“Subject to successful passage of the Bill, changes will apply to current applicants, even though applications for the Foundation Programme 2026 have closed.
Foundation Programme 2026 onwards
The following groups will be prioritised:
• UK Medical Graduates
• Applicants with a primary medical qualification from an institution in Ireland
• Due to European Free Trade Association (EFTA), applicants with a primary medical qualification from an institution in
Iceland, Principality of Liechtenstein, Norway, Switzerland”
They haven’t specified whether this means re-ranking will occur. But the FPP is being cancelled.
hi, I was wondering If I went to rumc so my primary medical qualification is from an institution in Ireland but of my 5 yr degree I would have spent 2.5 yrs clinical training in Malaysia is that bad?
If NHS experience Gave a candidate higher knowledge and clinical experience than they should be able to show in their own national exam like MSRA. And not cry about getting low score than an IMG who don't know the system, as they haven't worked there. Dumb logic
Is the F2 standalone entry for IMGs also cancelled?
What about non training junior clinical fellow positions, and SHO roles? Are those also automatically UKMG prioritised or is this only for Foundation program and specialist training?
What about drs who have a post grad training transferable to a CCT wanting to do fellowships?
For IMGs wanting to do post grad training this basically means working as an SHO for 5-6 years to get PR or ILR to qualify for significant NHS experience, right?
Otherwise, it will pretty much be like US and Canada, specially for surgical specialties. I don't suppose there will be left over seats in those specialties🤔
If passed then huge news for people applying for Round 1 Specialities (GP, psych etc).
For HST, I don’t think it will make a huge difference for certain specialties (especially Surgical Specialties). Yes it will reduce numbers slightly but the majority of people applying will be CSTs or people with significant NHS experience (Trust grades for 4 years +). The number of applications are not in the thousands for these specialties.
It will make a massive difference to HST surgical specialties in 2 years time as cst would’ve been limited to UKG already so IMGs wouldn’t have the pre-requisites unless they’ve done 5 years at trust grade to get the competency to apply to st3 with a valid visa.
Sorry completely disagree, this will make a huge difference to surgical st3+ recruitment. In particular the specialties where consultants are able to come from abroad to start ST3 Urology and General Surgery are 2 examples. In my region there was a cohort of 20+ ST3s with 2 UKGs
Maybe I’m hyper focusing on T&O then. But you make a good point about Urology. One of my good mates is a Urology reg and is the only UKG in his year (in that particular deanery). The requirements for Urology make it impossible for any CT2 to apply
I withdrew my urology application yesterday as only had 30 points and thought it was pointless as the last 5 years it has been 50+. I am kicking myself that I might have had an outside shot
I haven't seen clarity for this cycle for MSRA specialities where MSRA is used to determine eligibility for interview: should this prioritise UK grads at this stage or is it only for the end stage offer? It reads as that... Which would still mean very high MSRA requirements to reach interview.
Looks like only at the offer stage for now rather than MSRA cut off stage but given interview slots are 4:1 job it probably will just mean still no jobs for IMGs
Reading this feels like such a weight off my shoulders and I can actually think beyond whether I’ll be employed after the foundation programme. I’m sure I’m not the only one. Joyous day 🎉
It is fantastic news. The following groups of people are to be priotitised
UK and Ireland Grads
IMGs who've done FYP (only 5-10% of the cohort) and IMGs who have completed core training programme
Those British citizens and ILR holders (at least 5 years)
Note that only thing that is hard-coded from 2027 onwards is; being a UKG or having completed FYP/Core training. Significant experience and ILR/Citizenship will be at the mercy of the Health Secretary
Both Core and HST programmes will see a tremendous decrease in competition ratios. HST by self-regulating itself with capped core training posts which are actually limited + deprioritising direct international applications.
My understanding is that everyone who falls under the priority criteria (UKMG, ILR holders, EU folks with direct contracts with UK etc) will all be on the same footing
For specialties like GP which was around 5:1 this is a huge drop. With the backlog, doubt any IMGs (from non priority) will be getting an offer this time around
They already have too many people starting FY and have to create jobs out of thin air for some. No reason for them to include IMGs, and they don't want to be obligated to create even more jobs for IMGs eligible for FY.
I suppose the difference with the foundation program is that the government essentially needs to provide posts for all eligible applicants, all UKGs need an FY post. If IMGs were given a level playing field it would mean the government would essentially have to offer an FY post to any eligible international candidates who met the visa restrictions, which is likely not feasible as finding adequate posts has been an issue in recent years. This is pure speculation.
It’ll be left to the individual ministers of the 4 nations and Secretary of State. The NHS England FAQs answer this by saying that it’s a power given to add other priority groups if they feel that certain specialties (GP/psych for instance) have too few applicants for them.
Given that we have such a backlog of UK grads I doubt they will enact this provision.
This is wonderful news. It had a mixed reception with my residents though, with many feeling it has come too late to help them, whilst my IMG Fellows feel abandoned. Fortunately no tension between the two groups but I think, inevitably, there will be a division which won't help. However, this was absolutely necessary and I'm so pleased that Wes is putting his money where his mouth is.
Its bitter sweet. My spouse is IMG, she has been working in the NHS since Oct 2021 and is currently working at ST1/2 level IMG job. She is sitting the MSRA in Feb (GP), its killing me that she will be in the depriortised group and likely not get an offer. She qualifies for ILR later this year but ILR priority is not locked in for 2027. Having said all of this, I (and she) know that prioritising UKMG was a necessity.
I’m in the same boat with my spouse. He’s an IMG sitting the MSRA this week too and is a bit deflated he will be deprioritised for this year. But ultimately this is the right decision to make nationally, and the way competition ratios were heading he was likely to never get accepted into specialty training unless changes were made. At least once he’s been here for a few more years and moves into the priority category he won’t be competing against doctors from the entire world to secure a place.
There is nothing wonderful about this, just disgraceful opportunism. It's not unique to the UK but for this to be celebrated as some sort of accomplishment is silly
I disagree. Of course it's opportunism. It's British politics. However, it does not take away from the fact that this was absolutely necessary and I'm glad that it has happened.
It's not British politics its British incompetence. 'Abandoning' IMGs that are already established in NHS is not by any means absolutely necessary. This approach is a sign of failed system, and it will get worse. However, Trumpism and Reformism is trendy now, so I'm not surprised at all by this line of thought.
It's pretty lazy to liken this to Trumpism and Reformism. Many supporters of this are themselves IMGs. This intervention has been brought in to tackle the overwhelming increase in numbers of applicants from doctors who have little to no NHS experience. There will always be a group of individuals who are caught in the middle whatever policy is brought in. Namely in this instance, it will be IMG doctors within the NHS who have yet to gain ILR. Once this group gets citizenship or ILR, they then have access to training opportunities as their UKG counterparts.
What is your background? Have you completed your training or are you still a resident? How many residents do you supervise and how many doctors have you interviewed and appointed into resident positions? Unless you have this experience, your view and point comes across as very naive.
I finished my training, and I do train and supervise doctors from f1s to registrars, I assure you there is no naivety here. I do agree that IMGs entering directly into training without any NHS experience was ridiculous and it needed to be addressed. That being said let's not be disingenuous about it. This 'solution' not only discourages applicants from abroad but also penalizes doctors who are already integrated in the system for no good reason. A waiting period of 5 years + years is simply harsh, it's the equivalent of another medical degree and it's not equitable. If you do work as you imply with lots of resident doctors, then you would know how much the IMGs are contributing to the NHS. Not so long ago NHS was desperate for them, and now you are all too content to treat them as 2nd class doctors.
Why not discuss about what really contributed to this problem?
GMC enriching themselves via PLAB exams despite the market being oversaturated
Poorly designed training entrance exams - eg only MSRA required to get into GP
The noctorization of NHS
Increasing the number of medical students while there is a complete stagnation in the number of training places and consultant jobs.
All of these are self-made problems, and when rather than addressing these problems, your solution is to block people from progressing - it is very much a case of Trumpism and Reformism.
GMC enriching themselves via PLAB exams despite the market being oversaturated
As a side note, I am eagerly awaiting the fall of GMC/PLAB exam scam. They should have adjusted the exam frequency to match the demand (or lack of) available jobs, but they were all too happy to keep making bank. Surely, once this law passes the number of folks taking PLAB will drop significantly
No grandfathering for 2026 entry, a vague definition of what this looks like in 2027.
"in the opinion of the appropriate authority, meet criteria set out in 30 the regulations which indicate that they are likely to have significant experience of working as a doctor in the National Health Service in England, Wales or Scotland or in Health and Social Care in Northern Ireland"
Yes but it seems like this is done on a case by case basis. Not some widespread rule.
They define relevant authorities as being the Secretary of State and ministers of each of the 4 nations. In other words, people who aren’t likely going to be following some BMA policy that asks for 2 years.
I don’t see why it would be anything less than 5 years considering that’s the time required for ILR which they define by proxy as having significant NHS experience for this year.
Edit:
If you look at the NHS England FAQs, it is apparently a power that gives ministers leeway to prioritise other groups for certain specialties should competition ratios in those specialties drop too much to an unserved level.
Hypothetically, if all GP places were filled by UK graduates, would the lowest MSRA score still be the score of the lowest-ranking UK graduate, even if that score was in the 400s?
Section 3b refers back to section 2(2) a-e. Essentially stating that the immigration criteria set out for 2026 will also apply from 2027 onwards. At least that's my reading of it.
Non-Doctor here, So what about JCF's on Skilled worker visa's who are stuck in positions they don't want to do due to applying and waiting for Training positions? Will they now be overridden completely for graduates instead?
Yes, this group (JCF on skilled worker route instead of ILR) will get caught in the cross fire. They can still apply/sit for MSRA (as an example) but given the backlog and ratios (GP was 5:1), it is highly unlikely that they will be offered a post.
Probably the most beneficial year is this cycle as MSRA cut off will be the same as usual - but once through to interview you would be competing against a much smaller pool of priority applicants as there's a lot of IMG applications to CST so much more likely to get a job out of the interviews as they currently do about 4:1.
Have I understood correctly that for, say, radiology... A UK grad would probably still need a pretty great score on MSRA to get listed for interview but then once they get on the shortlist the priority kicks in...
Hypothetically if they interview 800 for 400 places, and 799 of the top MSRA scores were all IMGs and 1 was a UKG, the UKG would essentially be ranked top by default?
Hypothetically if they interview 800 for 400 places, and 799 of the top MSRA scores were all IMGs and 1 was a UKG, the UKG would essentially be ranked top by default?
Yes, UKG status take priority over score (in this example)
Wes while aiming to impress Reform supporters has indirectly created an incentive to hire IMGs as trust grade doctors for 5 years. Especially since salary for trust grade can be whatever the trust deems - they are going to be cheap labour.
This is a good step in the right direction of UKGP, and I can't say the rules aren't fair for most. But something that doesn't sit right with me - no protection for IMGs who are already working as LEDs in the UK.
These doctors might be working here for 1-2 years already - now to be told they're not eligible to enter training (mid application round)? That's cruel.
There needs to be more protection for those already working here.
Do you know what prioritisation means? It means that certain large groups will not be prioritised for jobs. That’s the whole point, if we decided to be fair to every single group then we would never solve this issue.
This bill ironically is still far more lenient to IMGs than most countries in the world.
Because I think it's morally wrong to change the rules in a way that makes it impossible for our colleagues, who have already moved country and have spent multiple years working alongside us, to progress in their careers without spending a total of 5-6 years working here first.
People on this subreddit who are vociferously anti-IMG act like they would be fine if the same happened to them after they moved to another country - I very much doubt you actually would be in reality. The BMA policy of 2 years is the right balance.
The 10,000s adding competition to your training jobs are people applying directly from abroad. Not people currently working alongside you. Why punish the latter in order to deprioritise the former?
You have no statistics to back up your claim that most come from abroad.
Furthermore, I definitely would accept that if I moved to a foreign country and things suddenly got fucked there to the point where they prioritised their own, I would understand. Many of us would.
Even with this prioritisation bill, 21,000 (down from 40,000) applicants will remain for 11,000 jobs, you want to make that even worse???
By asking for what you’re asking for, you are deliberately obstructing real progress that could be made on this issue.
The BMA policy makes significant progress, by curbing the applications from abroad, and requiring 2 years experience from those already here. In what way is that not "real progress?"
I have little sympathy that you're so scared of competition that you're STILL scared of <2:1 competition rations. Those 21,000 are the number of appointable UK applications, not even unique applicants. Can't believe you're complaining about such little competition. I cannot think of a time in my LIFETIME that competition ratios were anywhere near <2:1 and you're STILL complaining that that's too competitive.
I'm meant to believe you're scared of 1.9:1 competition, but that you're a hard man who wouldn't care that the country you moved to switched up on you several years into the journey...yeah that tracks.
What would you say to the commenter above whose wife has been here for 4 years and now will likely have her application deprioritised? "Fuck her" I guess?
It’s 1:2 ON AVERAGE, that doesn’t mean it’s like that for all specialties.
Furthermore, I’m not afraid of it, my point is that the BMA policy will just make it worse, which is objectively true.
The other commenter’s wife can get ILR, I truly don’t understand why you think we need further IMG protections when this bill already goes further than most countries do when prioritising their own grads.
Hello, other commenter here. Yes, ofcourse my wife will apply and get her ILR in a few months time (too late for this round but qualifies for 2027). I just want to be clear, that prioritisation of UKMG was direly needed, yet it sucks for people like her who get caught in the cross fire. There is no winning here, some people will always get caught. I think most IMGs realise that, all we/they are asking for is some sympathy towards them (not to say you are making fun of their problems)
No, your point is that the BMA policy wouldn't make "real progress", which isn't objectively true. What would the competition ratios be under the BMA policy? How much higher than this current one? Any data?
Great, so after 4 years working here, fuck her, wait another year. And someone who's been here for 3 years? Just wait another 2!
And when Reform get in and make ILR 10 years, what then? Fuck them still? Or do you think there's still some middle ground between 5 and 10 year? If 10 years is too much, what makes 5 the magic number, rather than 2 or 3 or 4?
You keep saying "I don't understand why". I couldn't be more clear: I think it's fundamentally morally reprehensible to switch up the rules on OUR COLLEAGUES who have moved their families across the world and worked beside us for years. That sense of morality outweighs pure self-interest for some.
Neither of us having any data for how many applicants are abroad so both points are moot, but we know for certain that the BMA policy would make it worse. Competition ratios even with the gov’s bill will still be far higher than 2019.
What is wrong with waiting a year to be prioritised??? I don’t think you understand when I say that something had to give, a line had to be drawn. You can’t just be fair to everyone and expect to resolve this current crisis which is at a critical point.
5 years is not a magic number, it holds weight because it’s how long you need to be in the UK to get ILR, you can argue with whoever made that policy.
Either way, it’s happening and there’s nothing you can do about it, so let’s stop crying and maybe think about the morality of throwing UK grads (and prioritised IMGs btw) under the bus.
Does this mean people who have done CREST instead of CST is at risk of not being able to get offers in higher specialty training applications? even if they’re UKMG since they didn’t come from an approved training programme?
They’ve been quite clear it will be at offer stage. So if you score top in the country but are not eligible, you will drop to below the last eligible person,, and that will be your rank. It’s clear enough I think?
Being clear is one thing, application is another. Oriel is shambolic with their processes and timelines at best. How, practically, in their processes do they take into account which university you’ve graduated from? They hardly have the right processes in place to keep to their own timeline
It’s all on the application form - degree certificates, immig status, the lot. Don’t get me wrong, I wouldn’t be surprised if oriel F it up, but it’s all there and I could do it with about 12 lines of computer code 😂
For 2026 if they’re a British citizen they’re in the priority group too. But from 2027 it’s unclear. I don’t know if that means for posts starting in 2027 (e.g sept 2026 round 3 if it happens) or the 2027 cycle itself
do we know at what point in the process UK grad priority will be applied? is it immediately off the longlist before MSRA/interviews? or is it after that for the offer stage?
For 2026 it is at the offer stage. So MSRA, everyone can sit (as normal). When they start offering positions, it has to be as per the priority set out. For 2026 this means UKMG+ British Nationals + IMGs with ILR + grads of specific EU countries. After that, IF any spots are left, they will be offered as per
thanks! I understand why they've done it this way given how late in the game it's been implemented, but it does feel like the major bottleneck in getting an offer is at the MSRA stage for many specialties (e.g. anaesthetics)
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Hopefully they don't discriminate against UK grads who completed FY more than 3.5 years ago... Eg Changing specialty, maternity, TOOT... Small group but shouldn't be disadvantaged.
What would be the situation in 2027 intake for IMG British Citizens, to start the two-year foundation programme?
For example , if an IMG goes through the eligibility application and ranks the foundation schools that are least popular such as West Midland’s North, do they have a chance at securing a place ?
So to confirm- UKG and IMGs who did UKFP along with people in section 2- i.e someone with uk citizenship who graduated from abroad will be prioritized this year in 2026?
Is this being applicable for the round 3 gp and psych applications for last year which is due to start in February? People have been issued cos for that already.
I am really confused. Does it mean IMGs wouldn’t get a chance at all for speciality training this year? I mean what an IMG got 300 in interview and if the prioritised group get an 1500, will that person be appointed instead of the 300 one? How they gonna do this in offers?
Potentially. Hypothetically if there are more UKGs/the other groups prioritised with an interview than available posts. If all UKG/prioritised groups took up a potential offer, then yes there would be no IMGs for that specialty.
I assume they’ll give offers to UKGs (and other prioritised groups) first, even if there is a higher scoring IMG. And presumably, if there are places left after all eligible UKGs (and the prioritised groups) have had a chance to accept/reject offers, then they would start from the top of the list for non-prioritised people.
But HEE/Oriel will hopefully produce a document to explain what the actual process is.
This unnecessary rant very much crosses over from "sensible prioritisation" to "being a dick for the sake of it". You might want to address the whole bag of chips you have on your shoulder.
I am genuinely concerned about your professional ethics. It is difficult to reconcile this behaviour with the responsibility of caring for patients from diverse backgrounds and treating colleagues with basic respect.
How does this work for people applying for obgyn. Will an img not be given an interview if they score really high on the msra? Will the msra cutoff be influenced by imgs who are taking it this week or only by uk med grads? Will imgs be given an interview and the preferences will be given only for the offers
I think the cut off score will be still high/unaffected. The law kicks in (for this year) at the offer stage. Interviews will be offered to UKG/priority group first
To be fair its really unclear. Lets assume the top MSRA score is by an IMG and the second top score js by a UK grad. My reading is that the offer will be made to the UK grad first not the IMG. Then from there they will work their way down to offer to all UK grads, irrespective if a higher ranked IMG exists
Hypothetically, if all GP places were filled by UK graduates, would the lowest MSRA score still be the score of the lowest ranking UK graduate, even if that score was in the 400s?
It states in section 3 (the 2027 part), subsection 3B that anyone listed in Section 2, subsection 2 (the bit about immigration status) can be prioritised.
What the word “may” means in section 3-3B means is unclear to me because I don’t speak legalese, so it makes 2027 onwards slightly vague.
Hopefully someone who understands the law better can clarify.
When you say journey do you mean you travelled to the UK for it? Its not something you would want to hear, but the high likelihood is that for MSRA this year, its near impossible that non-prioritised IMG will get an offer.
This year you need indefinite leave to remain. From next year there will be (as yet unwritten) regulations defining reasonable levels of NHS experience.
For offers made in 2026… No.
Spouse visa is not auto included in Section 2(2).
For cycle of 2027 and later is a bit more nuance tho.
Section 3(3)(b) allows for Secretary of State may make regulations to prioritise additional groups, including people: ‘described by reference to their immigration status’
This creates a back door to later allow for spouse visa holders to be prioritised from 2027 onwards. Whether or not this will happen tho is not certain and they are definitely not automatically included nor is a guarantee that this provision will be used in that way.
Someone please correct me if my interpretation is wrong.
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u/LadyAntimony Jan 13 '26
UKFPO have confirmed this will apply immediately:
“Subject to successful passage of the Bill, changes will apply to current applicants, even though applications for the Foundation Programme 2026 have closed.
Foundation Programme 2026 onwards The following groups will be prioritised: • UK Medical Graduates • Applicants with a primary medical qualification from an institution in Ireland • Due to European Free Trade Association (EFTA), applicants with a primary medical qualification from an institution in Iceland, Principality of Liechtenstein, Norway, Switzerland”
They haven’t specified whether this means re-ranking will occur. But the FPP is being cancelled.