A letter from the Royal College of Physicians (RCP) has been published today in The Times, warning that the NHS will continue to lose talented early-career doctors unless urgent action is taken to fix the training bottlenecks holding them back.
A powerful joint letter from the RCP president and resident doctor leaders has been published today in The Times, warning that the crisis facing resident doctors will not be solved without a fundamental reset of how the NHS plans and delivers medical training. They make the case that competition ratios, limited training posts and inflexible pathways – not a lack of motivation – are driving growing frustration among the next generation of physicians.
Responding to Fraser Nelson’s article, Try this cure for the trainee doctor crisis, RCP president Professor Mumtaz Patel – alongside the co-chairs of the Resident Doctor Committee, Dr Catherine Rowan and Dr Stephen Joseph, and the chair of the Student and Foundation Doctor Network, Dr Seán Coghlan – argues that the problems facing early-career doctors ‘run deeper than immigration rules or medical school numbers’.
The letter highlights frustration among resident doctors working in a system marked by ‘unpredictability and intense competition’, with specialty training ratios now ‘neither fair nor sustainable’. The authors note that despite their commitment to the NHS, many doctors find themselves stuck in non-training posts without clear routes to progression because training numbers have not kept pace with rising demand.
The RCP warns that expanding medical school places without a parallel increase in specialty training capacity simply ‘shifts the bottleneck downstream’, leaving more doctors competing for too few opportunities. The letter also stresses that the NHS ‘cannot rely indefinitely on locums and internationally recruited doctors’ to fill longstanding workforce gaps. Instead, the authors call for a meaningful expansion of training posts based on population need, fairer and more transparent recruitment processes, and proper investment in educational supervision.
The publication of the letter underscores the RCP’s ongoing next generation campaign, which has gathered testimony from thousands of doctors across the UK and highlighted structural issues driving dissatisfaction, bottlenecks and attrition within the medical workforce.
The full text of the letter sent to The Times is as follows:
Letter to the Editor
Fraser Nelson is right to highlight the frustration felt by resident doctors entering a training system marked by unpredictability and intense competition. But the challenges run deeper than immigration rules or medical school numbers. Through our next generation campaign, the Royal College of Physicians has heard from thousands of resident doctors who remain deeply committed to the NHS but feel let down by inflexible systems. These doctors do not lack motivation or resilience. What they lack is a training pathway designed for the realities of modern medicine.
Competition ratios for specialty training have reached levels that are neither fair nor sustainable, and too many resident doctors are in limbo, working in jobs without clear career progression, simply because training numbers have failed to keep pace with demand. Long-term workforce planning must be linked to training capacity. Expanding medical school places without expanding specialty training posts only shifts the bottleneck downstream.
The NHS cannot rely indefinitely on locums and internationally recruited doctors, and if we want to retain UK graduates in the NHS, we must offer more than slogans about respect. We need a meaningful expansion of training posts based on population need, fair and transparent recruitment processes, and investment in high quality educational supervision.
Resident doctors are not looking for special treatment. They are asking to become the consultants and GPs our NHS urgently needs. Fixing this is not controversial – it is essential.
Professor Mumtaz Patel
President, Royal College of Physicians 11 St Andrews Place, Regent’s Park, NW1 4LE
Dr Catherine Rowan and Dr Stephen Joseph
Co-chairs, Resident Doctor Committee, Royal College of Physicians 11 St Andrews Place, Regent’s Park, NW1 4LE
Dr Seán Coghlan
Chair, Student and Foundation Doctor Network, Royal College of Physicians 11 St Andrews Place, Regent’s Park, NW1 4LE