New law has dramatically reduced overseas doctors’ chances of securing NHS specialty training places

The proportion of doctors accepting NHS specialty training places from the group that includes most overseas-trained doctors has fallen from more than one in four to less than one in 50 (this is the final training stage before becoming a GP or consultant).

That’s according to new analysis of provisional data from NHS England by the Nuffield Trust which finds that the Medical Training (Prioritisation) Act, which became law this year, has achieved its immediate aim of prioritising NHS-trained doctors for NHS jobs over those who trained overseas. [1]

The Act came into force in March to address how intensely competitive the application process for training places had become. The total number of specialty training applications increased more than five-fold in the decade to 2025, rising from around 16,500 to almost 85,000 applications annually. This growth was driven primarily by doctors trained overseas, whose applications increased more than thirteen-fold.

In 2025, 28% doctors accepting a specialty training place were from what is now defined as the ‘non-priority’ group, which includes most doctors who trained overseas. [2] In the first recruitment round under the new law, this fell to just 1.8%. The change has happened despite overseas-trained doctors continuing to make up a large proportion of those applying for specialty training: doctors in the non-priority group accounted for 51% of all applications in 2026.

In 2026, only five of 16 medical specialties had any accepted places from non-priority candidates. [3]

However, the analysis warns that the longer-term consequences of the new rules are less certain. While application numbers from non-priority doctors remained high in the first year of the new system, future cohorts may decide that applying for UK specialty training is no longer a realistic route into the NHS. This could particularly affect specialties that have historically relied more heavily on overseas graduates, including general practice, psychiatry and obstetrics.

The government has committed to creating up to 4,500 additional specialty training places over the next three years. The authors say it will be important that any expansion focuses on the specialties where the NHS will need more doctors in the future and should align with the government's ambition to shift more care out of hospitals.

Nuffield Trust Fellow, Lucina Rolewicz, said:

“There is no doubt that the new law has had a big impact in terms of strengthening the domestic training pipeline for doctors. The numbers show just how dramatically the rules introduced this year have shifted access to specialty training away from overseas-trained doctors and towards predominantly UK-trained doctors.

“The question now is what this means for the NHS in the longer term. The NHS needs to make sure that prioritising homegrown doctors boosts the domestic workforce without reducing the overall supply of doctors and creating concerning staffing gaps.”