Thousands of doctors, nurses and pharmacists join UK registers from overseas each year. Many arrive experienced and confident, then find the NHS works differently. Referral letters, prescribing systems, consent rules and team hierarchies all follow local habits nobody explains. Family and friends are far away, and a visa or a repayment clause can make problems at work feel impossible to raise. Good induction and the right contacts make the first year much easier.
Your regulator sets the registration steps: PLAB for most international doctors with the GMC, a two-part test of competence for nurses and midwives with the NMC, and the GPhC's international process for pharmacists in Great Britain. Once in post, ask for a structured induction and a named supervisor. Your employment rights, including protection from discrimination, are the same as any UK colleague's, whatever your visa.
Registration steps by profession
Key facts
- Doctors (GMC)
- Most international medical graduates pass PLAB 1 and PLAB 2 and show English language evidence. PLAB meets the Medical Licensing Assessment requirement.
- Nurses and midwives (NMC)
- Test of competence in two parts: a computer-based test, available worldwide, and an OSCE at an approved UK test centre. Up to three OSCE attempts. An approved English language test is also required.
- Pharmacists in Great Britain (GPhC)
- A separate process for pharmacists qualified overseas, under reform. Check the GPhC website for current steps.
- Pharmacists in Northern Ireland
- Register with the Pharmaceutical Society of Northern Ireland, not the GPhC.
The GMC and NMC cover the whole UK. Pharmacy is the exception: the GPhC regulates Great Britain only. Read your regulator's own pages before paying for courses or agencies which promise a faster process.
Questions to ask in your first weeks
Local systems cause more stress than clinical work for many new arrivals. Ask your supervisor or manager for clear answers to these questions:
- Who do I call for clinical advice on each shift, and how do I escalate urgently?
- How do referrals, discharge letters and electronic prescribing work here?
- What are the local rules on consent, capacity and safeguarding?
- Which tasks need sign-off before I do them alone?
- Who is my named supervisor, and when do we meet?
The GMC runs a free Welcome to UK practice workshop for doctors new to the UK, covering ethics and professional standards. Many trusts run induction programmes for internationally educated nurses. Ask HR what your employer offers.
Keep a list of local differences
Each week, note three things which work differently from your home country, such as a form, a phrase or a rule. Bring the list to supervision. The list speeds up learning and shows your supervisor where induction fell short.
Your rights at work
Employment rights apply to you in full. These include the National Minimum Wage, paid holiday, rest breaks, sick pay and protection from discrimination. Race discrimination under the Equality Act 2010 covers colour, nationality and ethnic or national origin, as well as race itself. If you face different treatment, read the discrimination guide.
Some recruitment contracts include clauses requiring you to repay costs if you leave early. Read the training repayment guide before signing, and ask a union for advice if a clause seems unfair. Visa questions need a regulated immigration adviser or solicitor. A union, Citizens Advice or your employer's HR team can point you to one.
Isolation and wellbeing
Moving country removes your usual support network. Join a staff network for international colleagues, a faith or cultural community, or a professional association. The professional isolation guide and the communities list have options. Register with a GP soon after you arrive, so help is in place if you need care.
Support organisations for international staff
Pharmacist Support
Profession-specific support for pharmacy people, including wellbeing and practical help.
Check the provider's current criteria for pharmacists, trainees, students and family support.
BMA wellbeing services
Counselling and peer support for doctors and medical students.
The main wellbeing services have their own access rules. Additional member services may require membership.
Doctors' Support Network
Peer support for doctors and medical students with mental-health concerns.
Check membership, group arrangements and confidentiality guidance. Peer support does not replace treatment.
Doctors in Distress
Group-based support and wellbeing programmes for healthcare workers.
Programme audiences, dates and availability vary. Confirm a current programme includes your profession.
Nurses can join the RCN for advice and representation, and pharmacists can contact the Pharmacists' Defence Association. For free employment advice, contact Acas in Great Britain or the Labour Relations Agency in Northern Ireland. In an emergency call 999. For urgent mental health help, use the urgent support page, NHS 111 or Samaritans on 116 123.
Common questions
What exams do international doctors take to work in the UK?
Most international medical graduates pass PLAB 1 and PLAB 2 and provide accepted English language evidence before applying for GMC registration with a licence to practise.
How do overseas nurses register with the NMC?
You pass a computer-based test, which is available worldwide, and an OSCE at an approved UK test centre, and meet the NMC's English language requirements.
Do pharmacists in Northern Ireland register with the GPhC?
No. Pharmacists in Northern Ireland register with the Pharmaceutical Society of Northern Ireland. The GPhC covers England, Scotland and Wales.
Do I have the same employment rights on a Health and Care Worker visa?
Yes. Your employment rights, including minimum wage, holiday, rest breaks and protection from discrimination, are the same as any other worker's. Get visa advice from a regulated immigration adviser or solicitor.
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