The Royal College of Physicians (RCP) has published a full write-up of the findings from its national next generation campaign survey of resident doctors, revealing deep concerns about the quality and experience of postgraduate medical training in the UK. The RCP survey results paint a stark picture of training being delivered in an environment of rota gaps, relentless service pressures and widespread burnout.
Drawing on responses from over 1,000 resident doctors across the UK and authored by a group of early-career physicians, the RCP has published a full survey write-up, a blog on next steps from Dr Hatty Douthwaite, a registrar in renal and general medicine and deputy chair of the RCP Resident Doctor Committee (RDC), and a set of 10 campaign priorities that set out what doctors would like from the medical training review.
The RCP national ‘next generation’ survey of resident doctors reveals:
- Just a quarter (26%) of resident doctors feel ready for the next step in their career
- Less than 1 in 5 (17%) think that postgraduate recruitment processes are fair
- Most (72%) cited insufficient staffing and rota gaps as the biggest negative impact on training quality and wellbeing
- This was followed by high clinical workloads (66%) and poor IT (59%)
- Only 65% of respondents expect to still be working in the NHS in 5 years.
"Opportunities for training are limited by short staffing, heavy workload, lack of direct supervision opportunities and lack of interest from consultants in training development," commented one resident doctor.
Another commented: "There’s no flexibility built into the system. When someone is off sick or away, we’re just expected to absorb the extra workload without recognition, or support. When I advocate for my training needs, I’m made to feel like a burden or a troublemaker. The system is broken, and we’re burning out trying to hold it together."
Working with its RDC and Student and Foundation Doctor Network, the RCP has been campaigning for action to reduce competition ratios in specialty training. The RCP warns that without urgent action, the NHS risks losing a generation of talented doctors who feel undervalued and unable to develop the skills needed for safe, effective consultant practice.
Systemic pressures are eroding both training quality and resident doctor wellbeing, leaving many feeling undervalued. The majority (72%) cited poor staffing levels and rota gaps as the biggest negative impact, followed by high clinical workloads (66%) and poor IT systems (59%), which add daily inefficiency and frustration.
Resident doctors consistently described internal medicine training (IMT) as overly focused on service provision with very little time for training, education, procedures or outpatient clinics. Many feel like ‘service fodder’ rather than doctors in training, with opportunities for feedback, mentoring and skill development rare or tick-box in nature.
Among the RCP’s next gen top 10 calls for reform are:
- Fair and transparent recruitment processes that bring down competition ratios
- Rota and rotation reform that makes training more flexible and supportive
- Guaranteed protected learning time and national standards for supervision
- Assessments that add value, ending the current ‘tick-box’ approach
- Better digital, financial and leadership training to support the future NHS
- Get the basics right by creating safe, supportive workplaces
- Long-term workforce planning that increases medical training places.
Dr Hatty Douthwaite, lead author and deputy chair of the RCP Resident Doctor Committee said: "The national medical training review must confront the underlying structural problems that shape how doctors are developed and supported. Operational fixes alone are not enough to provide the change that resident doctors need. Across the country, resident doctors have been clear about what is broken – recruitment processes that feel inconsistent or unfair and workloads that leave little space for genuine learning and risk widespread burnout."
Dr Catherine Rowan and Dr Stephen Joseph, co-chairs of the RCP Resident Doctor Committee, said: "These findings make stark reading, yet reflect what has long been known – that postgraduate medical training must urgently adapt and reform if we are to successfully train and retain the next generation of physicians. The current system is strained, often at the expense of medical training, and risks doctor burnout.
"Resident doctors are expected to deliver frontline care while learning complex skills, but the structures that are supposed to protect them from ever-increasing service pressures are either stretched too thinly or are simply non-existent. The medical training review offers a once-in-a-generation opportunity to fundamentally improve how we deliver medical training. If we fail, we risk losing the high quality NHS workforce that we need to meet future population demand."
The NextGenPhysicians campaign was launched by the RCP in 2024 to ensure that resident doctors are supported and empowered to deliver the best possible patient care. The findings will feed directly into the NHS England national medical training review.
