NHS England has terminated the Medical Training Initiative, a scheme that offered medical professionals from low- and middle-income countries the opportunity to work in British hospitals for up to two years. The programme, commonly referred to as “earn, learn and return,” had operated since 2011 and provided placements to between 400 and 500 foreign-trained doctors each year.
The decision to end the MTI has prompted significant criticism from the UK’s medical institutions. The Academy of Medical Royal Colleges, representing all 23 medical royal colleges, expressed disappointment with the closure, characterizing the programme as a successful example of international medical collaboration that strengthened professional relationships between the UK and partner nations while supporting healthcare development overseas. Officials from the academy noted the scheme cost NHS England £176,000 annually and represented an important demonstration of British soft power on the global stage.
An internal review by NHS England concluded that the MTI was not fulfilling its stated objective of improving healthcare quality in overseas countries, citing concerns that some foreign doctors remained in the UK rather than returning home. The review also identified instances of wage exploitation, with participating physicians receiving lower compensation than UK counterparts performing equivalent work. Current MTI participants will be permitted to complete their placements, and those who applied by March will proceed with their placements before the scheme winds down following that round.
Medical leaders have expressed concern that discontinuing the programme could worsen existing physician shortages within the NHS, which relies heavily on international graduates who constitute two-fifths of its medical workforce. Some senior doctors suspect the closure relates to workforce allocation disputes between the government and resident doctors, with speculation that it may have been intended to address demands from the British Medical Association for prioritizing UK medical graduates in competitive training positions. The Royal College of Physicians of Edinburgh and Royal College of Surgeons of Edinburgh both voiced disappointment, emphasizing the mutual benefits the scheme provided to participants and the broader healthcare system.
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