27.11.2025
Responding to The General Medical Council’s (GMC) state of medical education and practice in the UK: workforce report 2025, published last week (21 November 2025), Dr Maya Naravi, Vice President of RCEM, said: “We welcome the GMC’s annual Workforce report and its focus on diversity within the workforce, including the experiences of international medical graduates and the ongoing challenges around gender parity despite some movement in the right direction.
“Emergency Medicine has one of the lowest proportions of female doctors across all specialties, at 37%. Ensuring a healthier work–life balance through proper workforce planning, flexible training pathways, and supported transitions in and out of training may help address this imbalance in the future, making the specialty more attractive and sustainable.
“The report lays bare the extent to which Emergency Medicine has come to rely on locally employed doctors (LEDs). Our specialty has the highest proportion of LED doctors of any field and the highest ratio of LEDs to doctors on the specialist register. This is further reflected in Emergency Medicine having the highest specialty and specialist (SAS) ratio of any specialty, with 0.57 SAS doctors for every doctor on the specialist register with a Certificate of Completion of Training (CCT). This demonstrates the essential contribution of SAS doctors to Emergency Care and the ongoing demand for these roles. Their contribution must be fully recognised and embedded within future workforce design, educational planning including access to fair study budgets, and the shaping of training pathways.
“This combined reliance on LED and SAS doctors evidences a system dependent on these groups to deliver core emergency care. This is not a sign of healthy system design, particularly for equitable access to education and supervision. It is a direct reflection of longstanding, inadequate workforce planning for a specialty under sustained and escalating pressure. The high competition ratios also demonstrate the continued demand from doctors who want to train and build their careers in Emergency Medicine, yet we have had no recent increase in training places to facilitate this.
“The report also highlights the insecurity built into this part of our workforce, with 91% of locally employed doctors in non-permanent contracts, the least secure form of medical employment. This situation is untenable for the future. This situation undermines career progression, risking destabilisation of departments. Locally employed doctors must be given access to stable, secure posts that support transition into training, meaningful development, and long-term retention. Without this, Emergency Medicine will continue to rely on a revolving workforce with limited opportunity to progress.
“This report comes on top of the GMC Workplace Experiences report, released earlier in the year. It is of no surprise that EM doctors report the highest rate of difficulty providing patient care amongst specialist groups, and are in the top two for burnout risk. The major factor here is overcrowding, and it remains a damming indictment of NHS leaders who remain separated from reality, and on whose watch the poor experiences of their patients and employees in Emergency Departments have been normalised, in a way that it would never be for other patient or professional groups.
“RCEM has been calling for more effective workforce planning, and has contributed to the 10 year plan workforce review. We hope that future workforce plans are created with greater care than previous iterations. We have also made a series of recommendations aimed at improving staff retention, and crucially, wellbeing in Emergency Care. Policy makers and healthcare leaders must commit to fostering conditions that allow emergency clinicians to feel supported, valued and able to deliver the care they are trained to provide, in a system where patients are experiencing corridor care and long waits.”