The BMA’s UK resident doctors committee (RDC) has called on the Government to greatly expand the number of specialty training posts in the NHS, as more and more doctors find themselves without training positions. This year around 20,000 applicants are expected to miss out on specialty training due to a lack of formal training places, depriving doctors of certainty about their future and patients of the consultants and GPs they are in desperate need of. 

In a motion passed last week,¹ the committee condemned the failure of all four UK nations’ governments to provide enough training opportunities to keep up with the UK’s need for a growing medical workforce. It further set out proposals to try to mitigate the issue by prioritising UK medical graduates for these jobs while also protecting the careers of international medical graduates (IMGs) currently working in the NHS. 

Specialty training posts are critical to a doctor’s career, allowing them to become the consultants and GPs of the future.  Last year 4.7 applications were made for every specialty post, with the number set to rise again this year.² In 2019 the ratio was just 1.9 applications per post.  

Due to failures of the current specialty recruitment system, many doctors are facing underemployment even as patients find it harder to see a doctor.  As the number of applicants has increased over the last decade, the number of training posts has remained static, creating bottlenecks that are leaving entire cohorts of doctors in career limbo. 

The UKRDC is now set to lobby the UK governments to adopt a plan of action to address the growing crisis. In order to reduce the crushing competition ratios and provide clear and efficient routes for doctors to develop their skills, the committee has set out a multi-pronged approach.

Firstly, training posts must be increased. Secondly, UK medical graduates should be prioritised for those posts, providing a steady pathway for the highly trained specialists the country needs. Thirdly, there should be a mechanism by which IMGs who are currently in the UK are protected. 

UK RDC co-chairs Dr Melissa Ryan and Dr Ross Nieuwoudt said: 

“Any patient can see that the UK needs more doctors – England has one of the lowest numbers of doctors per person in Europe. It is a scandal that desperately-needed doctors are finding their careers stymied, unable to progress because the training places are not there for them to do so. Come August this year we could potentially see thousands of unemployed doctors – shockingly that is while patients across the UK are waiting far too long for treatment. 

“The failure to properly plan for the future of the NHS workforce is a political one, and it needs a political solution. Along with restoring doctors’ pay, restoring the ratio of training posts is now an essential priority for any government that cares about the future of the NHS.  

“The UK has spent considerable time and public money on the medical education of these doctors. That is before taking into account that some medical students leave university with over £100,000 of debt. This is not only a terrific waste of potential careers but a perversely inefficient way to plan a workforce.  

“It is a simple fact that those who have experience in the NHS via their medical school and early years as doctors are more adapted to the system - yet in creating arbitrary competition ratios with applicants outside the NHS we are forcing these early career doctors to consider going to train in less-familiar health systems themselves.  

“In the long term the Government needs to face up to the fact that the country needs more consultants and GPs, and to achieve this we need to create more training places.  But while these artificial shortages exist, it is vital we do everything possible to keep UK medical graduates in the system, and the Government cannot to let their talents and the money already spent on them go to waste.” 

Notes to editors

1. In a committee meeting on 4th March 2025. The full motion reads: 

 
This committee condemns the persistent failure of UK and devolved nation governments to significantly expand medical specialty training posts and resolves to  

i)       demand that UK and devolved nation governments, NHS/HSC bodies, and statutory education bodies implement a specialty training recruitment process that lawfully prioritises medical graduates from UK medical schools. 

ii)   ensure equal access to specialty training for those international medical graduates (IMGs) who are already GMC registered and practising in the UK on or before the 5th of March 2025 who have completed or go on to complete two years of NHS/HSC experience or NHS/HSC funded care working as a medical doctor (grandfathered IMGs). Any IMG doctor starting medical practice in the UK on or after 6th March 2025 will be deprioritised for the purposes of specialty training applications compared to UK medical graduates and IMGs meeting the grandfathering criteria previously mentioned. Work will be undertaken to consider how this policy could be delivered across the 4 nations recognising the different circumstances presented by cross-border working in Northern Ireland and the Republic of Ireland. 

iii)    demand that UK and devolved nation governments, NHS/HSC bodies, and statutory education bodies provide increased funding for the expansion of postgraduate training posts and subsequent consultant/GP posts to meet the growing demand for specialty training, significantly reduce competition ratios, prevent unemployment amongst doctors, and help provide the medical workforce the UK population needs. 

iv)   work robustly towards reform of trust/board recruitment practices so resident doctors in locally employed posts are free from exploitation, career uncertainty, risk of excessive financial burdens, and are able to seamlessly evidence the experience they gain in these posts against equivalent experience in training. 

   2. Data taken from HEE. 59,698 applications were made for 12,743 posts. 

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