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Medical training in the UK for Greek nationals

by Christos Sideras - University of London, christos.sideras [at] gmail.com
Presentation was generated by the British council and provided by the HELMSIC

General Advice
Change of continuity is not something usually undertaken lightly and there are a number of considerations that come to mind, some of which are briefly outlined as follows, which to a large extent are candidate specific:
-         Cultural differences may make your training experience in the UK different to the one in Greece, as well as impact on social maturation.
-          Access to family and friends, as well as a familiar cultural and physical environment contrasted with access to new experiences is a very important aspect to consider.
-          Language-specific training to your specialty of choice is another important factor, especially for such specialties depending on communication skills to elicit history and provide therapy such as psychiatry. This may also be impacted upon by long term personal plans for career and settlement.
-          Quality of training, research and teaching opportunities, which to some extent may be specialty and centre specific.
-          Availability of stimuli of personal interest, whether this would refer to daily routines or a possibility of exploring an interest eg further degrees in subfield.
-          Run-through training is another consideration and in the majority of specialties there is a need to re-apply from core to higher training in the UK, which may mean that you will have to move from one area to another, though in all likelihood this will not be necessary. In summary, the basic training lasts 2-3 years and is followed by another 3-7 of higher training, bringing the training time to 3-9 years in total, depending on the specialty of choice ie General Practice vs Paediatric Neurosurgery.

All this being said, if you have a good think about where you see yourself in 10 years time and feel that training or training-in-part in the UK is what you wish, on the whole I would probably suggest that earlier is better, ie consider doing medical school training or basic training (called foundation training) prior to your specialty training as it will familiarise you much more with the local procedures as well as the language. It may make applying easier also if you are in the UK already. It should be noted though that individuals can be made welcome either for fellowships or substantial training positions at any stage of their career.

Medical School
Applications to Medical Schools may be made through UCAS:

This is a list of the UK Medical Schools, with a further link of a helpful site with information about studying medicine in the UK, including pages for those considering medicine as Graduate entrants, for which there is a shortened course of 4 instead of 5 years:
http://www.medschools.ac.uk/Students/UKMedicalSchools/Pages/UK-Medical-Schools-A-Z.aspx
http://www.medschoolsonline.co.uk/index.php?pageid=11

Elective placements
Alternatively, if you are a medical student and wish to do a clinical elective or a research project at a UK institution, you may approach a clinician or a researcher individually and apply to that particular institution; most would have the information available on the medical school sites.

List elective sites in specific universities:
http://www.kcl.ac.uk/schools/medicine/ugstudy/electives/visitingexchanges/
http://www.ucl.ac.uk/medicalschool/electives/
http://www.smd.qmul.ac.uk/undergraduate/electives/index.html
http://www.medsci.ox.ac.uk/study/electives
http://www.medschl.cam.ac.uk/education/elective/

GMC Registration
It is essential for your status as a medical practitioner be recognised in order to be able to work in the UK, whether a graduate of a UK, European or International medical school.
You should be able to register with the GMC using these links once you have completed your training:
http://www.gmc-uk.org/doctors/before_you_apply/registration_factsheet.asp
http://www.gmc-uk.org/doctors/registration_applications/join_the_register.asp
http://www.gmc-uk.org/doctors/registration_applications/s3_p1.asp

Foundation Training
If you are considering applying for a Foundation Programme, it is important to bear in mind that the deadline would normally be in October of the previous year to the beginning of the post, which would be in August. This would normally be done through this website, which also has all the relevant information:
http://www.foundationprogramme.nhs.uk/pages/home/how-to-apply

The FAQs section 3 outlines the various documents needed and English Language requirements:
http://www.foundationprogramme.nhs.uk/pages/medical-students/faqs#answer95

Foundation Training normally runs for two years, but most European medical schools would get one year recognised as counting towards foundation training. The suggestion is that EU graduates apply for the F1/F2 posts, but say that if they have done one year of internship, they would only wish to do one year. It is important to remember that you will need to complete a certain time period, so if thinking of coming mid-year and applying for one of the time-limited but counting towards training posts, do bear in mind that it is likely you will still need to do a full year of Foundation to get signed off - eg Aug 2010 to Aug 2011.
http://careers.bmj.com/careers/hospital-medical-healthcare-jobs.html

It would be expected that as part of your Foundation Training you would have completed a number of courses, such as ILS, ALERT and Simulation courses. The latter would be available across the UK also, please look up individual centres at each locality.

http://www.resus.org.uk/pages/ilsinfo.htm
http://www.bmsc.co.uk/sim_database/centres_europe.htm
http://www.alert-course.com/course-information/trining-dates-for-2010/

If interested it would be a good idea to check the Foundation Training website regularly as there may be news there.

Specialty Training (Eligibility)
In order to be eligible to apply for Specialty Training you will need to have the competencies as stated above, ie medical school degree, English language proficiency, registration with the GMC and foundation competencies. I will explain what the latter entails as it is the only one not covered already.

This document, from one of the deaneries (KSS) outlines very well the issue. You will need to complete 24 months of general medical training somewhere in the UK or Europe and use this training to say you have the competencies to progress with specialist training.
http://m.kssdeanery.org/prospectus/how-apply/foundation-competencies

With regards to getting competencies for foundation (to apply for an ST post), there does seem to be a bit of a procedure, whereas you will need to have a specific certificate.
For acute specialties (eg Surgery), you will need to fill in an Alternative Certificate of Foundation Competencies Form A
For non-acute specialties (eg Psychiatry), you need to fill in an Alternative Certificate of Foundation Competencies Form B

The forms should be available from MMC and the Deaneries in due course, but were not at the time this document was prepared.
Again, you may need to complete some courses, particularly ALS, but it would also strengthen your application to consider aspects of professional training beyond this:

This is the explanation at the MMC website, which may be helpful:
http://www.mmc.nhs.uk/specialty_training_2010/recruitment_process/stage_1_-_eligibility/are_you_eligible_to_apply.aspx

For a more technical overview, the Operational Framework outlines this in Section G, paragraph 83 (page 27).

Useful documents and FAQs
http://www.foundationprogramme.nhs.uk/pages/home/key-documents
http://www.foundationprogramme.nhs.uk/pages/medical-students/faqs#answer95

Specialty Training (Application)
If you wish to be fully registered in Greece and apply to specialty training afterwards, you may do this through individual deaneries for most specialties with the MMC website being quite useful as it has some relevant information. This is the list of deaneries:
http://www.mmc.nhs.uk/default.aspx?page=284
The list of Royal Colleges, which play an integral role in setting out training, may also be accessed from this list:http://www.aomrc.org.uk/members.htm

If, for example, you wish to apply for psychiatry in London, the relevant links would be the following:
http://www.rcpsych.ac.uk/specialtytraining.aspx
http://www.londondeanery.ac.uk/
http://www.rcpsych.ac.uk/training/nationalrecruitment.aspx
https://trainingjobs.rcpsych.ac.uk/

Clinical Research Programs
Research training is increasingly demanded for at an earlier stage in one’s career and this reflects the growing awareness that a clinical academic is essentially dually trained in both clinical medicine as well as research. Thus research training can be started at any of a number of stages, but would normally require more or less 10 years of training, including undergraduate, graduate and postgraduate work allowing you to work as an independent researcher at the end of this, having the skills to ask the right (or at least answerable!) questions, carry out the necessary experiments, manage your lab and attract funding. As you choose a specialty for the clinical training, you can also choose for your research training specific methodologies, associated with a number of skills not necessarily dependent on the subject matter of choice eg molecular genetics or epidemiology.

The UK Clinical Research Council Collaboration and the academic community in general have recognised this and have tried to support research training for doctors through a variety of schemes throughout their careers.
www.academicmedicine.ac.uk/careersacademicmedicine.aspx
www.ukcrc.org/workforcetraining/doctorsanddentists/

The earliest point at which you can start this, unless you have already completed research prior to applying for a medical degree, is through an MD-PhD programme, which is available through the following universities:
www.medschl.cam.ac.uk/education/courses/mbphd/
www.ucl.ac.uk/mbphd/

Rather than doing a regular Foundation Training, for those considering an academic career, an Academic F1/F2 may be more suitable and those would also be made available through the BMJ Careers website and individual deaneries.
www.foundationprogramme.nhs.uk/pages/academic-programmes/how-to-apply/view-list

Academic Clinical Fellow training is the equivalent of Core Training and allows for 25% of one’s time to be spent on research working towards a grant application. The Clinical Lecturer post is the equivalent of Higher Specialty training and includes 50% of the time dedicated to research.

Basic Research Programs
If interested in Basic Research, without any clinical component, the track of undergraduate, postgraduate and postdoctoral research training can be followed. This can be a helpful starting point:
www.academicmedicine.ac.uk/careersinbiomedsci.aspx
If wishing to do your undergraduate degree in the UK, you should apply through UCAS

There are a number of PhD opportunities in a variety of fields, which can be searched for, amongst other places, at the following sites:
www.postgraduatestudentships.co.uk
www.jobs.ac.uk
Alternatively, you can apply for a specific project funding at any of the funding bodies, though this would require some groundwork on your part, in addition to having identified supervisors and an institution that would provide the support for your research.