For IMGs Who Are Tired of Waiting, Here’s a Way Forward:
Step-by-Step Personalized Mentorship to Achieve MRCEM
Recently I interacted with a doctor. Let’s call her Dr. A.
She got distinction in MBBS, cleared PLAB on her second attempt and paid for three observerships/ clinical attachments. But because those weren’t scheduled back-to-back, she had to take frequent leaves from work. Each time, she lost her job back home, and with every gap, it became harder to get rehired since HR had started labelling her as a frequent “job hopper.” Each time she came for a clinical attachment, she enrolled in add-on courses like Train the Trainer, POCUS, and others; each costing an additional £250–£400. Flights and stay weren’t cheap.
To make ends meet, she picked up extra night shifts, all while applying and reapplying in the hope of securing her first NHS role.
Two years later, even after 500+ applications, she was still outside the system. Thousands of pounds spent. Countless nights wondering if she had let her family down. Her parents were aging. The money she had spent could have been a home deposit.
She wasn’t just chasing exams, she was carrying the weight of being the main breadwinner, while her parents were marching towards retirement.
And she’s not alone. I know many international doctors like her - talented, ambitious, hardworking, yet stuck between two worlds. It’s not a lack of skill that holds them back, but the absence of a clear path, often blocked by forces beyond their control. Political shifts, visa hurdles, or wider geo-economic barriers become the deterrents, not their ability or dedication.
The Harsh Reality for IMGs
After MBBS, the choices are tough:
❌ PG Entrance exams in the home country: 2–3 attempts, years lost, and still no guarantee of the specialty or location.
❌ PLAB, AMC, USMLE: Just entry tickets. The real struggle begins afterward - work visas, unpaid attachments, repeated rejections, and the constant pressure to upgrade your CV.
❌ Diplomas & MScs: £15k–30k, often unrecognized as true clinical qualifications.
❌ MSRA: Held only once a year, with scores climbing higher each cycle as the pool of GMC-registered doctors grows. Last year alone, around 10,000 doctors joined the register. In 2025, nearly 50% of Foundation Year 2 doctors were without job contracts after qualifying.
This ballooning pool means stiffer competition. Some candidates even prepare part-time with extra hours to give the MSRA their best shot. The result? Ever-rising cut-offs, where even a borderline score can leave you without a training number and another precious year wasted.
All of this drains what you can’t buy back:
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Your prime working years.
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Your financial stability.
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Your chance to be present with family.
What If You Didn’t Have to Choose Between Career and Family?
Imagine instead:
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Staying in your local hospital, close to loved ones.
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Not pouring £7–9k into courses, travel, and visas.
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Preparing directly for a globally respected specialist qualification - MRCEM.
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Building your portfolio while still earning, still being there for your family.
That’s the clarity this mentorship is designed for.
The MRCEM Mentorship Program
This isn’t another online course. It’s personal, one-to-one mentorship with someone who has walked this road, earned GMC Specialist Registration in EM via portfolio pathway and has internationally recognised qualifications in emergency medicine from RCEM and European Board of EM, internal medicine (MRCP), acute medicine, critical care and resuscitation, paediatrics, geriatric medicine, family medicine, legal medicine, medical education and healthcare management.
What You’ll Get
✅ Case-Based Teaching: Two live interactive sessions per month, mapped to the RCEM curriculum, using real ED cases, not dry theory.
Note: the MRCEM Intermediate (written) exam currently has a pass rate of only ~30–35%. If rote Q-bank practice were enough, this number would be much higher. Clearly, there’s a disconnect between crammed theory and its practical application. This program bridges that gap.
✅ Personal Mentorship: Monthly 1:1 session where you bring two acute care cases from your own practice. Together, we’ll do a deep dive - safe, practical, and tailored to your context.
✅ QIP Guidance: Full support to conduct an audit cycle at your workplace, developed into a Quality Improvement Project. The final result will be strong enough to present at an international conference.
✅ Career-Ready Portfolio: Templates and frameworks aligned with UK residency standards. You’ll learn how to document your progress meaningfully, building a portfolio that showcases your growth.
✅ Exam-Ready Structure: A planned, step-by-step path to MRCEM over 2.5–3 years. This mirrors the realistic timeframe of an ED residency after MBBS. No rushed, tick-box shortcuts
and rote learning of q-banks. Instead, deliberate, structured practice tailored to your progress and local milieu.
✅ Peer Support: Access to a small, motivated, supportive peer group. This isn’t about competing. It’s about learning together, sharing challenges safely, and encouraging one another to become better clinicians every day.
✅ Post-Program Mentoring: Even after the program ends, you’ll have three 45-minute sessions with me for career discussions, OSCE mocks, or anything related to EM.
Why This Matters
International medical graduates don’t just need another course. They need a way out of limbo - a clear, affordable plan that saves time, protects family stability, and brings certainty back to their careers.
❌ No endless waiting.
❌ No crushing debt.
❌ No uprooting life for observerships or clinical attachments.
❌ No hoping for a miracle MSRA score whose cut off shifts every year and leaves candidates stranded for another year!
Instead:
✔️ The flexibility to continue applying for jobs abroad while upskilling, so their careers keep moving forward, not stalling.
✔️Clearing a membership exam can even by-pass the need to do PLAB and save you money!
✔️ A direct path to improving clinical skills, aligned with the RCEM curriculum, with the ultimate goal of achieving MRCEM.
✔️ A well rounded portfolio that stands out – where you grow as a doctor, and work on various other aspects of your development like audits, conference presentation, teaching, and quality improvement.
✔️ The ability to stay in your home country and still progress (and if you move abroad mid-journey, the virtual format means you won’t lose momentum.)
✔️Post MRCEM you are not only employable in your home country, but in UK/ Gulf etc.
✔️ Get a career that grows without putting your family second.
The Commitment
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Plan 1 (2 years): £210/month × 24 months – This plan shall include case based and theoretical lessons that cover the curriculum for MRCEM secondary.
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Plan 2 (2.5years): £180/month × 30 months – This plan shall include what’s covered in Plan 1 and integrated lessons covering MRCEM OSCE
Post-Program Mentoring: Even after the program ends, you’ll have three 45-minute sessions with me over the next six months. These can be used for career guidance, interview preparation, OSCE mock practice, or any other support you need in Emergency Medicine.
Intake: 18 candidates only. Start: January 2026.
No free trials. No gimmicks. This is real mentorship for doctors ready to take control.
Why Not Cover MRCEM Primary?
You may ask, “Why not cover the MRCEM Primary as well?”
If you look through the curriculum, the Primary exam is largely fact-based. I could have extended the mentorship just by adding coverage of those topics but in truth, it’s mostly about straightforward reading and memorizing facts which you can do alongside this program.
I’ll certainly share practical tips for tackling the Primary exam, but I don’t believe it’s a good investment for candidates to pay separately for something that is essentially self-study. Instead, my mentorship focuses on what truly transforms you as a clinician: the clinical aspects, right from the start. As we progress through the syllabus, I’ll weave in the relevant anatomy and physiology so that your understanding is complete but always grounded in real-world practice.
Who It’s For
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Doctors who’ve completed internship and registration.
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Working in hospitals with 500+ beds (for case mix).
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Ready to choose Emergency Medicine - not just test the waters.
Ready to Stop Waiting?
If this resonates, email me at hgmirani@emstrategist.co.uk with “Mentorship” in the subject, along with your CV.
I will be hosting a private virtual session soon to answer your questions before enrolling.