The UK has recognised the important role its health professionals play in achieving the Millennium Development Goals. For doctors to contribute to these efforts without detracting from domestic service and training commitments presents a challenge. Moreover, doctors need suitable education in order to make appropriate and effective contributions in resource-poor settings. In this article it is argued that, while mechanisms exist within current UK postgraduate training that permit a degree of flexibility to training pathways, they are not structured in a way that facilitates work in low and middle income countries. Furthermore, the knowledge and skills required to make contributions to global health are not sufficiently served by existing training. A model for a national curriculum and tiered qualifications in global health is proposed, based on rigorous appraisal and mentoring to complement the training pathways for UK specialisation, allowing doctors to add global health skills at a level appropriate for their career plans.