NHS career pathway for international medical graduates
Once you hold GMC registration, the practical NHS pathway usually runs first-NHS-post → portfolio + CREST form → specialty training application. Most IMGs start as a trust-grade doctor or clinical fellow (SHO or registrar level) to build UK experience, then apply into the national specialty recruitment rounds. Pay, hours and progression follow the national medical pay bands published by NHS Employers.
What this covers
Secure GMC registration
You cannot start a substantive NHS medical post without a licence to practise.
Apply to trust or clinical-fellow roles
NHS Jobs, TRAC and trust careers pages advertise most first IMG posts.
Build a portfolio
Log procedures, teaching, quality improvement and audit against the specialty curriculum you plan to enter.
Apply into specialty training
National recruitment rounds run annually — self-assess against the person specification well before applications open.
Read the guides in this cluster
- Finding your first NHS post as an IMGWhere NHS jobs are advertised, how trust and clinical fellow roles differ, and realistic timelines from GMC registration to first shift.
- NHS specialty training routes for IMGsHow UK specialty training works, when IMGs can apply, and how Membership Royal College exams and portfolio requirements fit in.
- Portfolio and CREST form for NHS applicationsWhat the CREST (Certificate of Readiness to Enter Specialty Training) form needs, and how to build an evidence portfolio your NHS supervisor will sign.
- NHS pay bands and what IMGs actually earnHow NHS medical pay bands work, the difference between basic pay and enhancements, and what a first NHS post typically pays.
Official sources
Every fact above should be confirmed against the controlling source before you act on it.