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Exploring barriers to expanding medical training numbers in England: A national survey of medical education directors

Year: 2025

Type: article

Abstract: INTRODUCTION: The UK faces a shortage of the medical workforce, which has prompted the NHS Long Term Workforce Plan to propose increases in medical training placements for resident doctors. Despite widespread agreement on the need for expansion, concerns persist regarding the ability of NHS trusts to provide adequate educator capacity, funding and infrastructure to support additional trainees. This study aims to identify the key barriers to trainee expansion as perceived by directors of medical education (DMEs) in England. METHODS: Between June and August 2024, a cross-sectional survey was conducted of DMEs responsible for overseeing medical education within NHS trusts in England. Respondents were asked both quantitative and qualitative questions to elucidate the relative importance of challenges to trainee expansion, and the data were analysed using descriptive statistics and thematic analysis. RESULTS: A total of 29 DMEs participated in the survey. The majority (93.1%) identified funding constraints as a critical barrier to trainee expansion, with many trusts struggling to meet financial demands despite NHS England salary contributions. Additionally, 89.7% of respondents reported inadequate educator capacity, and 72.4% cited a lack of suitable facilities to accommodate increased trainee numbers. Concerns were also raised regarding the ability to meet curricular and rotational requirements, particularly for higher specialty trainees. DISCUSSION: There is an urgent need for trainee number expansion, but this study highlights challenges in expanding medical training placements, including non-financial barriers. Addressing educator shortages, ensuring sufficient funding and improving facilities are essential to successfully implementing workforce expansion plans.

Source: Clinical Medicine

DOI: 10.1016/j.clinme.2025.100523

Authors: Michael Batavanis, Anmol Arora, Samuel Aryee, Nisha Nathwani

Institutions: University of Cambridge, Addenbrooke's Hospital, University College London, Hillingdon Hospital, Bedford Hospital

Language: English

Topic: Healthcare Systems and Challenges

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDGs: Reduced inequalities, Quality education, Decent work and economic growth, Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500