The state of medical education and practice in the UK: workforce report 2025

Foreword

Global talent has been central to UK health services since the inception of the NHS. In recent years, internationally trained doctors have formed an ever-increasing proportion of the profession, with over two thirds of new registrants last year having qualified outside the UK.

This year’s report, however, indicates that this upward trend may be levelling off. While the number of internationally qualified doctors is still increasing, it is doing so at a notably lower rate compared to the sharp increases of recent years.

Strikingly, looking across the UK, greater numbers of international doctors are also leaving the workforce, with many never having secured employment.

Of the internationally qualified doctors who took up UK registration having passed the Professional and Linguistic Assessments Board (PLAB) test in 2024, far fewer had obtained employment within six months compared to previous years, indicating a contracting employment market for international doctors in the UK.

The choice to uproot your life and career is a complicated and personal one. But it must be made with the best available evidence and in the full knowledge of the range of outcomes that might materialise. That’s why we believe sharing these findings is key, so that a doctor’s decision to come to the UK is properly informed.

Our report also reveals trends around doctors, both UK and internationally qualified, securing training posts.

In the last decade, the number of doctors offered postgraduate medical training places has nearly doubled, from 6,415 in 2013/14 to 12,176 in 2023/24. But the number of applicants also grew over that period, including a significant growth in applications from internationally qualified doctors, many of whom apply for specialist training after working in a locally employed role. This has also meant that the non-UK proportion of all those who receive offers has increased. In 2018/19 international graduates received 26% of all offers made, increasing to 34% in 2023/24.

The UK government has stated its intention to prioritise UK medical graduates for postgraduate training in England.* It is critical that any changes made by the UK’s governments and system leaders are based on what the data tell us about how the system has been working. For instance, while more international doctors are securing places in specialty training programmes, their success rates in those applications remain much lower than those for UK-trained doctors – in 2024, 23% compared with 69%. And some specialties are especially reliant on international doctors. In general practice – central to the government’s vision for neighbourhood health services – half of 2024’s first-year trainees qualified outside the UK.

Efforts to build a more sustainable health system, one that better meets the needs of its workforce and the patients it serves, are welcome.

But care must be taken to make sure decisions are rooted in evidence, and consider the impact on the wider medical workforce, where day-to-day service provision relies heavily on international doctors.

Past trends are not a guarantee of future realities. Doctors represent a mobile workforce, whose skills are in high demand around the world. The internationally qualified doctors who have historically come to the UK could quite conceivably choose to deploy their talents elsewhere if they feel they have no future job progression here. Any hardening of rhetoric and falling away of support could similarly undermine the UK’s image as a destination for the brightest and the best.

It is vital that workforce policies across all four countries do not inadvertently demoralise or drive out the talent on which our health services depend. There are 138,405 licensed doctors who qualified abroad working in the UK, making up 42% of the total. If we see even a small percentage increase in them leaving, our health services will end up with huge holes that they’ll struggle to fill. Retaining doctors – be they UK or international graduates – relies on them having opportunities to grow and develop to their full potential. That includes through postgraduate training, but also the presence of compassionate, inclusive workplaces that allow them to deliver high quality care.

Whatever the future makeup of the workforce, we all – from employers to regulators, policymakers to the profession itself – have a duty to recognise the essential contribution all doctors make, irrespective of background, and to make sure that each one is supported and valued accordingly.

That’s crucial for the professionals providing care but, also, most importantly, for the patients receiving it.

* https://assets.publishing.service.gov.uk/media/6866387fe6557c544c74db7a/fit-for-the-future-10-year-health-plan-for-england.pdf

Part 1: Key issues in the workforce

This report presents the key findings from our analysis of trends and patterns in the number, demographics, and place of primary medical qualification (PMQ) of doctors holding a licence to practise in the UK. In part 1, we spotlight two particularly compelling and high-impact findings.

• There was an increase in non-UK graduate doctors relinquishing a licence in 2024. At the same time, the number taking up a licence plateaued and a lower proportion of those have managed to then secure employment in the UK, compared to recent years. These factors combine to show a clear worsening of the UK job market for newly arrived non-UK-qualified doctors.
• The number of non-UK PMQ doctors applying for postgraduate training has increased, with many having worked in locally employed (LE) roles for several years before applying. Yet UK-qualified doctors continue to have far higher rates of being accepted into a training programme.

Part 2: Overview of the workforce and recent changes

Part 2 provides an overview of the professions’ changing demographics, with a closer look at the history of female doctors in the UK medical profession and an increase in younger doctors reporting a disability. It also provides the latest data on the growth of LE doctors, showing the LE-to-specialist ratios of all specialties. There is analysis of doctors’ movements at key career stages and an early tracking of doctors entering the workforce via the ScotGEM initiative.

Reference tables and data annex

In addition to this report, accompanying reference tables provide a broad range of data about doctors, covering their register including information about career stages, postgraduate training programmes, specialty groups, complaint patterns and work locations. A data annexe has also been provided to show the numbers behind all charts and tables in the report that are not supported by reference table data.

Downloads 

• Combined data annexe
• The register of medical practitioners
• The register of medical practitioners – at national and regional levels
• Doctors in formal postgraduate training and their training programmes
• Doctors we recognise as trainers on formal postgraduate training programmes
• Doctors’ reasons for leaving
• Fitness to practise data
• Fitness to practise data – at national and regional levels