A last-minute government pay rise offer and commitment to create 4,500 specialty training places has led to the British Medical Association (BMA) calling off a four-day resident doctor strike planned from Monday at 7am, until Friday at the same time.
Dr Jack Fletcher, chairman of the BMA had strongly advocated for more jobs for resident doctors, at a time when a rapid expansion of medical school places led to training places not keeping pace.
“All we have asked for is a fair offer that secures enough jobs to tackle the madness of doctor unemployment and take steps to address the erosion of our pay,” Dr Fletcher said.
The BMA will now take the offer, which includes an average 6.6 per cent pay increase to be fully implemented by April 2027, to its resident doctor members for approval.
It averted what would have been the 16th round of strikes since 2023 – and when the NHS faced a “triple whammy of pressure” because it coincided with warm weather and the World Cup.
The UK doctor shortage and unemployment bottleneck
Now the NHS is discovering that increasing the number of graduates is easier than increasing the number of specialist training posts.
A doctor typically progresses from medical school to foundation training (two years) through to specialty training (GP, surgery, anaesthetists, psychiatry, emergency medicine, etc.) to progress to becoming a consultant or fully qualified GP.
The bottleneck is often the specialty training – many doctors finish foundation training but find there are not enough specialty training places for everyone who wants one.
Currently, NHS hospitals have offered just 13,000 specialty training posts annually, but receive 25,000-33,000 applications – leading to an excess of up to 20,000 medical students missing out.
Early career doctors are impacted the most by the training shortfall. With around 20,000 missing out each year, the data points to 52 per cent of second-year newly qualified graduates unable to find jobs.
That means the public investment per medical graduate – estimated to be £230,000 – is partly wasted because some leave the NHS or UK.
The mismatch worsened in 2020 when the UK medical school intake increased by 7,000 students, and a new visa rule led to a sharp rise in international graduate applications from 12,000 to over 25,000.
International doctors were originally encouraged to come to the UK to help fill workforce shortages, but now compete directly with UK graduates for a fixed number of places.
The government’s new commitment to create 4,500 more training posts helps, but the BMA is likely to push for more.
The government’s offer paves the way forward
Professor Ramani Moonesinghe, national clinical director for critical and perioperative care at NHS England, said: “It is extremely welcome news that the BMA has called off next week’s strike – for both patients and NHS staff.
“The BMA has recognised the positive changes we have made for both resident doctors and patients over the last year – but we are not complacent, we know more is needed and that working conditions have not been good enough, and we will continue to do more to make the NHS a desirable place to work.
“I want to thank staff across the NHS who have worked extremely hard to maintain care for patients throughout recent industrial action – and I really hope today is a positive step in the right direction to end strikes once and for all, while we continue to ensure the NHS is the best place to work for resident doctors now and in the future.”
Health Secretary James Murray said the decision to call off the “unnecessary strikes” was “a positive and welcome development – especially for patients.
He added that after a 28.9 per cent pay rise for resident doctors over the last three years, “the country simply cannot afford to increase the pay offer for this year”.
The resident doctors’ agreement suggests governments may increasingly need to combine pay settlements with reforms to training, recruitment and career progression. Whether that becomes a template for resolving other public-sector disputes will depend on whether doctors themselves decide the offer goes far enough.
The surplus of doctors is only part of the NHS’s challenge; it remains below the OECD average of around 3.5-4 doctors per 1,000 people and patient waiting lists remain high.
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