1 day Ago By Emma Morgan
Resident doctors have said they are going through a “really awful” time of decreasing job security, with an estimated 20,000 expected to miss out on an NHS specialty training place this year due to a sharp increase in competition for posts.The British Medical Association (BMA) is urging the Government to expand specialty training post numbers, which have stagnated while applicants have increased, partly due to a rise in the number of UK medical school graduates and also the removal of a test which previously required foreign-qualified doctors to demonstrate they were needed in the UK.In 2024, 4.
7 applications were made for every specialty post, with the number set to rise again this year, while in 2019 the ratio was 1.9 applications per post, according to BMA data.if(window.
adverts) { window.adverts.addToArray({"pos": "inread-hb-ros-inews"}); }When UK medical students graduate, they begin two years of foundation training, where they spend blocks of time working in different specialties.
In general, they then apply for internal medical, core surgical, acute care, GP or other specialist training such as paediatrics or psychiatry. Unless their programme runs straight through to being fully qualified, they pursue a higher training pathway in the area they want to specialise in and work towards becoming a consultant.It is becoming increasingly difficult for doctors to secure posts beyond their foundation training, with many forced to take years out to reapply, or having to decide whether to move across the country for a job.
The BMA has set out proposals to try to mitigate the issue by prioritising UK medical graduates, while also protecting the careers of international medical graduates currently in the NHS. if(window.adverts) { window.
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adverts.addToArray({"pos": "mpu_tablet_l1"}); }‘A failure of workforce planning’ Dr Melissa Ryan, who is co-chair of the BMA Resident Doctors Committee, told The i Paper: “It is a failure of workforce planning, not from this Government but from successive governments, that this has been brewing for quite some time.“It’s incredibly stressful” for resident doctors, who are “very worried,” she said, adding that this is pushing them to seek work overseas.
“You think that you’re going to be a doctor and that it’s going to be a relatively safe career, and it’s becoming increasingly uncertain as to whether you’ll even end up with a job, let alone the fact that we get flung round the country to do parts of our training.“It’s a crying shame, and at the end of the day it’s the patients that are going to miss out.”In 2024, there were 12,743 training posts available, with 10,628 UK graduates and 14,868 international graduates applying.
By 2026, the number of overseas applicants is projected to rise to 29,429.Health Secretary Wes Streeting told GB News this week: “We’ve got this bizarre situation where graduates from UK medical schools are competing on an equal basis with overseas applicants for the same jobs. “I think that is a crazy position for our country to be in, and as we speak, I am looking at the changes we need to make to put an end to that situation.
”Shonnelly Novintan has learned that there will be no training jobs available in her chosen specialty in her region of England this year Shonnelly Novintan, 27, is currently working as a core surgical trainee in Essex. Having completed her two foundation years, she managed to secure a two-year surgical training place, and now wants to pursue higher training in plastic surgery.if(window.
adverts) { window.adverts.addToArray({"pos": "mpu_mobile_l2"}); }if(window.
adverts) { window.adverts.addToArray({"pos": "mpu_tablet_l2"}); }“It’s very difficult, it’s very competitive,” she said.
In order to put forward the best possible application, she has been completing audits and publications in her spare time. She told The i Paper: “It’s not like you can spend one weekend and write a paper; it often takes well over six months just to publish something, let alone the work involved doing it.”Like her peers, she has also self-funded her exams, which cost over £1,700, done part-time teaching and spent her free weekends in the hospital to gain enough experience for a surgical interview.
She said that applicants are expected to fit this in “not just around a full-time job but around a busy on-call rota job, so often you have to use your annual leave,” and people do this willingly because of their “passion” for the job.No jobs hereHowever, last week Dr Novintan found out that there will be no jobs in her deanery – which covers the whole of the East of England – this year. “It’s where I’ve bought a house, it’s where my partner and I live, so it’s very tough, because then we’ve had to have that conversation about relocating and living away from each other for a year or two, or deferring my career for a year, which I’m not inclined to do given how hard I’ve had to work just to get an interview.
”She is also conscious that if she relocates it will not be the last time she potentially has to move, as there are more stages of training to come.if(window.adverts) { window.
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adverts.addToArray({"pos": "mpu_tablet_l3"}); }“The issue that I have is that I’m now partially skilled, so I either take several years to apply to get into my field, during which time I will deskill, or I have to apply for a different field which might be slightly less competitive, and take years out to skill in that field.“There’s no job security.
If I don’t get a job, it’s not like I can apply for locums,” because “a lot of the hospitals are in debt and are letting go of their semi-regular locums.“You’re in limbo, you’ve used all your annual leave so you’re often quite burnt out, with no guarantee [of a job]. It’s just a really awful time of your life.
”Sarah*, a 29-year-old foundation doctor working in South Wales, told The i Paper that she is having to consider whether she can stay in medicine as the jobs-applicants ratio in the GP training pathway she wants to pursue reaches five to one.Sarah, who is disabled, cannot move away because of the care she needs, which makes applying for training places more difficult. Each time she applies, she must prove her disability and why she cannot relocate.
Having completed her two foundation years, she has applied unsuccessfully three times for GP training, and while she has a contract lasting until August 2026, she does not know what will happen after that.In 2024, 4.7 applications were made for every specialty post, with the number set to rise again this year, while in 2019 the ratio was just 1.
9 applications per post, according to BMA data (Photo: Jeff Moore/PA Wire)Doctors apply for GP training through an exam rather than an interview, and Sarah said she “revised for over six months each time” she has taken it, “including taking a lot of time out of family commitments,” because “I knew how important it was,” but she now feels like “it was for nothing”.if(window.adverts) { window.
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adverts.addToArray({"pos": "mpu_tablet_l4"}); }This year, there were around 4,100 GP training posts available, but 15,400 people who passed the exam – and thousands more who didn’t – applied, according to Sarah’s application portal. Sarah said her exam score would have secured her a job two years ago, but competition has been rapidly increasing.
Strain on mental health“It’s affecting my mental health. I’m genuinely having to consider my options to leave medicine if this carries on, because it’s unsustainable.” She said that she cannot start planning a family because she would only be eligible for maternity pay in a training position, “so I’m essentially putting a family on hold.
“I genuinely could not work any harder, and it’s still not getting me to where I’ve been promised.“If I have children, I will be asking them not to do medicine,” she said, adding that when she started at university she remembers a lecture slide which stated that the students would “have a job for life”. “That was just a lie”.
She has decided to apply once again for the traditional training pathway, but “if that doesn’t work, I don’t know what I’d do.“My supervisors are being incredibly supportive to try and help me explore the route of becoming a specialist associate doctor, so to not do a formal training pathway but to explore local trust doctor options, but that’s not an option for everyone.”Maya Machesney, 24, is a fourth-year medical student at the University of Sheffield, who hears about the experiences of her peers on a regular basis as part of her role as the Doctors’ Association UK’s student lead.
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addToArray({"pos": "mpu_tablet_l5"}); }Maya Machesney is in her fourth year of university but has already been told she should be thinking of the specialty she’d like to pursue When she graduates next year, she will enter into a system of random allocation for her first two years of training, and will then have to compete for a place on the core training pathway she chooses.Whilst previously, decisions on foundation places were based on academic achievement, applicants are now asked for their preference on the area of the country they want to work in, and do not have to sit a situational judgement test. Although around 75 per cent got their first choice last year, others were sent to their bottom choice.
Ms Machesney thinks that the new system causes “anxiety” for students from an earlier point, while under the previous programme students could work out where they could feasibly apply based on their academic results.Placeholder jobsShe told The i Paper that she has friends who are graduating this year, and several are among the 700 across the country who have been given placeholder jobs, meaning that they have not yet been matched to a confirmed programme and although they have been told the rough area of the country, they cannot be certain where they will be.“I don’t think anyone would assume that job security is something that in medicine you would be worried about, but it is.
”#color-context-related-article-3507062 {--inews-color-primary: #E33A11;--inews-color-secondary: #F7F3EF;--inews-color-tertiary: #E33A11;} Read Next square HEALTH Pharmacies under most pressure in deprived parts of the North as GPs shutRead MoreShe said that she has already been told by resident doctors that she should be working towards the specialty she would like to pursue now, “which is really stressful, because it just makes your life so goal-oriented,” and “if you don’t get your dream job you might have to change the course of your life”.She said that it “is a huge sacrifice” to decide at the age of 16 or 17 that you want to spend five or six years at university and then begin climbing a “competitive ladder” for years of their careers. if(window.
adverts) { window.adverts.addToArray({"pos": "mpu_mobile_l6"}); }if(window.
adverts) { window.adverts.addToArray({"pos": "mpu_tablet_l6"}); }She added: “I think a lot of it takes away from you as an individual sometimes.
I think it’s really important that as much as possible people can get the jobs that they want.”Dr Ryan and her committee co-chair 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.“The failure to properly plan for the future of the NHS workforce is a political one, and it needs a political solution.
”Dr Ryan, who is training in paediatrics, told The i Paper: “The Government needs to sit down and do some really firm workforce planning. They need to say: ‘here’s how many doctors we need per head of the population, here’s what we’re going to do to have training programmes’.Dr Melissa Ryan has said the Government must address the issue with “urgency” (Photo: British Medical Association)“When we’re talking of medical students that invest time and money – and the Government also puts time and money into them – it would make sense to prioritise those medical graduates over doctors from overseas.
“It doesn’t make sense financially to me to spend all the money on these doctors and then have them go and work in Australia because they can’t get a training programme.“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.
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addToArray({"pos": "mpu_tablet_l7"}); }She said that the Government cannot simply increase the number of training places, because it could not do so to the extent that it would cover all of the applicants, so it must formulate a more effective workforce strategy with “urgency”.What the Government saysA Department of Health and Social Care spokesperson said: “This Government is committed to building our home-grown talent by training thousands more doctors, including specialists and consultants.“As part of our plans to refresh Long Term Workforce Plan, we are listening to the concerns of resident doctors to improve their working lives and make sure the NHS has the right people with the right skills to deliver the care patients need.
“This will build on the pay deal agreed with the BMA last year which ended the crippling strikes.”The DHSC says it is currently carrying out a review of postgraduate medical training, and that the foundation programme allocation system will be reviewed from 2026.The Welsh Government said: “We’re currently investing £294m into health professional education and training in Wales.
“Since 2019, we’ve supported a significant increase in the number of postgraduate medical training posts. We now have nearly 2000 trainees in secondary care training programmes, including 160 GP training places every year, and an increase of approximately 350 speciality training posts.”NHS England has been contacted for comment.
*Name changed on request from doctor..
