Reflecting on the findings of the RCP’s report Training physicians for the future resident doctors Dr Laura Bannon and Dr Sacha Moore argue that postgraduate medical training has not kept pace with the realities of modern medicine. In this next generation blog, as more doctors pursue flexible careers, academic opportunities and non-linear training pathways, they make the case for a system that recognises capability wherever it is developed and prepares physicians for the future.
The RCP has launched Training physicians for the future: a blueprint for reforming postgraduate medical training, a major new report setting out a long-term vision for how medical training should evolve to meet the needs of patients, doctors and the NHS. Drawing on extensive engagement with resident doctors, educators and physicians across the UK, the report identifies the changes needed to create a training system that is flexible, high quality and fit for the future.
Today's training system was largely designed for a generation of doctors whose careers looked very different. Medicine has changed. Medical careers have changed. Training must change too.
Resident doctors are increasingly combining clinical work with research, education, leadership, quality improvement and innovation. More doctors are choosing to work less than full time. More are moving between training and non-training roles. More are building careers that look very different from the traditional path many training systems were designed around. The challenge is that postgraduate medical training has not always kept pace.
Across the RCP's next generation campaign, we heard from doctors who wanted greater flexibility, better recognition of skills gained outside traditional pathways and training that felt more relevant to the realities of modern medicine. The message was clear: while careers are becoming more diverse, training often remains built around assumptions that no longer reflect how many doctors learn, work and develop professionally.
The evidence shows this is becoming increasingly important. Nearly half (47%) of resident doctors who responded to the RCP's 2025 next generation survey said they wanted to work less than full time in the future. Our report argues that flexibility should no longer be treated as an exception that doctors have to negotiate around. It should be a core feature of training design.
But this conversation is about more than flexibility – it’s also about recognising where learning happens. Doctors develop valuable skills through research, leadership, education, quality improvement and locally employed roles. Yet capability gained outside formal training programmes is still recognised inconsistently. The report argues that progression should focus more clearly on the knowledge, skills, judgement and professional capabilities doctors can demonstrate, rather than simply the amount of time spent in a particular post.
That principle is particularly important for clinical academia. The NHS depends on clinical academics to improve patient care, drive innovation and translate research into practice. Yet consultant clinical academics now make up just 3% of the senior clinical workforce, and many doctors pursuing academic careers continue to navigate systems designed primarily around conventional clinical pathways. The report calls for greater flexibility, better integration between academic and clinical training, and stronger support for the next generation of clinical academics.
The future of healthcare itself is changing too. Tomorrow's physicians will increasingly work across hospitals, neighbourhood services and multidisciplinary teams. They will need to understand digital systems and artificial intelligence (AI). They will require capabilities in leadership, service improvement and system working alongside clinical expertise. Training must help doctors develop those skills.
That is why this new RCP report calls for training programmes to support flexible working, recognise capability wherever it is developed, expand opportunities in research and leadership, and prepare doctors for future models of care. It also proposes a single longitudinal ‘training passport’ to help doctors carry evidence of capability and development throughout their careers.
None of this is about lowering standards. Patients deserve highly trained physicians who are equipped for increasingly complex healthcare systems. The goal is not to make training easier. It is to make it more relevant, more responsive and better aligned with the realities of modern medicine.
The medical education and training review provides an opportunity to do that. As decisions are made about the future of postgraduate medical training, we need systems that recognise diverse careers, support flexibility, value academic and professional development, and prepare doctors for the future.
After all, today’s medical workforce will not follow a single path, and if training remains built around a single traditional career model, the NHS risks losing many of the doctors it most needs to retain.
Our training system should recognise that reality and be designed accordingly.
Dr Laura Bannon is the RCP Resident Doctor Committee (RDC) representative for Kent, Surrey & Sussex and a member of the writing group that developed Training physicians for the future. She works as a registrar in respiratory and general internal medicine in Sussex.
Dr Sacha Moore is the RCP RDC representative for Wales and a member of the writing group that developed Training physicians for the future. He works as a registrar in nephrology and general internal medicine on the Wales clinical academic training pathway.
Dr Laura Bannon
Resident Doctor Committee representative – Kent, Surrey & Sussex
Dr Sacha Moore
Resident Doctor Committee representative – Wales
