On 25 March 2026, the International Postgraduate Deanery (IPD) team received unexpected news: NHS England had discontinued its funding of the Medical Training Initiative (MTI) Scheme. Just like that, a long-standing route supporting international doctors was coming to an end, with changes taking effect from 1 April 2026.
To say this came as a shock would be an understatement.
The MTI scheme was run by Academy of Medical Royal Colleges (AoMRC), and around one-third of IPD doctors used the MTI Government Authorised Exchange (GAE) visa route to enter and work in the UK. For many doctors receiving funding from their home government or training body, this was not just a preferred route—it was the only route available.
While the MTI scheme officially closed to new applicants on 31 March 2026, College applications were thankfully given a three-month grace period to honour existing applicants. Applications completed after 30 June 2026 would not be accepted, with no exceptions.
That grace period was welcome—but it also meant the clock was suddenly ticking very loudly. No one enjoys a deadline. A deadline involving immigration paperwork? Even less so.
The closure had an immediate and significant impact on IPD doctors and the workload of the IPD team. We were deeply disappointed by the decision, particularly given the short notice. Almost overnight, we found ourselves navigating a wave of urgent enquiries from HR departments, consultants, and international doctors—all understandably anxious about what this meant for their futures.
The weeks that followed were intense. Emails multiplied, Teams meetings filled calendars at an alarming rate, and diaries quickly became overcrowded. It is probably fair to say caffeine became one of the team’s core operational resources.
In a short period, approximately 23 applications had to be expedited alongside six extensions. For context, we usually ask for applications to be submitted three to six months before a doctor’s intended start date. This allows doctors and hospital HR teams time to gather all required documentation, while also giving the IPD team the opportunity to carry out essential due diligence before supporting GMC registration and/or MTI GAE Certificate of Sponsorship (CoS).
Compressing that work into a much smaller timeframe created enormous pressure—but the team rose to the challenge.
What stood out most during this period was the commitment, resilience, and care shown by the IPD team. Despite the pressure, we remained focused on helping as many doctors and employing units as possible, while maintaining the high standards expected of the programme. Behind every application was a person, a career, and often years of planning—and that perspective never left us.
Although this chapter has been challenging, it is not the end of the story.
The College is now taking a leading role in national discussions around a potential successor to the MTI Scheme—one that preserves the purpose, opportunities, and values of the original programme.
Summary
The closure of the MTI Scheme created significant uncertainty and a substantial operational challenge for everyone involved. Despite intense pressure and tight deadlines, the IPD team worked tirelessly to support affected doctors and stakeholders. As the College helps shape future solutions, the commitment to supporting international medical professionals remains unchanged.