Medical training at breaking point: will an increase in learners push the system over the edge?

There have always been tensions between service delivery and training in the NHS. But trainers, trainees, and policy makers alike are warning that medical education now requires urgent attention to stop the future workforce pipeline failing altogether. This is particularly true in England, where actions from its long term workforce plan are already under way and placing increasing demands on teaching capacity.1

Last June, the long term workforce plan set out an ambition to double the number of medical school training places, taking the total number of places up to 15 000 a year by 2031-32 (table 1) It also announced pilots for medical apprenticeships2—this academic year will see 200 join the workforce. The goal is that, by 2031, some 13% of medical students will be apprentices. On top of that, there is a plan to increase training places for physician associates to over 1500 in that same timeframe.

But new staff need training—and this requires NHS organisations and trainers to have capacity. It seems that too little focus has been paid to this crucial matter. Speaking at the NHS ConfedExpo conference in Manchester on 12 June, Sheona MacCleod, director of education and training at NHS England, said that NHS England wanted to work with NHS employers on how to manage the expansion of doctors in training and deliver the placements they would need.

“If we are looking at significantly increasing foundation and specialty training, how are we going to ensure that we have the education capacity?” she said. “That’s something we really want to work with employers on. How …