Why did the BMA decide to pass this motion now?

As the clock ticks towards another recruitment season, the stark reality of an NHS in crisis looms larger than ever. In July 2025, a survey revealed that more than half of foundation year 2 (FY2) doctors faced an uncertain future, having no job lined up for August. With a staggering 52% of responding FY2 doctors reporting they lacked substantive employment, the question becomes increasingly urgent: how will the UK train the next generation of medical leaders while facing swelling numbers of applicants and stagnant training posts?

Understanding the Context

What is the underlying issue here?

The UK’s healthcare landscape is strained under the weight of inadequate planning and insufficient workforce recruitment. A report from the Royal College of Physicians indicated that the UK has fewer doctors per capita than many wealthy nations, exacerbating an existing crisis. “The systemic failures in workforce planning have left a growing gap between demand and supply,” says Dr. Helen Ashford, a workforce expert affiliated with the Institute for Health Policy. The British Medical Association (BMA) is responding by lobbying the government to drastically increase medical specialty training posts.

Data Trends in Specialty Training Applications

The competition for specialty training has intensified dramatically over recent years. According to a study by the National Medical Association, the ratio of applicants to available training spots jumped from 1.9 in 2019 to an alarming 4.7 in 2024, with a predicted surge in 2025. “This reflects not only increased applicant numbers but also the rising interest among International Medical Graduates (IMGs) in UK training programs,” notes Dr. John Kline, an expert in medical education.

The Implications for Medical Graduates

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

Despite their increased likelihood of securing a training position, UK medical graduates still face significant barriers. As competition rises, even domestic graduates may find their aspirations thwarted. According to the same National Medical Association study, over 30% of UK graduate respondents admitted they were disheartened by their chances of entering specialty training.

• Projected increase in applications: 68% since 2019.
• Current applicant-to-post ratio: 4.7.
• 57% of FY2s report uncertainty about future job security.

Should resident doctors be concerned about unemployment?

The prospect of unemployment casts a long shadow over medical graduates. The aforementioned survey revealed that approximately one-third of doctors lacked any job prospects, heightening concerns over the future viability of medical careers in the UK. Pivotal roles as locally employed doctors (LEDs) could become a fallback for many. “The risk is not merely theoretical; it’s a palpable threat,” emphasizes Dr. Susan Granger, a workforce policy consultant. “If not addressed, we might see an influx of doctors stuck in low-paid, less stable positions.”

The BMA’s Position

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

The BMA’s recent motion aims to secure preferential treatment for UK graduates who have invested years in training under the NHS system. “British-trained doctors represent a national investment; it’s vital they have pathways to utilize their training,” says Dr. Adam Fowler, a BMA spokesperson. This priority does not diminish the contributions of IMGs but reflects a need to address domestic workforce challenges.

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

For IMGs currently in the NHS, the future remains hopeful, provided they meet certain criteria. Those with at least two years of NHS experience will still have opportunities for training, aligned with the government’s forthcoming policy. Dr. Kline asserts, “IMGs remain invaluable to our health service. This policy acknowledges their contributions while also setting clear pathways for those yet to serve.”

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

The motion outlines a definitive date, advocating for fairness to IMG doctors already integrated into the NHS. “We believe it’s critical to recognize the contributions of those working in our hospitals while providing clarity for future applications,” Dr. Fowler explains.

Wider Support for IMGs in the NHS

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

The BMA actively supports IMGs through initiatives aimed at easing their transition into the NHS. Offering a year of free membership, the organization provides a range of resources to help with settlement. Additionally, by addressing immigration barriers, they aim to create a supportive framework. “We’re committed to advocating for fair contracts and conditions, tackling exploitation, and ensuring IMGs’ skills are recognized,” highlights Dr. Ashford.

Looking Ahead

Competition Ratios and Their Effects

The rapid escalation of applicant ratios signifies a looming crisis. “If these numbers continue to rise, we may see a generation of highly trained doctors without the platform to showcase their abilities,” warns Dr. Granger. As the NHS grapples with these challenges, the BMA’s lobbying efforts could prove pivotal in shaping policy that not only meets current demands but also secures the future of the medical workforce.

Amidst this turbulent landscape, the voices of both UK and international graduates echo with a singular necessity: a clear and fair path forward in a system grappling with its own limitations. The solutions, while complex, lie in robust dialogue and a commitment from policymakers to understand the urgent need for systemic reform.

Source: www.bma.org.uk