Worker Visa – Guidance for applicants on GOV.UK
• Email for dedicated and prioritised visa support and advice for any NHS staff including GPs and practices: UKVINHSTeam@homeoffice.gov.uk

England

• Skilled worker sponsorship on the NHS England website 
• Email: england.sponsorship@nhs.net

Scotland

• Skilled Worker Sponsorship on the Scottish Medical Training website
• Email: tier2sponsorship@nes.scot.nhs.uk

Wales

• Skilled Worker Sponsorship on NHS Wales website
• Email: NWSSP.certificateofsponsorship@wales.nhs.uk

Northern Ireland

• Skilled Worker Visa information on the NIMDTA website
• Email: immigration.nimdta@hscni.net

BMA

• Certificate of sponsorship on the BMA website

What happens if I don’t submit a new CoS before the end of the grace period? 

• Your visa application will be considered on the basis of the information you have already provided and may be refused. 

Should my dependants apply at the same as me? 

• Yes. Your dependants should apply at the same as you to extend their visas. If your dependants apply later their applications may not be considered in line with your application and may be refused.

Will this affect my application for Indefinite Leave to Remain (ILR)? 

• No. Any extension taken under this scheme submitted before the expiry date of your visa will extend your permission under Section 3C of the Immigration Act 1971, and this time period within the UK will be counted as Skilled Worker permission for the purposes of calculating eligibility for settlement. Section 3C extends the person’s existing permission until the application is decided (or withdrawn).  

Can I continue my training using the additional four months offered by this scheme? 

• No. If your training is extended (i.e. your CCT date is delayed), you will need to apply for a normal visa extension. You can then use the additional 4 months post CCT date should you need it once you have successfully completed your training.

Can I undertake locum work during the additional four months offered by this scheme? 

• Yes. You will be able to work as a locum GP whilst you are seeking permanent employment in the field. However, the purpose of this scheme is to find permanent employment at a Skilled Worker licenced employer.

Can I travel overseas during the additional four months offered by this scheme? 

• No. If you were to leave the Common Travel Area (consisting of the UK, Ireland, Isle of Man and Channel Islands) whilst your application is outstanding it will be treated as withdrawn and you will be unable to return the UK. If you were to leave the Common Travel Area during this period you will need to make an application from overseas once you have been offered a job.

Key areas to become familiar with:

Consultation structure

UK GP consultations are typically 10–15 minutes. Within this time, doctors are expected to take a focused history, examine when appropriate, assess risk, and discuss a management plan. Consultations follow a patient-centred structure, which means balancing clinical priorities with the patient’s ideas, concerns and expectations. Time management therefore becomes an important skill. For more information on consultations in general practice read our super condensed topic guide.

Guideline-based Care

Clinical decision-making in the UK is strongly supported by both local and national guidelines. Nationally, the National Institute for Health and Care Excellence (NICE) publish evidence-based guidelines covering investigation, treatment and referral thresholds for many conditions, and summarised versions of these for general practice are available via the CKS | NICE website

• Prescribing practice is also guided by the British National Formulary (BNF), which provides information on indications, dosing, interactions and safety considerations, which ensure healthcare professionals prescribe safely. You can download a smartphone app for the BNF for quick access to these. 
• In addition to national guidance, there may be further guidelines for the local area or hospital you are working in, which give preferred recommendations based on local antibiotic resistance patterns, service availability and cost effectiveness. Local guidance should be prioritised in clinical practice, although when it comes to exams, knowledge of national guidance will be expected.

Managing risk and uncertainty

General practice often involves managing undifferentiated symptoms and clinical uncertainty. A common approach used in UK practice is safety-netting. This involves explaining to patients what symptoms to monitor, when further advice or urgent care is required and where they can access this. Clear documentation of this advice is an important part of good clinical practice and supports patient safety.

Referral systems

In the UK, GPs are often the first point of contact to healthcare and play a central role in coordinating patient care and access to specialist services. Some services can be accessed by self-referral (meaning the patient can contact the service directly, depending on local arrangements), but many services require a GP referral before a patient can be seen in secondary care or by community teams such as mental health services.

Referrals may be routine, urgent, or through specific fast-track pathways when there is concern about a serious condition, such as suspected cancer. For urgent same-day concerns, the GP may contact the specialist service directly by phone, or advise attendance at the hospital emergency department with a written clinical summary. Most other referrals are sent electronically and usually involve a structured referral form and or a referral letter.

Patient autonomy and shared decision-making

UK healthcare places strong emphasis on patient autonomy and shared decision-making.

• Patients are encouraged to be active partners in decisions about their care.
• Doctors may encounter situations where patients choose not to follow recommended treatment or prefer alternative options.
• Where patients have decision-making capacity and understand the risks and benefits, these choices should be respected.
• Supporting patients to make informed decisions is therefore an important part of consultations.

Clinical Areas to become familiar with

Doctors joining UK general practice may notice that some clinical areas are approached differently in UK general practice. This can reflect differences in disease patterns and how services are organised, but also the wider social and cultural context. Reviewing some common UK guidance in the following areas may be helpful:

• Women’s health including contraception, abortion care and menopause management.
• Mental health in primary care, including initial assessment and management of depression, anxiety, self-harm and suicide risk.
• LGBTQ+ health, including inclusive communication, awareness of health inequalities, and familiarity with gender identity services.
• Safeguarding, including recognising and responding to concerns about safety at home, for children and adults at risk, including domestic violence and other forms of abuse.
• End-of-life planning – including discussions about DNACPR, advance care planning, hospice and anticipatory medications.

Cultural awareness

The UK is a diverse and multicultural country. According to the 2021 Census, around 18% of people in England and Wales identify with Black, Asian, mixed or other minority ethnic groups, and many communities have diverse cultural, linguistic and religious backgrounds. Patients’ beliefs, cultural practices and lived experiences can influence how they understand illness, seek care and make decisions about treatment. Clinicians are expected to provide respectful and equitable care for all patients.

This aligns with professional standards and legal responsibilities, including the Equality Act 2010 and the Public Sector Equality Duty.

Social norms

Interpersonal style in UK general practice is often polite, friendly, and relatively informal. Patients commonly expect a warm greeting, introductions by name and role, and a conversational tone. Patients may prefer to be addressed by their first name, but it is best to check and follow their preference. Some patients and clinicians use light or self-deprecating humour to build rapport, but humour can translate differently across cultures and should be used cautiously, particularly until you are familiar with the patient and the context. Compared with some healthcare settings internationally, interactions may feel less hierarchical, and maintaining an approachable but professional manner can help establish trust.

Professional boundaries

Despite approachability being valued, the doctor–patient relationship is professional, not personal. Avoiding conflicts of interest, maintaining clear boundaries, and respecting confidentiality are core values.

Language and communication skills

Proficiency in medical English supports effective communication with colleagues and other healthcare professionals. Medical terminology and acronyms are commonly used in professional settings, although these may vary between organisations and healthcare systems and should be used with caution.

Patient communication

In consultations with patients, clear and plain language is preferred, and medical jargon is generally avoided. You may need time to become familiar with regional accents, dialects and colloquial terms that patients use to describe symptoms or health concerns.

Communication with colleagues

General practice in the UK typically involves working within multidisciplinary teams. Communication is often collaborative, and in some settings colleagues may use first names rather than titles, reflecting a relatively flat team structure compared with many hospital environments.

In day-to-day general practice this includes maintaining confidentiality and sharing information appropriately, ensuring patients are supported to make informed decisions and consent to care (including assessing capacity where relevant), and practising in a way that is open, fair and respectful. Familiarity with ethical considerations around safeguarding, boundaries, equality and inclusion, and end-of-life decision-making is also important.
 

In UK practice, medico-legal requirements are duties that arise from a combination of law (statute and case law) and professional regulation (primarily the GMC).

They are obligations that, if breached, could lead to clinical negligence claims and resulting legal action, regulatory investigation, or both.

You have a legal duty to protect children and vulnerable adults from harm, even if this means breaching confidentiality. 

Medical indemnity arrangements in the UK

The GMC states that you must make sure you have adequate and appropriate insurance or indemnity arrangements in place covering the full scope of your medical practice in the UK.

Indemnity for clinical negligence claims arising from NHS care varies across the four UK nations.

• In England, the Clinical Negligence Scheme for General Practice (CNSGP) applies.
• In Wales, it is the General Medical Practice Indemnity (GMPI) scheme. 
• In Scotland and Northern Ireland GPs are required to obtain their own indemnity for clinical negligence claims, and this is available from the traditional medical defence organisations (MDOs), which include the Medical Defence Union (MDU), Medical Protection Society (MPS) and the Medical and Dental Defence Union of Scotland (MDDUS) amongst others. 
• The RCGP does not recommend a specific medical defence organisation, and doctors are advised to undertake their own research when considering the different options available.

NHS indemnity also varies across the UK for GP trainees. 

• GP Specialist Trainees (GPSTs) in England, Wales and Scotland can access NHS indemnity schemes. 
• GPSTs in Northern Ireland need to arrange their own indemnity but can claim this back from the Northern Ireland Medical and Dental Training Agency (NIMDTA). 
• NHS indemnity schemes in England and Wales only provide assistance with clinical negligence claims so doctors are advised to also have membership of an MDO for support with regulatory or medico-legal matters. IMGs should familiarise themselves with how these schemes operate, as they may differ from indemnity or insurance arrangements in other countries, and take advantage of the guidance offered by their MDO. 

In the UK, patient data is strictly protected under laws such as the Data Protection Act 2018 and UK General Data Protection Regulation (GDPR). You must ensure patient information is kept confidential, shared only on a need-to-know basis, and stored securely.

These responsibilities apply to all formats, including electronic records, messaging systems and any digital or AI supported tools used in clinical practice. Where AI tools are used, they should be approved by your organisation, used in line with local information governance policies, and limited to the minimum necessary information.

Patient-identifiable information should not be entered into non-approved or public AI tools. More guidance on responsible use of AI can be found via BMA and RCGP.  

Continual Professional Development (CPD) is essential in the UK and there are many courses, webinars, and other development offerings you could sign up for.

• Check out the RCGP eLearning modules on consultation skills, communication, and ethics
• Use the NHS e-Learning for Healthcare (e-LfH) platform to review clinical topics and complete relevant training modules. Access requires a GMC number and NHS account.

Many institutions have support programmes for IMGs, including mentorship, workshops, and social events to help integrate into the GP community. Joining relevant professional organisations such as the RCGP and your local faculty.
The British Medical Association (BMA) can also offer support.

Speak to someone who has been through the same journey.
The RCGP has an IMG group where you can connect with your peers and an international and overseas group on the RCGP forum.

These induction days cover both clinical and cultural expectations. Your local deanery often organises these and information and upcoming sessions can be found on your local deanery website.

• Attend the GMC’s Welcome to UK Practice workshop and online resources
• The RCGP also holds an annual IMG Induction event in July of each year which when live, you can find here. This event does book up quickly, but should you not be able to join for any reason, we do record the sessions and post them to our YouTube

• Observe experienced colleagues and ask for feedback on your consultation style
• Practice explaining diagnoses and management plans in simple, concise language. NHS patient-facing information pages, such as those on Conditions A–Z, can be a useful reference for how conditions and treatments are explained clearly for patients.

Adjusting to life in a new country and job can be stressful. Remember to seek help if needed. 

• RCGP wellbeing resources 
• BMA wellbeing support services
• NHS Practitioner Health

Guides to buying and renting property in the UK can be found on property website Rightmove which will also give you an idea of the housing options available across the UK, and associated costs.
Some additional resources:

• Expatica and Britain Explained – Comprehensive guides to housing in the UK
• Citizens Advice – Guides to renting and buying property for England, Scotland, and Wales
• housingadviceNI – Housing guide for Northern Ireland
• Gov.uk checklist for those looking to rent a house or flat in England 
• Gov.uk guide for home buyers in England and Wales

In the UK, schools are either state schools funded by government and are free for all pupils, or they are independent schools and charge fees to the parents of the pupils.

Education is compulsory for all children between the ages of five (four in Northern Ireland) and 16 and is devolved in the UK, with each of the four nations having separate systems. 

Children usually attend primary and secondary schools closest to where they live if there are places available. In England, you must apply through the local council for a school place.

Each school has regular inspections and you can view the reports on the Ofsted website to find out how well a school has performed. Schools in Scotland, Wales and Northern Ireland have similar inspections.
 
Further education and higher education are not compulsory although the UK has some of the best universities in the world!

For an overview of the education system in the UK and more information on the individual systems in the four UK nations follow the links below:

• England
• Scotland
• Wales
• Northern Ireland 
• The UK Education System
• Schools and education

There are several childcare options available to parents including nannies, nurseries, childminders and creches. In most regions children from age three are entitled to some free childcare.

There is country specific detail for England, Scotland, Wales and Northern Ireland and more general information on childcare options and costs across the UK on these websites:

• MoneyHelper,
• Expatica

Setting up a new bank account can be challenging. There are different types of accounts and costs. 
It is worth checking with your existing bank to see if they have a relationship with a bank that has a presence in the UK. You may be able to apply for an international account online. For example, Barclays, Lloyds, HSBC, and NatWest all offer international bank accounts. 

MoneyHelper has numerous articles on how to open a bank account, types of bank account and how to choose the right bank account for you. 

Here are some helpful guides on all things related to banking and managing your finances:

• Expatica
• Britain Explained 
• Opening a UK bank account without proof of address 
• Opening a bank account with a mobile-only bank option

You may be able to drive in the UK (England, Wales and Scotland) for up to 12 months on your foreign licence. You can check eligibility on GOV UK as well as get information on exchanging your foreign licence for a UK licence.

The process in Northern Ireland is different.

Anyone who is a resident in the UK can access the NHS. The NHS is free to all at the point of delivery. You should register with a GP in your local area to ensure you can easily access medical care if and when you need it.
Dental care is provided separately from GP services. NHS dentistry is not universally free for adults and access can vary by area, so you may need to register with an NHS dentist (or use a private dentist) for routine dental care.

Eye care is usually provided through community opticians. Many people access eye tests through high-street optometry services. NHS-funded eye tests are available for certain groups (for example children, people over 60, and those with specific medical conditions), and you will need to pay for routine eye examinations if you are not in one of these groups.

You can find more information on services provided by the NHS here. 

There are numerous broadband, mobile phone and TV providers in the UK. Here are some useful resources to help you get started:

• How to get a UK sim card and mobile phone
• How to set up TV, home phone and internet.

You can compare deals on comparison websites such as:

• Broadband Choices
• Comparethemarket.com
• Gocompare.com
• Uswitch.com. 

Living costs vary across UK countries and regions, with the highest costs generally found in London. This is often taken into account in salaries by including an allowance known as London weighting. 

You can find an overview of the cost of living in the UK on Numbeo and Expatica 

Registration and Licensing

• Apply for GMC registration and check your qualification is recognised
• Pass IELTS or OET for English language proof
• Complete PLAB 1 & 2 (if required)
• Receive your GMC licence to practise

Visa and Immigration

• Apply for a Health and Care Worker Visa
• Obtain your Certificate of Sponsorship (CoS)
• Complete TB test and police clearance certificate

Employment and key documents

• Accept and sign your job/training offer  
• Apply for a National Insurance number (if not already issued)
• Arrange appropriate medical indemnity cover before starting work (e.g. through a medical defence organisation)

Prepare copies of:

• Passport and visa
• GMC registration certificate
• Medical qualifications and translations (if needed)
• Immunisation record

Finances and Practical planning 

• Arrange initial accommodation for your arrival
• Open or plan to open a UK bank account
• Bring sufficient funds for your first month in the UK 

Professional and System Preparation

• Review NHS structure and how primary care works
• Familiarise yourself with NICE guidelines and the BNF
• Learn common consultation models
• Familiarise yourself with common NHS clinical systems (e.g. electronic patient records and prescribing systems)

Cultural and Personal Preparation

• Learn about UK workplace culture and communication style
• Join IMG support networks (e.g. BMA IMG Hub, RCGP IMG Programme)

Employment and induction

• Complete occupational health clearance with your employer
• Attend local and Trust/practice induction
• Confirm rota, supervision arrangements and start date (if applicable)

Registration and administration

• Register with a local GP once you have a UK address
• Provide proof of address where required
• Ensure payroll, pension and bank details are set up

Mandatory training

• Complete safeguarding training (adults and children)
• Complete equality, diversity and inclusion training
• Complete information governance and basic life support training/CPR

Professional support and development

• Identify your clinical supervisor/educational supervisor (if applicable)
• Understand appraisal and revalidation requirements
• Access IMG support resources