The Royal College of Physicians (RCP) has supported a statement calling for a fair and evidence-based approach to recognising the contribution of international medical graduates (IMGs) in postgraduate medical training recruitment.
The statement from the Academy of Medical Royal Colleges responds to the UK government's plans to define what constitutes ‘significant NHS experience’ for doctors applying for specialty training from 2027 onwards as part of work to implement the Medical Training Prioritisation Act 2026.
The Academy has said that significant NHS experience should be defined as no less than 2 years and no more than 3 years, recognising the contribution of doctors who have already developed experience working in the NHS while supporting the retention of UK graduate doctors.
The RCP supports a definition of significant NHS experience based on 3 years of NHS work, while stressing that any threshold should be evidence-based and kept under regular review as application numbers change and evolve. Decisions should take account of factors including competition ratios, NHS workforce requirements, patient demand and immigration patterns.
RCP president Professor Mumtaz Patel said: "Based on current thinking, and recognising that the evidence is limited, we have supported the development of regulations that recognise doctors with 3 years of significant NHS experience alongside UK medical graduates and other priority groups. In our discussions with NHS England, we have emphasised the importance of putting these regulations in place in good time for the 2027 recruitment round."
Through its next generation campaign, the RCP has called for action to improve access to postgraduate medical training and create a more sustainable training pathway for doctors. The college believes that tackling training bottlenecks and supporting progression must go hand in hand with recognising the contribution of international colleagues already working in the NHS.
"Over the past few years, unsustainable competition ratios have affected the career progression of too many resident doctors, which is why we welcomed this legislation," explained Mumtaz. "But we have been very clear that the NHS relies on the skills, expertise and dedication of international medical graduates (IMGs), who make a vital contribution to patient care across the UK."
In its response to an NHS England stakeholder engagement exercise, the RCP said that future prioritisation should be based on NHS experience rather than immigration status, helping to create a system that is fair, transparent and welcoming to the UK's international medical workforce.
"Setting thresholds too high could risk losing experienced international doctors from the NHS," said Mumtaz. "It’s important that we find the balance between a training system that supports and enables UK graduate doctors to enter postgraduate training schemes in the NHS while recognising the substantial contribution made by IMGs who have chosen to build their lives in the NHS."
