The Medical Training (Prioritisation) Bill 2024-2026

The Medical Training (Prioritisation) Bill (Bill 360 2024-26) is a government bill. The bill would introduce a system that gives graduates from UK medical schools (and certain other groups) priority for training places to become doctors. The government pledged to do this in its 10-year health plan for England.

The bill was introduced in the House of Commons on 13 January 2026. The government has asked Parliament to fast-track the bill, and it will have all Commons stages (second reading, committee of the whole House, and third reading), on 27 January 2026.

The bill would apply across the UK and the UK Government says it has worked with the Scottish Government, Welsh Government and the Northern Ireland Executive to agree a unified approach across the four nations.

The government has published explanatory notes to the bill (PDF) as well as an impact statement. The bill contains some delegated powers, meaning it gives powers to make further legislation to other bodies (such as ministers) without the need for another bill. The government has published a memorandum for the Lords Delegated Powers and Regulatory Reform Committee (PDF), which explains the reasons for each case of delegated power, to assist the committee’s scrutiny of the bill.

What are the aims of the bill?

In order to become fully registered doctors, UK medical graduates must complete two years of foundation training. To become a consultant in a specialist area of medicine or a GP, doctors require further speciality training, which can take between three to eight years. The bill would introduce a system that prioritises medical training places (for foundation and specialty training) for graduates of UK medical schools in the UK and certain other groups.

Prioritisation for medical foundation training from 2026 onwards (clause 1)

The bill would prioritise the following groups for UK Foundation Programme places:

• UK medical graduates:
  • People who obtained their medical qualification within the UK, excluding those who have spent a majority of their time training for that qualification outside of the UK, Channel Islands or Isle of Man.

• People in the priority group:
  • People who obtained their medical qualification within Ireland, excluding those who have spent a majority of their time training for that qualification outside of Ireland.
  • People who obtained their medical qualification from some countries with which the UK has existing international agreements. Currently this includes graduates from institutions in Iceland, Norway, Liechtenstein and Switzerland.

Prioritisation for specialty training in 2026 only (clause 2)

The bill would prioritise medical specialty training offers for places in 2026 for:

• UK medical graduates (as defined in clause 1).
• People in the priority group (as defined in clause 1).
• People who have started or completed relevant training to prepare for specialty training.
• People with specified citizenship or immigration status. Broadly summarized, this includes those with British or Irish citizenship, the right of abode in the UK on the basis of Commonwealth, indefinite leave to remain or enter the UK, or people with post-Brexit residence rights under the EU Settlement Scheme.

The government has explained, in the explanatory notes to the bill (PDF), that the inclusion of immigration status as a qualifier for prioritisation in 2026, is a temporary proxy to include applicants who already have significant experience working in the four UK health services.

Prioritisation for specialty training from 2027 onwards (clause 3)

The bill would determine how interviews and offers are prioritised for speciality training, from 2027 onwards.

The people that would be eligible for prioritisation are the same as those set out above (prioritisation for speciality training in 2026 only, clause 2), with two key differences:

• Prioritisation based on immigration status would not apply automatically.
• The government would be able to set out new prioritisation groups, using further regulations. The regulations would limit to further prioritisation to people who:
  • are likely to have “significant experience” of working as a doctor in the National Health Service in England, Wales or Scotland or in Health and Social Care in Northern Ireland, or
  • fall within a specified immigration category.

The government has explained in its explanatory memo to the bill (PDF) that the aim any further regulations, specifying further prioritisation groups, would be to capture people with “significant experience” of working as a doctor within the UK health services. NHS England has said it will work with stakeholders to agree on how “significant experience” is best defined.

When is the bill expected to come into force?

The government has asked Parliament to fast-track the parliamentary progress of the bill. A fast-tracked bill, also known as an expedited bill or emergency legislation, is a bill which passes through all the normal parliamentary stages in both Houses, but on an expedited or fast-tracked timetable.

The explanatory notes to the bill (PDF) say it requires Royal Assent by 5 March 2026 so that it can be implemented for foundation and specialty training posts starting in August 2026 and the bill “does not have time to go via normal procedures”.

Why is the government introducing the bill?

In its 10-year health plan for England, published in July 2025, the government pledged to give priority for NHS jobs to UK-trained doctors, amid concerns about increasing competition for specialty training posts and UK medical graduates being left without jobs. The government has said the bill implements its commitment in the 10-year health plan for England.

Government offer to the British Medical Association

In December 2025, the government made an offer to the British Medical Association (BMA) to improve access to specialty training places for medical graduates trained in the UK and Republic of Ireland. This was part of efforts to resolve the resident doctors strike called for 17 to 22 December 2025. The offer included bringing forward emergency legislation to address this.

The BMA surveyed members before rejecting this offer on 15 December. The BMA reported that its resident doctors committee chair said the government proposals “did not go far enough to address doctors’ concerns”. After the BMA had confirmed its decision to proceed with the strike, the Secretary of State for Health and Social Care, Wes Streeting, told the Health and Social Care Committee that the government would continue work to bring forward the proposed legislation.

How competitive are speciality training posts?

In 2025, there were a total of 80,218 applications for 9,479 speciality training posts in the first round of applications. This meant that for every post there were on average 8.5 applications. Competition varied substantially between specialties.

Competition for medical training posts has increased over the last ten years. While the number of doctors offered medical training places has nearly doubled, from 6,415 in 2013/14 to 12,176 in 2023/24, the number of applicants also grew. This is partly because the number of international doctors who apply has increased. The non-UK proportion of all those who receive offers rose from 26% in 2018/19 to 34% in 2023/24.

Nevertheless, the application success rate for international doctors remains much lower than for UK-trained doctors – 23% compared with 69% in 2023/24.

General practice is particularly reliant on international doctors. Half of first-year GP trainees qualified outside the UK in 2024.

Concerns about increasing competition for specialty training posts

Recently there have been various concerns about increasing competition for specialty training posts and concerns that UK graduates who have completed the foundation programme subsequently cannot access training posts and therefore progress to higher medical training.

In February 2025 NHS England launched a Medical Training Review into postgraduate training for medics and the first report was published in October 2025. The Medical Training Review and 10-year health plan for England, published by the government in July 2025, cite various reasons for the increased competition in specialty training places:

• increases in the number of medical degree places in England (without an equivalent increase in specialty training places)
• candidates applying for more than one specialty training place due to increased competition
• an increase in the number of overseas medical graduates applying for specialty training posts

The Medical Training Review has said increases in the number of overseas medical graduates applying for UK training posts started before 2019. It says the trend reflects increased service needs in secondary care, changes to working hours regulations and overseas medical graduates being “significantly over-represented in LED [Locally Employed Doctor] posts”.

The government (in its response to written parliamentary question 92219) and the Medical Training Review have also cited immigration policy changes from 2019 for the increase in the number of overseas medical graduates applying for UK training posts. These include:

• adding doctors to the shortage list for work visas in 2019,
• removing the resident labour market test in 2020, and
• introducing health and care visas in 2020.

How have stakeholders responded to the bill?

Various stakeholders have welcomed the bill. Some have raised concerns, such as:

• the effects on international medical graduates and whether the bill would reduce opportunities for career progress,
• whether the bill is fair to international graduates who have already financial, professional and personal ties to the UK system,
• a lack of clarity in the bill about how it would affect international medical graduates, and
• the effect on the NHS workforce and its ability to fill staffing gaps.