Registered Is Not the Same as Training

Why this is a separate, harder problem

Our IMG Pathway guide maps how an MBBS becomes a registered doctor in the UK or Australia — the exam, the paperwork, the supervised year. That's real progress, and it's also not the finish line most people assume it is. Registration makes you legally able to work as a doctor. It does not give you a training post in the specialty you actually want, and in both countries, competing for that post is its own separate, often more competitive process — run by a different body, on a different timeline, with its own exam. This guide is about that second, harder problem.

The big one: the Medical Training (Prioritisation) Act 2026

If you plan to train in the UK, this is the single most important thing to understand right now, and it's recent enough that a lot of existing guidance hasn't caught up with it. The Medical Training (Prioritisation) Act 2026 (cited in Parliament's own record as Act 2026, c.7) received Royal Assent on 5 March 2026 and came fully into force the next day, 6 March 2026, under the Act's own commencement regulations. Its long title is "to make provision about the prioritisation of graduates from medical schools in the United Kingdom and certain other persons for places on medical training programmes."

Update (Sep 2026) — how it actually works, now that NHS England has published the operational guidance: this is not a scoring penalty applied to your interview performance. It's a two-group offer system. Everyone is ranked purely on merit from the selection process, exactly as before. Separately, each applicant is sorted into a "priority" group or not — and applicants in the priority group are simply offered posts before anyone outside it, working down each group's own merit-ranked list. You land in the priority group if you meet any one of three conditions: your primary medical qualification is from the UK, Ireland, Iceland, Liechtenstein, Norway, or Switzerland; or your immigration status is British citizen, a Commonwealth citizen with right of abode, an Irish citizen, someone with Indefinite Leave to Remain, or EU settled/pre-settled status; or you've already completed a qualifying UK training route such as the Foundation Programme. That middle condition matters a lot for Indian-trained doctors specifically: an Indian MBBS graduate who has gained ILR, or who holds Commonwealth citizenship with right of abode, is in the priority group despite not having a UK medical degree — this is a real route in, not a technicality, and it's broader than "you must have trained in the UK." This applies to essentially all 2026 specialty recruitment rounds (from Round 3 onward, appointing for 2027 start) except ST1 Public Health.

The context driving this, per parliamentary briefing material: applications for UK specialty training places rose from roughly 12,000 in 2019 to nearly 40,000 in the run-up to this Act, following visa restrictions on overseas applicants being lifted in 2020. The Act does not ban international medical graduates from applying — you can still apply for IMT, Core Surgical Training, and other specialty programmes. What it does is legally put anyone outside the priority group behind everyone inside it in the offer queue, regardless of interview rank, which is a materially different situation from a few years ago.

What this means practically: if UK specialty training is part of your plan, check your own immigration status against the priority-group criteria above before assuming you're automatically deprioritised — it may hinge on residency status as much as where you trained. Either way, budget for it being a longer, more competitive road than older guides describe, and have a genuine backup (Australia, or returning to India after FMGE/NExT) rather than treating UK training as the default outcome of getting GMC-registered. Verify current detail directly on gmc-uk.org and NHS England's own recruitment pages before you commit money or years to a plan built around it — recruitment-round specifics can still shift year to year even though the underlying mechanism is now confirmed.

The UK process: MSRA, Oriel, and timing it right

Mechanically, once you have full GMC registration, applying for UK specialty training (IMT, GP training, Core Surgical Training, etc.) runs through:

• The MSRA (Multi-Specialty Recruitment Assessment) — two papers, Clinical Problem Solving and Professional Dilemmas, sat by both UK graduates and IMGs applying to most specialties.
• Oriel — the national online recruitment portal where you apply, rank your preferred deaneries, and receive offers.

The practical trap for IMGs specifically: MSRA sittings and Oriel application windows run on a fixed annual timeline (MSRA is typically sat in January, with Oriel applications in autumn before that), and you need full GMC registration in place with enough runway before those windows — not scrambling to finish PLAB 2 the same month applications open. Visa sponsorship availability also varies by deanery and specialty, which the Prioritisation Act's new preference ordering makes more consequential than it used to be — work this backward from your target MSRA sitting, not forward from "whenever I pass PLAB."

The Australia process: college pathways (RACP, RACGP)

Australia doesn't run a single centralised training-application system the way the UK's Oriel does — postgraduate specialist training is organised by each specialty's own college, and IMGs are assessed for "comparability" to an Australian-trained specialist at that college's discretion, separately from your AHPRA general registration.

For physicians, the Royal Australasian College of Physicians (RACP) runs two routes: an Accelerated Specialist Pathway, open only to specialists holding specific qualifications from five recognised systems (UK CCT/CCST, Ireland's CSCST, Hong Kong's dual Fellowship, and — relevant to many of this site's readers — India's MD in General Medicine or Paediatrics plus a DM in your specialty), which typically has no interview and a roughly 6-week turnaround; and a Standard Specialist Assessment Pathway for everyone else, involving a formal interview and up to 6 months. Both lead to a comparability outcome — Substantially Comparable (roughly 6–12 months' supervised practice to top up), Partially Comparable (up to 24 months plus peer review), or Not Comparable — before specialist AHPRA registration follows.

For GPs, the Royal Australian College of General Practitioners (RACGP) runs its own Specialist Pathway: primary source verification through the AMC, a comparability assessment of your qualification and experience, securing an approved general-practice position, provisional or limited AHPRA registration based on your comparability outcome, a 6-month Practice Experience Program with workplace-based assessments, and — if only partially comparable — the AKT, KFP, and CCE fellowship exams before you can apply for Fellowship and specialist registration.

The upshot: Australia's postgraduate route is college-by-college and qualification-specific rather than one national process, which means the honest first step is checking your specific specialty's college directly (RACP, RACGP, RACS, and others each run their own IMG specialist pathway) rather than assuming one process applies across all of them.

UK vs Australia, side by side

This table describes process shape as of when this page was written. Both the UK's Prioritisation Act and Australia's college-specific requirements are exactly the kind of thing that changes with real consequences for your timeline — verify current detail directly with the GMC/NHS recruitment pages or your specific specialty college before building a plan around any row here.

What's genuinely unsettled right now

• Whether the priority-group criteria themselves change in future recruitment cycles — the mechanism described above (merit ranking within two offer groups, and the three ways into the priority group) is NHS England's current published guidance as of September 2026, not a permanent fixture of the Act; specialty-by-specialty exceptions beyond ST1 Public Health could be added or removed in future rounds, so re-check NHS England's own specialty recruitment pages each cycle rather than assuming this page's description is still current a year or more from now.
• Whether other colleges beyond RACP/RACGP publish an equivalent Accelerated pathway for Indian qualifications — this page only confirmed RACP's; if your specialty is surgery, anaesthesia, psychiatry, etc., check that specific college (RACS, ANZCA, RANZCP, and others) directly rather than assuming RACP's terms apply.
• MSRA and Oriel timelines shift slightly year to year — treat the "typically January/autumn" timing in this guide as planning orientation, not a fixed date, and confirm against the current recruitment cycle's own published dates.

A practical starting checklist

A working list, not an exhaustive one — check each item as you confirm it for your own situation. Your progress is saved in this browser only.

Sources & methodology

Every regulatory and legislative claim on this page is sourced directly from a primary source — UK Parliament's own bill tracker and commencement regulations, NHS England's own published specialty recruitment guidance for the Act's practical mechanism, and the RACP and RACGP's own IMG pathway pages for the Australian college process — not from prep-company or forum summaries. Where implementation detail wasn't available from those primary sources (see "What's genuinely unsettled" above), that gap is stated explicitly rather than filled in with a guess.

• UK Parliament — Medical Training (Prioritisation) Act 2026, bill tracker and status
• The Medical Training (Prioritisation) Act 2026 (Commencement) Regulations 2026 — SI 2026/221
• NHS England — Prioritisation for Specialty Recruitment (the operational guidance)
• House of Commons Library — briefing on the Medical Training (Prioritisation) Bill
• House of Lords Library — briefing for Lords stages
• GMC — for current specialty training recruitment guidance
• RACP — Accelerated Specialist Pathway
• RACP — Standard Specialist Assessment Pathway
• RACGP — Specialist Pathway for IMGs