UK medical graduates are to be given priority access to specialty training jobs in the NHS, as part of emergency legislation unveiled today by the Government.
Outlined as part of the Medical Training (Prioritisation) Bill, the proposed legislation will seek to ensure that UK medical graduates be prioritised for access to core and higher training places from 2026.
In addition to legally mandating prioritisation of UK medical graduates, the Government had further pledged to this year create an additional 1,000 specialty training posts in England, which will be open to applications from April 2026.
The disparity in applications to available specialty training posts has seen competition ratios spiral in recent years leading to many doctors facing unemployment as a result.
Analysis conducted last year by The Doctor magazine revealed that 59,698 applications were made for the 12,743 specialty training posts in 2024, a 39.5 per cent increase on the number of applications made in 2023.
FLETCHER: Government waking up to issue
BMA resident doctors committee chair Jack Fletcher has cautiously welcomed the proposed bill, stating that the announcement of emergency legislation suggested that the Government was ‘finally waking up to the urgency of the situation’ regarding training places.
He warned, however, that the proposals were merely a first step to resolving a much larger challenge, and the creation of 1,000 new training places in England (as announced in the government’s 10 Year Plan) would not alone be enough to tackle the scale of the crisis.
He said: ‘Today is a step forward, but we are still a long way from giving resident doctors in the UK confidence the Government can finally solve the jobs crisis.
‘This is a new policy of prioritising UK medical graduates for NHS jobs, which will come into effect across the four nations and will to some extent reduce the number of doctors who can’t find work despite the state having spent time and money training them up.’
He added: ‘If patients are hoping this news will mean substantially more doctors on the wards to treat them, they will be disappointed. There remain no new posts, and this alone will not dent the massive gap between applicants and places – nearly thirty thousand this year in England.
‘To fix the jobs crisis for doctors, we will still need thousands more genuinely new jobs – this is why doctors in England voted overwhelmingly in December to continue with industrial action over the job's crisis in the NHS.’
International effect
As well as UK graduates, medical graduates from the Republic of Ireland, Norway, Iceland, Switzerland and Liechtenstein would also see their applications prioritised for specialty training and the foundation programme, owing to pre-existing trade agreements between the UK and these countries.
IMGs (international medical graduates) already in the UK and who have completed foundation or core training or who have secured indefinite leave to remain, EU settled status or British dual-citizenship, will also be eligible for prioritisation for specialty training.
IMG doctors from outside these categories would not be prevented from applying for specialty training roles. However, their applications will not be prioritised.
Dr Fletcher warned that Government’s proposed approach for UK graduate prioritisation differs from that previously set out by the BMA.
Under the association’s recommendations, all IMG doctors registered with GMC and practising in the NHS by 5 March 2025 and possessing at least two years’ experience in the NHS should also receive prioritisation.
Doctors in limbo
Dr Fletcher said: ‘We are concerned about the effect on doctors with significant NHS experience who have trained abroad. We’ve made clear that any change to specialty training post applications would need to protect and recognise those international doctors with significant experience; something that this legislation at present does not go far enough on.
‘We appreciate that the UK Government is finally moving with more urgency, using emergency legislation – which begins to recognise the scale of the issue – but we need to go further and faster.’
The prospective law, which is part of efforts to restore specialty training competition ratios to more reasonable levels, will also prioritise UK graduates’ access to places on the UK foundation programme.
Shortages of places on the UK foundation programme saw almost 700 medical graduates allocated ‘placeholder’ posts rather than definite job offers, leaving hundreds of new doctors in limbo as to where they would be working.
By prioritising UK graduates for foundation programme places, the Government hopes it can greatly reduce the number of new doctors not given firm job offers and that resolving instances of placeholders will be far quicker.
While still subject to further scrutiny before becoming law, the terms of the bill, if passed, would see prioritisation applied at the offer stage to specialty posts starting in 2026.
For the foundation programme, prioritisation will be applied at allocation to the foundation school.
For more information on the new Bill and how you might be affected, please check out the FAQ section on the BMA website.