RCP college tutors (CTs) and associate college tutors (ACTs) are a vital part of the RCP’s education community, providing leadership, guidance and day-to-day support for resident doctors across the UK. The RCP CT and ACT network is our national community of physicians leading and supporting postgraduate medical education for physicians across the UK.
Through this network, tutors share good practice, connect with peers and influence RCP policy on training and workforce. It provides a vital two-way link: CTs and ACTs receive guidance, updates and opportunities from the RCP, while also ensuring the experiences and concerns of doctors in training are heard at a national level. The UK network meets three times a year and holds an annual conference online.
Read on for the latest update from our June 2025 meeting.
Updates from the RCP
- Leadership and strategy: Professor Mumtaz Patel was elected RCP president in April. A new RCP strategy is being developed in consultation with fellows and members. CTs/ACTs are encouraged to engage with membership surveys and share feedback with comms@rcp.ac.uk to help shape strategic priorities. Results of the CT survey will be shared at the upcoming CT and ACT national conference on 17 September.
- Internal medicine training (IMT) recruitment: Applications have risen to 8,500 for 1,650 posts (a 40% year-on-year increase). Projections suggest more than 10,000 applicants in 2026. The RCP and Joint Royal Colleges of Physicians Training Board (JRCPTB) are working to address recruitment pressures.
- New Consultants Committee update: Key priorities are transparency in college governance, increasing the appeal of fellowship, and planning the 2026 New Consultants conference. Resources will be hosted on the RCP Launchpad platform.
- Resident Doctor Committee (RDC) / Student and Foundation Doctor Network (SFDN) update: The RDC has strengthened regional representation and contributed significantly to the postgraduate medical training review and Next Generation Oversight Group. The RDC and SFDN chairs have met with Prof Sir Chris Whitty and Prof Stephen Powis to advocate for resident doctors – especially around study budgets, recruitment issues and generalism in medicine. SFDN has written to NHS England on IMT changes, multi-specialty recruitment assessment (MSRA), and raising concerns about unallocated foundation posts.
Next generation campaign update
2025 is the year of next gen at the RCP.
Our next generation campaign is designed to rebuild trust among resident doctors, especially following the physician associate debate.
An oversight group of around 40 physicians (half of whom are resident doctors) meets monthly to shape outputs such as statements, podcasts and toolkits on medical education and postgraduate training, system reform and regional engagement.
So far, the group has:
- published a position statement on competition ratios
- successfully called for a national postgraduate medical training review
- launched a series of blog articles and think pieces
- run a national survey (1,000+ responses) of resident doctors.
The next generation campaign will continue to call for action on competition ratios, advocate for improvements to training quality and feed into the 10-Year Workforce Plan in England.
During an open discussion, delegates emphasised the need to enhance the practical member offer for the next generation of doctors, especially around professional development, CPD and fellowship value. They called for better long-term workforce planning and a more flexible, competency-based approach to recruitment.
The RCP reiterated that competition ratios will continue to be a key national issue, highlighted generalism as a focus, and asserted that all doctors – regardless of training status – should receive educational support.
The CT/ACT group also discussed:
- generalist and specialist training: We need to resolve national inconsistencies in general internal medicine (GIM) training expectations, which currently vary significantly across regions. While local innovations (eg improved clinic planning or parallel rotas) can offer solutions, they often emerge in response to broader systemic gaps. An increasing reliance on post-CCT fellowships suggests that core programmes may not fully equip physicians with the skills or experiences required for consultant roles.
- balancing service delivery with medical training: This remains a key challenge in the NHS. Protected clinic attendance is essential to ensure high-quality learning opportunities for resident doctors. Dedicated clinics for IMTs or the use of virtual supervision could help resident doctors to gain meaningful clinical experience without compromising service needs. Clinical supervision must be recognised in job plans.
- less than full time working (LTFT) and medical curricula: LTFT doctors are encouraged to use the NHS TIS self-service CCT calculator. Curriculum acceleration is rare and must be justified.
- clinic space: Lack of physical space for clinics remains a challenge. Solutions include shadowing, use of underutilised space and virtual clinics.
- recruitment and policy outlook: IMT recruitment processes will not change in 2025. The RCP will continue to advocate for solutions to growing competition ratios that are causing bottlenecks in specialty training.
Follow up Q&A briefing
UK medical graduates and foundation doctors are increasingly concerned about being disadvantaged in IMT recruitment due to rising competition ratios for limited training places. UK-trained applicants are not prioritised for UK training posts, even if they have prior NHS experience. Applicants who have less clinical experience than overseas-trained doctors are more likely to score lower in the recruitment process. Owing to the high volume of applications, the increased shortlisting score has significantly raised the level of competition for securing an interview for IMT directly from foundation training.
However, no major changes to the IMT recruitment process are expected this year. The NHS England medical training review is exploring solutions to bottlenecks in specialty training.
The RCP has called on the UK government to:
- address competition ratios for specialty training and ensure that publicly funded medical school places lead to the recruitment of more NHS doctors
- explore mechanisms to ensure that UK graduate doctors can continue their training in the NHS on postgraduate training schemes in time for the 2026 recruitment process
- ensure that IMGs working within the NHS have access to career development, educational opportunities, and are supported to deliver high-quality patient care. The important contribution of IMGs to the NHS must be recognised
- make a long-term commitment to expand IMT and specialty training posts based on population need
- increase educator and supervisor capacity
- recognise and remunerate educator and supervisor roles in senior doctor job plans.
Who is responsible for medical training in the UK?
Download our infographic setting out the organisations that are responsible for planning and delivering the physician training pathway in the UK.
What is the RCP role in medical recruitment?
The RCP collaborates with the Royal College of Physicians of Edinburgh (RCPE) and the Royal College of Physicians and Surgeons of Glasgow (RCPSG) to make up the Federation of the Royal Colleges of Physicians of the UK.
The Federation develops and delivers:
- continuing professional development (CPD)
- examinations (Membership of the Royal Colleges of Physicians of the UK – MRCP(UK))
- training (JRCPTB)
Read Left in the lurch: our position statement on competition ratios.
In February 2025, due to a data processing issue, incorrect examination results were communicated to a group of candidates in the UK and internationally who took the Part 2 written examination in September 2023. Out of 1,451 candidates in the MRCP(UK) Part 2 written examination on the 6 September 2023 (Diet 2023/3), 283 were given the wrong result – 61 candidates who were told they had failed had passed and 222 candidates who were told they had passed had failed.
The Federation commissioned an independent review to identify what went wrong, how we have responded to fix the problem, and how to support the doctors affected. The presidents of the three royal colleges of physicians, on behalf of the Federation, wrote to the statutory education bodies (SEBs) for the four UK nations, asking them to consider a range of options for those impacted candidates in UK physician training. The Resident Doctor Committees of the three royal colleges of physicians also wrote to the statutory education bodies (SEBs), appealing their decision not to allow those affected by the MRCP(UK) Part 2 examination 2023/03 diet issue to progress into higher specialty training.
The Federation has apologised and offered wellbeing resources, counselling sessions, refunds and appeals, as well as up to £500 reimbursement for examination study support, which is available to each candidate who applied for, or had plans to, resit the Part 2 examination. While only a small number of IMTs were affected, the potential impact on applications and career progression has been significant.
Read the latest news and updates from the Federation of the Royal Colleges of Physicians of the UK.
High-quality training and safe service delivery depend on well-supported consultants and educational supervisors, yet many feel overburdened, under-recognised and unable to meet their responsibilities. Insufficient SPA time, unacknowledged demands, heavy GIM workloads and a lack of support from their employers all contribute to diluted supervision quality and reduced trainee support.
Options to support senior doctors and supervisors:
- Protect and enforce SPA time for medical education.
- Job planning for clinic supervision.
- NHS employers should recognise and reward educational supervisors.
- Expand the medical educator workforce to share responsibilities and reduce burnout.
- Deliver targeted training, peer support networks and national recognition schemes.
- Read Empowering physicians: effective job planning for better patient care.
It’s not easy to get the balance right between training and service delivery.
How could we protect training time in system under pressure
- Protected learning time: Training needs to be explicitly planned into job plans and rotas. Clinical exposure alone isn’t sufficient – residents need time for reflection, supervision and formal teaching.
- Supervision capacity: Without adequate numbers of trained, available supervisors – particularly on the acute take – resident doctors risk becoming service providers rather than learners.
- Job planning reform: Consultant job plans must include time for education, not just direct clinical care. This is particularly important in GIM, where service provision often falls on fewer individuals.
- Rota design: Current rota gaps and short-term fixes (eg over-reliance on locums) often result in resident doctors missing out on opportunities like specialty clinics, leadership roles or procedural skills.
- Cultural shift: Leadership must value training as a core function of service delivery. The quality of tomorrow’s workforce depends on the educational experiences provided today.
The unselected take provides a breadth of experience, teaching resident doctors how to:
- make decisions under pressure
- manage teams and prioritise tasks
- triage and risk assess
- diagnose and treat acute presentations
- lead short-term interventions.
GIM clinics offer depth of knowledge and continuity of learning, teaching resident doctors how to:
- develop generalist diagnostic skills
- manage multiple conditions and uncertainty
- treat chronic disease over a longer period of time
- communicate effectively and share decision making with patients
- work with primary, community and social care.
The RCP has called for:
- investment in GIM training – it is not just service cover
- long-term workforce planning that separates service delivery from medical training
- national reform of GIM training.
Read Why the NHS needs to reset its approach to training the next generation of physicians.
Despite clear curriculum requirements (eg 80 clinics by the end of IMT), many IMT doctors struggle to access outpatient clinics.
Options to improve clinic attendance include:
- protected clinic time in rotas
- clinic logbooks or online portals
- consultant ‘clinic buddy’ or named clinic supervisor
- dedicated ‘clinic blocks’ (ring-fenced time for clinic weeks, months or rotations)
- locum cover or team job planning.
Options to improving consultant engage could include:
- protected time for outpatient teaching in job plans
- recognition schemes for those who actively support outpatient teaching
- teaching supervisors how to train resident doctors in clinic skills
- standardised supervision expectations with national guidance on outpatient teaching
- support from NHS leaders to prioritise outpatient teaching.
Lack of physical space for outpatient clinics is a widespread problem, especially post-COVID. Targets to bring down waiting lists means that teaching resident doctors is less of a priority, more clinics are being delivered virtually without resident doctors in the room, and physical space is at a premium in many hospitals.
The RCP has called for:
- protected educational space in outpatient departments
- inclusion of medical education in outpatient transformation programmes
- recognition that all outpatient clinics (whether digital or face-to-face) are learning environments
- the inclusion of training infrastructure (not just digital infrastructure) in outpatient care redesign by integrated care boards (ICBs) and NHS trusts.
Read Prescription for outpatients and the RCP toolkit, Time to focus on the blue dots.
Competency-based training (CBT) is central to the UK postgraduate medical training model, underpinned by curricula set by the medical royal colleges and approved by the GMC. In principle, CBT allows all resident doctors in training programmes – whether full-time or LTFT – to progress once they have demonstrated the required competencies, regardless of time served. However, implementation across different regions, specialties and training programmes is not always consistent.
While the principle of ‘progression based on capability rather than time’ is embedded in curricula like the internal medicine (IMT) stage 1 curriculum, in practice many programmes still equate full-time equivalence (FTE) with expected annual progression. This can be particularly evident at annual review of competence progression (ARCP) panels.
In the 2025 RCP next generation survey, around a fifth (21%) of respondents were working LTFT and almost half (47%) were planning to do so in the future. Yet national workforce and training models have not caught up with this increase in LTFT working. Growing service pressures and patient demand can mean that rotas do not necessarily accurately reflect full time equivalent (FTE) adjustments, so LTFT doctors in training may find that their competency-based educational opportunities (as opposed to service provision) – like clinics, procedures, leadership roles – are reduced, because they are squeezed into fewer sessions. LTFT doctors may also miss out on hospital or deanery teaching that is scheduled on their non-working days. Finally, good quality LTFT training relies on the understanding and expertise of individual supervisors, which can vary considerably.
Despite the increase in LTFT working, there has been no proportional increase in training posts. This is placing a strain on training quality and patient care. Resident doctors provide most out of hours care and ward cover and LTFT working can lead to rota gaps – workforce planners must take this into account.
The RCP has called for:
- greater flexibility from employers on LTFT working – better rota design
- explicit support for LTFT in national workforce planning
- more granular data to inform national workforce modelling
- protected time and support for trainers and educators to support LTFT doctors in training
- ringfenced time for medical education and supervision.
Read Why flexibility and an individualised approach in medical education matters.
Many resident doctors report a disconnect between clinical and academic training, especially at IMT and in the first years of higher specialty training. Some feel that academic work is undervalued, unsupported or seen as peripheral to clinical training.
The lack of formal integration between academic and clinical roles leaves resident doctors struggling to balance competing demands, often without coordinated supervision. Limited protected time means research, teaching and quality improvement (QI) work are pushed into personal hours, while poor visibility of academic pathways limits access to opportunities and mentorship.
As a result, academic activities can feel tokenistic – reduced to checklist exercises rather than meaningful preparation for a career in academic medicine.
Academic internal medicine training (AIMT) posts, such as National Institute for Health and Care Research (NIHR) academic clinical fellowships, offer 25% protected academic time but uptake and clarity on career progression remain variable. Recent ARCP and portfolio reforms aim to move away from tick-box tasks toward meaningful academic work, though implementation is inconsistent.
The 2024 NIHR integrated academic training review called for better integration of academic and clinical pathways, with NIHR, NHSE and the Academy of Medical Sciences developing follow-up actions. The RCP, JRCPTB and some deaneries are also increasing support through local academic leads and guidance for early-career physicians, including in non-research fields like education, policy and digital health.
Read Making the case for research: resource kit for doctors.
Useful dates
- CT/ACT national conference: 17 September
- Next CT/ACT Network meeting: 27 November
- Call the medical registrar 2025: register for access on demand until 28 November
If you would like to learn more about the RCP CT/ACT Network, please contact UKRegions@rcp.ac.uk.
