Doctors ‘have no clear career path’ amid rise in competition for training posts

Doctors have called for an “urgent expansion” in medical training places in England after new NHS figures revealed increased competition for certain posts in 2025.

The data sends a “deeply worrying message to the next generation of doctors”, the Royal College of Physicians (RCP) said.

Resident doctors also warned their “career prospects feel increasingly grim”, with “chronic bottlenecks” in training leaving many worried about their future in medicine.

The figures show there were 8,841 applications for internal medicine training (IMT) – the first step to becoming a consultant physician – for 1,678 posts in 2025.

This is compared with 6,237 applications for 1,698 posts in 2024, meaning the competition ratio increased from 3.69 to 5.27.

RCP president Professor Mumtaz Patel said: “These new competition ratios lay bare the crisis facing medical training and resident doctors and send a deeply worrying message to the next generation of doctors.

“We hear loud and clear the concerns from our early career doctors who have dedicated years to studying, training, exams and service to the NHS, and are left with no route forward in their chosen career paths. They deserve better.

“We need urgent action to address competition ratios and an expansion of both IMT and higher specialty training posts based on population need.

“The UK Government has committed to ensuring doctors leaving medical school in the UK can continue their training in the NHS.

“It must do this in time for the next recruitment round and recognising NHS experience would be a sensible first step.”

Some 10,607 resident doctors in England have joined medical specialty training programmes starting from August.

An NHS England spokesperson said: “Filling every one of our core and specialty medical training places across England means we have a record number of highly trained, skilled, and compassionate doctors starting their training to provide vital care for patients right across the country.

“However we know that competition ratios are too high and are causing undue stress for applicants, which is why we are working with the Government on a revised workforce plan, and we will create 1,000 extra posts over the next three years through the 10-year health plan, to help ensure all our trainee doctors who want a job in the NHS can get one.”

Dr Stephen Joseph, co-chair of the RCP’s resident doctor committee, said: “Our career prospects feel increasingly grim.

“Year upon year, we have seen competition for training posts rise, leaving more and more early career doctors without a clear path forward.

“These chronic bottlenecks in the training pathway leave many doctors extremely worried about their future in medicine.

“Many have been working in a high pressure NHS environment for years already, and find the door slammed shut on training progression.”

Dr Joseph claims the NHS is in an “absurd scenario” where “hospitals are short-staffed because there aren’t enough training posts”.

“Many resident doctors will now be left in limbo – stuck in non-training roles, potentially facing unemployment at the end of foundation training, unable to progress in the NHS training pathway and at high risk of leaving the profession altogether,” he added.

“This represents a significant loss of investment for the health service.”