The Royal College of Physicians (RCP) has warned that prioritisation alone cannot resolve the shortage of training posts, after new figures showed that more than 3,200 appointable doctors competed for fewer than 1,700 internal medicine training places.
New figures for the 2026 recruitment round show that 8,468 applications were made for 1,683 internal medicine training (IMT) posts, a competition ratio of 5.03. More than 3,200 applicants were judged appointable for fewer than 1,700 available places.
The RCP has welcomed action through the Medical Training (Prioritisation) Act to address escalating competition for specialty training. However, it warned that changing who is prioritised for existing posts is not a substitute for expanding postgraduate training capacity.
Dr Dan Furmedge, RCP senior censor and vice president for education and training, said:
‘We welcome some improvement in access to specialty training for prioritised applicants. But while prioritisation has changed who secures training places, it has not addressed the fundamental shortage of opportunities for doctors to progress. More than 3,200 applicants were judged appointable for fewer than 1,700 places. This is a significant bottleneck in the development of the physician workforce on which patients will depend in the future.
‘We need a properly funded expansion of postgraduate medical training, matched by investment in clinical educators, protected training time and high-quality supervision. That must be accompanied by a long-term workforce plan that connects medical school places, postgraduate training and the consultant workforce the NHS needs.
‘Prioritisation alone will not solve this capacity problem. Without expanding opportunities, we risk losing talented doctors who want to build their careers in the NHS.’
Dr Ricia Gwenter, RCP Resident Doctor Committee co-chair, said:
‘This is particularly frustrating when resident doctors are working in services struggling with staffing shortages and rota gaps. Our 2025 next generation survey found that 72% of respondents identified poor staffing and rota gaps as a major pressure on their training and wellbeing. There are doctors desperate to progress, while the NHS continues to struggle with workforce pressures.
‘Prioritisation has made a difference for some applicants, and that is welcome. But it must not be mistaken for a solution to training bottlenecks. Resident doctors need more than a better chance of competing for the same limited number of places. They need a credible, properly supported pathway through training, with enough opportunities to develop the skills and expertise patients need.’
The figures come shortly after the RCP published Training physicians for the future: a blueprint for reforming postgraduate medical training. The report calls for a funded expansion of training capacity aligned with medical school places and the future consultant workforce, alongside stronger accountability for training quality, transparent education funding and protected time for trainers and resident doctors.
The RCP has consistently supported action to bring unsustainable competition for training posts under control, while recognising the vital contribution international medical graduates make to the NHS. It has argued that prioritisation should recognise significant NHS experience, including among international medical graduates who have chosen to build their careers in the NHS.
Read Training physicians for the future: a blueprint for reforming postgraduate medical training.