Induction and refresher scheme FAQs and glossary of terms

Who is this scheme aimed at?

The scheme aims to introduce and update qualified GPs to be able to return to practice safely, keeping up high standards expected within the NHS.

There are three parts to the scheme:

  • Induction for doctors who have never worked as an NHS GP
  • Refresher for qualified GPs with previous NHS experience who have not practised for two or more years and would like to return to work as an NHS independent practitioner in England
  • Portfolio for GPs who can produce a portfolio to demonstrate that they have maintained their skills while working abroad as a GP and kept up to date with changes in NHS practice (please see separate guidelines for this )

How long will the scheme be in place?

National I&R schemes have been in place since 2002. This scheme was revised in March 2015 and will be annually reviewed

How do I apply for the scheme?

The scheme is co-ordinated through the GPNRO website. You will find information to guide you through the application process. If you are eligible, you will be able to download the registration form, complete and return to the NRO

How long will it take to complete the scheme?
Each doctor will have a formal review of their qualifications and work experience by an I&R lead. You may be invited to take a learning needs assessment (MCQ) which will help inform the length of a supervised placement to see if further assessment or training is required.
Placement length varies and is planned around an individual doctors learning needs

What qualifications, approvals and certificates do I need?
You need to be:

  • Medically qualified and have completed formal training as a general practitioner inthe UK (CCT), hold a recognised EU GP qualification or hold a Certificate of Eligibility for GP Registration (CEGPR)
  • On the GMC GP Register, in good standing and hold a current licence to practice as a GP
  • Have the right to work or hold a visa that permits you to work in the UK
  • Have applied for (and hold approval before the clinical placement is commenced) by NHS England and admitted to the National Medical Performers List (NMPL) with conditions that permit you to enter the GP I&R scheme

Any doctor with formal GMC conditions or undertakings, who is required to complete a remedial training plan imposed by NHS England and is considering a return to NHS general
practice. They should contact their NHS England regional team to discuss their circumstances and level of support 

I trained abroad and have no UK experience. Am I able to apply for the scheme?
Any qualified GP who has been granted a CEGPR or is an EU qualified GP and is on the GMC GP Register (without GMC conditions or undertakings - except those relating solely to health matters) with a licence to practice is eligible to apply

I have previous UK work experience as a NHS GP but not practised recently. Am I able to apply for the scheme?

Any doctor (UK or EU qualified or holding a CEGPR) who has previously worked as an NHS GP but has been out of general practice for two or more years and is on the GMC GP
Register (without GMC conditions or undertakings - except those relating solely to health
matters) with a licence to practice is eligible to apply

Do I need to sit assessments?
Doctors on the I&R scheme are required to arrange an educational and career review with
the I&R lead. If formal learning needs assessments are required then you will be asked to sit
the two MCQ assessments which are held 4 times per year

  • Clinical Problem Solving (CPS)
  • Professional Dilemmas paper Situational Judgement Test (SJT)

These may be sat overseas in designated assessment centres. Dependant on the outcome of these, you may also need to do a simulated surgery assessment.
If English is not your first (or your qualifying medical degree) language you will receive formal feedback on your language and communication skills to inform your placement learning plan

During the placement the educational supervisor will provide regular feedback and document this in the Workplace Based Assessment (WPBA) log book (there is a separate Band 5 WPBA logbook to the standard scheme)

What happens if I fail or do not complete any of the assessments?
The I&R lead will be able to give you advice and options. Applicants are able to attempt the
scheme up to a maximum of four times.
The GMC will be informed of the outcome of all assessment attempts. Successful applicant assessments will remain valid for a year from the pass date

What happens if I do not complete my supervised practice placement?

You will not be able to work as an independent GP in England without full inclusion on the NMPL and removal of the I&R conditions agreed by the NHS England regional team

Are there jobs available if I do complete the scheme?
You will be able work in the NHS as a locum GP, apply for formal GP salaried posts or partnerships in England. There are many areas where there are GP vacancies and these are frequently advertised in the medical press

If I am not working, how do I get my DBS?
If you are unable to find a suitable umbrella body from the website then there is a company called GP Systems who have helped a number of I&R doctors obtain their DBS. Their website is

What exactly is needed in terms of occupational health clearance and how do I know which provider to approach?

Your Occupational Health Clearance should state that you have had the necessary blood work and are fit to practice. It is also a requirement that you are cleared for EPP (Exposure Prone Procedures). There is a copy of the NHSE Health Assessment form that covers all of the requirements on our website. The OH provider needs to be a SEOQHS accredited provider (or working towards it). A list of OH providers can be found at:- Please note it is worth ringing around a few providers as the charges can vary a great deal

Do I need evidence of past appraisals? What happens if I don't have this evidence? How can I retrieve proof of previous appraisals?

Ideally you should provide copies of your last appraisals, whether they were done in the UK or abroad. You may be able to obtain a copy by contacting your previous employer. If you are unable to provide a copy or have never had an appraisal then please state this on the NPL application. If you have used one of the appraisal toolkits e.g. Clarity, Fourteen Fish, GP Tools or MAG (these are the most common ones used) then you should be able to retrieve a copy from there. You may need to contact the toolkit provider if you can longer access the system.
Clarity is the only toolkit that requires a subscription to be maintained. So if you have maintained your subscription with Clarity, you will be able to retrieve a copy of your past appraisals. If not, then you can contact Clarity direct and request a copy. The contact details are:-
T: 0845 113 7111

When should I start paying my indemnity?

If your NPL application is straight forward and there are no issues then we would advise that the Medical Indemnity is the last thing you sort out for your NPL application. If your indemnity is more complex e.g. indemnity being provided by a commercial organisation, then NHSE would like to review the policy before you agree to it to ensure that it is adequate and appropriate. So in these cases you will need to start the process earlier

At what point is it best to ask to have my GMC licence to practise reinstated?

As soon as possible, as you will need to be registered with the GMC and on the GP Register before you can be accepted onto the National Performers List

What happens if my revalidation is due before or during my placement?

Please contact the I&R Team at Cheshire & Mersey
They can issue you with a REV11 - provision of Medical Services Statement (PMSS) which
you email to the GMC and confirms that you are currently on the I&R Scheme.
Return to the home page for further information

Induction and refresher scheme glossary

CCT Certificate of Completion of Training (GP)
CEGPR Certificate of Eligibility for GP Registration
CPD Continuing professional development
CPS Clinical Problem Solving
EU European Union
GMC General Medical Council
HEE Health Education England
HMRC HM Revenue and Customs
I&R Induction and refresher
MCQ Multiple choice questions
MD Medical Director
MDDUS Medical and Dental Defence Union of Scotland
MDO Medical Defence Organisations
MDU Medical Defence Union
NMPL National Medical Performers List (England)
MPS Medical Protection Society
MSF Multi source feedback
NRO National Recruitment Office
PD Professional Dilemmas
PSQ Patient satisfactory questionnaire
RO Responsible Officer
SJT Situational Judgement Test
WPBA Workplace Based Assessment




  • Q1. Who is eligible for the scheme?
  • Q2. I am a doctor who trained abroad and have no UK experience. Am I able to apply for the scheme?
  • Q3. How much money is in the bursary?
  • Q4 How do I apply for the scheme?
  • Q5. What approvals or qualifications and certificates do I need to work as a GP in England?
  • Q6. How long is the scheme for?
  • Q7. If I am on a short scheme (MCQ Band 5 outcomes) what additional assessments will be required?
  • Q8. What support will I get when I am on the scheme?
  • Q9. How much money is available for the scheme in total?
  • Q10. How many years will the scheme be in place?
  • Q11. What happens if I do not complete my supervised practice placement?
  • Q12. Do I have to sit exams?
  • Q13. What happens if I fail any of the assessments?
  • Q14. Are there jobs available if I do complete the scheme?
  • Q15. Will you pay for my indemnity cover?