Our workforce is undoubtedly changing.

The latest GMC workforce report shows a striking 18% increase in the number of licensed doctors on its register between 2018 and 2022. Numbers have increased by 46%, most markedly among SAS and Locally Employed Doctors (LEDs), which is almost entirely down to a marked increase in the latter. LEDs are a very heterogenous group, including doctors just after foundation training (‘F3’), doctors in posts between core and specialty training, locum consultants and post-training fellows seeking further subspecialty experience. The biggest contingent however are trust-grade doctors and clinical fellows who arrive with medical qualifications gained abroad. The GMC currently registers significantly more international medical graduates (IMGs) than UK graduates every year at present.

There are also notable changes in employment behaviours among this cohort. Recently, significantly more of these IMGs have stayed in the UK beyond the short-term and more have entered training than previously. Some will seek entry to the specialist register via the portfolio pathway, but many hope to enter training in our specialty, typically at ST4 level.