Resident doctors face mounting uncertainty amid NHS training bottlenecks

Resident doctors across the UK are grappling with rising anxiety and unemployment as competition for speciality training posts intensifies, exposing deep flaws in NHS workforce planning, The i Paper reported.  Despite government pledges to expand opportunities for UK medical graduates, thousands of doctors remain in limbo—unable to progress in their careers and increasingly disillusioned with the system.

After completing two years of foundation training, UK medical graduates typically apply for speciality posts in areas such as internal medicine, surgery, general practice, paediatrics, or psychiatry. However, the number of available training positions has failed to keep pace with demand. In 2024, there were 59,698 applications for 12,743 posts—a ratio of 4.7 to one. By 2025, that figure surged to 91,999 applications for 12,833 roles, raising the ratio to 7.2 to one.

Some specialities face even starker competition. Emergency medicine saw a 14 to one ratio, psychiatry 22 to one, cardiothoracic surgery 74 to one, and sexual health an extraordinary 98.5 to one.

The British Medical Association (BMA) described the situation as “a disaster long in the making,” blaming successive governments for failing to expand training capacity in line with medical school intake.

The crisis has prompted first-year doctors in England to vote in favour of strike action, with 34% reporting no substantive employment or regular work from August. Health Secretary Wes Streeting has pledged to create 1,000 new training posts over three years and prioritise UK graduates and NHS-experienced doctors. However, the BMA argues that the scale and pace of reform must accelerate to prevent further attrition.

Shivam Sharma, deputy chair of the BMA’s resident doctors’ committee, warned that rising competition ratios are driving doctors out of the system. “You’re waiting up to 22 months to see a child psychiatrist, and at the same time you have this 22 to one competition ratio,” he said. “We need decisive action immediately.”

The imbalance between UK and international graduates has also grown. In 2024, 10,628 UK graduates and 14,868 international graduates applied for training posts. By 2025, those numbers rose to 12,305 and 20,803 respectively, intensifying pressure on limited places.

Shonnelly Novintan, 28, a spokesperson for the Doctors’ Association UK, is seeking a higher speciality training post in plastic surgery. Despite her qualifications, there were no posts available in her region this year, and only 42 nationwide for over 280 applicants. She currently works in a trust-grade role—a non-training position with limited career progression and fewer professional benefits. “It’s nerve-wracking,” she said. “This is my second time applying. If I don’t get a place, I’ll be on my third attempt with two years out. That’s substantial time to put your life on hold.”

Health Minister Stephen Kinnock acknowledged the severity of the issue, stating that the government is reviewing postgraduate training and expanding training places. “Current first-year doctors will emerge into a very different professional landscape,” he said. However, he criticised strike action as “needless and counterproductive,” urging the BMA to continue working with the government to improve conditions.

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