New NHS data shows impact of Medical Training Prioritisation Act on specialty training recruitment

The latest workforce data from NHS England shows a shift in speciality training recruitment following the introduction of the Medical Training Prioritisation Act in March 2026

Early figures from the live recruitment cycle suggest a marked reduction in competition ratios, a substantial change in the make-up of successful applicants, and near-complete filling of posts by prioritised candidates.

Recruitment outcomes across speciality training

Across the current cycle, there were 37,689 applications appointable for 9,520 speciality training posts. This equates to an overall competition ratio of approximately 4 applicants per post.

When prioritised candidates are considered separately, 19,706 applications fell into this category, reducing the effective competition ratio to around 2 to 1 for these applicants.

The data also shows that 98% of all available training posts have been filled by prioritised candidates, an increase compared with 72% in the 2025 recruitment round.

Analysts caution that application numbers do not directly equate to individual doctors, as each candidate is permitted up to five applications, meaning the true number of applicants is lower than the total application count.

Shift in prioritisation and offer patterns

A key feature of Medical Training Prioritisation Act is the strong effect of prioritisation at the offer stage. Because the legislation came into effect during an ongoing recruitment cycle, prioritisation was applied at the point of offer rather than at the application stage, a mechanism expected to evolve in future rounds.

In round one of recruitment, only 1.75% of accepted offers were taken up by non-prioritised applicants. This is a decline from 27.95% in the previous year.

Acceptances by non-prioritised applicants fell from 2,168 to 163 within a single recruitment cycle.

Where non-prioritised applicants were successful, they tended to secure posts in specialities or geographic areas where prioritised applicants had not applied or declined offers.

General Practice sees full prioritised fill

One of the most surprising outcomes has been in General Practice training, where all available posts were accepted by UK graduates or doctors already working within the NHS. This compares with 62% in the previous year’s intake.

The shift suggests a substantial change in the distribution of training opportunities, particularly in high-demand areas where competition has historically been intense.

Background and implementation

The changes stem from the introduction of the Medical Training Prioritisation Act, designed to address concerns over increasing competition for postgraduate medical training places faced by UK-trained doctors.

The policy prioritises UK-trained medical graduates and doctors with significant NHS experience over international medical graduates when allocating speciality training posts.

For the 2025 cycle, a proxy measure of immigration status was used while consultation continued to define “significant NHS experience” for future implementation.

Recruitment data is drawn from the Oriel recruitment system, the national platform used for speciality training applications.

As the current cycle continues and candidates continue to make individual decisions, NHS England has noted that the figures are subject to change in the coming weeks.