We must train doctors for the NHS of the future, not the past’: RCP calls for 10 Year Health Plan to drive reform of medical training

The future of the NHS lies in communities, not hospitals.

Our recent RCP workshop on the hospital to community shift and the follow-up ‘Time to focus on the blue dots’ toolkit set out our detailed thinking on how and why this is so important.

To keep people well and deliver high-quality, sustainable care, we must train doctors to work across a much broader variety of settings. Yet too often, medical training is confined to hospitals, reinforcing outdated models of care and limiting opportunities to develop the skills needed in today’s NHS.

The results of the RCP’s 2025 next generation survey highlight the disconnection between training environments and the care we expect doctors to provide. Just 26% of respondents felt their current role was preparing them to progress in their career and fewer than one in five (19%) felt equipped in research skills. Despite NHS ambitions to expand digitally enabled care, only 9% reported feeling trained to use digital health technology effectively.

Meanwhile, more than 40% said that geographical rotational training had negatively affected their experience, impacting on the continuity of their education and creating logistical and personal challenges. These concerns reflect a wider truth: training systems have not caught up with the realities of modern medicine.

We expect doctors to lead integration across acute, community and primary care – but we don’t give them the opportunities or support to train in these settings.

The recently published 10 Year Health Plan must drive change. If we want doctors who can design and deliver neighbourhood-based care, reduce health inequalities and champion prevention of illness, we must change how and where they learn.

Community placements – whether in planned specialist care, care homes, virtual wards or hospital at home – must become a routine part of medical training. That means investing in infrastructure, educational supervision and system-wide coordination so resident doctors can experience what integrated care looks like in practice.

It also means updating curricula. Population health, digital care, social determinants of health and systems thinking are not ‘nice to haves’ – they should be core competencies for medicine in the 21st century. And the appetite is there. After all, over a quarter (26%) of next generation survey respondents said that their current role was not preparing them to submit a competitive application for the next stage in their career pathway. If we want to build a more preventative, integrated and digitally enabled NHS, we must train our doctors accordingly.

If we don’t change the way we do things, we’ll lose them from the system.

Over a third of respondents to our next generation survey (35%) said they were either planning to leave the NHS or weren’t sure if they expected to be still working in the NHS in 5 years. One in three (33%) intends to work abroad in the future.

Reforming training – so it aligns with the values and interests of our future doctors as well as the needs of our future healthcare system – is urgent and essential.

The next generation of doctors is ready to lead.

We must be ready to train them for the NHS we want to see.

Dr Theresa Barnes
Clinical lead for outpatient care 
Royal College of Physicians