Trend of IMG doctors leaving NHS could threaten general practice, warns GMC

A trend for internationally qualified doctors to leave the NHS workforce is ‘gathering pace’ and could threaten general practice and the Government’s plan for neighbourhood health, the GMC has warned.

A new report by the regulator shows that greater numbers of non-UK qualified doctors left practice last year – 4,880 doctors, who obtained their primary medical qualification outside of the UK and who had been working in the UK, left in 2024, a 26% increase on the previous year’s 3,869. 

The regulator said that this is the first significant year-on-year rise since the pandemic, with 3,968 non-UK qualified doctors leaving in 2022 and 3,824 in 2021.

The GMC said that this is particularly worrying as some specialties are ‘especially reliant on international doctors’, citing general practice as the main example.

It comes after the Government’s 10-year plan pledged to prioritise UK medical graduates – and other doctors who have worked in the NHS ‘for a significant period’ – for foundation and specialty training.

But the GMC said that it is critical that any changes made are based on what the data says ‘about how the system has been working’.

The report said: ‘For instance, while more international doctors are securing places in specialty training programmes, their success rates in those applications remain much lower than those for UK-trained doctors – in 2024, 23% compared with 69%.

‘And some specialties are especially reliant on international doctors. In general practice – central to the government’s vision for neighbourhood health services – half of 2024’s first-year trainees qualified outside the UK.’

GMC chief executive Charlie Massey said the wider impact on a current workforce that is ‘heavily reliant on doctors from all over the world’ must be considered before any policy changes.  

He said: ‘Doctors represent a mobile workforce, whose skills are in high demand around the world. Internationally qualified doctors who have historically chosen to work in the UK could quite conceivably choose to leave if they feel they have no future job progression here, or if the country feels less welcoming.

‘Any hardening of rhetoric and falling away of support could undermine the UK’s image as somewhere the brightest and the best from all over the world want to work.

‘It is vital that workforce policies do not inadvertently demoralise or drive out the talent on which our health services depend. Doctors who qualified outside of the UK make up 42% of those working in the UK. If we see even a small percentage increase in them leaving, our health services will end up with huge holes that they’ll struggle to fill.’

He added that this problem would be ‘compounded in general practice’.

He added: ‘Whatever the future makeup of the workforce, we all – from employers to regulators, policymakers to the profession itself – have a duty to recognise the essential contribution all doctors make, irrespective of background, and to ensure that each one is supported and valued accordingly. 

‘That’s crucial for the professionals providing care but, also, most importantly, for the patients receiving it.’

In response to the report, the RCGP warned that losing international medical graduates after training risks worsening GP shortages and called for easier routes to remain in the NHS.

Earlier this year, the college wrote to the Government to demand a ‘permanent, sustainable solution’ to visa sponsorship issues for international medical graduate (IMG) GPs.

As it stands, IMG GPs who typically spend three years completing their training in the UK are unable to meet the threshold of five years to apply for Indefinite Leave to Remain upon qualifying. And, with most GP practices not signed up to the visa sponsorship scheme, most IMGs are finding it ‘difficult’ to stay in the country.

RCGP chair Professor Kamila Hawthorne said: ‘The NHS, not least general practice, relies heavily on international medial graduates (IMGs) to deliver the increasing volume and complexity of care patients need.

‘If fewer are working in the NHS post-qualification, as today’s report finds, it will have consequences for our already overstretched general practice service, and the amount of time patients are waiting for care. This is a deeply concerning trend, and the reasons for it must be identified and addressed.

‘We regularly hear from our IMG members how arduous and expensive the process to stay working in the NHS post-qualification can be given the need to secure employment in a practice with a licence to sponsor them.

‘As such, we want to see GPs from overseas given the right to apply for Indefinite Leave to Remain upon completion of GP training.’

Last year the GMC found that the UK had more doctors from ethnic minority backgrounds than white doctors, while numbers of non-UK graduates in GP training continued to rise.

Pulse has contacted the Department of Health and Social Care for comment.