# Navigating the Crisis: A Cross-Sectional Survey Analysis of Resident Doctors’ Experiences of Specialty Training and Employment in Today’s NHS

## TL;DR

This study explores the challenges faced by UK resident doctors in specialty training and employment within the NHS, highlighting emotional strain and high attrition rates.

## Contribution

The paper provides new insights into the systemic issues affecting resident doctors' career progression and mental well-being in the NHS.

## Key findings

- Only 39% of resident doctors secured specialty or higher training posts.
- 65% reported missing out on advertised roles due to recruitment system failures.
- Over one-fifth of respondents left the NHS or medicine due to these challenges.

## Abstract

Objective: To examine resident doctors' experiences of training conditions, career opportunities, workforce perceptions, and emotional strain in the NHS's current specialty training and local recruitment pathways.

Design: A cross-sectional, anonymous survey of UK resident doctors conducted via an online questionnaire. Quantitative and qualitative data on employment status, training opportunities, recruitment processes, and emotional well-being, from both the anonymous survey and NHS datasets, were collected and analysed via descriptive statistics and thematic analysis.

Setting: The NHS faces a deepening crisis. The demand for doctors continues to rise, yet qualified resident doctors encounter increasing barriers to entering specialty training or gaining secure employment.

Participants: A total of 288 UK resident doctors received the survey in June and July 2025. Participation was voluntary, and no incentives were offered. One hundred two surveys were completed, giving an overall response rate of 35% (N=288).

Results: Respondents reported growing competition for both specialty training and local employment posts, which is supported by NHS training and employment data. Only 39% (N=102) of respondents secured Specialty or Higher Training post, while just 8% (N=62) were successful applying for a trust-grade position despite substantial time and effort invested. Almost two-thirds (65%, N=62) reported missing out on advertised roles due to recruitment system failures. Respondents reported overwhelmingly negative emotions relating to fear, sadness, and anger, which directly impact staff morale and wellbeing. This manifests in significant stress, anxiety, and dissatisfaction with their career prospects alongside feelings of hopelessness, disillusionment, and demotivation. Over one-fifth (21%, N=102) have left the NHS or medicine altogether over the last two years.

Conclusions: Resident doctors currently face unprecedented challenges in applying to, and progressing in, NHS training and recruiting systems. These difficulties are having a profound effect on morale, well-being, and career viability, which is contributing to increased attrition from both the NHS and the medical profession. Urgent reforms to both training pathways and recruitment processes are needed to safeguard both workforce retention and high-quality patient care.