Rising competition for non-training resident doctor posts in the NHS: an FOI-based analysis from the Midlands

Background Competition for UK medical training posts has increased substantially over the past decade, but little is known about competition for non-training resident doctor roles. Methods We conducted a Freedom of Information request-based study of National Health Service (NHS) trusts in the Midlands to examine competition ratios for non-training resident doctor (senior house officer and middle-grade) posts between 2024 and 2025. Of the 42 trusts contacted, 14 (33%) responded and 9 (21%) provided data complete enough for analysis. Results Aggregate mean competition ratios rose from 84 to 195 applicants per vacancy for senior house officer posts, and from 28 to 59 for middle-grade posts, between 2024 and 2025, across nine trusts. At individual-trust level, ratios reached as high as 714 (senior house officer) and 152 (middle-grade) applicants per vacancy in 2025. These levels exceed competition ratios reported for specialty training programmes. Conclusions This study provides the first empirical evidence of substantial and rising competition for non-training resident doctor posts. These findings have significant implications for workforce planning, leadership decision-making and the sustainability of non-training resident doctor roles within the NHS.