BMA specialty training policy FAQs

Why did the BMA decide to pass this motion now?

Data have shown a significant year-on-year increase in the number of applicants for specialty training places (particularly among international medical graduates, or IMGs), without a commensurate increase in the number of places available. This is particularly concerning to resident doctors and medical students, who fear this increased competition for places will negatively impact their ability to progress their careers. Instead of training to become consultants or GPs, many may find themselves stuck in fixed-term, zero-hours or insecure employment.

What is the underlying issue here?

The UK has far fewer doctors than equivalently wealthy countries, and successive governments have failed to adequately undertake workforce planning for the NHS. This means that there aren’t enough specialty training places available to develop the senior medical workforce the UK will need in the future.

The BMA will continue to lobby the government to significantly expand the number of medical specialty training posts, while also addressing the immediate problem facing UK graduates currently applying for specialty training places amid increasing competition.

UK graduates are already more likely to get into training, why do they need to be prioritised?

Although a smaller proportion of IMGs who apply for speciality training are usually offered places when compared to their UK graduate peers, the high competition levels still result in many UK graduate doctors unable to access specialty training.

Should resident doctors be concerned about unemployment? Do we know how many may be unemployed in August?

In July 2025, we published a survey which found that half of foundation year 2 (FY2) doctors had no job to go in August.

Some 4,401 doctors were asked whether they have substantive employment or regular locum work from next month. Of the 1,062 FY2 doctors who responded, 52 per cent said they did not. Overall, a third (34 per cent) of the doctors who responded did not.

The results of the poll led UKRDC to ballot foundation year 1 (FY1) doctors, to bring specialty training into a new, linked dispute with government.

It’s also important to note that some FY2s with job offers may not be going into training, having instead found jobs as locally employed doctors (LEDs, or Clinical Fellow, Trust Grade doctors). While these jobs are often fixed-term and insecure, if doctors are unable to access training, competition for LED posts may increase – risking medical unemployment in the future.

However, it’s imperative that – considering the workforce shortages and the backlog in the NHS – LEDs are not devalued and used as an inexpensive way to plug up gaps created by systemic issues like the specialty training bottlenecks.

Why has the BMA chosen to lobby for prioritising UK graduates over international graduates? 

The BMA believes it is essential that doctors trained in UK medical schools should be able to progress their careers in the UK. This applies regardless of a doctor’s nationality. This policy calls for priority for doctors who have studied in the UK for at least four years of medical school, know the NHS systems, and who have received investment from UK taxpayers and the NHS. UK graduates also face barriers to training in many other countries, where graduation, citizenship or residency requirements vary.

The BMA recognises that there are many international graduates in the UK who are also currently settled and working in the NHS. This policy aims to ensure that this select group is also prioritised.

What does this motion mean for IMGs working in the NHS today? 

This motion doesn’t establish any government policy. It does, however, set out the BMA’s position.

IMGs have always played a crucial part in our health service and are valued colleagues. If the BMA’s policy were implemented by the UK government in full, those IMGs working in the NHS before 5 March 2025 would still be able to apply for training on the same basis as UK graduates if they have two years of NHS experience (or in the future once they have completed two years of service).

Why has BMA set a date after which IMGs would be deprioritised for UK medical training programmes? 

To ensure fairness for those IMGs who are already working in the NHS, we believe it is right to prioritise NHS doctors over those who have yet to practise in the UK.

We understand that, should the government implement our policy, a different date would be set. We included a date in our motion, as we believe that it will be important for the government to do the same, so that new rules are clear to doctors applying to specialty training from overseas.

What wider work is the BMA doing to support IMG members?

IMGs bring a diverse range of skills, knowledge and experience to their medical practice in the UK, which has been hugely beneficial to patients and the NHS. 

We offer IMGs a year of free membership when coming to the UK, and provide lots of resources to assist in settling into the NHS and the UK. 

We are also committed to breaking down the barriers with the UK immigration system. We have lobbied extensively on visa issues, provide legal support to our members through our immigration advice service, and can help individual members.

On the ground, our staff and members are campaigning for doctors within LED roles, many of whom are IMGs, to get the right national contract (usually a SAS contract). Getting on a substantive and agreed contract reduces exploitation, visa difficulties, and can help ensure terms and conditions adequately reflects a doctor’s expertise and commitment, including improving opportunities for career development.

Do you have data for how bad the competition ratios in specialty training have become?

Yes. We have data showing rising numbers of applicants in the first round of specialty training across 2023, 2024 and 2025 – with particular rises among IMGs. We know, for instance, that in 2019 the ratio was just 1.9 applications per post – this increased significantly to 4.7 last year, and we expect it to be much higher this year. Since 2019, the number of applicants has increased by 68% in just three years.