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It wouldn’t be wrong to say that international medical graduates (IMGs) form the backbone of the NHS workforce. To this day, around 35% of NHS doctors and nurses are from countries outside the UK, including EU nations. In fact, 1 in every 3 healthcare workers in the NHS is a foreign-trained professional. Yet, they deliver care at par with NHS standards, having passed rigorous medical exams, attended mandatory workshops, and completed essential training to qualify for clinical roles in the UK.
However, this dynamic could soon change.
Earlier this month, the Department of Health and Social Care released a 10-year plan for the NHS workforce. A few key points have sparked concern, particularly among the international medical community:
Priority will be given to UK medical graduates for specialty training posts.
Overseas recruitment is set to be reduced by 10% by 2035. [1]
Although the NHS plans to increase the number of specialty training posts by over 1,000 in the next three years, the above measures have left many aspiring doctors feeling uncertain about their future. Currently, a significant number of PLAB/UKMLA-cleared, GMC-registered candidates are struggling to secure jobs or training positions despite meeting all eligibility criteria.
Struggles of Overseas Doctors
Most international medical graduates in the UK come from India, Pakistan, and Nigeria, along with several countries listed as "red list" nations by the British Medical Association (BMA)—countries where the health systems are considered to be under-resourced. [2]
NHS recruitment bodies have gradually made it harder for new IMGs to land entry-level positions such as FY2 standalone, trust-grade, or non-training roles. This is partly due to the growing number of overseas applicants flocking to the UK. Yet, curiously, PLAB slots have not been reduced—fueling the false perception that recruitment is still thriving. Many only realize the job market’s competitiveness after arriving, when they see few vacancies and fierce competition.
Despite these hurdles, aspiring IMGs go through clinical attachments— mostly by paying hospitals for observational opportunities—followed by ALS, ATLS, and other courses, often out-of-pocket. Many junior-level job postings now list MRCP/MRCS Part 1/2 as essential requirements, despite these exams traditionally being for specialty training posts.
On top of that, some jobs even require a minimum of 4 months NHS experience—an ironic demand for newly registered doctors seeking their very first NHS role.
MedBound Times connected with Dr. Yahiyah, GMC-Registered Doctor from India, for his thoughts on the "10-year plan for the NHS workforce".
This plan comes as a surprise—and not in a good way. GMC should pause PLAB exams or reduce the number of sessions to avoid this bottleneck in specialty training. That alone would save many aspirants from disappointment.
Dr. Yahiyah, GMC-Registered Doctor from India aiming for surgical training
Job Vacancies That Vanish in Hours
NHS job postings for IMGs often close within 4 hours of going live, overwhelmed by the volume of applications. This high influx began post-COVID, during a wave of aggressive recruitment to fill healthcare vacancies. But now, very few roles are available, leading to frustration among UK graduates as well, who are also struggling to secure specialty training.
According to the British Medical Association, around 20,000 doctors may not get into specialty training this year.
How Will This Impact IMGs?
Those already in the system—GMC-registered doctors waiting for jobs—will understandably be disheartened. Medical students abroad who dream of a career in the UK may now hesitate before embarking on the UK pathway.
MedBound Times also connected with Dr. Athira, MRCP Part 1 qualified, Aspiring Internal Medicine Specialist, for her thoughts on the "10-year plan for the NHS workforce".
“Reducing IMG workforce numbers is heartbreaking for those of us chasing our dreams. Licensing exams are costly and time-consuming. If there are no jobs, what’s the point?”
— Dr. Athira, MRCP Part 1 qualified, Aspiring Internal Medicine Specialist
Those in non-training jobs are also under immense stress, unsure whether they’ll get into a training post—or even find a new job once their current contract ends.
Is This a Good or Bad Move?
It depends. For UK medical graduates, it's a welcome development—they deserve access to training opportunities in their own country. But for IMGs, it’s a grey area. Reducing immigration from high-volume or red-listed countries could help address system overload, which was a concern raised by the Health Secretary.
That said, this plan does not halt overseas recruitment; it aims to streamline it. Now, only highly skilled doctors with competitive profiles may be able to make it to the UK.
What Should IMGs Do Now?
This is a long-term plan. The current atmosphere may feel discouraging, but situations evolve. Every sector has highs and lows—this too shall pass.
To the many young doctors aspiring to build a future in the NHS, here’s a word of advice:
“Keep striving for excellence—because whether in the UK or anywhere else, true skill and dedication in medicine are always recognised.”
References:
Fit for the Future: 10 Year Health Plan for England – Executive Summary. London: UK Department of Health and Social Care, April 2025. https://assets.publishing.service.gov.uk/media/686639056569be0acf74db89/fit-for-the-future-10-year-health-plan-for-england-executive-summary.pdf.
NHS Employers. “Code of Practice: Red and Amber List of Countries.” Accessed June 15, 2025. https://www.nhsemployers.org/articles/code-practice-red-and-amber-list-countries.
(Rh/Dr. Shubham Halingali/MSM/SE)
