Doctors trained outside the UK took just 1.8% of accepted NHS specialty training places in 2026, down from 28% the year before, according to a new analysis of the first recruitment round run under the Medical Training (Prioritisation) Act.

The Nuffield Trust examined provisional NHS England data and found the law, which came into force in March 2026, had sharply changed who secures the training posts that lead to becoming a GP or consultant. Under the Act, applicants in a priority group — mostly UK-trained doctors, plus doctors from Ireland, Iceland, Norway, Liechtenstein and Switzerland — are offered places before non-priority applicants.

Only five of the 16 medical specialties accepted any non-priority candidates at all in 2026. That was not because overseas-trained doctors had stopped applying: they still made up just over half, 51%, of all applications. The 1.8% figure is the share of accepted offers, not individual applicants' success rates.

The change follows a decade in which applications for specialty training rose more than fivefold, from around 16,500 a year in 2015 to almost 85,000 in 2025, while the number of training posts grew by only 11%. Nuffield Trust fellow Lucina Rolewicz said the numbers showed how dramatically the new rules had shifted access to specialty training away from overseas-trained doctors and towards those trained predominantly in the UK.

The think tank warned the longer-term effects were less certain: specialties that have historically relied on overseas graduates, including general practice, psychiatry and obstetrics, could face shortfalls if future applicants decide UK training is no longer a realistic route. The government has committed to creating up to 4,500 additional specialty training places over the next three years, and the Department of Health and Social Care said the law had halved competition rates for UK-trained doctors.