Last updated: 1 July 2026. The regulations defining "significant NHS experience" for 2027 recruitment are still to be published and will change parts of this page, so check the date above.
The Medical Training (Prioritisation) Act 2026 gives UK medical graduates and certain other groups priority for NHS foundation and specialty training places. It changes the order in which training offers are made, and from 2027 who is shortlisted, rather than who is allowed to apply. If you are an international medical graduate, it does not close the door, but it does change where you stand in the queue, and by how much depending on your exact situation. Here is a calm, complete account of what it actually does.
Key takeaways
- The Act prioritises UK and Irish graduates and defined groups for foundation and specialty training.
- It received Royal Assent on 5 March 2026 and applied to the 2026 recruitment round.
- In 2026 it works at the offer stage; from 2027 it also applies at shortlisting.
- IMGs can still apply; non-prioritised applicants are offered posts after priority groups.
- A 2027 "significant NHS experience" route is coming but is not yet defined.
What the Act says, in one paragraph
The Act requires those making offers for UK foundation and specialty training to offer places first to UK medical graduates and other specified priority groups, and only then to everyone else. Prioritised applicants are considered ahead of non-prioritised applicants, and non-prioritised applicants are offered a post only if places remain once the priority groups have been served. It does not change eligibility to apply, the ranking of applicants, or the underlying relationships between the GMC, NHS England, and the recruitment offices.
Timeline
The government introduced the bill in the House of Commons on 13 January 2026, having pledged the policy in its 10-Year Health Plan for England in July 2025. Because applications were already live, it was fast-tracked, with all its Commons stages taken on 27 January 2026, and it received Royal Assent on 5 March 2026, with its provisions commenced the following day. That timing was deliberate, so the rules could apply to foundation and specialty posts starting in August 2026. The policy also formed part of a December 2025 government offer to the BMA during the resident doctor dispute.
Who is prioritised
For specialty training offers made in 2026, the priority groups are:
- UK medical graduates, meaning those holding a UK primary medical qualification, excluding anyone who spent all or most of their training for that qualification outside the UK, Channel Islands, or Isle of Man.
- Graduates of the Republic of Ireland, and graduates of Iceland, Liechtenstein, Norway, and Switzerland, reflecting reciprocal agreements.
- Those who have completed, or are on, a relevant qualifying UK programme: the Foundation Programme for entry to core training, or core training for entry to higher training.
- For 2026 only, applicants with a specified immigration status: indefinite leave to remain, settled status under the EU Settlement Scheme, British or Irish citizenship, or Commonwealth right of abode.
For the Foundation Programme, the priority groups are UK graduates and graduates of the Republic of Ireland and the four European countries above. The immigration-status route does not apply to foundation.
How 2026 differs from 2027
In 2026, prioritisation for specialty training was applied at the offer stage only, because shortlisting was already underway when the Act commenced, and for foundation it was applied at allocation to foundation school. Your prioritisation status was determined from the information in your application at the point of submission.
From the autumn 2026 round, for posts starting in August 2027, prioritisation will apply at both the shortlisting and the offer stage, which is a considerably stronger filter, because it can affect whether you are interviewed at all. The 2026 immigration-status category will not carry over automatically. Instead, the government will make regulations, with the consent of the devolved nations, defining additional groups, focused on those with "significant NHS experience".
Common misconceptions
Are British citizens with international medical degrees prioritised? For specialty training in 2026, yes, via the immigration-status route (British citizenship). For the Foundation Programme, no, because the immigration-status route does not apply to foundation, so a British citizen who studied medicine abroad was not in the foundation priority group.
What about international campus students? They are prioritised only if the majority of the degree was completed in the UK. Someone who did, for example, two preclinical years abroad and three clinical years in the UK is prioritised; someone who did most or all of the degree abroad is not.
Does this ban IMGs from training? No. IMGs can still apply, are still ranked, and are offered posts once the priority groups have been served. The Act changes the order of offers, not the right to apply.
Has "significant NHS experience" been defined? Not yet. It will be set out in regulations before the autumn 2026 round opens, and until then nobody can tell you exactly how much NHS experience will count.
What is not affected
The Act does not touch locally employed doctor, trust grade, or clinical fellow roles, which remain open to IMGs and are a major part of the NHS workforce. It does not change GMC registration or the eligibility criteria for training, and it does not remove the ranking process, which still determines order within each group. And it does not stop IMGs applying for training in the first place.
What happens next
The next milestone is the 2027 regulations defining "significant NHS experience", developed with the devolved nations and intended to be ready for the autumn 2026 application round. This matters because it is the route through which IMGs already working in the NHS could be brought into the priority group. The BMA has argued for prioritising IMGs with at least two years of NHS experience, and the government has said it is working through how NHS experience should be recognised. For scale, in 2025 around 15,723 UK-trained and 25,257 overseas-trained doctors competed for 12,833 round 1 and 2 specialty posts, and total applications for the 2026 rounds exceeded 47,000, against roughly 12,000 applicants as recently as 2019. Alongside the Act, the government has said it will expand specialty training in England, with around 1,000 additional posts reported.
Practical options for deprioritised IMGs
If you are not in a priority group, the options have not disappeared, they have reordered. The locally employed doctor route into an NHS post, building UK experience toward a future "significant NHS experience" definition, remains real, though slower and uncertain, and we cover the decision in detail in should IMGs still sit PLAB in 2026. It is also worth weighing other licensing routes directly, which we compare in PLAB vs AMC CAT vs MCCQE1 vs USMLE. The right move depends on your ties to the UK, your immigration status, and your flexibility on destination.
Frequently asked questions
When did the Prioritisation Act become law? It received Royal Assent on 5 March 2026 and its provisions commenced the next day, after being introduced on 13 January 2026 and fast-tracked through Parliament.
Who does the Act prioritise? UK medical graduates, graduates of Ireland and of Iceland, Liechtenstein, Norway and Switzerland, those on or through a relevant UK training programme, and, for 2026 specialty offers only, those with specified immigration status.
Can IMGs still get into UK specialty training? Yes. IMGs can apply and are ranked, and are offered posts after the priority groups. The Act reorders offers rather than removing access.
What changes in 2027? Prioritisation will apply at shortlisting as well as at offers, the 2026 immigration-status category will not apply automatically, and a regulations-based "significant NHS experience" route will be defined.
Does the Act affect non-training NHS jobs? No. Locally employed doctor, trust grade, and clinical fellow roles are unaffected, as are GMC registration and eligibility to apply for training.