The proportion of doctors accepting NHS specialty training places
from the group that includes most overseas-trained doctors has
fallen from more than one in four to less than
one in 50 (this is the final training stage
before becoming a GP or consultant).
That's according to new analysis of
provisional data from NHS England by the Nuffield Trust which
finds that the Medical Training (Prioritisation) Act, which
became law this year, has achieved its immediate aim of
prioritising NHS-trained doctors for NHS jobs over those
who trained overseas. [1]
The Act came into force in March to address how intensely
competitive the application process for training places had
become. The total number of specialty training
applications increased more than five-fold in
the decade to 2025, rising from around 16,500 to almost 85,000
applications annually. This growth was driven primarily by
doctors trained overseas, whose applications
increased more than thirteen-fold.
In 2025, 28% doctors accepting a specialty training place were
from what is now defined as the non-priority' group, which
includes most doctors who trained overseas. [2] In the first
recruitment round under the new law, this fell to just 1.8%. The
change has happened despite overseas-trained doctors continuing
to make up a large proportion of those applying for specialty
training: doctors in the non-priority group accounted for 51% of
all applications in 2026.
In 2026, only five of 16 medical specialties had any
accepted places from non-priority candidates. [3]
However, the analysis warns that the longer-term consequences of
the new rules are less certain. While application numbers from
non-priority doctors remained high in the first year of the new
system, future cohorts may decide that applying for UK specialty
training is no longer a realistic route into the NHS. This could
particularly affect specialties that have historically relied
more heavily on overseas graduates, including general
practice, psychiatry and obstetrics.
The government has committed to creating up to 4,500 additional
specialty training places over the next three years. The authors
say it will be important that any expansion focuses on the
specialties where the NHS will need more doctors in the future
and should align with the government's ambition to shift more
care out of hospitals.
Nuffield Trust Fellow, Lucina Rolewicz said:
There is no doubt that the new law has had a big impact in terms
of strengthening the domestic training pipeline for doctors. The
numbers show just how dramatically the rules introduced this year
have shifted access to specialty training away from
overseas-trained doctors and towards predominantly UK-trained
doctors.
The question now is what this means for the NHS in the longer
term. The NHS needs to make sure that prioritising homegrown
doctors boosts the domestic workforce without reducing the
overall supply of doctors and creating concerning staffing gaps.
Ends.
Notes to Editors
- The provisional data covers
the specialty recruitment that has happened so far in 2026. The
recruitment process is still ongoing for some roles, but it is
not expected that this would change the trends significantly.
- The Medical Training (Prioritisation) Act became law in March
2026 and created two groups of applicants. The priority group
includes NHS-trained doctors, and doctors who trained in
countries with which the UK has longstanding reciprocal
agreements around recognising medical graduates, including
Ireland, Iceland, Liechtenstein, Norway and Switzerland, as well
as individuals meeting specified immigration criteria. Most
doctors who trained overseas fall into the non-priority group.
Under the new system, appointable candidates in the priority
group are offered places before those in the non-priority
group. From 2027 onwards, further provisions relating to
"significant NHS experience" are expected to be introduced and
will replace immigration status, which is being used for this
year's recruitment round only.
- The only medical specialities to accept any doctors from the
non-priority group in the 2026 recruitment round were Emergency
Medicine, Cardiothoracic Surgery, Internal Medicine, Obstetrics
and Gynaecology and Paediatrics.
