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The CEGPR and IIP (International Induction Programme) – all you need to know

If you are a GP who is preparing for the IIP or CEGPR Scheme then this blog is for you!

If you are a GP who has not worked in the UK before and you plan on being a GP in the UK, the IIP (International Induction Programme) is a route through which you can potentially work as a GP in the NHS.

For the most common route to becoming a UK GP for International Medical Graduate doctors (PLAB – MSRA – GP training) see our main GP Training Entry Blog.

To join the National GP Training Support group click here.

For our MSRA mock exams (similar to IIP Scheme Mock Exams click here.

What is the GP IIP scheme?

The GP International Induction Programme is a route for international qualified GPs who have not previously worked in the UK, to start working as a GP in the NHS.

It can include a combination of MCQ assessment, Simulated Surgery assessment, Workplace based assessments and supervised GP placement.

There are two recognised pathways for IIP if you are already a GP. The first is a full induction programme (known as the Learning Needs Assessment – see below) and the second is a streamlined CEGPR (Certificates of Eligibility for GP Registration) route – usually for GPs from certain GMC-approved countries such as Australia, New Zealand, Canada and South Africa.

How to apply and eligibility criteria for the GP IIP

You can register for the scheme via the GP National recruitment office website (GPNRO). However it is important to ensure you have the necessary documents in order to work in the NHS. These include:

  • Certificates of Completion of Training / Certificates of Eligibility for GP Registration (CEGPR)
  • Being on the UK GMC Register
  • Have a current License to Practice
  • Being on the Medical Performer’s List
  • A Skilled Worker Visa

It is recommended to contact the GMC to check if they recognise your GP qualifications and whether you can apply for CEGPR or not.

Once registered you will be provided with an account manager who will guide you through the process, ensuring that the programme is tailored to your specific circumstances. This initiative can include certain benefits such as:

– help with indemnity costs.
– childcare costs.
– a bursary up to £3500 a month for a clinical placement.

When you first register for the IIP you will be allocated a HEE local lead who will meet with you and review your previous experience – prior to this they will ask you to complete a self-assessment form. Registration can be a complex process and so your account manager will help guide you through the process and documentation.

Based on this meeting and the information you provide, if you are accepted onto the GP IIP scheme your HEE lead discuss with you:

  • an option for an observational placement.
  • eligibility for Learning Needs Assessment (LNA).
  • if you need any further paperwork before you can take the LNA.

What is the Learning Needs Assessment (LNA)?

The Learning Needs Assessment is an assessment route that consists of two MCQ papers +/- a simulated surgery assessment.

The online MCQ assessment component is held at HEE approved centres globally. The MCQ assessment is held eight times a year, approximately every 6 weeks.

The assessment consists of two parts – a Clinical Problems Solving (CPS) paper and a Professional Dilemma Paper (PD). The scores are standardised and for the CPS paper you are allocated a band and for the PD paper you are allocated a pass or fail based on your score. You can take our focused mock IIP papers here.

CPS Paper and Banding

For the CPS paper there 88 items and you have 65 minutes to complete the paper. The items are made up of either Single Best Answer Questions, with a few Multiple Best Answer questions or Extended Matching Questions. There is no negative marking and the band you are allocated determines if you need to sit the simulated surgery. Below is an illustration of the banding:

Banding Standardised score Outcome
1 18 or below Below the minimum standard required
2 19-26 Below the minimum standard required
3 27-49 Adequate level of performance may need up to a maximum of 6 months WTE induction- sit simulated surgery
4 50-59 Good level of performance, may need standard induction of about 3 months WTE
5 60 or above Excellent level of performance with little if any induction

For Bands 1 and 2 it is recommended that the candidate takes a short break before resitting the paper to improve their knowledge. For bands 4 or 5 there is no need to sit the simulated surgery if this is the outcome of their first attempt.

Our MSRA Clinical Crammer online course is useful for preparing for the clinical component of this exam.
Our Clinical Flash Cards cover core guidelines that you need to know.
Our MSRA Mock exams will test you in the core areas that are tested in this assessment.

PD paper and scoring

The Professional Dilemma paper is a situational Judgement test. This paper looks at 3 domains:

  • Professional Integrity.
  • Coping with pressure.
  • Empathy and sensitivity.

It is important to note that whilst there are 62 items for which you have 124 minutes to complete the paper, there are 12 pilot items which will not contribute to your final score. The paper will be split into a) ranking questions and b) choosing the three most appropriate options for a situation.

You will be allocated a pass or fail based on your standardised score. Usually the pass mark is a standardised score of 27 or above.

Our SJT Principles audiobook course is useful for preparing for the PD component of this exam.
Our MSRA SJT Mock exams will test you in the core areas that are tested in this assessment.

Tips for the MCQ Assessments

  • There is no negative marking so please attempt every question
  • Even for the SJT ranking questions if your ranking order is incorrect there is a potential to still score 8 marks so please attempt every question rather than skip or miss it out
  • Familiarise yourself with the software before taking the assessment – there is a tutorial available online
  • Read through the GMC Good Medical Practice guidelines as this will help you with the professional dilemma part.
  • For the simulated surgery ensure you are familiar with the instructions and format as well as the technology if taking virtually.

How many attempts do I have for each paper?

You are allowed 4 attempts for each paper within a 12 month period from the date of your first result.

Can I resit a paper to improve my score?

Yes you can, but if you passed the paper and are only sitting it to improve your score, please note that you will have to self-fund this resit.

What is the simulated surgery?

Depending on your MCQ score and previous attempts you may be asked to sit the simulated surgery assessment. Depending on COVID restrictions this will either take place at RCGP Headquarters (30 Euston Square, London) or virtually via Microsoft teams.

The simulated surgery consists of 12 cases. Each consultation (case) will last 10 minutes and there will be a 5 minutes break between each case. During this time, you will be able to review the case notes for the next case which provides some background information about the next consultation.

Each case will be a typical presentation that you may come across in a General Practice setting. For each case there will be a role player and an examiner. The examiner will only intervene if necessary and so it is important to focus on your consultation with the role player.

Our CSA-125 online course is used by many doctors preparing for the simulated surgery assessment.

The cases will be recorded, and you will be marked based on 5 domains:

  1. Gathering medical information.
  2. Eliciting the patient’s concerns.
  3. Explaining the diagnosis.
  4. Managing the problem.
  5. Effective consulting.

Your results will be forwarded to your HEE team who will then discuss your marks and next steps.

Completing the scheme

Based on your assessment scores, your HEE lead will discuss with you how long your supervised GP placement will be – but it can be up to 6 months. During this time, you will be expected to complete your Workplace Based Assessments, as well as your mandatory training (when you first accepted onto the scheme you will be given online access to the e-learning modules needed for mandatory training).

Once you have successfully completed your placement, mandatory training and started work on your appraisal you will have completed the scheme and will be able to work as a GP in the NHS.

What does the streamlined CEGPR route consist of?

If you are using the streamlined CEGPR route then this would involve submitting a portfolio of work to the RCGP for evaluation by the GMC. This is then followed by a tailored clinical placement from 3-6 months.

How we can help you with the GP IIP Scheme

1) Our GP Training Support Facebook group will keep you up-to-date with all core clinical and GP-related content that are important for both assessment types.

2) MSRA Mock SJT and Clinical Mock Exams: Focused Clinical and PD mock exams in the same style as used for the IIP programme. Key learning points to help boost your score in the real assessment. Click here for options and bundles.

3) MSRA Clinical Crammer Online Course. Chapter based, clinical teaching programme covering core guidelines, conditions and presentations needed for the clinical MCQ paper. Click here for details and samples.

3) SJT Principles audiobook course. A focused audiobook course covering the GMC Good Medical Practice guidance and examples of how to approach SJT questions. Designed to boost performance in the PD component of the assessment. Click here for details and sample.

3) CSA-125 Online Course: 125 CSA-type scenarios broken down in an intense 6+ hour online training course. Ideal if sitting the simulated surgery part of the programme. Full details of coverage and sample here.

In summary

We have seen many doctors start their journey as GPs in the UK and hope that you will soon be one of them!

Whichever route you end up taking we hope that we can support you on your journey to what is an extremely rewarding career!

About us

Dr Aman Arora is a GP who is now 100% committed to transforming medical education, helping doctors across the globe to ace their exams and enhance their careers. He is proud to hold FRCGP (Fellow of Royal College of General Practitioners). Previous roles include:

  • GP Training Programme Director
  • NHS GP Appraiser
  • GMC PLAB 2 Examiner
  • GP Recruitment Examiner
  • GP Recruitment Question-writer
  • HEWM IMG Board Member
  • HEWM Advanced MRCGP AKT Trainer

Dr Pooja Arora is a GP with a background in Medical Politics, passionately focusing on improving the opportunities and working conditions for junior doctors. Previous roles include:

  • Vice Chair Birmingham LMC
  • BMA Council Member
  • BMA General Practitioners Committee elected representative 
  • BMA Sessional GP Committee elected representative 
  • BMA National Deputy Policy lead for working at scale
  • HEE GP Ambassador
  • HEE GP Stage 3 Assessor
  • RCGP Midland Faculty AiT representative

* Blogs written by Dr Aman and Dr Pooja Arora are not for professional, financial or medical advice. Please seek appropriate professional, legal or financial advice where appropriate *


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