The decision to abolish the medical training initiative (MTI) scheme risks reversing years of progress in medical diplomacy and repeating earlier mistakes in the UK’s treatment of international medical graduates (IMGs), according to Dr Peter Trewby.
History of International Medical Recruitment
In the early 2000s, the government actively recruited IMGs and established a new GMC exam centre to process applicants at scale. Thousands came to the UK, but the number of available posts was insufficient. The government responded by ending the permit-free visa, which had allowed IMGs to work in the UK, so doctors could only apply for posts when no UK graduate had applied, regardless of relative merits.
International exchanges built over decades ended abruptly.
Introduction of the MTI Scheme
Following strong lobbying by the medical royal colleges, the MTI scheme was introduced to allow suitably qualified doctors to come to the UK for a maximum of two years before returning home. The scheme benefited the UK, the NHS, international graduates and UK trainees, while also serving as an effective example of UK soft power.
Impact of Abolition
Abolishing the scheme removes a successful route for international collaboration, including education and research, and risks signalling again that nationality takes precedence over merit. For an NHS that prides itself on its inclusivity, this is a serious regression.
Dr Peter Trewby is a retired consultant physician and former director of international medical graduates at the Royal College of Physicians.
