NHS Clinical Attachment/ Medical Observership
For international medical graduates (IMGs), completing the PLAB or UKMLA is a significant step toward joining the UK’s healthcare workforce. But once these exams are behind you, the path to securing your first NHS role can still feel uncertain. One option often considered is undertaking a clinical attachment—sometimes also called a medical observership.
While not mandatory, clinical attachments can offer IMGs valuable insight into the NHS environment, boost clinical confidence, and help bridge the gap between qualifying and working. This guide explores what clinical attachments involve, whether they’re right for you, how to apply, and how to get the most out of the experience.
What Is a Clinical Attachment?
A clinical attachment is a short-term, supervised observational placement within an NHS hospital. These placements are usually between four to six weeks long and allow IMGs to follow a healthcare team in a specific department. The goal is not to work or treat patients independently, but to observe and understand how clinical care is delivered in the UK.
You’ll likely be placed under the guidance of a consultant who may gradually allow limited supervised involvement based on your qualifications and the Trust’s policies. Those who have passed PLAB 2 or UKMLA may be allowed to engage in more tasks, though hands-on responsibilities remain limited without full GMC registration.
Typical activities during a clinical attachment might include attending ward rounds, observing outpatient clinics and surgical procedures, taking patient histories, and clerking patients under supervision. These experiences can help you become familiar with NHS protocols, improve your communication skills in a UK context, and adjust to the expectations placed on junior doctors.
Is a Clinical Attachment Necessary?
This is a personal decision that depends on your background, confidence level, and long-term goals. Many IMGs secure NHS jobs without ever completing a clinical attachment. That said, attachments can be especially helpful if you’ve had a break in your clinical practice, feel unfamiliar with the UK healthcare system, or want to explore a specific specialty before applying for jobs.
It’s important to understand that a clinical attachment is not a guaranteed route to employment. While some candidates do build useful relationships during their placements, hospitals are not obliged to offer roles to those who’ve completed attachments. The real value of the experience lies in gaining exposure, boosting your interview confidence, and demonstrating initiative on your CV.
Financially, attachments are unpaid and may involve a placement fee. You’ll also need to budget for accommodation, travel, and daily expenses. The cost-benefit balance depends on your unique situation and how much insight or reassurance you feel the attachment would give you.
How to Apply for a Clinical Attachment
There is no centralised application system for clinical attachments in the UK, so finding opportunities requires initiative. Start by identifying NHS Trusts or hospitals you're interested in, particularly those with departments aligned to your career goals. Many hospitals outline clinical attachment opportunities on their websites, usually under education or HR sections.
Sending a formal email to the HR department expressing your interest is a common first step. Include your CV, details of your qualifications, and specify the department or specialty you’re applying for. Alternatively, if you know a consultant working in the NHS—either directly or through contacts—they may be able to support your application more informally.
You can also turn to professional networks and IMG forums. Groups like the Forum for International Doctors in the NHS on Facebook often feature posts from candidates sharing where and how they secured attachments. A simple Google search using terms like “clinical attachment NHS [city]” can also help surface opportunities.
Some NHS Trusts known to offer attachments include University Hospitals Southampton, East Sussex NHS Trust, the Royal Free London, and Leeds Teaching Hospitals, among others. Requirements vary, with some accepting only GMC-registered doctors, while others will consider candidates who have passed PLAB 2 or UKMLA. Please find some links below to apply:
Medical Education - Clinical Observership Programme - Barts Health Academy
Clinical Attachment Placements - Doncaster and Bassetlaw Teaching Hospitals
Clinical Attachments – ESHT Medical Education
Medical Observerships - Leeds Teaching Hospitals NHS Trust
Applying for clinical attachments with LPT - Leicestershire Partnership NHS Trust
Clinical attachments - North Tees and Hartlepool NHS Foundation Trust
Clinical Attachment | Essex Partnership University NHS Trust
Clinical Attachments and Electives - University Hospitals Coventry & Warwickshire
Coming Soon - Cardiff and Vale University Health Board (Currently Closed but keep checking back for updates)
Visa and Administrative Requirements
If you are not already in the UK, you will need a valid visa to undertake a clinical attachment. Most candidates apply for a Standard Visitor Visa, which permits short-term unpaid study or observation in the UK. Be sure to apply well in advance, as visa processing times can vary depending on your country of origin.
Hospitals may also require additional documents as part of their application process. These may include proof of your qualifications, confirmation of PLAB 2 or UKMLA results, a current CV, immunisation records, DBS clearance (background check), and references from supervisors or tutors.
Preparing for Your Attachment
To make the most of your placement, it’s wise to prepare ahead of time—particularly if you’ve been out of clinical work for a while. Those fresh from PLAB 2 will already have a good grounding in UK-style communication and basic protocols, but brushing up further can only help.
Revisiting clinical resources such as the Oxford Handbook of Clinical Medicine, Oxford Handbook for the Foundation Programme, or Macleod’s Clinical Examination can help refresh your knowledge. It’s also helpful to review common cases and clinical presentations specific to the department you'll be working in.
Day to day, you should expect to observe more than actively participate—especially if you are not GMC-registered. That said, being punctual, asking thoughtful questions, and showing professional curiosity can make a strong impression on your supervising team.
Accommodation and Living Considerations
Some hospitals offer on-site accommodation for clinical attachment participants, but this is not guaranteed and often comes at a cost. If the hospital doesn’t provide accommodation, you’ll need to secure your own short-term housing nearby. Start searching early and factor this into your budget.
While you are not paid during the attachment, you may be able to access canteen services, staff common areas, and hospital facilities, depending on the Trust’s policies. Clarify what’s included before your attachment begins so you can plan accordingly.
Final Thoughts
A clinical attachment can be an incredibly useful experience for international medical graduates preparing to enter the NHS. It offers the chance to observe UK clinical practice, understand workplace culture, and become comfortable in a hospital setting before taking on a paid position. Though not essential, it can be particularly valuable for those who feel uncertain, out of practice, or simply want a smoother transition.
However, it is not a shortcut to employment. No hospital is required to offer you a job because you completed an attachment. For this reason, you should only pursue one if you see it as an educational experience worth the time and cost.
Three Key Tips for a Successful Clinical Attachment
1. Understand the purpose.
Approach the attachment as a structured learning opportunity—not a guaranteed pathway to employment. Use the time to observe, ask questions, and absorb how the NHS functions from within.
2. Arrive prepared.
Review core clinical knowledge and NHS systems before your placement begins. Confidence and competence go hand in hand when trying to make the most of the experience.
3. Be engaged and professional.
Treat the placement with the same seriousness as a paid role. Punctuality, curiosity, respect, and initiative will help you make a positive impression and get more from your time.
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