Doctor leaders vote to ‘prioritise’ UK medical graduates for training posts
Doctor leaders have backed a proposal to prioritise UK medical school graduates over international medical graduates (IMGs) for training posts.
BMA leaders voted in favour of a motion to guarantee all UK medical school graduates a foundation programme post for all future recruitment cycles, as well as offering UK graduates specialty training posts first.
At the final day of their annual representative meeting (ARM) in Liverpool today, BMA representatives took part in an ‘open debate’ on reforming postgraduate medical training and were presented with two conflicting motions to help form future policy.
It comes after GP leaders criticised BMA resident doctors for passing a ‘protectionist policy’ around speciality places at last month’s UK LMC conference, arguing that it disadvantaged IMGs.
The successful motion at the ARM, proposed by the BMA UK Medical Students Conference (MSC), condemned the ‘Government’s failure in workforce planning’ as the cause of medical students facing unemployment in the near future.
MSC deputy co-chair for education and training Callum Williams opened up the debate in favour of the first motion by saying that ‘foundation programme recruitment is broken’.
He continued: ‘For years we’ve had over subscription so that means we haven’t had enough posts for the number of applicants. That’s been driven by UK medical school graduates increasing, but also an increasing number of international graduates.’
Mr Williams pointed out that the system the MSC was proposing was in line with other countries such as Australia, New Zealand and Ireland – as well as in the UK’s dental foundation programme.
‘It recognises that those people who invest in significant amounts of money, often accumulating debts over hundreds of thousands of pounds, as well as the taxpayer investment, should be prioritised for those jobs, considering they require them for registration.
‘We know the Government is thinking about this. Wes Streeting has given interviews where he alluded to this. Media comments over the last few months have increasingly said they are going to do this.
‘This policy gives us the best ability to influence that on your behalf, to ensure that all our members are protected.’
The second motion, proposed by the BMA East of England Regional Council, criticised such prioritisation of UK graduates over equally qualified IMGs as undermining the BMA’s policy on fairness.
Doctors were then invited to take the stand and give brief statements on in favour of either motion.
Many doctors voiced concerns over an ‘arbitrary’ cut off point listed in the first motion regarding specialty training recruitment for IMGs, claiming that it was ‘unfair’ and created a ‘two-tier system’ of international medical graduates.
The motion wanted to introduce a process whereby UK medical graduates are offered posts for medical specialty training posts first; but with an exception for GMC-registered IMGs who had been practising in the NHS/HSC on or before the 5 March and who have ‘two years or go on to gain two years of NHS/HSC experience’.
Those speaking in favour of the second motion, opposing any restrictions on specialty training applications based on country of primary medical qualification, stressed that the problems with UK workforce were not due to an influx of overseas doctors, but a lack of training posts.
Dr Khadija Khan said: ‘We keep hearing about UK graduates being jobless, but the data shows that many of them don’t transition straight into specialty trading by choice.
‘Prioritising UK graduates won’t fix systemic underfunding. It will only scapegoat IMGs and deepen the divide. We should fight for more jobs, not fewer doctors.’
During the open session, doctors were also asked to vote on various statements to do with training and education.
These statements included:
- ‘We support the current model for using Preference Informed Allocation to access foundation training.’
- 68% of respondents disagreed/strongly disagreed
- ‘We support the current recruitment model including MSRA used for assessing suitability for specialty training.’
- 67% of respondents disagreed/strongly disagreed
- ‘All specialty training recruitment processes should have an interview component.’
- 87% of respondents agreed/strongly agreed
- ‘We believe that specialised foundation programmes should be allocated competitively.‘
- 85% of respondents agreed/strongly disagreed
The outcomes of these votes, in which audience members were asked how strongly they agreed/disagreed with each statement, were informal; they will not be used to make BMA policy but to gather opinion on the current postgraduate system.
Earlier this week at the ARM, doctor leaders voted in support of GPs declining to prescribe specialist medication in certain circumstances – including if initiated by non-prescribers.
The motions in full
OS1 – Motion by MEDICAL STUDENTS CONFERENCE: Whilst international medical graduates (IMGs) are a valued part of the UK’s medical workforce, this meeting is concerned by exponentially increasing competition ratios for speciality training, driven primarily by overseas recruitment. This meeting therefore condemns the Government’s failure in workforce planning which has left many medical students and residents in the UK in the untenable position of facing unemployment in the near future. We therefore call on the four nations statutory education bodies and the Department for Health & Social Care to:-
- i) guarantee all UK medical school graduates a foundation programme post for all future recruitment cycles and prioritise UK medical school graduates in the preference informed allocation ranking for UK Foundation Programme recruitment;
- ii) introduce a process for medical speciality training recruitment where UK medical school graduates are offered posts first before any unfilled posts are opened to all other applicants;
- iii) Introduce an exception to part ii for IMGs who are GMC registered and practicing in the NHS/HSC on or before the 5th of March 2025 and who have two years or go on to gain two years of NHS/HSC experience;
- iv) expand foundation programme and speciality programme posts to match increases in UK medical school places with the appropriate workforce planning for expansion of GP and consultant posts CARRIED IN ALL PARTS
OS2: Motion by EAST OF ENGLAND REGIONAL COUNCIL: That this meeting condemns
the persistent failure of UK and devolved nation governments to significantly expand medical specialty training posts and rejects policies that discriminate against international medical graduates (IMGs) already working in the NHS. Prioritizing UK medical graduates over equally qualified IMGs undermines existing BMA policy on fairness, weakens workforce retention, and risks patient care. This meeting resolves to:-
- i) oppose any restrictions on specialty training applications based on country of primary medical qualification, reaffirming equal opportunities for all doctors working in the UK;
- ii) ensure fair access to training for all GMC-registered doctors already contributing to the NHS, without arbitrary cut-off dates or discriminatory prioritization;
- iii) demand that UK and devolved nation governments expand specialty training posts and consultant/GP positions to reduce competition ratios, prevent unemployment, and sustain the medical workforce;
- iv) reform recruitment practices to prevent exploitation of locally employed doctors, ensuring career progression and fair treatment. MOTION FELL NATURALLY AS OS1 WAS CARRIED
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READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
About time! How did we get into this situation in the first place??
“First they came for the socialists, and I did not speak out—because I was not a socialist.
Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist.
Then they came for the Jews, and I did not speak out—because I was not a Jew.
Then they came for me—and there was no one left to speak for me.”
Whilst, I am a trade unionist I am NOT a doctor with an international medical qualification, but I have to speak out for my colleagues: a doctor is a doctor and access to specialty training should be based on merit alone, with exceptions made and support given to those with protected characteristics. Restricting access on the basis of the location of a doctors’ medical degree is as bad as discriminating according to sex, gender, race etc. IMHO.
Following the decision of the RB to pass Motion OS1, prioritising the wants and needs of UK medical graduates over IMGs, I am no longer able to support the BMA as an organisation.
I am therefore resigning my membership, effective from the close of the ARM.
I agree with L-J Evans; exceptions should be made and support given to those with protected characteristics such as UK nationality.
For 4 decades we’ve slavishly following USA neoliberal philosophy in politics and economics. Now globalism is being kicked out by Trump and neo-mercantilism and protectionism is in (anti-Adam Smith, The Wealth of Nations), the BMA’s carried motion is a sign of the weakness of our principles in order to keep step with this trend. The real issue for the BMA to confront is to campaign “bunker-buster” style for real GP funding and not to descend to Dr on Dr attacks.
I applaud L-J Evans’s principled resignation. I’m also a trade unionist (and not an IMG) but, though I’ve paid the subs, I’ve never been impressed with the BMA apparatchiki.
When will Pulse do a survey with the headline “100% of GPs unsatisfied with the BMA’s handling of the Govt?”
Restricting access in the location of applicants medical degree is justified where there are not enough places for applicants. The UK medical graduates needs foundation places to register with the GMC. It is not discriminatory to make room for them.
Sadly this absolutely needs to happen and I was disappointed by LMC conference decision to not prioritise UK graduates. Anyone knowing a relatively newly qualified doctor (child or friend) will understand the need for this. If the selection system actually worked on merit I may be persuaded otherwise. However the current job/training post allocation is not fit for purpose: a lottery that actually appears to disadvantage UK trainees. So I have to congratulate the BMA MSC. Finally the BMA shows some guts to support the next generation of Colleagues.
Perhaps UK Nationals should be prioritised for accomodation if homeless?
For medical treatment if unwell?
For school places?
For Welfare benefits?
Reform would no doubt be in favour.