The Doctors’ Association UK (DAUK) has warned that hundreds of newly-qualified doctors face an uncertain future after being allocated placeholder roles.
There are now less then two months before this year’s graduating cohort is due to start work.
Around 700 final-year medical students still have no information about which trust or rotation they will be working in. That’s around 5.5% of the cohort.
They have, in effect, been placed on a waiting list.
The delay hampers their ability to arrange relocations, find accommodation, and puts a strain on their mental health, DAUK’s student committee says.
It also creates challenges for NHS workforce planning and integrating graduate doctors into hospital systems.
DAUK’s student committee has highlighted the impact on individuals in an open letter to Health Secretary Wes Streeting and to the Department for Health.
The committee calls for an urgent review. It says the reform of the allocation system and workforce strategy are ‘essential’.
Read the letter in full below.
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Statement on placeholder jobs
This year, nearly 700 final-year medical students – around 5.5% of the graduating cohort – have been allocated to ‘placeholder’ roles within the UK Foundation Programme.
These positions function as a waiting list rather than confirmed jobs, and many new doctors still have no information about which trust or rotation they will be working in.
More than two months have passed since these doctors were randomly assigned to this reserve list. In contrast, their peers have already received confirmed placements and begun preparing for their transition into clinical practice.
This marks the third consecutive year that a large number of graduates — more than 700 in 2023 and again in 2024 — have found themselves in this position. This suggests that the issue is no longer an isolated backlog but a systemic and recurring feature of the current allocation process.
The system itself, which is based on a lottery rather than merit, understandably leads to frustration. Being placed into limbo at such a critical point undermines confidence in the process and raises concerns about transparency and fairness.
The impact on medical student wellbeing is profound, with clear implications for the future of the profession. A BMJ Open study published in February 2025 found that one in five medical students considered leaving the profession altogether1.
While mental health issues such as emotional exhaustion, anxiety, and depression were cited as key drivers to these dropout intentions, the added uncertainty of not having a confirmed post after graduation only compounds this burden.
Newly qualified doctors are experiencing burnout at alarming levels. The General Medical Council’s 2024 National Training Survey found that a majority of trainees report emotional exhaustion – emphasising the unsustainable working conditions they are entering into.2
Medical students accept a certain level of stress as part of their training but facing exhaustion so severe that many consider leaving the profession points to a far deeper crisis. On top of this, they are preparing to enter a healthcare system already under significant strain – an environment that further undermines their confidence and worsens existing mental health challenges.
This delay in receiving a secure job also creates challenges for workforce planning within the NHS. Foundation doctors are a core part of clinical teams, and late allocations leave little time for induction, rota planning, or integration into hospital systems. Trusts are left preparing to onboard staff with
minimal notice, which affects team stability and patient care.
With less than two months remaining before this year’s cohort is due to start work, many graduates are still unable to make basic arrangements such as securing housing or planning relocation. The timeline is unworkable, especially when considering the demands of starting a high-responsibility clinical role.
This situation raises broader questions about long-term planning. If the UK is consistently producing more medical graduates than can be immediately placed, urgent review and reform of the allocation system and workforce strategy are essential. Training future doctors is a long-term investment – but failing to provide them with timely entry into the system risks undermining that investment entirely.
Resources:
- Medisauskaite A, Silkens M, Lagisetty N, Rich A. UK medical students’ mental health and their
intention to drop out: a longitudinal study. BMJ Open. 2025;15(2):e094058. - Council GM. National Training Survey: Summary Report 2024. London: General Medical Council;
2024 2024 Jul 25.
