Association of Anaesthetists response to the Medical Training Review
Adopting the recommendations in the Medical Training Review could save medical training in the UK says Association of Anaesthetists
The recognition that reform of postgraduate medical education and training is urgently needed is a welcome one. Over the last ten years there have consistently been far more applicants for anaesthetic training posts than there are jobs available. The number of posts at CT1 level has actually fallen by about 10% over this time. Similarly at ST4 level over the last three years approximately 40% of applicants have been unable to obtain a national training number. In 2025 there were 12 applicants for every 1 place for CT1 anaesthesia, and 300 anaesthetists were not able to continue their training – clearly this situation cannot continue. Quite simply, it will not be possible to deliver the 10-year health plan and reduce waiting lists if this issue is not addressed and how training is delivered plays a key part in this.
The current distribution of training posts is unable to meet the needs of healthcare service providers as, in anaesthesia, there are simply not enough posts available. As the report notes, bottlenecks like these should be addressed as a priority. We believe that the government should commit to tackling workforce shortages by funding a significant increase in the number of specialty training posts in anaesthesia. To make any significant impact, realistically this will need to number in the hundreds over the medium term, and the government needs to start to recognise this reality.
We are pleased that the review has highlighted the need to increase flexibility in training. Increased flexibility is needed to allow individuals to ‘pace’ their careers, for example, removing barriers to rejoining training programmes for those who need to leave for any reason. Additionally, the process should be made easier for individuals to move to ‘less than full time’ working (as well as back again to ‘full time’). Women in the workforce are often disproportionately impacted by inflexible working arrangements; women are more likely to have greater caregiving responsibilities including childcare for example. There should be flexibility built into the system, or more doctors may be lost from the workforce.
The Association is clear that there is no such thing as a ‘non-training’ doctor. All doctors should be supported to learn throughout their careers. This is something that has been highlighted by the Association, and its SAS Committee in particular, for many years. We are therefore pleased to see the report acknowledging this fact. It is vital that Specialist, Associate Specialist and Specialty Doctors (SAS) and Locally Employed Doctors (LED) doctors are provided with the same opportunities as other groups and that this underutilised group is allowed to reach its full potential. We are aware from our membership that, unfortunately, doctors from minority ethnic groups and those with disabilities face additional difficulties in accessing postgraduate medical training and we hope that these groups are given appropriate support to develop their careers when the recommendations from this review are implemented.
Ultimately, this review served primarily as a listening exercise rather than a fundamental rethinking of how we train and support our doctors. However, a genuine transformation of medical education is exactly what is now required. The challenges facing the NHS and the increasing complexity of healthcare cannot be met through small adjustments or temporary fixes. We therefore urge the government not only to take this review seriously but to act decisively on its recommendations. Implementing these changes will be essential to securing the future of both our doctors and the patients who depend on them.
Dr Tim Meek, President, Association of Anaesthetists said:
“This is a once in a generation chance to improve doctors’ training, for their benefit now but ultimately for the benefit of their future patients – which could be any one of us. The government must listen and act upon these recommendations – carrying on regardless would condemn future generations to a system unable to provide the healthcare we all need.”
Dr James Brooks, Chair, Resident Doctors Committee Association of Anaesthetists said:
“I implore the government to take the recommendations in this listening exercise forward to bring about real reform for medical training in the UK that benefits both residents and patients. The Association of Anaesthetists will continue to be a leader in the field of anaesthesia to help deliver these changes.”
Dr Emma Wain, Chair, SAS Committee, Association of Anaesthetists said:
“The recommendations in this report have the potential to change medical training forever and the Association looks forward to playing its part in delivering these changes. I am so pleased the review recognises the contribution of SAS and locally employed doctors to the NHS and the importance of ensuring their development.”