New data published by the General Medical Council (GMC) reveals that more than one in five trainee doctors have felt hesitant about escalating patient care.
The GMC’s 2025 national training survey, the UK’s largest annual insight into medical training, surveyed over 71,000 doctors and trainers. For the first time, it asked about escalation of care – a critical safety issue. While 79% of trainees reported never feeling apprehensive, 21% said they had hesitated at least once in the last 12 months. The figure rose to nearly a third in specialties such as surgery, obstetrics and gynaecology, medicine, and emergency medicine. Those most hesitant to escalate care were also more likely to experience burnout.
The findings come at a pivotal moment, as the UK Government’s 10-Year Health Plan for England: Fit for the Future sets out a bold vision to transform the health services through a new workforce model.
Professor Pushpinder Mangat, Medical Director and Director of Education and Standards at the GMC, said: "These findings are extremely concerning because doctors need to work in environments where they feel comfortable escalating. When they don’t, there are potentially serious risks to patient safety.
The Government’s 10-Year Health Plan rightly recognises that a modern health service must empower its workforce and foster a culture of openness and safety. The GMC is committed to supporting this transformation and playing our part. The national training survey is one of several vital data resources we produce to help to identify where change is needed, and ensure that training environments are safe, inclusive, and fit for the future."
The majority of trainees remain positive about their training - with 76% saying their teaching was good or very good, and 87% rating their clinical supervision highly.
This year’s data highlights the general pressures faced by trainers with 29% reporting training was adversely affected because of rota gaps. The survey underpins the need for more flexible, fair, and innovative training pathways, reflecting the ambitions set out in the 10-year Health Plan for England, and the priorities of similar workforce strategics across the UK. It also strengthens our ongoing ask for training time to be protected, and capacity increased to support the needs of trainees, trainers, and the patients they care for.
Professor Mangat added: "Our data and workforce insights can support governments and organisations across the UK as they look to drive improvements to ensure that every doctor can thrive.
"We will continue to share our findings to help address concerns, celebrate good practice, and play our part in building a workforce that is confident, supported, and ready to deliver the health services of the future."
