There has been a significant rise in the number of students wanting to study medicine in the UK, figures show.

This is despite well publicised challenges in medicine in recent years, including strike action, nine health secretaries since 2020 and competition for specialty training posts.

In October 25,770 applied for medicine courses, a rise of 10.4% compared to the previous year. This rise reverses a consistent fall in the number of applications since 2022.

The highest number on record was in 2022, when 29,710 applied.

After A-level results were published last week, universities accepted 13,040 applicants onto medicine and dentistry courses.

This represents a 2% increase on last year, when 12,750 applications were accepted, but a 19% increase on 2020.

The increase has happened despite a disruptive few years for the medical profession.

Since the 2019 General Election there have been nine health secretaries, the latest being Yvette Cooper in Prime Minister Andy Burnham’s cabinet.

Industrial action has been a common theme too with 15 rounds of strike action between 2023 and this year until the BMA’s resident doctor members agreed to accept the government’s latest offer on pay and working conditions.

GP Dr Akash Gandhi runs The UKCATPeople, a website which helps students interested in medicine through the UCAS process.

He said medicine “remains an attractive career” and there are increasing numbers of students from a wide range of backgrounds considering the profession, including those who may be the first in their family.

“I think greater awareness that medicine is an achievable career path for people from different backgrounds is a positive development,” he said.

“Importantly, I don't think students are unaware of the challenges facing the profession. The strikes, pressures on the NHS and wider uncertainty around speciality applications are certainly things that students and their families are aware of when making decisions about their future.

“However, I don't think those challenges necessarily outweigh the reasons people are attracted to medicine in the first place.”

Medicine has its challenges like any profession, he added, but students recognise the rewarding aspects of it particularly if they gain work experience or shadow doctors.

University of Nottingham associate professor in medical education Rachel Woods said the Covid pandemic increased the visibility of healthcare professionals to young people.

“Many of the students starting university this year would have been in secondary school when the Covid pandemic hit. If becoming a doctor interested them during this period, it would have been quite good timing as they would have had the time to prepare, ensuring they got the GCSE and A level results needed to study medicine,” she said.

Medical schools have also increased their efforts to widen access to medicine, Woods added. “This can be a lengthy process as it requires efforts at several stages of education, starting from secondary school. So we may hopefully be starting to see this work paying off, which I really hope is the case.”

Creating future bottlenecks?

The British Medical Association (BMA) has called for a pause in the increases in student numbers until postgraduate training capacity has improved.

The union’s medical students committee chair Erin MacCabe said: "It is encouraging to see so many young people motivated to serve in our NHS, but enthusiasm alone can only carry a generation so far. Expanding medical school places without proper investment in the required infrastructure and educators risks diluting our world-class standards.

“Beyond graduation, expansion in numbers must be matched with more foundation and specialty training posts.

“While recent progress through the resident doctors' deal in England is a positive step forward, there is still a long way to go to fix the medical training pipeline to make sure this next generation of doctors can progress to become the GPs and consultants of the future.”

Professor John Alcolado, associate pro vice chancellor of a planned new medical school at the University of Wolverhampton, previously told Doctors.net.uk that calls for a managed reduction in medical school intake “looks like ladder pulling”.

“We should be honest with people and say look you can do five years of medical school – it may be then difficult to get a job.

“You might not end up being a cardiothoracic surgeon in your chosen specialty. To my mind fairness means if someone wants to study medicine, they’re aware of the risks of it – we should give them the opportunity,” he said.

Resident doctors are trialling changes to rotations to cut commutes and keep them in the same team for longer.

About 200 doctors in England will take part in pilots that will test different approaches, including reducing the geographical size of a rotation area, keeping clinicians in the same hospital trust when they move post and making rotations longer with fewer changes.

The British Medical Association (BMA) said the 19 projects could help end the “absurd” current system that can uproot doctors between different hospitals several times a year.

Resident doctors often receive very little notice of where they will be working next and the distance between hospitals can be vast, the union said.

In a Royal College of Physicians survey of doctors in training last year, 41% said geographical rotations had a negative impact on their training. Some 28% wanted them abolished entirely, and 50% said they should continue only with reform.  

NHS England said under the plans doctors should be able to travel less and stay closer to home, have more certainty about where they will be training and have more choice and control over their rotations.

Reform to the rotation system was part of the deal between the government and the BMA that ended resident doctor industrial action in 2024.

'Overdue for reform'

The pilot initiatives, which will take place across different stages of training, have been set up by NHS England and the Department of Health and Social Care with agreement from the BMA.

Dr Shivam Sharma, BMA resident doctors committee deputy chair and training lead, said rotations created difficulty for doctors and hospitals.

“This absurd system has been overdue for reform for years,” he said. “Doctors with their whole careers ahead of them are being sent from hospital to hospital, sometimes as often as several times a year. They are expected to uproot their lives, find new accommodation, rebuild their support networks, and adjust to an entirely new workplace – only to do it all again months later.”

While the system allows doctors to get a diverse range of experience, it is also an “exhausting burden” for clinicians, the BMA said.

Rapid changes prevent hospitals from having stable teams and doctors-in-training building strong relationships with colleagues.

The first phase of a nationwide medical training review led by NHS England published last year found the rotational structure was the second most frequently cited barrier to rewarding, satisfying postgraduate training.

If successful, the new approach should be rapidly rolled out, the union said.

Sharma added: “In some departments, colleagues barely have time to learn a doctor’s name before they move on. Resident doctors lose the opportunity to develop lasting relationships with consultants who understand their strengths, can invest in their development, and gradually give them greater clinical responsibility to become the experienced specialists we need.”

The pilots include:

• Smaller geographical footprints: in East of England core anaesthetics, the programmes have been redesigned to be within a single Integrated Care Board footprint, or geographically closer.  
• Longer and fewer rotations: some ST1s working in obstetrics and gynaecology in the South West will stay at one provider for 12 months, instead of rotating to a second provider after six months.  
• Keeping rotations in one trust or hospital, where possible: in London the Internal Medicine Training stage one programme will be in one hospital trust.  
• Offering longer duration posts for less than full-time trainees: in geriatric medicine in the North West, trainees who have been in their current placement for 12 months will potentially be able to extend it to 18 months.   
• Speciality training programmes: two programmes will be set up where resident doctors will only rotate between two trusts for the entirety of their training programme. In higher anaesthetics in the South West, for example, trainees will rotate between two sites, not three.

  

A Department of Health and Social Care spokesperson said: "We know that frequent relocations can have an impact on wellbeing, retention and workforce planning for resident doctors.

“That is why we've been working in partnership with the BMA and NHS England to review rotational training and launch this pilot, marking the completion of every commitment made under the 2024 resident doctor deal.

"This shows what government and unions can achieve by working together."

One in four resident doctors in the UK said their training is adversely affected because rota gaps are not dealt with appropriately, a major survey has found.

The General Medical Council’s (GMC) national training survey also found that one in three (29%) hospital doctors who are trainers said education is harmed by staffing issues.

Additionally, 141 trainees reported experiencing unwelcome sexual conduct on a daily or weekly basis, an increase of 23 trainees compared with 2025.

The GMC described it is a “small but real” increase.

The annual survey - answered by more than 51,000 doctors in training and nearly 23,000 doctors who are trainers – found 61% of resident doctors are at moderate or high risk of burnout.

However, the GMC pointed out that many indicators, including those for burnout and reporting of discrimination have shown “early signs” of improvement.

Despite “continued pressures on health services”, doctors in training were still positive about core components of their education, with over three quarters rating the quality of their teaching as good or very good, the regulator said.

But the regulator urged organisations to take action following the one percentage point increase in trainees reporting frequent unwelcome sexual conduct over last year.

“Any rise in this measure matters, and trainees must be able to work and learn free from harassment,” the regulator said. “We will continue to expect organisations to take direct action to address this.”

There were small improvements in the number of doctors in training experiencing discriminatory behaviour, the GMC found.

In all, 72% reported never experiencing micro-aggressions, negative comments, or oppressive body language from colleagues – a one percentage point increase from last year – and 63% said they felt confident reporting discrimination without repercussions, which is up two percentage points.

Other findings included:

• 55% of trainees reported having no support from a mentor.
• 64% said they have access to leadership opportunities.
• 22% reported that their working pattern leaves them feeling short of sleep on a daily or weekly basis.
• 52%, an increase of two percentage points on last year, said the rota design helped optimise their education and development, while 80%, again a small increase, were given enough notice about their rota in advance of starting their current post.
• 61% of foundation doctors said they felt adequately prepared for their first post, a rise of two percentage points from 2025, but for internationally qualified doctors the rate remained at 45%.

GMC chief executive Charlie Massey said while it was encouraging to see improvements in some areas, the survey also highlights variation in experiences.

“Every doctor, regardless of where they train or work, should have access to a high-quality training environment that supports their development and wellbeing.

'Goodwill stretches only so far'

“By acting on this evidence, we can all create conditions in which doctors can thrive and for patients to receive the best possible care.”

BMA council deputy chair Dr Emma Runswick said it was heartening that nine in ten doctor trainers say they enjoy the role.

“But goodwill stretches only so far in an understaffed NHS, and recent attempts to cut consultant pay for this work will only make matters worse.

She added: “Nearly three in ten hospital or secondary care trainers say gaps in doctors’ rotas go unaddressed and over a than a quarter of doctors can't use their training time as intended.

“Burnout remains rife - and is worsening for some, especially GPs. These doctors do one of the NHS's most vital jobs, often without the time or support to do it well.

“Reports of sexual harassment are rising and too many still fear the consequences of reporting discrimination. Doctors deserve training environments that are safe, not just survivable.”

The Department of Health and Social Care have been contacted for comment.news.doctors.net.uk/news/5YdRbpOUtUECxrYvUBu58B

They argue that the act denies British students studying medicine at the overseas campuses of British universities fair treatment and breaches ECHR principles designed to protect against discrimination.

The students say the law effectively excludes them from NHS training, because the allocation process for the foundation programme must now prioritise doctors who trained in the UK and other priority categories.

The solicitors argue that section 1 of the Medical Training (Prioritisation) Act 2026, read with section 4, is incompatible with their clients’ human rights under article 14 of the ECHR (read with article 2 protocol 1 and with article 8) and also contravenes article 8 of the ECHR read on its own.

>"Then there’s productivity. Why should doctors have their salaries insulated from the awful service they help deliver? Some of my colleagues work fiendishly hard; plenty more very much do not. But what matters for society is that the NHS overall now performs abysmally, delivering often dismal outcomes and always for ever more money."

This guy sounds like an insufferable prick to work with. I wonder what his colleagues think about him.

A doctors’ group has demanded a new set of standards for assessments in emergency departments after the death of two boys with appendicitis who were seen by advanced practitioners after being referred by GPs.

The children were “appropriately treated in primary care” and their GPs recognised the need for an urgent hospital assessment, Doctors’ Association UK told health secretary James Murray.

“These cases raise serious questions about the safety of current assessment systems in emergency departments and the roles of non-doctors,” Dr Sarah Jacques and Dr Steve Taylor, DAUK GP co-leads, wrote in a letter [pdf] to James Murray.

One of the boys, eight-year-old Ethan Hanson, died last year from septic shock, peritonitis and perforated appendicitis. He went to the GP because of abdominal pain, vomiting and a concern there may be a serious underlying cause.

The GP accurately recorded a raised temperature and tachycardia and advised he went straight to hospital, but did not send a written referral. There were several issues related to his care that were raised by the coroner.

Hanson was discharged from George Eliot Hospital in Nuneaton, Warwickshire after an assessment by a nurse AP who thought he had constipation.

A GP referral is equivalent to a medical consultant opinion in the community, and needs a further medical assessment, Jacques and Taylor wrote.

“It is deeply concerning that such referrals can result in decisions being made by non-doctors regarding their care or discharge before they are reviewed by a doctor. Patient safety must always be the priority,” they added.

DAUK is calling on the government to introduce a new set of standards – that any patient referred by a community GP to hospital must be assessed by a doctor and no patient presenting with undiagnosed symptoms should be discharged without the approval of a doctor.

Jacques and Taylor have asked the health secretary to review the current status of assessments in emergency departments to ensure doctors are involved in all cases of undifferentiated care and GP referrals.

“It is vital patients are kept safe and lessons are learnt before they become endemic,” they stated.

They raised the approach taken by the Leng Review, which looked at how physician assistants were used in wards, as an example Murray can use to investigate how many assessments are done by non-medics.

The Department of Health and Social Care said: “Our sympathies are with the families affected by these tragic cases. Patient safety must always come first.

“Advanced practitioners are highly trained professionals who play an important role in multidisciplinary teams, but they are not a substitute for doctors and should work within clearly defined roles and responsibilities.

“The NHS has safeguards in place to ensure patients receive the right care, with appropriate consultant oversight.”

Curious to know how they arrived at 3 years instead of 5

I find it interesting that the coroner did not mention anything about this child being seen by an ANP instead of a doctor, and goes on to blame the GP for not writing a referral letter or calling an ambulance for the patient.

Doctors' representatives have voted for advanced practitioners to have a scope of practice to avoid creating a "two-tier" system in healthcare.

Delegates at the British Medical Association’s annual representative meeting (ARM) backed a motion calling for “clearly defined limits of practice and requirements for supervision and oversight”.

These should be developed as part of a government review into the roles’ impact on patient safety and workforce development, doctors said.

Failing to implement such changes could lead to a system where poorer patients see advanced practitioners (APs) and those who can afford private treatment see doctors, the conference in Brighton heard.

The BMA has expressed increasing concern in recent months that patient safety is being put at risk by the use of APs, who are nurses and allied health professionals with a postgraduate degree, on doctors’ rotas.

At the ARM, Dr Samuel Parker from the BMA north east regional council accused the UK government of “investing billions of pounds of taxpayers’ money into a programme of doctor substitution”.

“A paradox of doctor shortages and doctor unemployment should not exist,” he added.

'Patients want to see a doctor'

He pointed to World Medical Association guidance which recommends physician-led multidisciplinary teams as the gold standard.

“Patients want to see a doctor and they should be able to. However, patients in deprived communities appear increasingly likely to rely on substitution.

“Tragically, the UK risks creating a two-tier health system, where those who can afford private healthcare will spend thousands of pounds to see a GP or consultant instead of seeing the NHS doctor substitute,” Parker said.

Speaking for the motion, resident doctor Dr Molly Nobbs said she asked a trainee AP in emergency medicine what their scope of practice was.

“Her answer is ‘there isn’t one’. That should terrify every single one of us,” she said.

One GP, although broadly in favour of the motion, expressed concerns about a part of the motion which requires APs do not diagnose or manage undifferentiated patients independently.

In the context of practices having to manage unlimited work “it would not be practical for every single patient to be discussed before going home,” he said.

Dr Emma Runswick, deputy chair of council, said: “We value our AP colleagues and what they can bring to multi-disciplinary teams but we are clear that some tasks must only be done by uniquely trained doctors. 

“If government can ensure there are clear scopes of practice defining what APs can and can’t do, and enforce them, then the risks of safety errors will reduce considerably.

“Workforce planning must not count on staff who are not appropriately qualified for the tasks they are being deployed to carry out – patient safety must be prioritised through a commitment to supporting the unique training of doctors. The conference has today supported this policy in very clear terms.”

Almost eight in 10 GPs have admitted to deviating from standard medical practice to avoid patient complaints or being referred to the doctors’ regulator, according to a new survey.

GPs said they are more inclined to prescribe certain medications, refer patients or spend longer writing notes to prevent backlash.

This practice – known as “defensive medicine” – can lead to overdiagnosis and leave patients feeling needlessly anxious.

In a Pulse survey of 836 GPs, some 78% agreed that the threat of complaints had led them to practise more defensive medicine than they feel is best for their patient.

One GP said: “I have found myself practising more defensive medicine at times, perhaps investigating or referring where previously I might have watched and waited.

“Despite time constraints, I find myself writing essays in patient notes to make sure I’ve covered my own back, safety-netted clearly.

“This, combined with patient attitudes, has made working in the NHS almost untenable in the current climate.”

'Growing sense of pressure'

Figures from NHS Resolution show it is dealing with around 3,000 cases a year involving GPs.

One doctor described general practice as a “very high-risk environment” and said “the only way to navigate this is to act and practise defensively and have a low threshold of risk”.

“Otherwise, almost certainly something will come back to bite you,” they added.

The poll forms part of a new report being launched at Pulse Live in Birmingham on Tuesday.

Dr Sarah Townley, deputy medical director at Medical Protection, said: “We know our members feel a growing sense of pressure.

“They’re worried about all sorts of medicolegal issues – complaints, claims, even police investigations – it’s definitely at the back of their minds.”

The NHS performs better when cash is tight, the head of the service has said.

Sir Jim Mackey, chief executive of NHS England, said that when the health service has “flexibility” with money it tends to “not spend it well”.

He also said that new patient experience standards, which will help the service keep people informed when they have been referred for care, will be rolled out.

Speaking at the NHS ConfedExpo conference in Manchester, Mackey said that “tension is a good thing” when it comes to NHS finances.

On money for the service, he told delegates: “If I’m absolutely honest, in all the time I have been in the NHS, we have performed better, and we have got better results, when things are quite tight.

“Generally, when we’ve had flexibility, we tend to not spend it well, we can tolerate pilots, we can invest in something that’s supposed to stop something else, and then before you know it, you’ve got two channels rather than one.

“So, I think the tension is a good thing. I don’t buy that we need a lot of extra money.” Mackey said that the service had “built credit with the Treasury so when there is headroom we will get it”.

He spoke as resident doctors in England prepare to go on strike over pay and jobs, and consultants and specialty, associate specialist, and specialist doctors are balloted over strike action.