Your roadmap to clinical practice and HEMS in the UK
This resource has been developed for international doctors and paramedics with a particular interest in progressing towards Pre-Hospital Emergency Medicine (PHEM) and Helicopter Emergency Medical Services (HEMS) within the UK.
The guidance on this page is shaped by the lived experiences of clinicians who have successfully navigated and secured roles within PHEM/HEMS at Air Ambulance Charity Kent Surrey Sussex (KSS). It is intended as a practical guide only, offering insights, tips, and reflections to support you as you begin or continue your professional journey through medicine and pre-hospital care. While everyone’s pathway is unique, we hope the shared experiences captured here will inspire and help you better understand the process and prepare for the opportunities ahead.
In the UK, there are currently around 410,000 registered doctors with the General Medical Council (GMC) and just under 42,000 registered paramedics with the Health and Care Professionals Council (HCPC). While many doctors work within the hospital care system and paramedics work within frontline ambulance services, only a relatively small percentage develop a specific pre-hospital critical care interest and ultimately may transfer into HEMS positions.















Roadmap to success for international Doctors and Paramedics
Stage 1: Gaining language proficiency qualification
What is expected?
Before anything else, you need to show that you can communicate effectively in a clinical environment. This is not just about passing an exam, it’s about proving you can safely interact with patients, relatives, and colleagues.
There are different types of tests available, some feel more intuitive for people who are clinically trained as they reflect real clinical scenarios. Others are more widely available and may be easier to access depending on your location.
Both the GMC and the HCPC require specific scores, and timing is important: your results must still be valid when you apply.
Principles
Clear communication underpins patient safety, clinical effectiveness, and public trust. Demonstrating English proficiency is the first mandatory step before entering any UK healthcare register.
In summary
- Choose one of the recognised English tests
- Prepare according to test format (clinical vs general English)
- Sit the exam
- Achieve required scores
- Ensure results remain valid (2 years)
- Use results within registration timelines (might be less than 2 years if used for professional body registration)
FAQs
What tests are accepted?
Two main tests are accepted:
- Academic International English Language Testing System (IELTS).
- Occupational English Test (OET)
What is IELTS?
IELTS is a general English test used globally for education, employment, and migration. It is designed to test your general English language ability across a broad range of topics. The IELTS was developed and managed by the British Council, IDP Education, and Cambridge Assessment English, and is accepted by employers, visa authorities, and universities.
It assesses:
- Listening (30 mins)
- Reading (60 mins)
- Writing (60 mins)
- Speaking (11–14 mins)
What is OET?
OET is a healthcare-specific English test designed for various professions. It is accepted by organisations such as the GMC, and HCPC. It is designed to assess your English communication skills in medical contexts to ensure you can effectively work in a healthcare environment.
It assesses:
- Listening (45 mins) – Healthcare topics
- Reading (60 mins) – General and medical texts
- Writing (45 mins) – Write a letter (e.g. referral/discharge)
- Speaking (20 mins) – Profession-specific role-play
How do OET and IELTS compare?
Feature | OET | IELTS |
Focus | Healthcare-specific | General and academic English |
Tasks | Clinical scenarios | Every day and academic scenarios |
Recognition | Medical councils | Universities, employers and Immigration authorities |
Ease | Familiar for clinicians | Can be easier for non-medical candidates |
Preparation | Clinical materials | Broad English study |
What scores are required?
Doctors:
- IELTS: 7.5 overall (≥7.0 each section)
- OET: Grade B (≥350)
Health and Care Professionals:
- IELTS: 7.0 overall (≥6.5 each section)
- OET: Grade B (≥350), no section below C (300)
How long are results valid?
- Valid for 2 years
- If used to apply for Professional Body registration, specific requirements of the regulatory body you are applying to may vary slightly
How much do tests cost?
- IELTS: ~£200
- OET: ~£300
How accessible are they?
- IELTS: widely available (140+ countries, frequent dates)
- OET: fewer centres
While formal language testing is a key requirement for registration, it’s important to recognise that using English in a real clinical environment can feel very different, particularly for those for whom English is not a first language.
Accents, regional dialects, fast-paced communication, and the pressure of high-stakes clinical situations can all present additional challenges, even after achieving the required test scores. Many clinicians describe needing time to build confidence in communication, especially in dynamic environments such as HEMS where clarity, speed, and team coordination are essential.
Recognising this as part of the transition, not a personal shortcoming is important. Supportive teams, exposure, and experience all play a significant role in developing confidence and fluency over time.
Stage 2: Gaining professional registration
What is expected?
Once your English language skills are confirmed, the next question is whether your qualifications are recognised in the UK.
For doctors, the process with the GMC is primarily about verifying your qualifications and experience. It’s structured and document-heavy, focusing on whether your training meets expected standards.
For paramedics, the HCPC takes a more comparative approach. They assess how closely your training aligns with UK paramedic education, which means your curriculum and clinical exposure are examined in detail.
At this stage, accuracy and completeness of documentation are critical.
Principles
Registration ensures that all healthcare professionals meet UK standards for training, competence, and professional conduct before applying to any UK clinical position.
In summary
For doctors (GMC)
- Verify your Primary Medical Qualification (PMQ) meets criteria
- Arrange Educational Commission for Foreign Medical Graduates (ECFMG) verification
- Gather internship or equivalent experience evidence
- Provide English test results
- Provide proof of identity (passport)
- Submit Certificate(s) of Good Standing
- Document last five years of activities
- Complete fitness to practise declaration
- Submit online application
- Attend identity check
- Respond to any requests for further evidence
For paramedics (HCPC)
- Submit proof of identity and address
- Provide professional qualification (primary qualification) certificate
- Complete a course information form, containing:
- Overall learning outcomes
- Course specific learning outcomes
- Course content
- Theoretical and practical hours
- Course assessment methods
- Submit Continuing Professional Development (CPD) evidence
- Provide English test results
- Provide a standard of proficiency mapping document
- Provide Good Standing and Character declaration
- Respond to any requests for further evidence
The “Doctor (GMC) pathway”
What is a PMQ?
Your Primary Medical Qualification (PMQ) is your Medical Degree. It must meet the criteria set by the GMC.
What do I need to check?
- Check your PMQ meets the General Medical Council (GMC) criteria for acceptable overseas qualifications
- Find out more about European Economic Area country qualifications.
What are the PMQ document requirements?
To be accepted as evidence by the GMC, your PMQ documents should comply with the following requirements:
- The institution that awarded the qualification must have an entry in the World Directory of Medical Schools (WDMS) with contact details to allow for verification of the qualification
- In must be the official degree certificate awarded by your medical school
- If not in English or Welsh language, it must be accompanied by a certified translation which includes:
- A photocopy of the original document stamped and signed by the translation service
- A complete and accurate English translation of the original document also stamped and signed by the translation service
- It must show the exact date you passed your final exam or assessment. If it doesn’t, then provide a letter from your university confirming this date.
It must be externally verified by ECFMG (MyIntel).
What counts as acceptable internship or clinical experience?
Candidates must provide a certificate or letter of completion from their institution, which gives details of the dates and specialties of rotations, meeting the following criteria:
- Minimum 12 months.
- At least:
- Three consecutive months in medicine
- Three consecutive months in surgery
Find out more about the criteria.
Candidates who didn’t complete an internship, must provide evidence of practice for two years continuously after graduation, with the following requirements:
- Undertaken in a public hospital that meets the standards for regulation within its jurisdiction and has established supervision, safety and governance systems in place
- Includes at least three months of practising medicine, continuously and without interruption
- Includes at least three months practising surgery, continuously and without interruption
- Completed under supervision
How do I demonstrate English proficiency?
A detailed guide to demonstrate English proficiency can be found under stage 1: Demonstrating language proficiency.
What is a Certificate of Good Standing?
A Certificate of Good Standing is used to confirm that a healthcare professional is safe, appropriately registered, and has no unresolved regulatory concerns. It is a key part of maintaining public trust and ensuring patient safety.
Candidates must attach a Certificate of Good Standing from each medical regulatory authority they’ve been registered or licensed with in the last five years, even if they’ve not worked in that country.
What should be included in the ‘details of activities for the last five years’?
The details of activities should comprise the most recent five years postgraduate medical experience, non-medical and other activities and every country candidates have been registered or licensed to work in during this time must be provided
Examples of other activities are:
- Clinical attachments
- Unemployment
- Maternity leave
- Study leave
- Vacation
- Career breaks
Employment references are only required for:
- Non-medical work
- Medical work without a registration or a license to practise with a medical regulatory authority
- An observership or clinical attachment exceeding two months in duration
What is the fitness to practise declaration?
You must declare any issues relating to:
- Health conditions
- Criminal history (including minor offences)
- Employer or university actions
- Negligence claims
Who can provide certified translations?
- Certified translations are provided by a certified translation service meeting the following criteria:
- It has a generally recognised professional accreditation, or
- It has a membership with a relevant professional or trade association
If you are applying from abroad, the British Embassy, Consulate or High Commission may be able to help you find a translator.
In the UK, professional associations of translators include:
- Institute of Translation and Interpreting
- Chartered Institute of Linguistics
- Association of Translation Companies
Guidance on demonstrating English proficiency can be found under stage 1: Demonstrating language proficiency.
How should documents be submitted?
- All copies must be certified copies of the original documents
- Uploaded as PDF files
- Multiple documents can be combined per section
What happens after I submit my application?
Once you submit your application, the GMC will complete a full assessment of it. You will be contacted if more evidence or information to support your application is needed.
How much does it cost to apply for a registration with license to practice?
Updated fees are provided on the GMC website.
How long does it take to complete the process?
The initial assessment should be completed within a few days, however any new document/information/evidence requested by the GMC and provided by the candidate will require the same assessment process. The whole information collected for an ongoing application lasts up to three months. If the period of three months expires while evidence is being collected, candidates will be asked to restart the process.
It is advisable to consider an overall period of at least 6 months to finalise the process.
The “Paramedic (HCPC) pathway”
What qualification do I need to practise as a paramedic in the UK?
You must hold a qualification equivalent to a UK paramedic degree and meet the standards set by the HCPC.
What are the requirements for your qualification to be accepted?
- Your qualification is relevant to paramedic practice
- It includes both theoretical and clinical training
- It meets HCPC standards of proficiency
Are there any other requirements to join the HCPC?
Yes, there are three main requirements to practice as a paramedic in the UK:
What evidence of qualification must be provided?
Required documents:
- Proof of identity and address
- Professional qualification certificate (paramedic or equivalent)
- Full course curriculum (syllabus/modules):
- Breakdown of theoretical and practical training
- Learning outcomes
- Assessment method
- Clinical placement hours and details
- Standards of proficiency mapping
- Declaration of good standing and character
If documents are not in English, certified translations are required.
How is my qualification assessed?
The HCPC compares your training against UK standards, including:
- Length of study
- Depth of clinical exposure
- Scope of practice
You may be asked to:
- Provide additional information
- Clarify specific competencies
What counts as acceptable professional experience?
You must provide:
- Detailed employment history
- Description of your role and responsibilities
- Evidence of clinical exposure
This should demonstrate:
- Autonomous practice (where applicable)
- Decision-making in patient care
- Exposure to emergency and urgent care settings
How do I demonstrate English proficiency?
A detailed guide to demonstrate English proficiency can be found under stage 1: Demonstrating language proficiency.
What is the good standing, character and health declaration?
You must declare:
- Any criminal convictions
- Health conditions affecting practice
- Disciplinary actions
What is required for Continuing Professional Development (CPD)?
You must show evidence of ongoing learning, such as:
- Courses and certifications
- Training records
- Reflective practice
How should documents be submitted?
- Take a photocopy of your original document, or scan and print it
- Show the original document to the person who is certifying it
- Ask the person certifying the document to write on the copy with the following:
- The statement “I certify that this is a true copy of the original document seen by me”
- Their signature
- Their name, professional title and their contact telephone number or email address
- Scan the certified copy, so that you have a digital file (PDF, JPG or PNG)
- Upload this file to your application
- Uploaded as part of the online application
- Clearly labelled and organised
Who can provide certified translations?
Certified translations are provided by a certified translation service meeting the following criteria:
- It has a generally recognised professional accreditation, or
- It has a membership with a relevant professional or trade association
Find out more on the HCPC website.
If you are applying from abroad, the British Embassy, Consulate or High Commission may be able to help you find a translator.
In the UK, professional associations of translators include:
What happens after I submit my application?
- Your application is reviewed by HCPC assessors
- You may be asked for additional information
- A decision is made based on equivalence
How long does the process take?
- Typically, 8 –16 weeks
- Longer if further evidence is required
It is advisable to consider an overall period of at least six months to finalise the process.
How much does it cost?
Fees are updated regularly on the HCPC website.
Stage 3: Finding the “right” job
Getting used to a different healthcare system
What is expected?
After registration, the focus shifts from eligibility to employability. The UK system – particularly within the National Health Service (NHS) – places strong emphasis on how well you match a specific role.
To do that, you need to gain some insight into the NHS system, which might entail getting direct professional experience within the system.
Even when your current experience and professional qualifications might be very similar to the job description, some evidence might not be immediately translatable and transferrable.
Be expected to take on one or more jobs, even at lower level, before applying to your dream job, especially if it is competitive as a HEMS clinical role.
Principles
Employment in UK healthcare is based on demonstrated suitability, not just qualifications. Applications must clearly show understanding of a different healthcare system and alignment with the role and organisational values for the specific job.
In summary
- Identify a suitable role
- Understand the job specifications and requirements
- Assess how your professional experience matches the role criteria
- Gain any qualifications or experience you may be lacking
- Consider applying for roles that provide relevant exposure and help strengthen your CV
- Build a network of professional connections, including people with relevant experience or who have gone through a similar process
- Seek mentors within the system who can offer guidance and support
FAQs
What are the best web-based resources to find clinical jobs?
Primary NHS job websites
- NHS Jobs: The main, official portal for all NHS England and Wales job vacancies. It is the most effective site for both doctor roles (consultant, GP, specialty) and Paramedic roles.
- trac.jobs: Many NHS trusts use this platform as their backend recruitment system. Searching here often provides more direct access to vacancies.
Best resources for doctor jobs
- BMJ Careers: A premier site for NHS doctor jobs, including hospital doctors, consultants, and GP vacancies
- Individual Trust websites: Searching for the “Work for us” page of specific Trusts is a direct way to find jobs.
Best resources for paramedic and ambulance jobs
Ambulance Trust Dedicated Sites:
- South East Coast Ambulance Service (SECAmb): Lists roles like Newly Qualified Paramedics, Specialists, and Emergency Medical Advisors
- College of Paramedics Job Board: A specialist job board for paramedic-specific roles.
How can I demonstrate relevant experience if my qualifications are not directly equivalent to UK standards?
If your qualifications are not directly equivalent to exams, such as membership of the Royal College of Emergency Medicine (MRCEM) or Fellowship of the Royal College of Anaesthetists (FRCA), your goal is to clearly establish functional equivalence, not just list credentials.
To do this effectively, describe scope of practice. Job titles vary widely across countries and are often poorly understood in the UK.
Instead of relying on titles:
- Describe what you did, such as:
- Led resuscitations
- Managed airways independently
- Made escalation decisions
- Include:
- Patient acuity
- Case mix
- Responsibility for supervision
Align your experience with UK expectations
Map your experience to domains expected of UK Emergency Medicine (EM)/anaesthetic trainees:
- Acute care exposure
- Procedural competence
- Decision-making under pressure
- Multidisciplinary teamwork
Show progression toward UK accreditation
Even if you are not yet equivalent, demonstrate a clear trajectory:
- Preparing for or sitting UK exams
- Completing recognised courses
- Gaining UK-based clinical or observational experience
- Build a detailed portfolio of activities and skills
If this is still not enough…
No matter how cumbersome the process might seem, accepting that part of your experience or training needs to be formally gained in the UK is sometimes required. Some institutions and organisations offer specific placements for international graduates to help them gain the necessary exposure and qualifications before their training or title are formally recognised.
Stage 4: Gaining and demonstrating experience
What is expected?
Prior experience in pre-hospital settings can be beneficial in helping individuals understand the challenges of delivering care outside the hospital environment, the patient journey before hospital admission and the way emergency services work together. However, recruitment processes should recognise and value transferable skills, knowledge and experience gained through different career pathways, healthcare systems and professional backgrounds.
In summary
- Build experience through a range of clinical and non-clinical opportunities including:
- Governance Days
- Observational experiences, etc.
- Recognise and evidence transferable skills gained in different healthcare settings.
- Develop experience in leadership, teamwork, teaching, quality improvement or service development.
- Seek opportunities to understand how pre-hospital and emergency care systems operate.
- Remember that there are multiple pathways to developing the skills required for pre-hospital emergency medicine roles.
Principles
Recruitment within UK healthcare is based on demonstrated capability, experience and alignment with the requirements of a specific role. While professional qualifications and registration establish eligibility to practise, employers may also look for evidence of relevant experience in pre-hospital emergency medicine and related environments. This experience can be gained through a variety of settings, including event medical services, motorsport medicine, sports medicine, urgent and emergency care, community healthcare, or voluntary response organisations. Such opportunities can help individuals develop and demonstrate transferable skills that are relevant to pre-hospital practice and strengthen future applications.
Stage 5: Writing an application
What is expected?
The recruitment process is not just selecting for knowledge, but assessing whether you are safe, effective, and adaptable. Strong candidates typically demonstrate:
Clinical credibility
- Specialty experience relevant to the post
- Progression through relevant exams
Non-technical skills
- Leadership under pressure
- Communication in high-stakes environments
- Teamwork across disciplines
- Situational awareness and decision-making
Reflective practice
- Ability to critically appraise experiences
- Evidence of learning and improvement
Professional maturity
- Understanding of role limitations
- Insight into governance, safety, and risk
- Realistic expectations of what working in a specific clinical role mean
Principles
Applications require more than listing experience. You need to show:
- How your skills meet the job requirements
- What impact you’ve had in previous roles
- Why you are applying for this specific position
The supporting statement is often the deciding factor.
Applying for a UK clinical role, including a HEMS Doctor or Paramedic one, is an extremely competitive process. Arguably being shortlisted is the most challenging part. There are usually high numbers of applicants for a small number of jobs. Shortlisters are often having to review hundreds of applications and filter down to tens of people going through to the assessment centre.
Many of the people applying undoubtedly possess the skills and knowledge required to be a good clinician, but it is about showcasing it within the application form. It is important to pay close attention to the essential and desirable criteria but avoid just listing that you possess these.
Those are the “what” but remember the “so what”. Strong applicants generally link how these criteria would benefit them within the role they are applying for, how it compliments their own personal attributes, and how these compliment the charity ethos or values.
Addressing all these elements in a concise manner is by no means easy but absolutely makes an applicant memorable when reading a high number of applications. It is also beneficial to demonstrate an ongoing commitment to a critical care role, so share the journey you have been on in preparation for applying for a HEMS Paramedic role.
In summary
- Identify suitable roles (NHS Jobs, recruitment platforms).
- Carefully read job description and person specification.
- Build your portfolio Audits, teaching, leadership roles Courses and certifications Presentations and publications Pre-hospital exposure
- Select high-impact examplesChoose experiences with: Clear personal contribution Measurable impact For each example, note: Your role What you did The outcome What you learned
- Tailor each section Map examples directly to the scoring criteria Avoid copying the same answer across sections Use fresh, relevant examples each time
- Refine and edit Proofread multiple times Remove vague or generic statements Check for clarity and brevity Ensure every sentence adds value
- Get feedback Ask someone familiar with UK applications to review Ideally, a clinician involved in recruitment and/or HEMS.
Note: KSS works closely with a number of NHS trusts to recruit clinicians to join the team, initially on a secondment basis. Any available opportunities will be advertised on multiple platforms (please refer to stage 3 FAQs).
FAQs
What matters more: quantity or quality of achievements?
Quality. A few well-described, high-impact experiences score far more than long lists with minimal detail.
Are postgraduate exams mandatory?
Not always, but they significantly strengthen your application demonstrating clinical progression and commitment.
How important is teaching experience?
Teaching experience is important, especially if you can demonstrate:
- Regular involvement.
- Reflection and improvement.
- Ability to teach under pressure (particularly relevant to PHEM/HEMS).
Do I need prior HEMS experience to apply?
No. Most successful applicants do not necessarily have direct HEMS experience. However, you must show active effort to understand the specialty and what the role involves.
How can I make my experience from outside the UK stand out?
Non-UK candidates can offer unique insight and skillset to any working environment, highlighting transferable skills
- Demonstrating equivalence in level and responsibility
- Be specific and reflective
- Demonstrate progression over time
- Highlight non-technical skills
What is the purpose of the personal statement in an application?
The personal statement is not a biography, and . Its primary purpose is to answer a single question:
“Why are you a strong and suitable candidate for this role?”
Selectors use the personal statement to assess:
- Your understanding of the role.
- Your motivation, supported by evidence rather than claims.
- Your ability to prioritise relevant experiences.
- Your level of insight and professional maturity.
In contrast to structured sections (which often reward discrete achievements), the personal statement evaluates your ability to integrate your experiences into a coherent, relevant narrative.
What are the most common mistakes in personal statements?
- Being generic
- Writing a purely narrative or autobiographical piece
- Listing achievements without context
- Overly emotive or exaggerated language
- Poor structure and lack of clarity
Stage 6: Sitting an interview
What is expected?
The interview is rarely about testing your clinical knowledge and skills as you will have showcased this through your application, short-listing process and/or clinical assessment session, and ordinarily the interviews are on a different date/time. This is intentional and allows you to focus on the interview as opposed to it being between clinical stations and the associated stress that comes with that. There is much more than just being a strong clinician, and so the panel will explore themes such as:
- How you operate in pressured environments
- How you function within a team
- Your communication style or how you manage conflict
- What resilience means to you
- Your knowledge of the charity and the wider work
- How you recognise your own limitations or seek help
This is an opportunity to get to know you professionally, but also to learn about you as an individual. Who you are is just as important as the content of your answer.

From the inside
Tom Mikrut
Clinical Director
KSS
Hear from Tom Mikrut
Clinical Director, KSS
“The KSS HEMS interview is normally face-to-face and likely at our operational base. The time allotted to each interview is generally around 45 minutes including introductions, the panel questions, and an opportunity for you to ask questions at the end. You are given the allotted time and are expected to manage the flow of answers to ensure you get through all of the questions.
The panel will generally consist of three people and be a mixture of our clinical leadership team, experienced HEMS clinicians, dispatchers or charity staff. Each panel member may bring different experience, but everyone involved understands you are likely to feel anxious and wants you to do well. We try to keep the interviews as close to a conversation as we can so please try your best to relax!
When answering questions, try to avoid being too descriptive. If you have an example, consider applying it the role you have applied for or linking it to why it is relevant to our service. It doesn’t have to be something that has gone perfectly, demonstrating you are reflective or have developed is just as powerful at times. It is important for the panel to get to know you, so try to answer as yourself as opposed to being too scripted or reliant on notes.
Linking answers to emerging research or charity workstreams can demonstrate a wider knowledge in addition to your answer and may be relevant to some questions you are asked.”
Principles
Success at interview for a UK NHS clinical role requires far more than demonstrating clinical knowledge. Candidates are expected to show sound clinical judgement, patient-centred decision-making, and the ability to apply knowledge effectively in complex and often uncertain situations. Interviewers frequently assess lateral thinking, adaptability, and the ability to prioritise competing demands while maintaining patient safety. Strong communication and teamwork skills are essential, particularly through the principles of Crew Resource Management (CRM), including situational awareness, leadership, task management, and effective use of available resources. Candidates should be prepared to discuss how they manage risk, work collaboratively under pressure, and learn from challenging experiences, as these attributes are often as important as clinical expertise itself.
In summary
Preparation should begin well in advance and may include:
- Thoroughly reviewing the job description and person specification
- Researching the organisation, its strategic priorities, and future challenges
- Understanding the Trust’s values and considering how your experience aligns with them
- Familiarising yourself with relevant national guidance, policies, and professional standards
- Speaking with key stakeholders, current post holders, and members of the wider team to gain insight into the role
- Seeking feedback and support from mentors, supervisors, and critical friends
- Reflecting on examples that demonstrate leadership, teamwork, patient safety, and service improvement
- Preparing structured responses using frameworks such as STAR (Situation, Task, Action, Result)
- Practising responses to both clinical and behavioural interview questions
- Preparing thoughtful questions about the role, team, and organisation
- Ensuring practical arrangements are in place and allowing sufficient time for final preparation and reflection before the interview
FAQs
Is the interview mainly a test of my clinical knowledge?
No. While clinical knowledge is important, interview panels are often more interested in how you apply that knowledge safely, communicate your decisions, manage risk, and work within a multidisciplinary team. Non-technical skills are often weighted as heavily as technical expertise.
How important are NHS Trust values?
Very important. Most NHS organisations recruit not only for competence but also for values and behaviours. You should understand the organisation’s values and be able to provide examples of how your own behaviours demonstrate them.
I have extensive experience overseas. How can I make it relevant?
Focus on transferable skills rather than differences in healthcare systems.
Explain:
- What the situation was
- What decisions you made
- How you communicated
- What you learned
- How the experience would translate into UK practice
Interview panels value diverse experience when candidates can demonstrate insight and adaptability.
What should I do if I do not know the answer to a clinical question?
Interviewers are often interested in your thought process rather than a perfect answer.
Consider:
- Acknowledging uncertainty
- Explaining how you would assess the situation
- Identifying risks
- Describing who you would seek support from
- Demonstrating safe decision-making
Unsafe confidence is usually viewed less favourably than honest, reflective practice.
Helpful links
Stage 7: Obtaining the right to work
What is expected?
The sponsoring employer must issue a Certificate of Sponsorship (CoS), which is an electronic record with a unique reference number confirming the details of the role and enabling the individual to apply for their visa.
KSS is not able to offer visa sponsorship; however, for individuals seconded to KSS, the employing NHS Trust may be able to act as the sponsoring organisation. Applicants are responsible for ensuring they meet all visa requirements, including eligibility, English language standards, and professional registration where relevant. Please refer to specific guidance on the UK government website.
Principles
Doctors and paramedics coming to work in the UK will usually require a visa under the Skilled Worker or Health and Care Worker route. This typically requires an offer of employment from a UK organisation that holds a Home Office sponsor licence.
And finally….
A clear message from people working for KSS is that a career in HEMS is not one to be entered into lightly. Regardless of background or route into the profession, the level of dedication required is the same, demanding resilience, sustained effort and a willingness to make personal sacrifices, particularly in the early years. It is a long and often challenging journey that requires clarity of purpose, strong support networks and a genuine commitment to continuous development.
Above all, those we spoke to emphasised the importance of pursuing this path for the right reasons, with a deep and enduring personal motivation. For those who do, the rewards are significant. It is a career that shapes both the clinician and the individual, offering a unique sense of fulfilment and professional pride that does not look to be regretted.

A letter from Dr Duncan Bootland
Executive Medical Director
KSS
A letter from Dr Duncan Bootland
Executive Medical Director, KSS
Obtaining a physician post at Air Ambulance Charity Kent Surrey Sussex (KSS) is something that we know is very desirable and we receive a large number of applications every time we advertise. Whilst recognising it’s a very competitive process, here is the advice I would give to people at various stages of their career when thinking about applying.
Before I start, the below is advice for applying for a stand-alone post with KSS and does not necessarily cross over to national PHEM training programme applications. I’d like to think it’s good general advice but if you’re thinking about applying for IBTPHEM training, it would be sensible to seek separate advice from someone (or ideally a few people) who have recently been through that process.
For those who are still medical students or are resident doctors in the early stages of their career, the most important advice is that we select doctors largely from the specialities of Anaesthetics, Emergency Medicine and Intensive Care Medicine. There are a few exceptions for doctors who come from specific military backgrounds but largely these are the three main ‘feeder’ specialties. Regardless of your ‘base’ specialty, you’ll need to have at least 6 months experience of both Anaesthetics and Emergency Medicine and have gained the Initial Assessment of Competence in Anaesthesia. For those in the early stages of their career, the most important bit is to ensure you’re building a strong foundation in your base specialty, regardless of which it is. All our best doctors are excellent in their in-hospital specialty.
For those who are applying from abroad, we will expect an equivalent level of professional training but given the differences in training programmes, if you are concerned about whether you meet the professional requirements, we’d encourage you to contact us before making an application.
Whilst we are keen to see ‘commitment to pre-hospital care’ that doesn’t mean to the exclusion of the other aspects of training that support your in-hospital practice, and it definitely doesn’t mean taking part in often expensive pre-hospital training courses. We’re more interested in audit or service improvement work related to the types of patients we treat (critically ill and injured medical and trauma patients) and especially where that relates to the first 24 hours or so of their care.
Prior pre-hospital experience does add value for us but less in terms of caring for pre-hospital patients and more in terms of gaining an understanding of what working within the pre-hospital environment feels like, what the patient journey looks and feels like before they reach hospital and how the ambulance service functions.
A demonstrable ability at being a good team worker is very helpful and there are myriad (enjoyable) ways you might demonstrate that.
For those further on in their training and starting to think about making an application, it’s worth bearing in mind that the short-listing process is probably the highest hurdle and so time spent understanding and then filling out the application form is invaluable. Consider whether it would be worth looking at the application form a year or two before you might be ready to apply and think about where you need to focus your efforts to ensure you can make the strongest application. Whilst we review the process each year and often slightly modify the process based on what we’ve learned, there are not usually dramatic changes.
Before applying, many people will want to join us on an observer shift and it’s true that this can provide an insight into the reality of what working for KSS is like. However, in our opinion an observer day on a clinical shift is less valuable than being a guest at one of our clinical governance days. Bear in mind a couple of things though, there is a long waiting list and, in part because of that, we are only able to accept physician observers at ST4 level and above (5 years post qualification) and you must attend a CGD before being added to the waiting list for an observer shift. Whilst joining us as an observer adds benefit in terms of making clear on the application you understand how we work at KSS, it adds only a little in terms of the overall scoring of the application.
Currently we advertise via an NHS Trust and so use the NHS application form (Trac). We create a job description for the post, with essential and desirable attributes for the candidates, and Trac then uses that to create a scoring matrix. Given the competitiveness for the posts, you’ll need to be scoring highly in most if not all the domains on the job description. To give yourself the best chance, make sure your application form demonstrates that and use the ‘free text’ boxes wherever you can to make sure it’s clear to those reading how you fulfil each domain, if the more standard boxes haven’t provided you that opportunity. Remember though, the short listers will be reading many, many applications and so writing War and Peace into the free text box isn’t likely to generate the outcome you want.
There are parts of the criteria that are obvious and some that take a little more thought in how you can demonstrate them. Leadership and management experience are easier if you’re already a Consultant but harder if you’re still in a Specialty Training post. If you’re struggling to get practical experience in an area, think about how you might cover that off with training courses or similar that, as well as supporting your application, will support future in-hospital Consultant posts.
Alongside the essential and desirable criteria, we’re going to want to understand why you’re applying. This sounds obvious but we’d like to know why you want a HEMS job at all, and why you want one at KSS specifically. Think about what you’ll gain from the post with us and potentially what you think we’ll gain from having you.
For those already in Consultant posts, it’s never too late to apply and we’re supportive of applicants regardless of seniority. Consider all the advice above but on top of this, try to consider the breadth of experience you’ve built, both clinical and non-clinical, and how that might support you in a HEMS doctor role. Endeavour to demonstrate that in the application form and specifically in relation to the essential and desirable criteria. We feel all clinicians regardless of seniority will benefit from a HEMS secondment at KSS; consider what it is you’re hoping to get out of the secondment as part of your professional development as a Consultant and think about how you can demonstrate that at different parts of the application process.
Whilst I wish you success, it’s a simple fact of number of posts available versus number of applications that your application might not be successful and for many people who have always succeeded, that can be challenging. We do our best to provide feedback, but the anonymous nature of the process makes it difficult to be too specific. If you’re not successful, perhaps ask a trusted colleague to review your form against the desirable and essential criteria and see where you might improve for the next attempt.
Once through short-listing you’ll be invited to a selection half-day which is different to most medical selection processes you’ll have been involved in. Whilst we evolve things between every selection event, during the half day we are likely to ask you to take part in some clinical scenarios, a fitness test, a short presentation (the title of which you’ll receive beforehand) and
an interview. The clinical scenarios are designed to look at characteristics we are interested in (team working, communication and nontechnical skills as examples) and are designed to be fair to those with and without prior pre-hospital experience – we’re not expecting you to demonstrate you already know how to be a HEMS doctor. The fitness test is simply a test of whether you can undertake the physical aspects of the role, not a test of super-human fitness, and is manageable by everyone with a moderate degree of fitness. The interview will be more in keeping with what you’re used to in terms of being asked questions by a small panel from KSS. The questions vary every time we run it but standard interview advice applies to this one too: it’s invaluable to have people you trust practice interview you and then provide honest, constructive feedback before the day. We aim to keep the interview as ‘conversational’ as we can and try to remember we’re very keen to see the real, relaxed you. There aren’t any perfect answers and the way you answer the question is often more important than the specifics of the answer.
I hope the above is valuable. Good luck in your application!
Duncan Bootland
Executive Medical Director
KSS

A letter from Emma Parkhe
Executive Officer/Paramedic
KSS
A letter from Emma Parkhe
Executive Officer/Paramedic, KSS
Working in HEMS is a highly sought-after role, which I feel very lucky to undertake. The opportunity to care for critically ill and injured patients, work within a highly skilled multidisciplinary team and make a difference at some of the most challenging moments in a patient’s journey is both rewarding and professionally fulfilling.
For those considering a future career in HEMS, my advice would be to focus first on becoming an excellent paramedic. While advanced clinical knowledge and technical skills are important, success in HEMS requires much more than that. The clinicians who thrive in this environment are those who consistently demonstrate sound clinical judgement, patient-centred decision-making and the ability to adapt to complex and often uncertain situations.
Before thinking about HEMS, focus on mastering your current role. Seek opportunities to manage seriously unwell patients, lead on scene, work in a variety of operational environments and build confidence in autonomous decision-making. The experience gained through day-to-day ambulance practice provides the foundations that HEMS clinicians rely upon every day.
One area I would particularly encourage people to develop is their non-technical skills. The principles of Crew Resource Management (CRM), including communication, situational awareness, leadership, task management and the effective use of available resources, underpin almost everything we do. The ability to communicate clearly, work effectively within a team and make good decisions under pressure is just as, and at times more important as clinical expertise.
HEMS is very much a team sport. As a HEMS paramedic, you will work closely with fellow paramedics, doctors, pilots, ambulance crews, emergency departments and partner agencies. We value clinicians who contribute positively to those around them, demonstrate professionalism and are willing to learn. Some of the strongest candidates are not necessarily those with the most impressive CVs, but those who can demonstrate self-awareness, resilience and a commitment to continual improvement.
Many aspiring HEMS paramedics focus solely on additional qualifications or specialist courses. While these can be valuable, they are rarely a substitute for strong operational experience and clinical credibility. We are looking for clinicians who are trusted by their colleagues, remain calm under pressure and have a proven track record of delivering high-quality patient care.
If you are considering applying for a HEMS role, take time to understand the organisation, its values and the communities it serves. Seek feedback from trusted colleagues and mentors, reflect on the experiences that have shaped your development and think about what you could bring to the team.
Most importantly, be yourself. Authenticity, professionalism and a genuine commitment to patient care go a long way.
I hope this advice is helpful. Whether a HEMS role is something you are considering now or further into your career, focusing on becoming the best clinician, teammate and leader you can be will always be time well spent. I wish you the very best in your journey and maybe even work with you at some point in the future!
Emma Parkhe
Executive Officer/Paramedic
KSS
And Finally...
A clear message from people working for KSS is that a career in HEMS is not one to be entered into lightly. Regardless of background or route into the profession, the level of dedication required is the same, demanding resilience, sustained effort and a willingness to make personal sacrifices, particularly in the early years. It is a long and often challenging journey that requires clarity of purpose, strong support networks and a genuine commitment to continuous development.
Above all, those we spoke to emphasised the importance of pursuing this path for the right reasons, with a deep and enduring personal motivation. For those who do, the rewards are significant. It is a career that shapes both the clinician and the individual, offering a unique sense of fulfilment and professional pride that does not look to be regretted.
At KSS, there is a team of approximately 80 paramedics and doctors (trainees, fellows and consultants), made up of a mix of secondments from the NHS and direct employees (on a full-time or part-time basis), who work alongside colleagues across the charity to deliver lifesaving treatment and care to those who are critically ill or injured.
We’re committed to a culture of inclusivity, respect, and diversity. We value the unique perspectives and experiences that our clinicians bring and are dedicated to ensuring equitable opportunities for all, regardless of background. We believe that a diverse workforce strengthens both our organisation and the care we provide to patients in our communities.
We recognise that starting the journey towards working in PHEM can feel daunting. Our aim is for this guide to answer common questions, provide clarity, and help ease some of the uncertainties you may face along the way.
We hope this resource proves helpful, and we wish you every success in your journey towards a HEMS career.
Disclaimer
This document is informed by lived experience and practitioner insight. It is intended as a supportive guide not a definitive or comprehensive source of information. Readers should refer to official guidance and relevant organisational or government websites for the most current and authoritative information. This content should not be used verbatim without consideration of local context and up‑to‑date policy.
