The Doctors’ Association UK (DAUK) has co-signed a letter to the Health Secretary warning of an impending employment crisis for resident doctors.
The letter to Wes Streeting, signed by a number of organisations representing NHS doctors including DAUK, calls for urgent reforms to workforce planning.
The letter highlights the findings of a recent British Medical Association (BMA) survey showing more than half of doctors completing foundation training in 2025 will not have secured employment.
Financial catastrophe
This represents not only a personal and financial catastrophe for thousands of newly qualified doctors, but also a major risk to patient care in an overstretched NHS.
“This is not just a statistic,” the letter states. “It represents a looming workforce crisis in the NHS.
“Thousands of newly qualified doctors, trained at great personal cost and national investment, are poised to enter unemployment while the health service struggles under immense clinical demand.”
The letter cites Health Education England (HEE) figures that in 2025 more than 30,000 doctors applied for just 10,000 training positions.
Training posts
The government has pledged an additional 1,000 training posts over three years, but this figure, while welcome, ‘is far from sufficient’, the letter says.
International recruitment is another key issue. The letter criticises the government’s encouragement of international medical graduates (IMGs) to sit the PLAB (Professional and Linguistic Assessments Board) exam without a guarantee of employment or career development.
It argues this risks creating false hope for doctors from abroad while worsening the UK’s own workforce bottleneck.
The letter also raises concerns over the expansion of medical school places without a corresponding increase in postgraduate training opportunities, as well as the growing reliance on physician assistants (PAs) in roles traditionally held by junior doctors.
Physician assistants
“The fast-track integration of PAs into clinical teams, often in roles traditionally filled by early-career doctors, has caused concern among junior doctors, especially given disparities in training, regulation, and accountability,” it warns.
DAUK and the letter’s signatories are calling for a package of urgent reforms, including:
- Substantially expand specialty training numbers to match domestic graduate output and wider NHS needs
- Regulate PLAB intake so international recruitment aligns with the system’s capacity to provide fair and structured career progression
- Clarify and regulate the role of PAs, ensuring their work complements not replaces early-career doctors
- In rural areas where the demand for healthcare is high compared to the number of available providers, it is essential to ensure a fair distribution of resources. Special focus should be given to geographically underprivileged regions, supported by attractive incentives to encourage healthcare professionals to serve there
The letter warns ‘the combination of over-recruitment, inadequate training opportunities, and unclear workforce planning is leading to disillusionment’.
Many young doctors may be forced to leave the profession or emigrate to countries such as Australia, Canada, and the Gulf states, ‘where their skills are valued and career progression is clearer’.
System failure
The letter concludes: “The NHS stands at a critical juncture. Without decisive intervention, we risk losing a generation of doctors – not from lack of talent or commitment, but because the system failed to offer them a viable future.
The letter requests a formal response from the Health Secretary within three months and offers to meet to discuss potential solutions.
Read the letter in full below.
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Doctors without jobs: a growing crisis in the NHS workforce
Dear Rt Honourable Health Secretary Mr Wes Streeting MP,
It is deeply concerning that, according to a recent British Medical Association (BMA) survey, more than 52% of doctors completing their foundation training in the UK in 2025 will be without secured employment when their programmes end.
This is not just a statistic, it represents a looming workforce crisis in the NHS.
Thousands of newly qualified doctors, trained at great personal cost and national investment, are poised to enter unemployment while the health service struggles under immense clinical demand.
A key driver of this crisis is the mismatch between the number of qualified doctors and the limited availability of structured training posts. In 2025, over 30,000 doctors applied for just 10,000 training positions. While the government’s pledge to create an additional 1,000 training posts over three years is welcome, it is far from sufficient.
At the same time, the government continues to encourage international medical graduates (IMGs), many from developing countries, to sit the PLAB (Professional and Linguistic Assessments Board) exam, which enables them to work in the UK. PLAB test capacity has expanded significantly, yet there is no guarantee of suitable employment or career progression once these doctors arrive. This practice risks creating false hope, financial hardship, and brain drain in countries already struggling with healthcare workforce shortages, while adding to the oversupply crisis in the UK.
Further pressure comes from the rapid expansion of UK medical school places, up around 25% over the past decade, without a proportionate increase in postgraduate training numbers.
In parallel, the fast-track integration of physician assistants (PAs) into clinical teams, often in roles traditionally filled by early-career doctors, has caused concern among junior doctors, especially given disparities in training, regulation, and accountability.
This combination of over-recruitment, inadequate training opportunities, and unclear workforce planning is leading to disillusionment. Many young doctors are now considering leaving the profession or emigrating to countries such as Australia, Canada, and the Gulf states, where their skills are valued and career progression is clearer.
Urgent action is needed. We call on the government to:
- Substantially expand specialty training numbers to match domestic graduate output and wider NHS needs.
- Regulate PLAB intake so international recruitment aligns with the system’s capacity to provide fair and structured career progression
- Clarify and regulate the role of PAs, ensuring their work complements not replaces early-career doctors
- In rural areas where the demand for healthcare is high compared to the number of available providers, it is essential to ensure a fair distribution of resources. Special focus should be given to geographically underprivileged regions, supported by attractive incentives to encourage healthcare professionals to serve there.
The NHS stands at a critical juncture. Without decisive intervention, we risk losing a generation of doctors – not from lack of talent or commitment, but because the system failed to offer them a viable future.
We request a response to this letter within three months and are available to meet with you to discuss the matter and explore appropriate solutions.
Signatory organisations
Prof Aamer Sarfraz, President, Association of Pakistani Physicians and Surgeons UK (APPS UK)
Prof Amit Sinha, President, British International Doctors Associations (BIDA)
Prof Amjad Shad, President, Nishterian Alumni UK
Dr Atef El-Kholy, President, British Egyptian Medical Association (BEMA)
Dr Colin Hutchinson, Chair, Doctors for the NHS
Dr Ellen Welch, Co-Chair, Doctors Association UK (DAUK)
Dr Faisal Raja, President, Rawalpindi Medical University Alumni UK
Dr Hina Shahid, Chair, Muslim Doctors Association (MDA) and Allied Health Professional CIC
Dr Irfan Rashid, Chair, Allama Iqbal Medical College Alumni UK (AIMCA UK)
Dr Javed Arain, Chair, Quaid E Azam Medical College Alumni
Dr Nabeel Arman, Vice President, Sudan Doctors Union UK
Dr Nadeem Sajjad Raja, President, Association of Pakistani Physicians Of Northern Europe (APPNE)
Dr Saadia Alvi, President, Punjab Medical College Alumni UK (PMCAUK)
Dr Shahid Latif, Chair, British Pakistani Psychiatric Association (BPPA)
Dr Waseem Khan, Chair, Association Of Pakistani Physicians And Surgeons, Scotland
