The campaign demands urgent reform of the student loan system in England and Wales, in particular the terms of Plan 2 loans, taken out by students who began university between 2012 and July 2023.

The campaign urges the government to:

• End the freeze on the salary repayment threshold
• Cut interest rates
• Introduce a lifetime cap on total interest paid

Dr Steve Taylor, DAUK’s GP co-lead, spoke to The Times for their latest campaign article, which highlights the burden of student debt on medics.

He said: “Probably of all graduates, doctors are among the ones who are going to be able to clear their debts, but that means that £100,000 loan will become £200,000 that is actually paid off. That’s money they’ve lost over their entire careers, in addition to being paid less than my generation.

“I went to medical school and I had free education. I had a student grant. I came out of university with no debt and started a career that has done pretty well over 30 years. How have we allowed 4.5 million young people to be shouldered with this dreadful system?”

Dr Taylor has previously called on the government to address student loan forgiveness for resident doctors.

Writing about ‘the student loan scandal’ on the DAUK Substack, Dr Taylor said: “Offering student loan forgiveness would be low cost to the treasury now, yet it would bring immediate relief for UK graduates working in NHS with money in their pockets.”

“Effectively a pay rise now and in future earnings, which will support UK graduates in their careers.”

He renewed that call in The Times, saying: “I’ve not quite understood why it hasn’t been part of the conversation. I suspect because it would create a contagion.”

Read The Times article in full.

Find out more about The Times and Sunday Times End the Graduate Rip-Off campaign.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Belittled workforce

It is difficult to reconcile the public’s expectation of unwavering compassion with the ease with which the same workforce is publicly belittled. As representatives of medical students and soon-to-be doctors, we are deeply concerned by public comments made by figures such as Mr Streeting that risk further erosion of public confidence. While we recognise that recent developments – including UK graduate prioritisation for training posts and progress on pay – suggest that collective action is beginning to have an effect, a pressing question remains: how can the Health Secretary undo what has already been said? For those of us lower down the chain, and the next cohort to inherit this rhetoric, the impact of his words has been hard-hitting. Here are some reflections from members of the DAUK medical student committee.

Joshua Haria:

“Wes Streeting’s comments are damning to the medical profession and certainly do not help the public’s increasingly unfavourable view of doctors. “It is saddening to see that doctors are not as respected as they once were, but obvious to me why so many doctors plan to emigrate. “Even some of my medical student peers have decided they are going to leave the NHS due to the continued poor offers that the government has proposed. “I am worried about joining the NHS workforce but I am hopeful that the situation may get better.”

Safira Taplin:

“As a medical student, comments dismissing the concerns of resident doctors make me anxious to join the workforce. “I worry about joining a system where I will be undervalued and makes me question how sustainable a career in the NHS will be.”

Sami MacRae:

“As a medical student and aspiring future resident doctor, undoubtedly our patients should be the core focus. Yet this does not negate the necessity of the resident doctor workforce needing to be supported, and so requires an improved relationship between politics and healthcare that is not currently present.”

Maya Machesney:

“In my final year of medical school, with friends already working tirelessly as junior doctors, Mr Streeting’s remarks could not be more insulting. “They trivialise genuine concerns and make it harder for the public to see doctors as what they are: professionals trying to keep patients safe in an overstretched system. “Ever resilient, the medical profession and healthcare workers will continue to work, deliver care and advocate for an NHS our patients deserve.”

Alyx Douglas:

“As someone who will soon be joining the resident doctor workforce, it is disheartening to hear tactless remarks aimed at them. “It is equally unfortunate to see such resistance to cooperation or compromise. “Patients benefit from the collaborative efforts of medics and politicians; the current standoff is unproductive and can’t continue.”

DAUK’s members are all volunteers. They campaign and speak in the media about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Clear communication and defined points of contact

Poor, inconsistent communication remains one of the most distressing features of the allocation process. Some deaneries respond within days; others remain silent for weeks. Many new doctors simply do not know who to contact when issues arise. We recommend:

• Establishing a national communication standard with clear response timelines. For example, acknowledgement within three working days, and a full response within seven.
• Requiring named contacts or dedicated inboxes for each FY1 upon allocation.
• Introducing a centralised FAQ and live update system, particularly for placeholder candidates.

National swap-system for deanery allocations

We propose a structured, UK-wide swap scheme to allow graduates to exchange deanery or job rotations under regulated oversight. This would reduce stress for those placed far from support networks or facing personal, financial, or health-related barriers.

Fairer allocation by reranking for jobs

Applicants who rank highly in the deanery allocation process automatically carry this advantage forward when selecting jobs within that deanery. We recommend applicants be re-ranked for job allocation within each deanery, with those in lower-choice deaneries given greater priority when selecting posts. This would create a fairer, more balanced system, mirroring the principles of the existing Foundation Priority Programme scheme. This already provides additional benefits to doctors in less competitive regions.

National audit: safety risks of last-minute allocations and placeholder roles

We call for a national audit to quantify the risks associated with delayed and placeholder allocations, investigate links to rota gaps and supervision issues, and provide evidence-based recommendations for mitigation (see Annex 1).

UKFPO stakeholder board with voting student and FY1 representation

Reforms must be shaped with, not imposed upon, the doctors they affect. We propose establishing a permanent UKFPO stakeholder board with voting seats for medical students and FY1s. Embedding lived experience into decision-making ensures policies are efficient, transparent, and grounded in reality.

Caring responsibilities and priority status

From 2026, only applicants formally recognised as a primary carer will qualify for priority allocation. This narrow definition excludes many graduates with joint or substantial caring responsibilities – such as co-parenting, caring for elderly relatives, or supporting siblings – despite the clear challenges of balancing these roles alongside a full-time medical degree. In addition, priority allocation will only apply to the deanery linked to the applicant’s medical school. For many, this is far from their home address and established support networks, which are often critical for new doctors managing caring responsibilities. This creates unnecessary disadvantage at a time when stability and support are essential for wellbeing and retention.

Recommendations:

• Broadening the definition of caring responsibilities beyond “primary carer.”
• Allowing applicants to claim priority based on either their medical school or home deanery.
• Introducing a fair process of appeal for applicants whose circumstances do not fit rigid definitions.

Annex 1: Proposed audit framework – safety of placeholder FY1 roles

Objective:

To assess the impact of placeholder FY1 allocations on patient safety, rota stability, and trainee wellbeing, and to provide evidence-based recommendations for improving allocation processes.

Cohort Definition:

• Placeholder FY1s: Doctors allocated to temporary or reserve status posts before securing a substantive FY1 role.
• Comparison group: FY1s allocated directly to substantive posts in the same cohort.

Identification sources:

• UKFPO allocation records (reserve/placeholder lists).
• Deanery HR / ESR data (contract type, start dates, interim placements).
• Induction and rota attendance logs.
• Trainee surveys for self-identification and validation.

Data collection:

• Patient safety metrics: incident reports, medication errors, missed handovers, rota gaps.
• Wellbeing indicators: stress levels, preparedness, absenteeism, early attrition.
• Operational impact: use of locum/bank staff, administrative burden, induction delays.

Methodology:

• Mixed-methods: quantitative (HR/rota/incident data) and qualitative (surveys/interviews).
• Multi-deanery national scope with independent oversight.

Outcomes:

• Quantify risks of placeholder roles to patient safety and team function.
• Assess effects on FY1 wellbeing and retention.
• Provide actionable recommendations to improve allocation safety, induction, and planning.

Specialty training

She is currently working in a trust-grade post, and described trying to secure a higher specialty training position as ‘nerve-wracking’ Dr Novintan, who wants to train in plastic surgery, was unable to find a single training post in her region this year. Nationally, there were only 42 posts for more than 280 applicants. Speaking to the i Paper, she said: “It’s very much on my mind that this is my second time applying. “If I weren’t to get a job this time, that would mean two years out of training,” adding it was a “substantial time to put your life on hold”. According to the i Paper, there were 92,000 applications for just 12,800 specialty training places across the UK in 2024. That’s a ratio of 7.2 to one. In some fields, the competition is even steeper such as 98 applicants per role in sexual health and 74 per post in cardiothoracic surgery.

Medical student

Miss Maya Machesney is DAUK’s medical student co-lead and a final-year student at the University of Sheffield. “It feels like a random lottery,” she said. “We’re worried that getting into specialty training will become less about passion and more about simply getting a job.” DAUK has called for urgent expansion of training places to match the demand. Dr Machesney said: “It’s a massive oversight of workforce planning.” Read the article in full in the i Paper online DAUK committee members are all volunteers and speak to the media about issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

NHS workforce

DAUK supports this expansion, and recognises the importance of investing in the next generation of the NHS workforce. However, this positive development comes against a backdrop of growing concern. Without robust, forward-thinking workforce planning, many of these students risk entering a healthcare system already buckling under immense strain. For the third consecutive year, almost 700 final-year medical students were allocated ‘placeholder’ roles through the UK Foundation Programme. This recurring issue represents a serious structural failure in how we allocate and support our new doctors.

Bottlenecks

The challenges extend well beyond the Foundation Programme. Specialty training remains heavily bottlenecked, with thousands of junior doctors each year unable to progress due to a shortage of training posts and a lack of a consistent, strategic workforce strategy. Many are left disillusioned – forced to delay their careers, seek alternative routes, or even consider leaving the NHS entirely. The NHS cannot afford to continue losing talented and committed future doctors.

Urgent reform

Urgent reform is needed: transparent workforce planning, expanded training capacity, and meaningful investment in career progression for junior doctors. We are frustrated that this is the current reality of our profession. But to every new student starting this September: we stand with you, we thank you for your commitment, and we remain hopeful that the profession you inherit will be in a better place than it is today. Medicine is and always will be an incredibly rewarding career. We hope that – with the right reforms – it will be a sustainable and fulfilling one for you and for generations to come.

Our student committee members are all volunteers and speak about issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our our GoFundMe.

Resident doctor training

“It has described how portfolios are built to apply for certain specialisms, leaving applicants ill-equipped to apply for other placements outside their area of interest.” It comes ahead of a short debate in the House of Lords debate on Wednesday (17 July). Lord Lansley (Conservative) will ask His Majesty’s Government what assessment they have made of the ratio of medical training posts in each specialty relative to the number of foundation year medical students choosing that specialty. Read the medical student committee blogs. Read the House of Lords document. Please support our work by joining DAUK or donating to our GoFundMe

There are now less then two months before this year’s graduating cohort is due to start work.

Around 700 final-year medical students still have no information about which trust or rotation they will be working in. That’s around 5.5% of the cohort.

They have, in effect, been placed on a waiting list.

The delay hampers their ability to arrange relocations, find accommodation, and puts a strain on their mental health, DAUK’s student committee says.

It also creates challenges for NHS workforce planning and integrating graduate doctors into hospital systems.

DAUK’s student committee has highlighted the impact on individuals in an open letter to Health Secretary Wes Streeting and to the Department for Health.

The committee calls for an urgent review. It says the reform of the allocation system and workforce strategy are ‘essential’.

Read the letter in full below.

Our student committee members are all volunteers and speak about issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Trish Suji:

It is daunting to imagine how much higher the competition ratios will reach by the time of my cohort’s applications. We have all heard from doctors on placement that have not got into training. Instead, they have found a job in Australia or one of the few junior fellow jobs in the UK. The same is true on Instagram or X – all over the country. I am in my final year, and barely a week after final results were released, discussion of the next worry began; unemployment after Foundation Year 2 (FY2).

Speciality training

I am aware that competition ratios are not always what they seem as many candidates apply for multiple specialities. However, the scoring matrices for training with high cut-offs are a difficult, and sometimes expensive, goal to reach by FY2. Many foundation doctors and core training doctors on placement have urged my friends and I to start working towards goals that will win points in applications, as early as the third year. This has also meant that having just sat finals, some of my peers immediately began discussion on post-grad exams for points.

Bottlenecks

There is an element of fear that needs to be addressed. I think informal talks by the royal colleges on speciality applications aimed at clinical/ final year medical students in the UK to explain the competition ratios would be a good idea. This would allow us to ask questions about becoming a competitive candidate and how to plan and what to do if we don’t get into training. The royal colleges would also hear more final year voices on the national feeling of their future in medicine. For now I am going to do my best at becoming a competitive candidate. But, I will also try to find out more on the next steps if I am not successful first time around.

Alyx Douglas:

The increasing competition for speciality training posts in the UK is leaving many doctors without a clear career path, forcing them into jobs they never intended to pursue, or out of work altogether. New medical graduates face immense pressure knowing that, just two years after qualifying, our future could be determined by a system that lacks sufficient training opportunities.

Relocation

Many specialities require relocation, but financial, personal, or visa-related constraints make this unfeasible for some, effectively shutting them out of their chosen careers. As a result, a growing number of UK-trained doctors are moving overseas, uprooting their entire lives just to escape a system that fails to support them. Countries like Australia and Canada offer better pay, working conditions, and structured training pathways, making emigration an increasingly attractive option. This only worsens the NHS workforce crisis, as more doctors leave while shortages persist.

Sense of dread

As medical students, we enter the profession with a sense of dread, fearing that after years of hard work, we may find ourselves in limbo — unable to secure training in our chosen field or forced into roles that don’t align with our passion. Without urgent reforms — such as increasing training posts, improving regional flexibility, and addressing workforce planning failures — the NHS will continue losing dedicated doctors to burnout, disillusionment, or emigration.

Anish Malik:

Receiving a letter of acceptance to medical school is not only a proud moment for prospective medical students, but also for their parents and family. The pride of the parents stems from the efforts of their child to get in, the prestige associated with the profession, and the knowledge that their child will have a secure and prosperous future. However, this does not seem to be the case anymore. Now, after five years of medical school and two years of foundation doctor training, the future of every doctor applying to speciality training has become uncertain.

Training places

While many specialities are crying out for more specialists to improve their service, impossibly, the doctors applying to train in these areas are being rejected, with training places remaining stagnant. The supply of doctors can be available to meet the demand for services, but it is not as they are not being allowed to train. The cohort of doctors applying to speciality training is larger than the number of training places available. As a final year medical student, who will be in this position in two years’ time, it does not inspire the hopeful future which was once promised. Instead it introduces questions of uncertainty. Many of my peers are planning a life outside of medicine past FY2.

Secure future

Others plan to continue their medical journey abroad despite the money the UK has spent on their training. These two avenues now provide more of a secure and prosperous future than being a doctor in the UK. The remainder of my colleagues will compete with international graduates to tackle the current system, but with unknowns about their future careers.

Maya Machesney:

Reaching speciality training is a feat in itself. Medical students are forced to rely on a random ballot-generated ranking to decide their fate, facing the uncertainty of being sent anywhere across the country. This can mean being separated from family, friends, and the support systems we’ve built, becoming junior doctors far from home, at a time when stability matters most.

Medical training

With so much uncertainty and personal sacrifice embedded into medical training, one thing must remain non-negotiable: the right to pursue our chosen career path. And yet, even this is being steadily undermined. Despite growing and urgent demand for doctors across many specialities, increasing numbers of junior doctors are being left without training posts, or are forced to consider leaving the UK altogether to achieve their aspirations. From the early years of medical school, we are encouraged to plan meticulously for our futures. But we are building up portfolios for specialities we have no guarantee of securing.

Competition

This culture of constant competition only fuels anxiety, especially when there is no guarantee efforts will lead to the roles some have spent years preparing for. We have all invested so much in this profession – emotionally, financially, and personally. We need evidence that our faith in the system has not been misplaced. It is time our dedication and commitment is reflected back in a fairer, more supportive system.

Meaningful reform

The DAUK medical student committee is calling for urgent and meaningful reform:

• Immediate expansion of speciality training posts in line with workforce demand and future NHS needs.
• National standardisation of portfolio requirements across specialities, to ensure fairness and clarity.
• Protect career progression for doctors taking time out of training.
• A published, accountable roadmap for workforce reform, showing how the Government and NHS bodies will meet current and future demand.

Please support our work by contributing to our crowd funder or by becoming a member.

Student protests

Students have expressed fear of being penalised for engaging in activism, with one participant explaining: “I always felt that, as a medical student, partaking in activism was going against the standards that we are expected to adhere to.” Some students have voiced concerns that their involvement in political activism may be seen as ‘unprofessional’, and there is growing anxiety over professional consequences. One student said: “My medical school would consider it unprofessional. They have said doctors should be apolitical.” Another student expressed fear about potential retaliation from the General Medical Council (GMC), citing the suspension of doctors involved in climate action groups such as Just Stop Oil. The overarching sentiment among students is that their right to protest is not adequately protected.

Right to protest

As one student noted: “The university has not gone out of its way to ensure our rights to protest are protected.” As activism in the UK increasingly faces criminalisation, medical students feel their voices are being silenced. One student shared their anxiety about the potential impact on their future career: “Protest is being increasingly criminalised in the UK and we are a highly regulated profession (GMC).” Another reflected on the fear of prejudice from university staff, stating: “The stigma and prejudice staff of the medical school will hold against me and may use to influence results when sitting exams.” A particularly concerning comment came from a student who said that ‘on pro-Palestine marches, people were being threatened with expulsion’.

Solidarity

The Doctors’ Association UK (DAUK) stands in solidarity with medical students, advocating for the protection of their right to protest and express their political beliefs without fear of professional retribution. The ability to stand for justice, human rights, and humanitarian causes is integral to the ethos of medicine, and it is imperative the medical profession supports its students in doing so. Medical schools must provide clear guidance on how students can appropriately express their political and social views without risking professional repercussions. With increasing instances of humanitarian events and global unrest, medical schools should take a proactive stance on educating their students on how to advocate for causes important to them, while ensuring their professional standards on protest are relevant and fit for the modern day. Please support our work by contributing to our crowd funder or by becoming a member.

Picture credit: Markus Spiske on Unsplash

Written by DAUK vice chair Dr Ellen Welch, and Cumbrian GP Dr Jennifer Lyall, and published by Scion Publishing, Cases Workbook for the MRCGP has been extensively updated for the new Simulated Consultation Assessment (SCA) – the practical exam required for completion of GP training.

The book is designed to be used by GP revision groups practising for the new membership exam of the Royal College of General Practitioners (RCGP).

It features more than 100 cases aligned to the new ‘Blueprint’ areas and the updated curriculum, alongside a comprehensive resource library.

Previous editions have won the Young Author prize and highly recommended in the general practice category at the BMA Book Awards.

The hardback version, which comes with a bespoke folder, is on offer to DAUK members for £37.09 (RRP £52.99).

The loose-leaf version is on offer to DAUK members for £27.99 (RRP £39.99).

Visit scionpublishing.com/dauk/ for details of how to obtain the discount.

Sign up to be a DAUK member.