Charlie Massey, chief executive of the General Medical Council, has warned that the pipeline and retention of internationally qualified doctors are showing increasing fragility. 

The NHS depends on overseas medics, but their commitment to the UK can no longer be assumed, Charlie Massey, chief executive of the General Medical Council (GMC), has warned. 

Speaking at NHS ConfedExpo in Manchester, he said that “active and conscious consideration” must be given to improving induction and consistent support for internationally trained doctors, to reverse an upward trend of those leaving the UK.

The NHS’ reliance on international doctors continues to grow, with internationally qualified medics making up 42% of the medical register. In recent years, two-thirds of new joiners were trained overseas. However, there are signs this trend is shifting, with more doctors choosing not to come to, or to leave, the UK, he said. 

The GMC’s latest workforce report shows a 26% rise in non-UK qualified doctors leaving the country. Meanwhile, growth in internationally trained joiners has slowed sharply, from over 60% to over 20%, and now to around 2%.

“In a more polarised global environment, questions of inclusion, belonging and fairness increasingly shape where internationally qualified doctors choose to work and stay,” Massey said.

“The NHS is reliant on internationally qualified doctors, yet the pipeline and retention are showing increasing fragility. We must do more to actively support and advocate for these doctors throughout their careers, with fair, consistent access to learning, development, and progression, especially for those outside formal training pathways,” he added. 

Severe consequences

In March, research from the Work Rights Centre showed that further restricting overseas recruitment will have severe consequences for the healthcare sector.

The number of visas granted for Caring Personal Service roles, which fall under the Health and Care Worker visa route, saw the steepest decline in absolute terms, from 107,847 in 2023 to as little as 3,178 last year and just 23 in the fourth quarter.

Calls for greater support and security for migrant workers in the NHS dominated the agenda at UNISON’s national health conference in April in Edinburgh. 

“We face harmful rhetoric, we face immigration uncertainty. We face a system that sometimes makes us feel like we’re needed but not really wanted. How can the NHS depend on migrant workers, while migrant workers are made to feel disposable?” said Emmanuel Akinlose, speaking on behalf of UNISON’s North Devon and Exeter health branch.

UNISON figures suggest that if the NHS had paid to train the foreign workers in the NHS, it would have cost the government £100,000-£120,000 per doctor and more than £20,000 per nurse. This adds up to a cumulative £14 billion saving to the NHS in training costs based on workers currently in post.

Last year saw a massive 74% decrease in the number of visas granted to health professionals, which dropped from a peak of 38,997 in 2022 to 10,060 in 2025. This includes a 93% decline in visas granted to nursing professionals, a 30% decline in visas granted to medical practitioners, and a 73% decline in visas granted to therapy professionals.