麻豆区

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14/11/25

14 November 2025

‘Bottlenecks in medical training reflect a long-term failure of workforce planning’: why the next NHS workforce plan must deliver lasting change

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Launched last year, the aims to support and empower residents to deliver the best possible patient care, while advocating for radical reform of the postgraduate medical training system.

During our Med+ breakfast session, Dr Max Thoburn interviewed Professor Mumtaz Patel, who set out the scale of the challenge during an open conversation in front of more than 100 people.

Professor Patel welcomed the diagnostic report of the medical training review, which she said reflected many of the challenges raised by resident doctors for years. But she warned that the key question now is 鈥榳hat happens next?鈥�.

With a plethora of organisations including medical royal colleges, NHS England and trusts all holding responsibility for different parts of the system, she stressed the need for clear accountability and realistic implementation timelines. 鈥楨veryone wants change,鈥� she said, 鈥榖ut it needs to be sustainable.鈥�

A central theme was the rise in training bottlenecks. from 1.4 in 2019 to around 5.27 this year. Professor Patel was unequivocal: this is the result of long-term workforce planning failures.

鈥楾he expansion of medical school places was well intentioned,鈥� she noted, 鈥榖ut foundation posts, supervision capacity and training time didn鈥檛 follow. The bottlenecks simply worsened.鈥�

Asked about physician assistants, Professor Patel was clear. 鈥楧octors cannot 鈥� and must not 鈥� be replaced. Multidisciplinary teams add huge amounts of value, but this should never be at the expense of medical training.鈥�

鈥榊es, trusts face competing pressures 鈥� ambulance waits, corridor care, emergency departments 鈥� but looking after our workforce must be front and centre,鈥� she argued.

On the question of prioritising UK graduates, she emphasised the importance of fairness. 鈥榃e must not disadvantage our international medical graduate colleagues who have served the NHS for decades,鈥� she said. 鈥楤ut NHS experience matters, and doctors leaving medical school in the UK should be able to continue their training in the NHS. We cannot continue losing good people.鈥�

The discussion turned to the , where Professor Patel welcomed local progress but warned that accountability and sustained implementation were essential. 鈥楪ood training and supervision lead directly to good patient care,鈥� she said. 鈥楽enior buy-in is improving, but we need monitoring. You need carrot and stick.鈥�

There was a clear appetite for greater transparency. 鈥楾he government must not use training numbers as a bargaining tool,鈥�  stressed Professor Patel. 鈥榃orkforce planning should be based on need, not negotiation.鈥�

On postgraduate exams, Professor Patel described the M麻豆区(UK) Part 2 written examination error (September 2023) as 鈥榙eeply distressing鈥�. She welcomed the 鈥檚 recommendations, emphasising that governance and processes must be strengthened to prevent future incidents.

Other key areas included the need for a radical rethink of generalist medicine training and better integration of community placements, digital health and AI technologies into curricula.

鈥楢 tweak here and there isn鈥檛 working,鈥� Professor Patel explained. 鈥楳any residents see general internal medicine as a tick-box exercise, so we need a radical rethink 鈥� high quality education, supported trainers and incentives that make generalist medicine a valued career choice. This is the only way we鈥檒l be able to deliver the 10 Year Plan hospital to community shift.鈥�

Ending with a conversation about flexibility, rotational training and inclusive workplace culture, Professor Patel agreed that the NHS should make inter-deanery transfers easier and tackle unacceptable behaviours and bullying. 鈥楥reating fair, inclusive and supportive cultures isn鈥檛 optional,鈥� she said. 鈥業t鈥檚 the foundation of safe and sustainable care.鈥�

Closing the session, Professor Patel thanked participants, reaffirming her commitment to championing the concerns of resident doctors throughout the next phase of the training review. 鈥榃e cannot let this become another report that sits on a shelf,鈥� she said. 鈥楻esidents need change, and they need it to last.鈥�

As the voice of physicians at every stage of their career, the 麻豆区 will continue to speak up on behalf of our fellows and members to shape the next phase of the 10 Year Health Plan, the 10 Year Workforce Plan and the national medical training review.

This Med+ 2025 breakfast session was exclusive to in-person delegates and is not available to watch on-demand. But don鈥檛 despair! You can until 10 February 2026. In the meantime, why not explore our medical streaming service, , packed full of webinars, videos and podcasts?