In the UK there are usually two or actually three ways of working and earning. Fourth way of working is attachment which does not earn you any money and actually it does not count to any experience as far as GMC is concerned. It may add points to your application though and enhance the prospects of getting a job in future.
First way of working is to work in rotations and enter a training programme - in this way you will actually sign up with a postgraduate training programme who will set all the necessary rotations for you leading to your certification as a doctor with basic training - usually it is for 2-3 years. This certificate could be in medicine, surgery, general practice etc. After achieving this certificate you can go into subspecialties like cardiology in medicine or urology in surgery or actually go into general practice etc. These programmes are run by what is called Deaneries - they ensure that the training is of good quality and the trainees are offered best opportunities for training. They have different hospitals under their supervision and therefore as a trainee you may be working for Urology in one hospital and in another hospital for training in vascular surgery etc. These jobs are offered in bulk and deanery and/or hospitals hold the interviews for selection. These training jobs start in February and August like we start postgraduate training in November in AKU. Since these jobs are processed in bulk so there is plenty of paper work that needs to be covered. So applications take time. I think last week of Jan or Feb is last date for August jobs and Last week of July or August is the last date for jobs starting in February.
Second way of working is to apply for different jobs for yourself. These are stand alone jobs in different hospitals, which become vacant because some one leaves the training in the middle or a new post is created and they are unable to fill these posts from regular intake. These are offered by individual hospitals and are usually short lived in the sense that they end in February or August depending on the availability of a doctor getting selected from regular intake. Some times a doctor leaves in the middle of training and if the hospital is happy with you then you get their rotations offered so in that sense you may be lucky to get 2 years of rotations in the hospital trust (a group of teaching/other hospitals come together to make a trust where almost all major services are provided so hospitals share their resources to provide all important surgical/medical services in the region - like Civil hospital could deal the nephrology issues and AKU could deal with Cardiac issues and overall they could become a Karachi hospital trust).
Third way of getting a job is locum job, in this situation if some doctor who is working as a regular trainee/service doctor and he/she goes on holidays but is likely to come back to the job then hospitals offer some one a temporary job. This could be from one day to months, depending on the kind of leave that their regular doctors take. Sometimes they don't come back because either they decide to test their luck somewhere else etc or they change their profession then again if you are lucky you could be offered a long term post. Locum jobs actually are 'mostly' offered through locum agencies and 'not mostly' directly from the hospital.
You need registration with GMC for all of these jobs. GMC now a days gives registration to a doctor who is offered to work in the UK even for one day. This job has to be a paid job and hospitals have to certify for that (consultants cannot just offer an unpaid job and get you registered with GMC). This registration is limited registration that means you can only work under supervision or in the hospital environment where a consultant is willing to take responsibility of your actions. This supervision may not be a training supervision. So in a way you my be working for some time but it does not count as a training position. The caveat/catch over here is that in order to get full registration (which is permanent registration) you need to have worked for at least one year in a proper training post or.and you should have at least two reports from recognised supervisors of training (who are confirmed to be supervisors from the deaneries). You can work for 'I think' 5 years on a limited registration then either you have to get full registration or you will have to work your way again PLAB etc or I don't know what GMC does to such people because mostly people get full registration by 5 years.
Of course the other catch you have to struggle for is that home office may not offer you a work permit free visa on a one day job offer (having said that I feel they are very considerate for doctors and do give you 6 months of work permit free visa in first application and you actually get it in one day if you go to their office personally without hassle). This used to be free of charge but now you have to pay £250 for this visa. YOU ARE NOT ALLOWED TO WORK WITHOUT THIS VISA. You also need approximately £350 for registration with GMC before you can start your job!!!
Now it is a different issue whether you will be eligible to take your MRCS, MRCP exam after going through stand alone posts or locum posts because some of the posts are not recognised for postgraduate training and actually for these jobs you have to get a work permit instead of work permit free visa and some hospital trusts (finding it desperate to get a doctor to work for them) do arrange work permits for overseas doctors who are eligible for registration and training/work in the UK.
Now as far as the application process is concerned - of course you can apply before you have passed your PLAB exam but the deaneries know that PLAB takes almost year to complete/pass so likelihood of getting shortlisted for interviews is very low without passing PLAB. There is a chance that you might be considered for interview if you have passed your PLAB I (provided you get short listed for these jobs).
Short listing process of course takes different things into account.
There must be other criteria/scoring areas for short listing process. Of course a panel is set up by the deanery for shortlisting process. The successful individuals are invited for interviews and final selection is based on the criteria set by the deanery.
So far I feel that it is very fair and impartial system of selection when you go through the deanery (first route - bulk application - rotation jobs). Other routes depend on luck and hospital's criteria for working.
The trick of the game probably is that likelihood of job increases if you are ready to go farther north (in UK) and farther west. These areas are a bit hard to live, rural UK (must say much much better than cities in Pakistan). Competition for jobs is tough in South and South East. These are touristy regions they are near the coast. Everyone wants to be there.
The rules for GMC registration are changing, actually rules for training are also going to change soon. So it is important that if you are interested you should visit GMC and DoH's websites routinely. Look for jobs on BMJ classified and do give it a go after you have passed PLAB I and have got a date for PLAB II (everybody knows that the results are usually available within two - three weeks after taking the exam in case of PLAB II so deaneries do consider this kind of time period).
In the UK most of the individuals do some other qualifications before applying for postgraduate training in medical fields so I am sure that has its own advantages. Fortunately so far they have not weighting for your scores in PLAB, but as the competition for jobs increases and GMC's claim of this exam being fair takes ground they will probably start considering scores as a valid criteria!! Anyway at the moment you can ignore this.
Hope this is helpful and wishing you all good luck
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