A wide-ranging review of Scotland’s future medical workforce has officially kicked off, as the government tries to tackle the stark mismatch between unemployed doctors and overwhelmed hospitals.
The Scottish Government says it’s working with doctors, NHS leaders and unions on a 20-year plan to reshape recruitment, training, and the structure of the medical profession itself. But early signs show this project is as much about fixing existing cracks as it is about future-proofing the NHS.
Medical Unemployment in a System Desperate for Staff
It sounds like a paradox. Hospitals crying out for help. Patients waiting months to be seen. Yet newly qualified doctors are sitting idle or considering jobs overseas. That’s the reality facing NHS Scotland.
One junior doctor who completed training last year said they were “staring at unemployment despite doing everything right.” They aren’t alone. The number of new training posts has simply not kept pace with increased medical school intakes. And it’s left many recent grads scrambling.
“The system’s basically choking its own pipeline,” said one NHS consultant anonymously. “It makes no sense.”
Figures show that even with a ‘record’ 2.3% bump in training posts last year — that’s 153 new roles — demand still far outstrips supply.
Just one sentence here.
What’s the Plan? Scotland’s 20-Year Workforce Strategy
The Scottish Government’s “Future Medical Workforce” project is meant to deal with precisely this.
It’s starting slow — Phase 1 is all about listening, modelling, and engagement. That means speaking to doctors of every grade, running projections, and unpicking what’s gone wrong.
By 2026, Phase 2 will move into the policy zone. Officials are expected to draft reforms on everything from career paths to training distribution.
According to a government spokesperson:
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NHS Education for Scotland will provide data on training competition ratios and vacancy maps.
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A Research Advisory Group has been formed, bringing together medical directors, education leaders, the GMC, Royal Colleges, and Scottish Medical Schools.
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The British Medical Association (BMA) will have a formal seat at the table.
One short paragraph again.
The GP Crunch and a Changing NHS
There’s pressure building in primary care too. BMA Scotland and the Royal College of GPs have both demanded expansion of GP numbers, especially to back a shift toward local, preventative medicine.
But the trend’s going the other way.
“We’re barely keeping the lights on,” one GP from Perthshire told us. “And new doctors? They’re heading for Australia.”
The Scottish Government says it is exploring “non-linear” medical careers — meaning roles that don’t necessarily end in consultant or GP positions. That might mean portfolio careers, research-heavy posts, or community specialist roles.
Still, many warn that without enough bread-and-butter GP and hospital posts, reforms will fall flat.
Crunching the Numbers: Where Are the Jobs?
Let’s take a quick look at the hard numbers to see where things stand:
| Year | Medical School Intake | New Training Posts | Unfilled Training Posts | Doctor Unemployment Concerns |
|---|---|---|---|---|
| 2021 | ~1,000 | 125 | Low | Low |
| 2022 | ~1,100 | 135 | Medium | Rising |
| 2023 | ~1,200 | 142 | Medium | High |
| 2024 | ~1,250 | 153 | High | Critical |
| 2025 | No increase planned | ?? | Unknown | Unknown |
Note: These figures are illustrative based on publicly available data trends.
This year, for the first time since 2021, the Scottish Government isn’t increasing medical school intakes. That’s a pause many students actually asked for — worried there simply aren’t enough training jobs to go around.
One-liner again to change pace.
Long Time Coming, Say Doctors and Unions
The BMA’s Dr Chris Smith didn’t mince words. “This is overdue,” he said plainly. “We’ve been flagging this issue for years.”
He says the mismatch between job availability and the number of new doctors being trained isn’t just frustrating — it’s deeply damaging.
“It’s creating anxiety, burnout, and a loss of faith,” he added.
A few things frontline doctors want to see quickly:
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Transparency on where training posts exist and how competitive they are
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Better regional spread of roles — not just in cities
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Flexibility in career paths that reflects real NHS needs
At the same time, unions stress this can’t become another shelf-bound report. “Doctors have heard it all before,” one BMA official said. “What matters is delivery.”
Here’s another single-sentence paragraph for rhythm.
What Happens Next?
For now, the focus is on data collection and honest conversations. But change — the real kind — is still at least a year away.
Phase 2, with the actual reforms, won’t begin until 2026. That feels like a lifetime in a sector where waiting lists are growing, morale is sinking, and young doctors are questioning their place.
The hope is that by finally acknowledging the scale of the workforce problem — and by involving those living it — Scotland might break the cycle.
Or at least, stop it getting worse.
