Frequently Asked Questions
about the International Induction and Return to Practice programmes for GPs
There is detailed information about both schemes available on the GP National Recruitment Office (NRO) website:
It is worth spending some time reading the information there, which is quite comprehensive. This document is intended as a brief summary of some of the key points.
Question: Is the I&R scheme compulsory even though I am on the GP Register?
Answer: Yes, if you have not worked as an NHS GP in the UK within the last 2 years, it is compulsory to complete the return to practice programme or International Induction scheme, even if you have accredited GP qualifications from abroad; this is to gain entry onto the performers’ list (see below). It is also compulsory to be on the GMC GP Register. These processes are separate.
Question: How do I apply for the I&R scheme?
Answer: You should complete an application form. Please follow those links for the relevant application forms that can be found on our website:
Question: What is the CEGPR streamlined route?
Answer: The Streamlined CEGPR route is for GPs qualified overseas from designated GMC approved training programmes outside the UK.
The Royal College of GPs (RCGP) and the GMC have agreed that Australian, Canadian, New Zealand and South African GP training programmes are close to those undertaken in the UK (which culminate in the MRCGP qualification) and those countries training programmes are recognised for the CEGPR streamlined route. Please use this link for further information on this route.
Recognition of all overseas training (from outside EU and Switzerland) and entry to the GMC GP Register with a Licence to Practise requires an application for a CEGPR (certificate of eligibility for GP registration).
RCGP contact details for enquiry about eligibility are:
Tel: 020 3188 7656
Tel from outside the UK: + 44 20 3188 7656
Question: I qualified as a GP in the UK before MRCGP was compulsory. What should I do?
Answer: Doctors who completed their JCPTGP or equivalent certification to become a GP but did not join the GMC GP register prior to 2008 can complete the UD2 form, which the GMC can send you on request.
Question: What is the Medical Performers List and how do I apply?
Answer: A GMC license to practise means that you are considered safe to practise as a doctor in the UK. However, it is being on the medical performers list which signifies that you are competent to work as an independent GP.
All UK GPs are on the national medical performers’ list (MPL) managed by NHS England (NHSE). The list exists to provide an extra layer of reassurance for the public that GPs practising in the NHS are suitably qualified, have up to date training, have appropriate English language skills and have passed through other relevant checks such as for criminal convictions with the Disclosure and Barring Service (DBS).
For the details of how to apply for inclusion performers list please follow this link. Please start your application to the medical performers’ list when you have been accepted to sit the MCQ and remember it may take up to 3 months or occasionally longer if evidence is required from abroad.
If you have any questions regarding MPL application, please contact our dedicated NHS England team at email@example.com .
You will not be able to start your supervised clinical placement until you have conditional inclusion on the performers’ list.
You will be awarded full MPL membership once you successfully complete your placement.
Question: Do I need separate references for the MPL?
Answer: No, the references required by HEE will normally be accepted for your application to join the MPL.
You will need to provide two clinical references covering the last two years. Please ask your referees to respond to our reference request as soon as possible and return the references to us electronically at IRscheme.firstname.lastname@example.org
Question: What if I can’t provide clinical references?
Answer: If you have no clinical referees, please provide a full explanation as to why this is the case and the names and addresses of two alternative referees who should be asked to complete the non-clinical references form.
Please note that NHS England may request additional references if these are deemed insufficient for the purposes of a MPL application.
Question: What is an observership?
Answer: Observational placements allow you to spend time in an NHS general practice so that you can learn about the role and work of an NHS GP in today’s rapidly changing health service. They are offered to Induction and Refresher (I&R) applicants at the very start of the process. If you would like us to arrange an observership for you, please email email@example.com
Question: What resources are available to help me prepare for the MCQ?
Answer: The MCQ consists of a situational judgement paper (SJT) with 62 questions and a clinical problem solving paper (CPS) with 86 questions. There is a detailed overview of the assessment on the GP NRO website
Useful resources to help you prepare for the MCQ include:
- The Fourteen Fish learning and appraisal site. This includes learning material for the I&R assessments and for an exam called the AKT (Applied Knowledge Test), which UK GP trainees need to pass before they can qualify. You will have free access to this for 1 year when you register for the I&R scheme with the NRO. It is strongly recommended that you register for Fourteen Fish, especially as you can also use it to record your learning during your placement. There is a module within it about exam technique which is particularly recommended.
- The Royal College of GP (RCGP) on-line learning site (http://elearning.rcgp.org.uk/) . You will have free access to this for 1 year when you register for the I&R scheme with the NRO. The RCGP’s Essential Knowledge Updates are a useful summary of new guidelines and research.
- National Institute of Clinical Excellence (NICE) guidelines relevant to primary care (www.nice.org.uk). However, it is unlikely that you will be tested on the detail of guidelines.
- E-learning modules on the electronic library for health (e-Lfh).
- Good Medical Practice guidelines from the GMC (https://www.gmc-uk.org/guidance/good_medical_practice.asp)
- Bradford Vocational Training Scheme website http://www.bradfordvts.co.uk/
- Pennine Vocational Training Scheme https://www.pennine-gp-training.co.uk/
- https://www.piernetwork.org/star.html paediatric clinical skills
- Fourteen Fish e-learning on Consultation skills https://www.fourteenfish.com/iandrss/welcome
There are commercially available websites such as passmedicine, emedica and the MCQ Bank which have practice MCQs, but you will need to pay a subscription to use them. Passmedicine has practice questions for the GP Specialty Recruitment Assessment, which might be useful.
There is an on-line tutorial which may help familiarise you with the layout of the MCQ (http://www.pearsonvue.com/athena/athena.asp).
Question: How long will my supervised clinical placement be?
Answer: This depends on your assessment results.
If you score band 5 in the CPS MCQ and pass the SJT, you will need a mandatory 1 month full-time placement.
If you score band 4 in the CPS MCQ and pass the SJT, you will need a mandatory 3 months full-time placement.
If you score band 3 in the CPS MCQ and pass the SJT paper, you will need a mandatory 6 months full-time placement.
Up to 6-month placement
Up to 3-month placement
Question: Where will my supervised clinical placement be?
Answer: It will be in an approved training practice. This means a practice which has been assessed and found to be a suitable learning environment and where at least one GP has a teaching qualification. We will try and match you to a practice near home, but can’t guarantee this, as it depends on capacity; training practices also host UK GP trainees.
Question: Will I get paid during my supervised clinical placement?
Answer: You will get a bursary from the GP National Recruitment Office. Please visit their webpage for more details.
Question: Is there anything I need to do BEFORE my supervised clinical placement?
Answer: The following documents (classified as pre-employment checks) are required before you can start your Clinical Placement.
- Basic Life Support certificate dated within the last 12 months
- Safeguarding Adults level 3 dated within the last 12 months
- Safeguarding Children level 3 dated within the last 12 months
- Occupational Health Clearance – provided by an NHS SEQOHS accredited provider. You can find a local SEQOHS OH provider here: http://www.nhshealthatwork.co.uk/find-providers.asp
- Enhanced DBS and Register for online update service - It is advisory to register for the DBS online update service when you have received your Enhanced DBS Certificate as this will keep your DBS up to date. Please note you only have 19 days after your certificate has been issued to do this.
Question: Is there anything I need to do DURING my supervised clinical placement?
Answer: Multisource feedback (MSF, also known as colleague feedback) and a patient satisfaction questionnaire (PSQ) are compulsory for placements of 3 months and longer.
Question: What will my working week consist of?
Answer: A week in a full-time placement (pro-rata for less than full-time) is comprised of 9 sessions of 4 hours 10 minutes (37.5 hours total) and include: 7 sessions of clinical work (surgeries and visits), 1 session of in-practice education (usually a tutorial with educational supervisor) and 1 session of self-directed learning out of the practice. This time may include attending hospital clinics (such as Dermatology, ENT, Ophthalmology etc.) in clinical areas identified as learning needs.
Question: What is an appraisal?
Answer: To remain on the performers’ list, GPs are obliged to take part in appraisal and revalidation.
Appraisal is the process whereby you demonstrate your learning and achievements over the previous year to your appraiser. Your Fourteen Fish (14F) portfolio will convert to an appraisal portfolio after your placement finishes, to allow you to use the evidence you have collected for the purpose of appraisal. An alternative to 14F is Clarity.
Revalidation occurs every 5 years and is the point at which the local Responsible Officer (RO) employed by NHS England makes a recommendation about whether you should be allowed to continue practising as a GP. In order to be revalidated, it is usually necessary to have 5 consecutive appraisals. This will of course be impossible for many doctors on the I&R scheme. The RO will therefore consider the evidence that you are able to submit and if it is insufficient to allow you to be revalidated at the designated time, they will recommend a deferral. Don’t worry if this happens, but do make sure you have your next appraisal when it becomes due – this will allow the RO to recommend you for revalidation.
Hospital appraisals don’t count towards GP revalidation.
Question: When will my revalidation be?
For all doctors new to the register, the revalidation date is set at five years from the point of their first full GMC registration.
London GP International Induction & Return to Practice Programmes
Professional Development Team