Getting Training where you want : An insight into upgrades and facilitated placement

¬ By Dr. Asadullah Anees Khan

        I wanted to write this post in order to help others who might be in a similar situation and are aiming to stay in a particular region while applying for Core Medical Training with a view to specialist training. My wife and I both wanted to apply for training in the same round, she was applying for GP training and I was applying for Core Medical training.


       Now I must mention, I really like my trust and it was the goal to stay here for further training if possible, but being on a Tier 2 visa and being subject to the Resident Labour Market Test (RLMT), I wasn’t hopeful of getting a post in this area. I applied for CMT in March, 2018. I had my interview on 26th April, 2018 and ranked my preferences. I was very disappointed when they released the offers and I was informed that even though I was deemed appoint-able to the post, I was on the reserve list due to the RLMT. I had ranked very few places and I would not suggest that but I had a few reasons for wanting to stay where I was:


  • We wanted to stay close to London and only ranked places within an hour from London
  • Wanted proximity to an airport
  • Wanted to stay close to where ever my wife got her GP training post (she found out a day before I found out about my preferences)


I had given up on getting a place after having ranked very few places but still held out for upgrades on Oriel.  Following were my preferences:



After two days, I received an email and a text message saying I had been offered a post in East Kent at Kent and Canterbury hospitals, which I was happy with. The thing I did not like were the rotations in that post as I didn’t have ITU, Gastroenterology or Respiratory rotations which are quite important in your training pathway. While ranking my preferences, I kept programmes which had Oncology at the top of my preference list while also preferring Palliative care (because it contributes to a career in Oncology). I also ranked places which were near my current place of work and preferred Surrey as my location as my wife and I like this place a lot.

Now the way the upgrade system works is if you are offered a post, you can rearrange your preferences on oriel if you have accepted with upgrades or held a post with upgrades. If you accept a post without upgrades or decline that offer, that decision is final.


asad (2)The picture  shows my ranking for CMT applications and the first one was at Royal Surrey which included Oncology as a rotation. I accepted my offer with upgrades and was hoping for a better offer before the offers closed.


On the day the offers were supposed to close, I was offered the post labelled 2 on the above picture whereas my previous post was 1. This gave me Gastroenterology and Respiratory rotations which I was very happy about. Now as the situation stood, I was upgraded to Margate hospital with both years of my CMT in the same hospital and my wife would have had to refuse her GP training post (which was in Wessex and a non-commutable distance).


However, we had recently read about something called a facilitated placement which is a way for them to allocate training to people who want to remain close to each other after getting training spots in different deaneries. Please go through the following guideline to help with information about enhanced preferences and ranking offers:

Please refer to the following link as well for and read about what is says under facilitated placement:


My wife filled out the form for a facilitated placement and she emailed it to GPNRO and CMT recruitment along with our marriage certificate on Priority 2 under the guidance for facilitated placements. While trying to accommodate people via facilitated placements, they try to match either of the two candidates rather than keeping one of them as a focal point and matching the other one. Both people can apply for a transfer based on this scheme. They gave my wife a list of places where she could potentially apply for a transfer but none of those places suited us. They emailed my wife thrice within a span of 5 days regarding new CMT posts and sent a list of places where a transfer was possible. The third and last list had a post at my current hospital. There were a couple of other places as well which would have been suitable and I emailed them with my preferences in numerical order. In a couple of days they offered me the post at my current hospital.


I immediately accepted because it was the first choice for me with 2 year rotations in Geriatrics (my current job), Palliative care (my first choice speciality – oncology would benefit from this post), ITU (very important to learn procedures and to manage critically ill patients), Respiratory (very important post and something I wanted), Rheumatology (my second choice speciality) and AMU as my last rotation.


Now my wife will be able to take her GP placement as well and we will live midway and commute to our workplaces.

If don’t know about the application process in general, please read Omar Alam’s guideline on applying for CMT and the application process:


some email addresses for point of contact:


GP :




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