Overseas Doctors Power the NHS, But Uncertainty Grows

Medscape reporting and survey data show why doctors are coming to the UK, what it takes to work in the NHS and what’s now pushing many to look elsewhere.


LONDON–(BUSINESS WIRE)–Doctors trained overseas make up a substantial and growing share of the UK medical workforce, with new data underscoring the NHS’s deep reliance on international recruitment at a time of mounting uncertainty. More than two-thirds of doctors who joined the UK medical register in 2023 trained outside the UK, according to the General Medical Council (GMC), while internationally trained doctors now account for 44% of all registered practitioners.

New reporting and survey data from Medscape shed light on what sits behind those figures—why doctors continue to come to the UK, the barriers they face in joining and progressing within the NHS, and the factors now prompting many to consider leaving.

Medscape’s dossier “Expat MD: The Ultimate Guide to Working Abroad” compiles insights from the UK, Europe, the Americas and Australia, alongside new survey data from over 1,200 physicians worldwide. The findings reveal that the NHS remains a major destination for doctors trained overseas, but growing uncertainty around training, progression and long-term prospects is prompting many to reconsider their future in the UK.

International medical graduates (IMGs) underpin care across hospital wards and general practice, often filling posts in areas facing the most severe staffing shortages.

Medscape reports the challenges overseas doctors face to work in the NHS. To practise in the UK, overseas doctors must meet English language requirements, pass exams such as the Professional and Linguistic Assessments Board (PLAB), secure General Medical Council registration and a sponsored work visa—a process costing months and thousands of pounds before their first shift.

“The fact that people get world-class treatment for free was a big selling point for me,” said Dr Pushpo Babul Hossain, who moved from Bangladesh to the UK in early 2020. But she told Medscape that adapting to the NHS came with unexpected challenges, from an unfamiliar workplace culture to gaps in induction and professional support.

Hossain, now IMG lead at the Doctors’ Association UK, said overseas doctors are often relied upon for service provision without receiving the structured training or mentoring available to UK graduates. “It’s quite hard for people who are international to get used to the NHS,” she said, adding that delayed or insufficient inductions can leave doctors feeling unsupported and exposed to risk.

Separate Medscape analysis shows that these pressures are unfolding at a time when policy signals are shifting. The UK government has set out ambitions to reduce reliance on overseas recruitment over the coming decade, while proposals to prioritise UK-trained graduates for postgraduate training have raised concerns among international doctors about career progression.

The GMC warns that such changes risk driving doctors away. In 2024, nearly 5,000 non-UK-qualified doctors left UK practice—up over 25% from the previous year. Only 13% of doctors who gained registration after passing PLAB secured a UK job within 6 months, a sharp decline from previous years.

Medscape’s survey of 1,271 doctors shows that most respondents (70%) plan to work abroad for better work-life balance and quality of life, while 46% cite financial incentives.

Europe remains the top destination for doctors working abroad, followed by the United States and Australia. UK-trained doctors favour Australia for their lighter rotas, more predictable hours, and better recovery time between shifts—though Medscape reporting notes the emotional strain from family separation and ongoing system pressures across borders.

Taken together, Medscape’s reporting suggests the global medical workforce is becoming increasingly mobile and selective. Doctors weigh lifestyle, training opportunities, safety and long-term security alongside pay when deciding where to build their careers.

“As health systems worldwide compete for talent, the UK faces a pivotal moment,” said Peter Russell, Medscape UK editor. “Overseas doctors continue to keep the NHS running—but our findings suggest that without clearer pathways, better support and a more welcoming environment, many may choose to take their skills elsewhere.”

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