The UK healthcare system has faced workforce challenges like staff shortages and threats of strikes by resident doctors. The government announced a plan in December 2025 to create 4000 new medical specialty training positions over the next 3 years. These positions would give preference to UK medical graduates (UKMGs). This proposal aims to support the locally trained doctors and strengthen the National Health Service (NHS). It increases the important concerns about the future of international medical graduates (IMGs).
The reasoning behind this plan is financial and practical. The UK pays £4 billion each year to train doctors. Many UK-trained doctors choose to leave the NHS to work abroad or in the private sector. > 2600 UK doctors underage of 40 left the official medical register, which shows a growing trend in 2024. The government wants to make sure that UK-trained doctors have better opportunities to continue their careers in the NHS to protect this investment. The government hopes to reduce competition and make career progression much easier for these doctors by prioritising them for specialty training posts.
It indicates a shift towards reducing the dependence on IMGs and promoting domestic training, although a recent proposal was rejected by doctors. Historical context, like the aftermath of Brexit, reveals the ongoing necessity for international workers in healthcare, which highlights the potential impracticality of these changes without adequate long-term methods. Prioritizing UK graduates could limit training opportunities for IMGs, further complicating their career advancement and making competition for available positions worse.
IMGs play an important role in the NHS. About 20,000 IMGs joined the UK medical register in 2024. This makes up 42% of the total medical workforce. They work in areas where there are shortages, like general practice, emergency medicine, psychiatry, and smaller hospitals. Many healthcare services worldwide struggle to function without them. There is an increasing number of IMGs who leave the MHS. About 4900 IMGs gave up on their licenses in 2024, which is a significant increase from earlier years. One major reason is that many IMGs are placed in locally employed doctor (LED) roles. These jobs are important for daily hospital work but lack clear training pathways, career development, and proper support. Many IMGs feel stuck in these positions with limited chances to move forward.
Fewer IMGs are getting employed quickly after joining the register. Only 13% found a job in 6 months in 2024, as compared to 20% a year before. This can create financial stress and uncertainty for doctors who have already invested in moving to the UK. IMGs face personal difficulties and professional challenges. Many struggle to adjust to the new healthcare system, different communication styles, and unfamiliar cultural expectations. They may experience loneliness, separation from family, and financial pressure. Some report facing discrimination or unfair treatment at work. There is often little support available to help them deal with these challenges.
IMGs will be essential for the NHS even with the government’s focus on UK-trained doctors. The healthcare system depends on its skills and contributions to meet patient needs and reduce waiting times. Many steps are needed to improve the situation. There must be fair access to training opportunities for UK graduates and IMGs. Everyone should have a clear and equal chance to progress in their careers. Better support systems must be introduced, like mentorship, cultural training, and mental health services. Efforts must be taken to create a sense of belonging for IMGs to promote inclusion and build supportive work environments. Strong and ethical leadership is required to make sure that all doctors are treated fairly. Better workforce planning is important to match the number of training positions with the actual needs of the healthcare system.
The plan to support UK-trained doctors is understandable. It does not fully address deeper problems in the NHS. IMGs have always been a key part of the healthcare system, and it will continue to be in the future. Many may choose to leave the UK for better options without proper support and fair opportunities. This could lead to serious staff shortages and negatively impact patient care. A balanced and inclusive method is necessary to build a strong and sustainable healthcare workforce.
Reference: Richard Antony P, Mo AH, Vijay N, Kam B, Mala R. International medical graduates: a workforce at a crossroad?. J R Soc Med. Published online February 24, 2026. doi:10.1177/01410768261421438
