When UK medical students graduate, they begin two years of foundation training, spending blocks of time in different specialties. They generally then apply for internal medical, core surgical, acute care, GP<\/a> or other specialist training such as paediatrics or psychiatry.<\/a><\/p>\n Unless their programme runs straight through to being fully qualified, after two or three years, they then pursue a higher training pathway in the area in which they want to specialise.<\/p>\n New FeatureIn ShortQuick Stories. Same trusted journalism.<\/p>\n In 2024, 4.7 applications were made on average for every core and higher specialty training post (59,698 applications for 12,743 roles), but the latest competition ratios<\/a> show that this figure has risen to 7.2, with 91,999 for 12,833 places. <\/p>\n The ratio was more extreme in some specialties than others. In emergency medicine it was 14 to one, while in psychiatry it was 22 to one, in cardiothoracic surgery it was 74 to one and in sexual health<\/a> it was 98.5 to one.<\/p>\n \u2018Disaster long in the making\u2019<\/p>\n The British Medical Association (BMA)<\/a> called this a \u201cdisaster long in the making as successive governments have failed to deliver enough training places to keep up with demand\u201d.<\/p>\n It comes as first-year doctors in England<\/a> represented by the BMA voted in favour of strike action over their jobs this week.<\/p>\n According to the union<\/a>, 34 per cent of resident doctors surveyed said they had no substantive employment or regular work from August.<\/p>\n Health Secretary Wes Streeting<\/a> has pledged in his 10-year NHS plan to create 1,000 new training posts over the next three years and prioritise UK graduates and doctors who have worked in the NHS for a significant period, but the BMA has said that action needs to be taken faster and on a wider scale.<\/p>\n In 2024, there were 12,743 training posts available, with 10,628 UK graduates and 14,868 international graduates applying. By 2025 the ratio was 12,305 UK graduates to 20,803 international graduates.<\/p>\n \u2018What is the point?\u2019<\/p>\n Shivam Sharma, a trainee in child and adolescent psychiatry and deputy chair of the BMA\u2019s resident doctors committee, told The i Paper that his peers are \u201cfeeling extremely worried and frustrated, and it\u2019s just driving them out of the healthcare system\u201d. <\/p>\n \u201cWhen you see the competition ratios rising exponentially every year [\u2026] you just think: \u2018What is the point?\u2019<\/p>\n \u201cYou\u2019re waiting up to 22 months to see a child psychiatrist, and at the same time you have this 22 to one competition ratio.\u201d <\/p>\n He said that the BMA welcomes Streeting\u2019s pledge to prioritise UK graduates<\/a> and doctors that have already been working in the NHS<\/a> for several years for training places, but \u201cwe need to see some decisive action immediately. We can\u2019t wait another year or two, when already thousands of doctors are unemployed in the UK.\u201d<\/p>\n He also said that the number of training places needs to be expanded by more than 1,000, as \u201ccompared to other wealthy countries, the UK just doesn\u2019t have enough doctors\u201d. BMA analysis suggested that the UK is about 40,000 doctors short compared to EU countries.<\/p>\n \u2018I just want to start my life\u2019<\/p>\n Shonnelly Novintan, 28, is a spokesperson at the Doctors\u2019 Association UK and is working to secure a higher specialty training place in plastic surgery. However, there were no jobs in her region of the East of England this year when she applied. Across the whole country, there were only 42 posts for over 280 applicants.<\/p>\n Dr Novintan is currently working in a trust-grade role: a temporary, non-training, service provision post where doctors perform largely the same duties as a specialty trainee but without the opportunity to progress, and with reduced access to privileges such as a study budget for courses and protected study leave.<\/p>\n She will be applying again for a training place for next year, and said: \u201cIt is quite nerve-wracking because now it\u2019s very much on my mind that this is the second time of applying, and if I weren\u2019t to get a job this time round, that would mean that I would be on my third time of applying with two years out\u201d. <\/p>\n She added that that is \u201csubstantial time to put your life on hold\u201d.<\/p>\n Dr Novintan is eager to keep applying for plastic surgery<\/a> even if she does not get a place this year, as \u201cI am really passionate about this job\u201d but \u201cI just really want to start my life\u201d.<\/p>\n She has known she wants to be a plastic surgeon since she became a doctor, \u201cso for me, everything has just been postponing plastics training\u201d.<\/p>\n \u2018Not very good for morale\u2019<\/p>\n Maya Machesney, 25, a final-year medical student <\/a>at the University of Sheffield<\/a> and medical student co-lead at DAUK, told The i Paper that after a \u201crandom lottery\u201d regarding where she will be placed for her foundation training next year, she finds the thought of specialty training applications \u201cdaunting\u201d because she is \u201clooking into the future, and it is still uncertain. It\u2019s really stressful\u201d.<\/p>\n \u201cI\u2019m still holding onto that grain of hope\u201d that things will get better soon, she said, but added that she doesn\u2019t think the increase in training place numbers already announced \u201cis going to cut it\u201d.<\/p>\n It is \u201ca massive oversight of workforce planning\u201d that specialty training places weren\u2019t increased at the same rate as medical school places over the past decade, she said. <\/p>\n \u201cWe\u2019re worried that getting into specialty training is going to be less about choosing your burning passion and more about just getting a job. I\u2019m concerned that will push people into specialties they don\u2019t want to do, which will lead to more burnout and drop-outs later in the process.\u201d<\/p>\n The competition for specialty training places does result in a sense of pressure to accept a job even if it does not come at the right time or in the right place, another doctor told The i Paper.<\/p>\n Daniel Faehndrich, 30, is in his second year of obstetrics and gynaecology training in the Kent, <\/a>Surrey and Sussex region. Obstetrics and gynaecology<\/a> is a run-through specialty, which means that only one application \u2013 after the first two foundation years of training \u2013 is required instead of two.<\/p>\n \u201cWhen I got this job, I wondered if I should wait another year\u201d before entering training to \u201cget a bit more experience\u201d, but \u201cthen you see the competition ratios go from seven to one in my year of applying to this year being 16 to one\u201d, he told The i Paper.<\/p>\n \u201cI almost feel guilty about the idea of wishing I hadn\u2019t taken the job because there are so many people fighting to get a job,\u201d he said. \u201cI have been quite unhappy at times.\u201d <\/p>\n![\"LIVERPOOL,](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/10\/SEI_268331292.jpg\")
Health Secretary Wes Streeting pledged several measures to address the competition ratios issue, but the BMA said he must move faster (Photo: Jeff J Mitchell\/Getty Images)<\/p>\n