General practice has become one of the clearest examples of the NHS’s reliance on international doctors within the formal training pipeline, according to the GMC’s Workforce report 2025. The report states that the 2024 cohort of firstyear GP specialty trainees (ST1) was half (50%) nonUK PMQ and half UK PMQ.  

This matters because general practice is central to primary care access and is highlighted in the report’s foreword as a core part of the Government’s vision for neighbourhood health services. A pipeline that is now evenly split between UK and international graduates is therefore exposed to policy changes that affect international training eligibility, migration incentives, or earlycareer employment conditions.  

The report links the GP intake pattern to broader training dynamics. It notes that nonUK graduates are increasingly entering UK postgraduate training each year, rising from 13,959 nonUK doctors in training in 2020 to 22,027 in 2024, driving the proportion of trainees who are nonUK PMQ from 21% to 28%. At programme level, general practice saw the “largest increases” in nonUK doctors in training.  

The report also discusses competitiveness. When viewed alongside competition ratios (applications per available post), general practice has a relatively low competition ratio for each training place. GP is not unique: histopathology, internal medicine and core psychiatry also show relatively low competition ratios alongside relatively high nonUK proportions at CT1/ST1. The report interprets this as evidence that nonUK doctors are applying for programmes that UK graduates are less likely to apply for.  

At the same time, the report shows that UK graduates still have higher offer rates even within programmes like GP. In 2023/24, 79% of UK graduates applying to GP received an offer, compared with 23% of nonUK graduates (for programmes with at least 50 applications).  

Why it matters: The report cautions policymakers to reflect carefully before changing how UK graduates are prioritised for postgraduate posts. It also notes that thresholds requiring NHS experience could alter the pool of eligible applicants and affect certain specialties more than others, particularly those with historically higher nonUK proportions, such as general practice and psychiatry.  

In practical terms, a GP intake that depends on international doctors creates a workforce planning tradeoff: policies aiming to reduce the proportion of international trainees could introduce shortterm disruption unless there are compensating increases in UK applicants, training capacity, or recruitment/retention measures to protect overall GP trainee numbers.