Guidance

Applicants with a break in practice within the last five years which does not meet the criteria may be able to demonstrate that they have mitigated the break by providing robust, objective, independent and verifiable evidence that they have:

• undertaken a substantive period of medical practice in another country
• a recent pass in an objective medical test (such as voluntarily taking and passing the PLAB test or passing an acceptable overseas registration exam within the two years prior to the application)
• been awarded one or more acceptable postgraduate qualifications (PGQs) obtained within the three years prior to the application for registration.

If the applicant is able to provide some but not all of the evidence listed above, the decision maker may also take into account the following to mitigate those evidence gaps:

1. Any other medical practice, for example, non-clinical roles such as teaching posts or periods of teaching, study, or research, which were restricted to holder of a medical degree (MBBS or equivalent) to be eligible for the role.
2. Evidence of a formally arranged, substantive clinical attachment undertaken at a UK hospital or a public hospital overseas (that meets the standards for regulation within its jurisdiction and has established supervision, safety and governance systems in place). Or, evidence of a clinical attachment undertaken in the UK as part of a formal programme for doctors who are refugees or asylum seekers.

In either case the applicant should provide:

1. Clear and verifiable information about the length of the clinical attachment in the form of a detailed log including hours per week worked, type of work, duties performed, and training attended.
2. An offer of the clinical attachment from the hospital and a satisfactory reference relating to the clinical attachment submitted on a GMC proforma. This should be completed by the clinician who supervised the clinical attachment and include commentary on all assessable areas, especially core medical skills.
3. Evidence to demonstrate that the clinical attachment is of sufficient duration to allow a meaningful assessment of an applicant’s knowledge and skills over a period of time.
4. Evidence of their learning from the clinical attachment, in particular how it has kept their medical knowledge and skills up to date, and how it will influence their day-to-day medical practice, future practice or future career plan
3. Evidence of medically related CPD and/or CME, medical refresher training, medically related return to work course or further successfully completed postgraduate study for which the award of a PMQ is a condition of entry.    

When considering medically related CPD and/or CME as evidence of how an applicant has maintained their knowledge and skills while out of practice, the decision maker will need to consider:

1. The extent and nature of the CPD and/or CME and whether the evidence demonstrates that the applicant has maintained a broad range of core medical knowledge and skills while out of practice.
2. Whether the applicant has taken a targeted and structured approach to CPD while out of practice.
3. The proportion of online CPD and/or CME undertaken and whether this is directly relevant to the applicant’s practice. Decision makers will need to take into account whether there are good reasons why online learning was the best available way for the applicant to keep their knowledge and skills up to date, for example if childcare responsibilities or remote location meant the applicant found it difficult to attend medically related learning with others.
4. The proportion of other CPD and/or CME activity undertaken, such as attendance at courses, seminars, symposiums, and conferences or medically related distance learning with academic accreditation; and whether this is directly relevant to the applicant’s practice.
5. Whether the evidence is supported by an overarching personal development plan.
6. Whether the totality of the evidence is clear and verifiable.
7. Whether the applicant has provided evidence that they have learned from the CPD/CME they have undertaken, in particular how it has kept their medical knowledge and skills up to date, and how it will influence their day to day medical practice or their future practice or future career plans.