New legislation is being fast-tracked through parliament, which will block the NHS from offering training jobs to foreign doctors unless no British doctors have applied for the role.
Since the lifting of visa restrictions in 2020, UK-trained doctors have faced growing competition from overseas-trained doctors for specialty medical training posts, with applicants rising from 12,000 in 2019 to nearly 40,000 this year.
The number of eligible applicants for the Foundation Programme (FP) has also grown from 8,137 in 2019 to 11,205 in 2025 partly driven by an increase in applications from graduates from international medical schools. To ensure UK graduates achieve full GMC registration and strengthen the domestic workforce, all eligible applicants (UK and overseas) have so far been guaranteed a place.
In recent years, FP applicant numbers have exceeded available places, causing delays in FP allocations while extra posts are created or vacancies arise from withdrawals.
Affected applicants are often placed in ‘placeholder’ positions, which confirm the foundation school but not the hospital. This information is frequently provided very late – sometimes close to the start date – creating significant stress for those involved.
The Medical Training (Prioritisation Bill) aims to fix this so that prioritisation can be implemented during the current application process, securing the commitment for years to come.
“Prioritisation will help build a sustainable medical workforce that meets population health needs, reduces reliance on an unpredictable international labour market, and maximises taxpayer investment in medical training,” the NHS said.
It adds that the Bill aims to secure a reliable supply of doctors for the future, ensuring those with a UK medical link are more likely to progress to consultant roles and continue their careers within the NHS.
“Internationally trained doctors make a huge contribution and will continue to do so. If passed, the Bill will also enable us to prioritise internationally trained doctors with significant NHS experience, and we are not excluding anyone from applying for training places, they just won’t be prioritised,” it said.
For 2026 starts, prioritisation will be applied at the offer stage because shortlisting is already underway. To ensure successful candidates are able to take up their posts in August with sufficient notice, eligibility has been defined using specified immigration statuses as a proxy for significant NHS experience.
From the autumn 2026 application round for 2027 starts, subject to the Bill’s passage, prioritisation will apply from shortlisting through to offers, and we will define “significant NHS experience” more precisely through regulations.
“Over the coming months, we will engage with key stakeholders across the UK to agree how NHS experience will be recognised from 2027 onwards,” the group said.
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