What is the purpose of sponsorship?

The Royal College of Anaesthetists (RCA) administers ODTS to assist doctors with proven ability in anaesthesia to obtain limited registration with exemption from the PLAB Test. Although the scheme is primarily intended for doctors who will benefit from postgraduate training in the UK and will return to their home country on completion of training, it is currently overwhelmed by doctors wishing to pursue a permanent career in the UK. The Scheme is administered on behalf of the GMC within a template approved by the Registration Committee.

What are the criteria for selection into the scheme?

1. All applicants must satisfy the GMC's minimum requirements, which are:

1. To have a basic medical qualification acceptable to the GMC
2. To have done at least one year in an internship post (Pre-Registration House Officer).
3. To have been qualified for at least three years and be of good standing with their Medical Regulator.
4. To have obtained satisfactory scores in the International English Language Testing System (IELTS)
5. To have not previously attempted any part of the PLAB Test.

2. In addition the Royal College of Anaesthetists will expect the candidate to meet the following criteria:

1. To currently be working, or having worked within the last six months, in their home county.
2. To hold a higher postgraduate qualification in anaesthesia that requires three or more years of clinical training, awarded by (and with a syllabus and standards set by) a national qualifications board e.g. the Indian Diplomate of the National Board (DNB) or MD Postgraduate Institute of Medicine, Sri Lanka.

What about trainees from countries that do not have a national qualification?

The RCA in special circumstances may agree to sponsor doctors who do not fulfil the criteria outlined in paragraph 2.2. This is intended to allow UK based Consultants, with established links overseas, to recommend doctors for sponsorship. These Doctors would normally have been chosen in their country of origin as likely to benefit from postgraduate training in the UK. However an additional condition for approval of such sponsorship is that the UK based Consultant is able to place the trainee in a suitable training post and ensure appropriate supervision.

Are there any restrictions on Doctors with Limited Registration obtained through the sponsorship route?

There are three main restrictions:

1. ODTS sponsored doctors can only be appointed to substantive training posts approved and funded by the Postgraduate Dean, e.g.SHO, SpR, FTTA.
2. The initial grant of registration is limited to a maximum of 12 months.
3. The Limited Registration will only cover the post, the grade and the period stated in the Certificate of Selection of Employment (CSE) completed by the relevant Medical Staffing Department. N.B .A trainee's registration may not be valid for all hospitals within a training rotation unless every hospital is listed in the CSE.

Can an ODTS sponsored trainee takes up a Trust Grade Post that offers the same training opportunities as an approved post and falls within the 'training capacity' recognised by the RCA?

No. Under the present arrangements with the GMC this is not permitted. However, where an ODTS sponsored trainee can benefit from training that is only available in an unapproved post, e.g. Clinical Fellow or Research Fellow, the RCA may consider sponsorship, provided that the objectives for training are clear and are approved by the Bernard Johnson Adviser. Trainees should be made aware that time spent in such a post would not count towards the CSST programme.

What about Clinical Attachments?

Well structured attachments with appropriate support are a useful way of introducing overseas trainees to UK anaesthetic practice and environment. However, doctors wishing to obtain limited registration with PLAB exemption via the ODTS route are expected to confirm their eligibility for sponsorship before leaving their home country. Clinical attachments cannot be used as a 'fast track' method of obtaining sponsorship. The criteria for selection to the ODTS will not be relaxed purely on favourable references obtained following a short clinical attachment.

When can sponsored doctors commence 'out of hours' duties?

The RCA requires every trainee to complete the Initial Assessment of Competency before being allowed to practice without direct supervision. Experienced overseas doctors working in the UK for the first time could undergo this initial assessment after a short period of familiarisation. It would be reasonable to expect ODTS sponsored doctors to pass this assessment well within three months of taking up a training post. This is an important initial assessment of the overseas trainee's suitability to continue training in the UK.

What is a period of sponsorship?

Sponsorship is available for a maximum of four years. Under current regulations overseas doctors with Limited Registration can apply for Full Registration after one year of satisfactory progress in a substantive post and therefore it would be very unusual for a doctor to remain in the scheme for the full period. Progress of sponsored doctors will be monitored by the ODTS office, initially at the end of the first period of employment in the UK and thereafter on each renewal of registration. Renewal of sponsorship is not automatic and will depend on satisfactory reports from two educational supervisors - one of whom should normally be the College Tutor.

If a College Tutor would like to discuss an individual trainee or any aspect of the ODTS they should contact Mrs Sandra Woods, the ODTS Administrator or Dr Preman Jeyaratnam, the Bernard Johnson Adviser, at the College via email odts@rcoa.ac.uk.

Reproduced with permission from The Royal College of Anaesthetists Bulletin 21 (September 2003).