In response to the competition ratios for the 2025 speciality recruitment round published by NHS England last week (18 September 2025) Dean of the Royal College of Emergency Medicine Professor Simon Carley said: “These figures give a clear indication of the scale of the challenge facing resident doctors choosing their specialty.
“Many specialities are significantly oversubscribed with the figure for EM showing that there were more than 5,000 applications for just 357 training – more than 14 applicants per place. Double what it was a year ago.
“As an EM clinician it is reassuring that so many residents want to choose our speciality, but we understand how hard and frustrating it must be with competition is so strong.
“As a College, we are not afraid of the prospect of EM being a competitive speciality to get into, but we strongly believe that the selection process for our speciality should ensure that those with a genuine interest in Emergency Medicine are recognised and supported to compete for a place.
“We are also concerned that the logistics of managing the increasing number of applications we receive risks undermining the quality of the selection process itself. Competition ratios have increased from 1.8 per place in 2018, seven per place in 2014, to 14 per place this year. This is not sustainable.
“RCEM has lobbied strongly for changes to the application process designed to include indicators of a commitment to the speciality. Sadly, several of these were rejected, including a proposal to recognise those who had attempted speciality specific exams.
“RCEM will continue to work constructively with NHSE, and other stakeholders, particularly as the implications of the Medical Training Review start to become more concrete.
“We believe that future approaches to recruitment will need to do more to recognise commitment and other kinds of early and sustained commitment alongside the many other qualities that successful applicants already demonstrate.
“We also look forward to the publication of the government’s revised workforce plan which is due this autumn, and which should recognise the scale of the challenge across the health sector when it comes to training, recruiting and maintain a highly skilled, specialised workforce.”