A new law prioritising NHS training places for medical graduates who studied in the UK has left British overseas students part-way though their studies frustrated and may dampen demand for specialist branch campuses, it has been warned.

The Medical Training (Prioritisation) Act, a new law giving UK graduates priority access to NHS training places, came into force in March.

The law was introduced following concerns that too many training places were going to foreign-educated graduates, leaving British students struggling to secure jobs after completing their government-subsidised medical training.

It means that places on the foundation programme, a two-year generalist training scheme all medical graduates must complete in order to work in the UK, will be prioritised for those with a medical qualification from institutions in the UK and five other countries that Britain has existing trade agreements with. International students who studied medicine in the UK will still be prioritised for training, regardless of their nationality or immigration status.

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Non-eligible students can still apply for the programme, but limited places mean they are much less likely to secure a spot than those who completed their studies in the UK – disadvantaging British students who have completed their medical studies abroad. 

A cap on UK medical school places has resulted in a surge in recent years in students choosing to study medicine overseas, with places like Bulgaria, Poland and Georgia among popular destinations.

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Sam El Mais, director of , an agency that supports students to study medicine in Europe, said there was “understandable frustration” about the law change among medical students already part-way through their studies abroad. 

“Many are British nationals who have self-funded their education and still want to return to serve the NHS. They do not see themselves as the same as overseas applicants with no UK connection.”

He said that while it is understandable that UK medical school graduates should be protected, “after that, it would be sensible for the system to recognise British nationals trained abroad as a UK-connected group, rather than treating them exactly the same as applicants with no UK connection”.

Henry Budden and Elgan Manton-Roseblade, co-chairs of the British Medical Association’s medical student committee, said they recognised that the legislation is a “huge disappointment” for some, but emphasised that the “UK taxpayer funds the education of medical students in the UK, placing the responsibility on the government to ensure these graduates are supported into work within the NHS rather than feeling compelled to move abroad”.

They continued: “The UK government has no control over the number of international medical school places and should work to ensure all UK graduates get the training and jobs they deserve.”

In a debate about the new law, health secretary Wes Streeting previously described overseas medical campuses as “commercial ventures” and said prioritising graduates from those institutions would “undermine sustainable workforce planning”. 

El Mais said that he did not expect the change in the law to diminish demand for international medical schools. 

“UK medical school entry remains highly competitive and limited, and many capable students still want a credible route into medicine when they cannot secure a UK place,” he said.

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He added that the law will not stop students from working in the UK – it will just make it harder to secure a training place – and that international medical training also prepares students to work in other countries. 

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“For the NHS, the risk is that British nationals trained abroad may not wait indefinitely for the UK route to become clearer. Doctors are a mobile global workforce, and the UK is already competing with countries such as Australia, New Zealand, the Gulf and the United States, where overseas-trained British doctors may find higher pay, clearer progression or better working conditions.”

The new law has also affected non-UK nationals studying medicine at overseas branch campuses. 

In Malaysia, around 850 international students at Newcastle University Medicine Malaysia, which offers UK accredited medical programmes, were left in limbo after the law meant they would no longer be prioritised for training places in the UK. 

Foreign graduates in Malaysia are also normally not permitted to work in the country’s health service, but the health minister has since stepped in, confirming on 7 May that the government will grant an exception and offer training places to the impacted students.

But Geoffrey Williams, a retired Malaysia-based academic who helped publicise the issues Newcastle’s students were facing, said the incident may fuel distrust in British branch campuses.

Branch campuses commonly advertise their courses as a cheaper way to obtain a UK degree than studying at their home campus. 

“What I see here is, for the first time, the British government have made clear that degrees issued by British franchise campuses overseas are not the same as British degrees…and this is the first time they have very clearly said they’re not the same.”

He said that although the university is not to blame for the government’s decision, there is “real anger” in Malaysia about the situation.

A spokesperson for Newcastle said that the government’s decision to prioritise UK-trained doctors for NHS postgraduate places “is a legitimate and understandable objective” but said they recognised the changes were “distressing and unsettling for students at our Malaysia campus”. 

They added that the branch campus would continue to offer the course to international students but was “enhancing student support and careers guidance” to reflect the changes and it “continues to engage constructively with relevant stakeholders in the UK and internationally regarding the implications of the legislation”. 

“We continue to market the programme transparently and responsibly, ensuring current and prospective students are provided with clear information regarding postgraduate training pathways and the evolving nature of medical workforce planning internationally.”

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helen.packer@timeshighereducation.com