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NHS references for overseas doctors: who to ask and how

By the Health Job Scout team · 5 min read · Fact-checked 28 October 2026

References can hold up a job offer, and this guide is for international medical graduates (IMGs) applying for NHS jobs. The NHS wants proof of where you worked and trained recently, and a referee in another country may be slow to reply. This post explains what the NHS Employers standard says and marks the places where the advice is ours. The standard is written for employers, so read it as a description of what the employer is trying to do with what you give them.

The three-year rule

For a new appointment from outside the NHS, the standard says employers should seek the references needed to confirm three consecutive years of employment or training immediately before your application. It does not set a fixed number of referees. The number and type depend on how many jobs or training posts you held in those three years.

The standard says that if you are moving from another NHS organisation, the minimum is a reference from your current or last NHS employer. Doctors on rotational training programmes are treated as continuously employed for the whole period of training. The standard says employers may find your most recent Annual Review of Competence Progression (ARCP) or Record of In-training Assessment (RITA) useful, and that any extra references should be proportionate to risk.

Overseas references for an NHS job

The standard asks employers to get a reasonable account of any significant period you spent overseas, which it defines as six months or more continuously. If you say you worked or trained overseas, employers should make every effort to get adequate references from the relevant body as early as possible, to avoid delay. They also check your dates against documents such as your passport or work permit, and they try to confirm that documents are genuine through the issuing body or, where that is not possible, through the relevant UK embassy or consulate.

So your history needs to match your documents. Our post on writing your employment history shows how to set it out, and describing a home-country house job covers a common case.

Who can be a referee for an NHS job

For employment, the referee is your employer, usually through its HR office. The standard says requests for employment history should be dealt with by HR or another personnel function, to remove the risk of a candidate pointing the new employer to someone who might give inaccurate information. In our experience it still helps to tell your line manager to expect a request, because HR may ask them for details.

If you have just left education, the standard says training history references should come from your professor, academic tutor or head teacher. Character or personal references are a different thing. The standard says they can help when a previous employer cannot be reached, and that they should come from people who are not related to you and have no financial arrangement with you. Examples it lists are professors, academic advisors or someone of some standing in the community.

What a reference must include

The standard says employers should get your history in writing. If confirmation arrives by email, it should be sent from a recognised email address, so check that your referee can reply from their organisation's own address. Every reference must include the referee's name, job title and a main landline number, so the employer can be sure the referee and the organisation are genuine. Ask your referee to include all three.

How to ask for an NHS reference

Ask early, ask politely, and make it easy. The wording below is our suggestion, so adapt it.

Subject: Reference request for my NHS job application

Dear [name],

I am applying for [job title] at [trust] in the UK, and I would be grateful if you could confirm my time at [organisation], from [start date] to [end date], as [your role].

The employer will contact [HR office or your organisation's reference address] with a request. If it would help, I can send my CV, my dates and the contact details the employer has asked for. Please let me know if anything is missing.

Thank you for your help.

[full name]

Send it before you apply if you can. A referee who already knows to expect the employer's request is less likely to hold things up.

If a reference is hard to get

The standard has a section for this. A previous employer may have closed, or you may not have worked for some time. In those cases it recommends seeking a reference from your last known employer and adding character or personal references to cover the three-year period. If an employer refuses to give a reference, a character or personal reference can provide assurance, and where few references are available the decision rests on what you can reasonably provide. Our advice: tell the recruiter early, explain the position in plain words, and offer the alternatives.

Keep it consistent

If a reference does not match what you wrote, the standard says employers should proceed sensitively and ask you directly for assurances, because there may be a reasonable explanation. It also says that in exceptional cases of serious misdirection, employers may report concerns to the NHS Counter Fraud Authority. The simple rule is to give accurate dates and job titles every time. Our posts on why honesty matters and the application checklist go through it.

How long it takes

The Royal College of Physicians says the whole pre-employment process for international medical graduates can take up to 8 weeks. References are one part of it, next to ID documents, registration evidence and other checks, so ask your referees early. If your GMC registration is still pending as well, GMC registration after PLAB covers that side.

NHS references for overseas doctors: the short version

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