Doctors who join the UK specialist register after completing specialty training abroad are significantly more likely to leave within five years than those who have been through UK postgraduate training, according to new GMC analysis in the Workforce report 2025.  

The report examines doctors who joined the specialist register between 2016 and 2019 and compares leaving rates based on whether they ever appeared in UK postgraduate training. The difference is substantial: 

• 39% of doctors who joined the specialist register and had never appeared in UK training left within five years. That equates to 1,843 out of 4,725 doctors. 

• By contrast, 9% of those who had been in any level of UK training left within five years, 1,175 doctors.  

The GMC interprets this as evidence that doctors who join the specialist register directly from abroad are more likely to have shorter UK careers compared with those who enter the workforce through UK training pathways.  

The report also highlights that retention varies by specialty, and that the gap between “never in UK training” and “appeared in UK training” is not identical across fields. The most striking example is ophthalmology: the report states that 46% of ophthalmology specialists who had not been in UK training left within five years of reaching the specialist register, 133 doctors.  

Why it matters: This finding connects directly to two major workforce debates highlighted elsewhere in the report: 

1. International recruitment strategy. Health systems often rely on recruiting experienced specialists from abroad to fill gaps quickly. But the GMC data suggests this approach may deliver shorter tenure unless supported by strong integration and retention measures.  
2. Training policy. Part 1 of the report notes that postgraduate training is a key motivator for many doctors migrating to the UK and warns that restricting training access for nonUK doctors could remove a significant pull factor. The retention analysis strengthens that point: involvement in UK training is associated with much better longterm retention outcomes.  

The report’s implication is not that the UK should rely less on international specialists, rather, that workforce sustainability depends on how doctors are supported to build lasting careers here. In practical terms, this could mean stronger onboarding, mentoring, career development pathways (including for senior joiners), and ensuring workplaces are inclusive and supportive, points echoed in the report’s foreword about the risk of “hardening rhetoric” and reduced support undermining the UK’s attractiveness as a destination for talent.