The latest NHS England management data has shown the real life and immediate impact of the Medical Training Prioritisation Act.
The Act came into force in March responding to concerns about increasing competition faced by UK-trained doctors for postgraduate medical training posts.
It has delivered what it promised despite being urgent legislation coming into effect during a live recruitment meaning we could only deliver prioritisation at offer stage rather than application stage as we will in the future.
Competition ratios have halved, prioritised doctors have filled 98% of roles, and in some specialties, like General Practice, all posts have been filled by prioritised doctors.
In summary, 37,689 applications successfully met the required appointable level for one of 9,520 specialty training posts. This is a competition ratio of 4-1. 19,706 applications were from prioritised candidates, reducing the competition ratio to 2-1.
This means 98% of posts were filled by priority candidates compared to 72% in 2025.
In round 1 only 1.75% of offers accepted to date are from non-prioritised applicants compared to 27.95% last year, a reduction from 2,168 to 163 in one annual cycle.
The non-prioritised applicants accepted roles only in specialties or geographies prioritised applicants did not want.
Also, for the first time ever, 100% of GP training places were accepted by UK graduates or applicants already working in the NHS. This compares to 62% last year.
Background
The latest application numbers drawn from NHS Specialty recruitment data on the Oriel recruitment system www.oriel.nhs.uk. This data is date stamped 27 June 2026, and is subject to change over coming weeks as doctors make individual decisions.
The Act prioritises UK trained medical graduates and those with significant NHS experience over International Medical Graduates for specialty medical training.
For 2025 we used a proxy measure of immigration status as we consult about the definition of significant NHS experience for future years.
Each candidate can make a maximum of 5 applications, so application numbers do not equate to number of applicants (individual doctors).
Information about the estimated competition ratios was previously published here: NHS England » Medical Training (Prioritisation) Bill – information for applicants to medical training