On Thursday 5th March, the UK Government’s Medical Training (Prioritisation) Act officially became law. This legislation affects recruitment into specialty training and the foundation programme across the UK.
The aim is to restore competition ratios for specialty training programmes to more reasonable levels. The law will make progress on this by prioritising UK graduates and other groups, as listed below. The Act also introduces prioritisation for the foundation programme, which the government expects will result in significantly fewer ‘placeholder’ offers than in previous years.
The Act is UK-wide and has been drafted in consultation with the governments of the devolved nations.
The Department of Health and NHS England have produced their own FAQs here.
Which groups of applicants will be prioritised?
For foundation programme places starting in 2026, the prioritised group will include:
-
Those with a primary medical qualification from medical schools in the UK or the Republic of Ireland.
- Those with a primary medical qualification from medical schools in Iceland, Liechtenstein, Norway and Switzerland (as the UK holds trade agreements with these countries).
For specialty training places (core and higher) starting in 2026, the prioritised group will include:
-
Those with a primary medical qualification from medical schools in the UK or the Republic of Ireland.
-
Those with a primary medical qualification from medical schools in Iceland, Liechtenstein, Norway and Switzerland.
-
Any doctor who has completed or are currently on the relevant qualifying UK training programme (for example, foundation doctors applying for core training or doctors who are completing or have competed core training applying for higher training).
-
Those within specific priority groups based on immigration status*
*This includes:
-
British citizens,
-
Commonwealth citizens who have the right of abode in the United Kingdom under section 2 of the Immigration Act 1971
-
Irish citizens who do not require leave to enter or remain in the United Kingdom under that Act
-
people with indefinite leave to enter or remain in the United Kingdom
-
people who have leave to enter or remain in the United Kingdom by virtue of residence scheme immigration rules within the meaning given by section 17 of the European Union (Withdrawal Agreement) Act 2020.
When will these changes happen?
The law will come into effect for the 2026 application cycle for both specialty training and foundation programme allocation.
What does this mean for the 2026 recruitment rounds?
For specialty posts starting in 2026
It is the UK Government’s intention that prioritisation will be applied at the offer stage for specialty training, as shortlisting is already underway.
For training posts starting from 2027 onwards, prioritisation will apply at both the shortlisting and offer stage.
For foundation programme in 2026
Prioritisation will be applied at allocation to the foundation school.
Allocation to the foundation programme has been delayed until the 12th March, to allow time for the law to pass through Parliament. The UK Foundation Programme Office has more information on allocation in 2026 here.
What does this mean for doctors who hold a degree from or students who are studying at a UK medical school’s international campus?
It depends on whether the majority of a medical degree was completed abroad or in the UK. If the majority of a medical degree was completed in the UK, then yes, that student or doctor would be prioritised.
For example, if a medical student attended an international campus for the first two years of their degree and then completes three clinical years in the UK, they will be prioritised. However, students who complete the majority or all of their degree abroad will not be prioritised. If you are a doctor with a medical degree from an international campus applying to specialty training, you may still be prioritised if you fall into one of the relevant priority groups (for example, if you completed the foundation programme).
Does this mean that UK citizens with an international medical degree would be prioritised?
For specialty training in 2026
Yes, as a British citizen, someone with an international medical degree holds the relevant immigration status and right to work so as to be included in the prioritised group.
For the foundation programme in 2026
UK citizens with international medical degrees will not be prioritised.
The foundation programme
Who is going to be prioritised for the foundation programme in 2026?
From 2026, UK graduates will be prioritised for places on the foundation programme, alongside graduates from the Republic of Ireland and four other European countries that the UK holds agreements with (Norway, Iceland, Switzerland and Liechtenstein).
This means that people who hold a degree in medicine from an international medical school (including UK citizens) will not be prioritised. Not being prioritised does not mean that international medical graduates cannot apply, but that jobs will be allocated to those in the prioritised group first.
What does this mean for timing of allocations for the 2026 round?
Allocation to the foundation programme has been delayed until the 12th March, to allow time for the law to pass through Parliament. The UK Foundation Programme Office has more information on what this means for allocation in the 2026 round here.
What does this mean for linked applications?
Linked applications will only be honoured if both applicants are allocated at the same stage, during allocation to foundation school and if there are two available places at the point of allocating both applicants. The UK Foundation Programme Office has published more detailed guidance here.
What does this mean for ‘placeholders’?
The UK Government expects that all eligible prioritised applicants, including UK medical graduates, will get a place on the foundation programme. The government will not be able to guarantee every applicant not in the prioritised group a place.
While the UK Government is not able to guarantee that there will be no ‘placeholder’ offers made in the 2026 round, they anticipate that prioritisation is likely to significantly reduce the number of UK graduates offered placeholders.
What does this mean for UK nationals who studied medicine at an international university?
No international medical graduates (other than those with degrees from the Republic of Ireland, Lichtenstein, Norway, Switzerland or Iceland) will be prioritised for foundation training. This means that UK nationals with degrees from other international medical schools will not be prioritised.
Will prioritisation occur in standalone FY2 recruitment?
Yes, the same groups of applicants will be prioritised for standalone FY2 recruitment as for the foundation programme.
What does this mean for foundation priority programme recruitment?
Due to the timing of the passage of the law, Foundation Priority Programmes will not be offered in 2026 in a separate recruitment process. Instead, these posts will be added to the main allocation round and allocated via Preference Informed Allocation (PIA).
What does this mean for refugee doctors who want to access the foundation programme?
As it stands, there are no specific provisions for refugee doctors to access training within the legislation. For the purposes of applying for training, they will be treated the same as other international medical graduates.
What does this mean for international students studying at UK medical schools?
International students are considered UK graduates and so will be prioritised, regardless of their nationality or immigration status.
Specialty training and UK graduate prioritisation
Who is going to be prioritised for specialty training in 2026?
As above, from 2026, the UK Government will prioritise UK graduates, alongside graduates from the Republic of Ireland and four other European countries that the UK holds trade agreements with (Norway, Iceland, Switzerland and Liechtenstein), for places in core and higher training.
International medical graduates who have already completed the foundation programme or relevant core training will be prioritised when applying for the next stage of training.
International medical graduates who have the permanent right to work in the UK (for example, through holding either Indefinite Leave to Remain, EU settled status or British citizenship) will also be prioritised.
This change does not mean that international medical graduates cannot apply for specialty training places, but that they will not be prioritised for a place.
Does this mean that UK citizens with an international medical degree would be prioritised for specialty training?
Yes, as a British citizen, someone with an international medical degree holds the relevant immigration status and right to work so as to be included in the prioritised group. This is different to the foundation programme, where UK citizens with international medical degrees will not be prioritised (unless they hold a degree from the Republic of Ireland, Norway, Iceland, Switzerland or Liechtenstein).
Will applicants who have completed core training only be prioritised for relevant higher specialty training?
Yes. Applicants who have completed core specialty training will be prioritised only for higher specialty training in a relevant specialty (for example, someone applying to general surgery ST3 following core surgical training would be prioritised). Applying to a programme unrelated to a core training programme will not lead to prioritisation. For example, if you have completed core psychiatry, you would not be prioritised in an application for core surgery unless you had met another criteria for prioritisation (such as having completed the foundation programme).
Are there any specialties that will not be included for prioritisation?
The only specialty currently excluded from prioritisation is Public Health Medicine (single Certificate of Completion of Training), as the specialty is open to medical and non-medical applicants.
Are academic posts included in prioritisation?
Academic posts are included in prioritisation.
The only exception is public health academic clinical fellow posts in England, where vacancies will be open to current non-medical public health trainees.
Are dental training posts included in prioritisation?
No, dental posts are not included in prioritisation. Oral and maxillofacial surgery is included in prioritisation, as this is a medical specialty despite the requirement for applicants to hold a dental degree.
What does this mean for refugee doctors who want to access specialty training?
Refugee status is not a standalone priority group. Individuals with refugee status will be prioritised if they fall within another priority category, such as holding Indefinite Leave to Remain (ILR) or if they have completed foundation or core training. The law will not change their eligibility to apply for Locally Employed Doctor (LED) roles.
Will the same groups always be prioritised from now on?
Legislation allows for the Secretary of State for Health and Social Care to make changes, through regulation, to who is prioritised for the foundation programme and specialty training. The government have said that this power is intended to respond to any changes in applications for programmes in future. For example, if applications for certain programmes, such as general practice significantly, as has happened in the past, they can remove these specialties for prioritisation. However, they have said that their aim is to avoid this as much as possible, by attracting more UK graduates to the specialities where service need is greatest.