However, DAUK is concerned that the Medical Training (Prioritisation) Bill announced by the Government risks being unfair, and ineffective in addressing the causes of the crisis.

The shortage of training opportunities is the direct result of poor workforce planning under successive governments, despite repeated warnings from DAUK and others in the profession.

Specialty training posts

The number of medical graduates has grown for years without a corresponding increase in specialty training posts.

The consequence is a widening gap between applicants and available places, one that this Bill does nothing to close.

Dr Pushpo Hossain, DAUK IMG lead, said: “It is concerning that international medical graduates (IMGs) are being implicitly framed as part of the problem, when they are not to blame.

“IMGs often bear the greatest risk within the system. Many have invested thousands of pounds in PLAB examinations, GMC registration, relocation, and visa applications and renewals.

International medical graduates

“IMGs often cannot walk away if the rules change as they are financially, professionally, and personally tied into the UK system.”

A BMJ investigation found English hospitals trusts recruiting doctors from abroad as ‘cheap labour’ as part of fellowship schemes in which they were paid less than trust-employed doctors and had fewer benefits.

A recent follow up investigation by the BMJ found a £40.5m programme to train doctors from overseas at a Midlands NHS trust failed to ensure they were paid fairly, among other issues.

This prompted calls for all national programmes involving international training fellows to be paused pending an review of employment conditions to identify and prevent exploitative practices.

PLAB examinations

The GMC’s most recent published accounts show that PLAB examinations generated £25m.

Dr Matt Kneale, DAUK co-chair, said: “That reinforces that there are strong system incentives driving the recruitment of IMGs with a matching expansion in training capacity.

“The concern is that some IMGs have been encouraged to come to the UK in good faith, incurring significant costs, only to find themselves locked into insecure roles with limited progression.”

DAUK also questions the fairness of changing prioritisation criteria midway through the process.

NHS workforce

Doctors who have entered the NHS workforce did so on the basis of the current rules, and changing the criteria now feels unfair and unethical.

Therefore, we call for provisions within the Bill to protect any doctor who has already commenced the application for the 2026 training cycle in good faith. This would have the effect of preventing their de-prioritisation under new rules.

Dr Hossain said: “We are concerned the Bill will result in many IMGs leaving the NHS and deter others from entering it.

“The NHS is on its knees and we need doctors, whether they are a UK graduate or an IMG, to staff the hospitals safely, reduce waiting times and provide quality care.

“UK medical graduates are not leaving the NHS because IMGs are taking their jobs, it’s due to a number of factors including years of pay erosion, poor work conditions, lack of work-life balance, and workforce planning by the government.”

Non-doctor roles

It’s also important to recognise that at the same time the Government and NHS bodies have facilitated the expansion of a range of non-doctor roles, which are replacing doctors. This includes the poorly planned introduction of physician associates and anaesthesia associates, which has generated significant patient safety concerns, professional confusion, and personal cost to people who pursued these careers in good faith, based on assurances given at the time.

The Bill fails to address one of the core issues, that there are no new training posts being created.

Without meaningful investment in additional training numbers, the gap between applicants and places will remain, competition will intensify, and patient care will suffer.

Dr Hossain said: “We’re also concerned by the narrative that risks pitting UK-trained medical graduates against IMGs. Both groups overwhelmingly want the same outcomes which are to work, to train, to staff hospitals safely, and to treat patients.

Workforce strategy

“Understaffed hospitals, rota gaps, and long waiting lists harm everyone, and won’t be fixed by dividing the profession.”

A fair and effective workforce strategy must be based on long-term planning, expansion of training posts, and policies that treat doctors with consistency and respect.

We are ready to engage on solutions that strengthen the NHS workforce and improve care for patients.

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.

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Dr Victoria Zaslona said it had been ‘painted as the fault of IMGs’ when the problem was a result of years of poor workforce planning.

She was speaking on national radio during a discussion on the news UK medical graduates are to be given priority access to specialty training jobs in the NHS.

Training places

The Government has announced it will prioritise UK medical graduates for training places from 2026. It is part of its efforts to end industrial action by resident doctors.

Dr Zaslona, speaking on LBC, said: “One important thing to be really clear about is that junior doctors want training places.

“They don’t want international medical graduates to not have jobs or not be given training. It’s just that they want to be able to have training places.

“This is the government’s way of painting the issue of no training places as IMGs’ fault.

Medical training

She said that poor workforce planning over many years led governments to make short-term decisions to plug rota gaps, rather than invest strategically in medical training.

This resulted in large numbers of IMGs being recruited into locally employed doctor roles. These are posts often offering little training, limited support, and insecure terms.

“They’ve made very quick decisions about trying to fill rota gaps and opened up schemes to bring IMGs to fill those gaps,” she said.

“They want to come to the UK. They’ve heard how good the training schemes are. And then IMGs have aspirations, as many doctors do.

IMGs not to blame

“This problem has been created by the government itself, and now it’s being painted as the fault of IMGs.”

Dr Zaslona warned that political rhetoric risked scapegoating IMGs and perpetuating racist narratives, rather than addressing structural failures.

Citing the GMC workforce report, she noted that doctors outside formal training schemes now make up a growing proportion of the workforce.

This, she said, was another illustration of how ‘training schemes are no longer fit for purpose’.

Fit for purpose

She said: “But no one yet is really talking about re-wiring or dismantling and rebuilding the system.”

Listen to Dr Zaslona’s interview in full on the DAUK YouTube.