The National Health Service (NHS) has discontinued the Medical Training Initiative (MTI), a programme that allowed around 400 to 500 foreign-trained doctors annually to develop their skills through placements in UK hospitals. The scheme, which began in 2011, enabled medical graduates primarily from low- and middle-income countries such as Pakistan, Sri Lanka, and Nepal to work and learn within the NHS for up to two years before returning home.
The MTI was viewed as an example of British global “soft power” and highlighted for its mutual benefits, supporting the development of overseas healthcare systems while also contributing to the NHS workforce. It cost NHS England approximately £176,000 annually and played a role in training thousands of international doctors over the years.
Medical professional bodies expressed strong disapproval of the decision, calling the closure abrupt and disappointing. The Academy of Medical Royal Colleges, which managed the MTI, stated the scheme was a successful example of international medical collaboration and noted its importance in sustaining both the NHS workforce and healthcare improvements abroad. A spokesperson remarked the MTI also enhanced the UK’s international reputation and represented a key element of British global engagement in health.
Despite the programme’s supporters, an internal review commissioned by NHS England concluded that the MTI was not fulfilling its intended purpose. The review found that some doctors remained in the UK beyond their placements, limiting the intended benefits to their countries of origin. It also uncovered concerns about wage disparities, with foreign doctors reportedly receiving lower pay than their UK counterparts despite similar work.
Some senior medical figures suggest the decision to end the MTI may be linked to ongoing disputes between the government and resident doctors in England. Since 2023, UK-based doctors have been striking over issues related to pay and working conditions. Observers speculate the move was partly intended to address demands from the British Medical Association (BMA), which has advocated for prioritising UK-trained graduates in specialty training posts amid a shortage of available positions.
An NHS England spokesperson confirmed the decision followed an independent review that found the scheme was not meeting its objectives. The spokesperson also stated that the closure was unrelated to the prioritisation of UK graduates, although steps are being taken to address domestic workforce needs.
Leaders from medical colleges expressed concern about the impact on the NHS. Dr Clare McNaught, president of the Royal College of Surgeons of Edinburgh, highlighted that international medical graduates comprise over 40% of the UK’s medical workforce and stressed the dependence of the NHS on their expertise for day-to-day services. Professor Mark Strachan, president of the Royal College of Physicians of Edinburgh, described the termination of the MTI as disappointing, noting the programme’s benefits both for participating doctors and for health services within the UK.
Doctors currently participating in the MTI will be allowed to complete their training, and those who had applied by the March deadline will still be accommodated as the scheme gradually phases out.