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Where have all the Doctors gone?

29 August 2025

The career landscape for doctors is dire; there are no two ways about it. An expansion of medical schools sounds like a positive move on the surface; surely this should create more doctors, thus decreasing waiting lists and reassuring the public that the NHS is working? But sadly this initiative is little more than smoke and mirrors, offering the illusion of a long-term fix, whilst actually creating more complex issues within the very heart of the NHS’s infrastructure. The reality is that doctors are unable to progress in their careers, and an influx of medical students has led to a bottleneck within the system, and an epidemic of unemployed doctors.[1]

As Ben Ireland points out in his article in The Doctor: in 2024, 59,698 applications were made for the 12,743 specialty training posts available.[2] This represents 4.7 applications made to every available post in 2024 compared with 3.4 per post in 2023, and 1.9 in 2019. The picture this paints for those trying to progress in the NHS, from medical students to registrars, is bleak. How can we improve a system that has been allowed to stagnate in this way? 

The impact on patients is serious — they cannot benefit from more doctors unless there are enough funded positions on each rung of the career ladder. If today’s registrars can’t become consultants, then tomorrow’s medical students will have zero opportunities for progression. This vicious cycle limits patients’ access to doctors and thus the care they need.

For doctors facing unemployment after years of training, turning to private practice or working abroad is understandable. In fact, just last year, the GMC published the findings of research outlining that thousands of doctors are considering leaving UK practice, with a lack of progression opportunities cited as one of the three top reasons for this potential exodus.[3]

Anna Pogodina, spokesperson for the CBS Student Committee, says:
‘This issue isn’t limited to a lack of medical school places. The real crisis is systemic underfunding of posts throughout the training pathway – from specialty training right through to consultant level. This creates bottlenecks where fully qualified doctors are unable to progress, affecting not only their careers but the careers of everyone below them.

Expanding medical schools may sound like the answer to long waiting times, but unless the whole system works together, it is patients who end up suffering. To be clear, there is no shortage of doctors – the shortage lies in the positions for them to fill. Something needs to change, and quickly.’

Anna points out that another issue is in the hiring of physician associates (PAs), which displaces training opportunities for junior doctors. This money-saving exercise means that tasks usually completed by FY1s, SHOs, or registrars are diverted to PAs, reducing clinical experience for trainee doctors, or even replacing them. Anna continues:

“As the CBS Student Committee, we are concerned that many trainees are being asked to sacrifice progression despite years of training. This does not just affect doctors–it affects patients, because bottlenecks in training mean fewer specialists coming through at a time when demand is growing. Without urgent action, the public will face longer waits and reduced access to the care they need.”

Medical students are feeling genuine fear about what their planned career will look like in reality, and the last thing they should be doing when signing up for medical school is worrying that there may not be a job at the end of it.

1. https://www.bbc.co.uk/news/articles/c4g625d3wd9o
BMA in new row as thousands of junior doctors cannot get ...The Timeshttps://www.thetimes.com › UK › Healthcare

2. https://thedoctor.bma.org.uk/articles/life-at-work/specialty-training-squeeze

3. https://www.gmc-uk.org/news/news-archive/thousands-of-doctors-could-be-considering-leaving---new-research-reveals-what-might-
make-them-stay

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