Training cannot be something that happens only when the NHS has time

As resident doctors, we do not need another review to tell us that training is under pressure.

We see it every day.

Across the RCP's next generation campaign, we have heard remarkably similar experiences from doctors across the UK. Clinics missed because rota pressures made attendance impossible. Teaching cancelled because there was nobody available to provide cover. Doctors rotating just as supervisors were beginning to understand their strengths and support their development. Training opportunities too often dependent on individual persistence rather than being reliably built into the job.

The numbers tell the same story. In the RCP's 2025 next generation survey of more than 1,000 resident doctors, only 26% felt ready for the next stage of their career. Just 65% expected to remain working in the NHS in five years' time. Meanwhile, 72% identified staffing shortages and rota gaps as having the greatest negative impact on training quality and wellbeing, while 66% highlighted high clinical workloads.

Medical training shapes the doctors that patients rely on throughout their careers. It develops clinical judgement, decision-making and the confidence to manage complexity and risk. Good training is not separate from patient care. It is one of the foundations of it.

Yet the opportunities that help doctors learn are often the first things to disappear when services come under pressure. Most medical training takes place through day-to-day clinical work. But experience alone is not enough. Doctors also need supervision, feedback, reflection and time to discuss difficult decisions. Our report describes this as the educational scaffolding that turns service into training. Too often, that scaffolding is lost when services are stretched.

That is why one of the central recommendations in our report is simple: resident doctor jobs should be designed for on-the-job learning. We are calling for every resident doctor to have access to at least two protected half-day training experiences every week, embedded in clinical work. We are also calling for NHS organisations to be staffed to deliver quality training, not simply minimum safe service delivery. If tomorrow's workforce is to be developed through today's services, training capacity must be treated as a core requirement, not an optional extra.

Continuity matters too. Many resident doctors told us they felt as though they spent much of their training moving: moving hospitals, moving teams. Moving just as they were establishing trust and relationships and had begun to feel part of a team. In our survey, 41% of resident doctors in national training programmes said geographical rotation had had a mostly or very negative impact on them.

We are not arguing for the end of rotational training. But we do believe it should be driven by educational need rather than movement for its own sake. Good supervisors need time to know the doctors they support. Mentors need time to build trust. Doctors need time to feel that they belong.

The same principle applies to educators. The willingness to teach is not lacking in the NHS. Time is. Only 52% of trainers report always being able to use their allocated educational time for educational purposes. We cannot continue to rely on goodwill alone. Education must be recognised, protected and properly resourced as a core NHS function.

The message we heard throughout the next generation campaign was remarkably consistent. Resident doctors are not asking for lower standards or less responsibility. They are asking for a system that reliably provides the supervision, continuity and learning opportunities needed to become excellent physicians.

The medical education and training review provides an opportunity to deliver that change. Now is the moment for governments, employers, education bodies and the wider NHS to make a choice. We can continue to accept a system where training is squeezed around service pressures, or we can build one that deliberately creates the conditions for doctors to learn and develop into clinicians who offer outstanding care for patients.

The future NHS depends on the doctors being trained today.

Training cannot be something that happens only when the NHS has time. It must be protected, valued and recognised as essential to delivering safe, effective and compassionate patient care.

Dr Áine Corry is the RCP Resident Doctor Committee representative for Northern Ireland and a member of the writing group that developed Training physicians for the future. She is training in internal medicine in County Down.

Dr Alice Cole works as a registrar in rheumatology and general internal medicine in north London and was a member of the writing group that developed Training physicians for the future. She is a former RCP clinical fellow.