Why Are Resident Doctors Leaving the NHS?

Why are resident doctors leaving the UK?

1. Real term pay cuts and rising living costs

2. Unsustainable workloads and rota gaps in the NHS

3. Limited training opportunities and delayed career progression

4. Better pay, working conditions and lifestyle overseas

5. Significant impact on NHS patient safety and workforce sustainability

Real term pay cuts and rising living costs

Junior doctor pay has fallen significantly since 2008, while training fees, rent and basic expenses have risen, pushing many early-career doctors to seek better pay abroad

Unsustainable workloads and rota gaps in the NHS

Chronic understaffing and high patient demand mean resident doctors routinely face burnout, unpaid overtime, and unsafe staffing conditions.

Limited training opportunities and delayed career progression

Countries like Australia and New Zealand offer higher salaries, safer rotas, improved staffing and more work–life balance, attracting UK-trained doctors.

Significant impact on NHS patient safety and workforce sustainability

High attrition rates increase waiting times, strain emergency care and cost the NHS billions, making this an essential issue for future medical students to understand

Statistic for UK doctors and Australia

of the overseas doctors who registered in Australia in recent years, roughly 60% came from the UK or Ireland

Different types of doctors in the ‘Doctor Exodus”

• Some doctors leave the NHS but not the UK (for example, to do locum, private or portfolio work).

• Some leave the UK entirely to work in countries offering better pay and conditions.

• A smaller number leave medicine altogether

Why are Resident doctors leaving the NHS? - Push Factors

• Real-term pay cuts and cost of living pressures

• Workload pressures, Rota gaps and Burnout

• The training bottleneck: Why can’t junior doctors get jobs

• Workplace Culture and Feeling Undervalued

• Wellbeing and Work-Life Balance

Real-term pay cuts and cost of living pressures

• The BMA argues that resident doctor pay has been eroded by around 21% in real terms since 2008

• Other analysts disagree: work with the Royal Statistical Society put the fall closer to 6 to 7%

• The figure is disputed, but all sides agree pay has fallen in real terms

• Combine that with increasing living costs: rent, commuting, exams and even GMC registration fees

Workload pressures, Rota gaps and Burnout

Many NHS departments operate chronically understaffed. When a rota has gaps, the doctors who remain often end up:

• Covering multiple wards

• Staying late after shifts

• Losing breaks

• Running unsafe workloads - working outside of their remits.

The training bottleneck: why can't junior doctors get jobs?

• Competition for specialty training has risen sharply

• there were around 1.4 applicants per place in 2019, but roughly 3.5 per place by 2025

• In practical terms, about 30,000 doctors applied for close to 10,000 training posts in 2025

• High competition for training + limited number of funded posts

• Some get stuck in non-training roles, delaying their progression. For an ambitious junior doctor, this can be incredibly frustrating

Workplace culture and feeling undervalued

• ullying or undermining behaviour

• Feeling blamed when systemic issues cause problems

• A lack of meaningful support from management

• Poor access to rest areas, healthy breaks or wellbeing resources

Wellbeing and Work–Life Balance

• Long shifts

• Nights and weekends

• High-pressure decision-making

• Emotional strain: Some doctors feel as if they have no control over their lives and no say in their working schedule

Why are UK doctors moving to Australia and NZ? - Pull Factors

• Higher pay

• Better working conditions and staffing

• Lifestyle benefits

• Training and Career Opportunities

Higher Pay

• Higher pay in Australia, New Zealand and Canada

• Some overseas jobs offer:

  • Relocation bonuses

  • Paid flights

  • Housing allowances

  • Improved overtime rates

Better working conditions and staffing - AUS and NZ

• Better staffing ratios

• Safer rotas

• More predictable hours

• Less pressure during shifts

• Greater autonomy

Lifestyle Benefits

Good weather, beaches, outdoor life, and a more relaxed pace are significant pull factors

Training and Career Opportunities

Some overseas healthcare systems offer clearer pathways, more funded training positions, or opportunities for fellowship experiences.

For ambitious doctors, it can feel like progression is faster and more supported abroad

Will things change by the time you graduate/ what is the government doing?

• Yes

• 10-Year Health Plan

10-Year Health Plan

• Prioritising UK medical graduates for specialty training (the Medical Training (Prioritisation) Act 2026 gives UK graduates priority access to core and higher training from 2026)

• Creating 4,000 to 4,500 additional specialty training posts in England to ease the bottleneck

Impact of doctors leaving on the NHS and patients

• Impact on patient safety

• Financial cost to the NHS

• Ethics

Impact on patient safety

When doctors leave:

• Waiting lists grow

• Rotas stretched thin

• Clinics are cancelled

• Emergency care becomes strained

Financial cost to the NHS

Training a doctor costs hundreds of thousands of pounds. When doctors leave early in their careers, the NHS effectively loses that investment.

Some estimates place the cost of poor retention in the billions.

Ethics - Key discussion point in interviews

As UK doctors leave, the NHS increasingly recruits from abroad. However, this raises ethical dilemmas, especially when recruiting from countries facing their own doctor shortages.

How Future Doctors Can Respond – Constructive Ways to Engage With the Crisis

• Protect your own wellbeing early on

• Get involved in advocacy

Protect your own wellbeing early on

Well-being habits start in medical school:

• Sufficient sleep

• Exercise

• Support networks

• Setting healthy boundaries

• Seeking help early

Get Involved in Advocacy

You can contribute through:

• Student unions

• BMA medical student committees

• Quality improvement projects

• Wellbeing initiatives

• Hospital leadership programmes