‘We risk losing an entire generation of our future physicians if this does not change’: RCP calls for urgent action to support Northern Ireland’s overstretched physician workforce

The new report, Turning the tide: Supporting Northern Ireland’s physician workforce, draws on evidence from a high-level roundtable convened by the RCP in November 2025, bringing together doctors, system leaders and policymakers from across Northern Ireland.

It highlights four critical areas requiring immediate action: workforce pressures and morale, training bottlenecks, system pressures including corridor care and the need to value and invest in clinical leadership.

The RCP is calling for a series of practical reforms, including:

• expansion of training places and redesign of recruitment processes to reflect medical school growth and better support retention in Northern Ireland
• support resident doctors with better supervision, fair access to training and flexible, modern career pathways including non-traditional and portfolio roles
  the development of structured career pathways and leadership opportunities for SAS and locally employed doctors
• action to tackle corridor care through system-wide discharge planning, intermediate care and the expansion of ambulatory and community care
• greater support for generalist practice and value-based care
• meaningful investment in clinical leadership development across all career grades.

The RCP says that rising demand, rota gaps and growing patient acuity have left many services under severe strain. Resident doctors and consultant physicians described unsafe workloads, erosion of goodwill and growing exhaustion, while specialist, specialty and associate specialist (SAS) and locally employed doctors reported inconsistent career progression and a lack of recognition despite their expanding role in delivering frontline care.

Commenting on the report, RCP president Professor Mumtaz Patel said:

‘Doctors in Northern Ireland are clear about both the scale of the challenge and the solutions needed. This is not about a lack of commitment or capability – it’s about creating a system that values its people, supports training and enables high-quality, dignified patient care. With the right action now, we can turn the tide.’

The briefing also raises serious concerns about escalating competition ratios for internal medicine training (IMT), which mean many doctors are unable to secure training posts in Northern Ireland. Roundtable participants warned that this threatens the long-term consultant pipeline, with one participant saying: ‘we risk losing an entire generation of our future physicians if this does not change.’

Clinicians further described the ethical and emotional toll of delivering care in overcrowded hospitals, where prolonged delays to discharge and insufficient community capacity have normalised corridor care. The report argues that these pressures cannot be solved by hospitals alone and calls for a renewed focus on generalist practice, multidisciplinary working and community-based models of care.

Alongside these system challenges, the RCP highlights the critical importance of investing in clinical leadership. Doctors across all career stages reported taking on leadership responsibilities without protected time, training or recognition, undermining both morale and service improvement.

Dr Sean Coghlan, chair of the RCP Student and Foundation Doctor Network, and a foundation doctor working in Belfast, said:

‘As a foundation doctor in Northern Ireland, it often feels like we’re working flat out just to keep services safe, with little time or certainty about our future training.

'We want to stay and build our careers here, but we need fair access to training, proper support and a system that values us if we’re going to be able to deliver the care our patients deserve.’

The RCP will continue to work with colleagues across Northern Ireland to champion the perspectives of resident, SAS and consultant physicians, and to support reforms in medical training, workforce planning and the culture of medicine.