RCP responds to GMC 2024 workforce report and calls for a review of postgraduate medical training

We know that competition ratios for postgraduate medical training are changing quickly. The UK government and NHS England (NHSE) must explore why this is happening and consider how we can enable more UK graduates to enter postgraduate training schemes, while supporting locally employed and international medical graduate doctors to access career development and educational opportunities and contribute to high quality patient care. 

People are working and training differently – we need to understand why and explore the potential wider impacts on long-term workforce planning. That is why the RCP is calling for a comprehensive review of postgraduate medical training. 

The RCP will continue to campaign for the funding and implementation of the Long Term Workforce Plan (LTWP) commitment to double medical school places and expand the number of postgraduate training places for physician specialties. This must be accompanied by a plan to support clinical and educational supervisors by working with the NHS to increase capacity for medical training. Protected time for education – and reviewing the training landscape now to ensure it is fit for purpose in the future – will be crucial to the success of the LTWP expansion of medical school places.

The GMC report published today highlights that the overall growth in UK doctor numbers in the past year is driven by international colleagues joining the NHS in locally employed roles. There are also a growing number of UK graduates taking up locally employed roles after they finish foundation training – 75% of F2s in 2022 did not immediately enter core or specialty training in 2023 – and they are staying in those jobs for longer periods of time. The reasons behind this growth in locally employed doctors must be a key aspect of a review of postgraduate medical training.

The RCP will continue to work with other royal colleges and the Federation of Royal Colleges of Physicians of the UK to engage with NHSE on the 2025 iteration of the LTWP.   

Senior censor and vice president for education and training, Dr Mumtaz Patel, who is acting as RCP president, said: 

‘This situation is untenable. We are actively working with our colleagues in Federation, across the colleges through the AoMRC, and with NHSE to address the recruitment and training issues. RCP has been lobbying for many years for increase in medical school places, and corresponding increases in training numbers to enable smoother career progression. It is imperative that our next generation of physicians are valued and supported in their educational and training journeys. We need to keep them in our UK training system rather than force them out. They need to feel valued and supported and we call for action and reform of the recruitment and training pathways.’

Seán Coghlan, chair of the RCP Student and Foundation Doctor Network, said:

‘It is simply unacceptable that doctors are being driven abroad and to alternative careers due to shortages in training posts. Change to the selection process is needed to ensure that foundation doctors are valued and empowered to enter national training.’

Dr Anthony Martinelli and Dr Catherine Rowan, co-chairs of the RCP Resident Doctor Committee, said:

‘Ever-increasing competition ratios for entry to internal medicine and higher specialty training are driving distress and despair for applicants. Many resident doctors will rightly be wondering how good candidates can fail to qualify for interviews to training programmes, whilst working daily on understaffed wards and struggling to access educational opportunities due to poor staffing. 

‘It is now clear that radical reform of postgraduate pathways is unavoidable. The next generation of physicians are increasingly struggling to progress into core and specialty training, despite vacant consultant posts across the country.’

Dr Mike Jones, executive medical director of the Federation of Royal Colleges of Physicians of the UK said: 

‘We recognise the concerns of those who wish to train in internal medicine. We have highlighted, and will continue to do so, these concerns to those responsible for recruitment so we can support doctors who wish to become physicians.’