UK Graduate Prioritisation Law: Who Counts as Prioritised in 2026 and 2027
On Thursday 22 October 2026, applications open for the first round of UK specialty training posts that begin in August 2027. This is not just another recruitment round. It will be the first in which the Medical Training (Prioritisation) Act 2026 applies at shortlisting as well as at the offer stage. For the first time, the priority rules will shape who gets interviewed, not only who gets offered a post.
That change makes one question more important than any other for international medical graduates (IMGs): who exactly counts as prioritised? The answer is different for 2026 and 2027, different for the foundation programme and specialty training, and it contains a few asymmetries that are easy to get wrong. This guide sets out what the British Medical Association (BMA) and the legislation itself say, so you can plan around facts rather than rumours.
What is the Medical Training (Prioritisation) Act 2026?
The Medical Training (Prioritisation) Act became law on Thursday 5 March 2026. It creates a legal requirement that certain groups of applicants, principally graduates of UK medical schools, are considered before everyone else for foundation and specialty training posts in the UK. The BMA published a detailed explainer on 13 January 2026 and updated it on 2 September 2026, which is the clearest account of how the 2026 recruitment round operated under the new law.
A crucial point that many IMGs miss: not being prioritised does not mean you cannot apply. It means that posts are allocated to those in the prioritised group first. You can still be offered a post if one remains, but the queue is ordered by law, not by score.
Who was prioritised for the foundation programme in 2026?
For the 2026 foundation round, UK graduates were prioritised for places, alongside graduates from the Republic of Ireland and four other European countries with which the UK holds agreements: Norway, Iceland, Switzerland and Liechtenstein. Graduates from all other international medical schools were not prioritised, regardless of their nationality. That last point deserves emphasis: UK citizens who qualified at international medical schools were not prioritised for foundation training.
Two timing consequences followed from the law. Allocation to the foundation programme was delayed while the legislation passed through Parliament, so applicants received their allocations on 12 March 2026. The introduction of prioritisation also led to a significant reduction in the number of placeholders, with the BMA noting that those on placeholders should generally receive programme allocations more swiftly than in previous years as withdrawals create spaces.
The same prioritised groups applied to standalone FY2 recruitment, and Foundation Priority Programmes were not run as a separate process in 2026. Those posts were instead added to the main round and allocated through Preference Informed Allocation.
How did specialty training prioritisation differ from the foundation programme?
The specialty training picture in 2026 had one important difference: the priority group was wider. As with the foundation programme, UK graduates and graduates from the Republic of Ireland, Norway, Iceland, Switzerland and Liechtenstein were prioritised for core and higher training places. But IMGs who had already completed the foundation programme were also prioritised, as were applicants who had completed relevant core training.
That second route matters. The BMA gives a concrete example: an international medical graduate who had completed core psychiatry would be prioritised when applying for higher training in child and adolescent psychiatry. But completing core training only carried priority into a relevant higher specialty. The same doctor would not be prioritised applying for a core surgery programme, unless they met another criterion such as having completed the foundation programme.
There is also one asymmetry between foundation and specialty that catches people out. For specialty training in 2026, a British citizen holding an international medical degree was included in the prioritised group, because the specialty criteria also recognised certain immigration statuses. That was different from the foundation programme, where UK citizens with international degrees were not prioritised at all. If you are a UK passport holder who qualified abroad, which round you are entering changes which rules apply to you.
Who counts as prioritised in 2027?
This is the question everyone is asking ahead of the October 2026 application window, and the honest answer has two parts: what the legislation already says, and what the regulations have yet to confirm.
The explanatory notes to the legislation set out the framework for specialty training posts starting in 2027 and beyond. The big change is that prioritisation will apply at the interview and offer stage, not only at the offer stage as in 2026. In practice, that means the priority group is considered first when shortlisting decisions are made, so prioritised applicants are more likely to reach interview at all.
The groups the legislation names for 2027 onwards are: graduates of UK medical schools and Republic of Ireland medical schools; people who have completed the UK foundation programme or another relevant previous stage of training in the UK; and groups specified by regulations who are likely to have significant experience of working as a doctor in the NHS in England, Wales or Scotland, or in Health and Social Care in Northern Ireland, or groups defined by reference to immigration status. As with 2026, international agreements are reflected separately, and this currently covers graduates from institutions in Iceland, Norway, Liechtenstein and Switzerland.
The precise definition of the 2027 priority group is expected to be set out in regulations from the Department of Health and Social Care. If you are applying in this round, which opens on 22 October 2026 and closes on 19 November 2026 for the August 2027 starts, per the published Round 1 dates, check the published regulations and your specialty recruitment office guidance before you assume you know which group you are in.
Which groups are not prioritised?
Several groups are easy to misunderstand, so here they are stated plainly.
First, graduates of a UK medical school who spent the majority of their degree at an international campus were not counted as UK graduates for foundation applications under the legislation. This is the legal reality behind the row over graduates of UK university overseas campuses, which I covered in detail earlier this month: the same GMC-accredited standard does not buy you the same recruitment status. If that describes you, you are treated as an IMG for prioritisation purposes unless you meet another criterion.
Second, international students who studied at UK medical schools are considered UK graduates and are prioritised, regardless of their nationality or immigration status. The law follows where you trained, not what passport you hold.
Third, the legislation makes no specific provision for refugee doctors. For training applications they are treated the same as other international medical graduates, and refugee status is not a standalone priority group. A refugee doctor is prioritised only if they fall into another category, for example by holding indefinite leave to remain or having completed foundation or core training. The BMA notes that the law does not change eligibility to apply for locally employed doctor roles.
Finally, the general position for IMGs holds: if you have an international medical degree, no UK foundation or relevant core training, and no qualifying immigration status, you are not in the prioritised group. You can still apply, and you can still be appointed, but you are considered after the prioritised group.
Are all specialties covered by the law?
Almost all. The only specialty currently excluded from prioritisation is public health medicine at single Certificate of Completion of Training level, because the specialty is open to both medical and non-medical applicants. Academic posts are included in prioritisation, with one narrow exception: public health academic clinical fellow posts in England, where vacancies are open to current non-medical public health trainees. Dental training posts are not included, although oral and maxillofacial surgery is included because it is a medical specialty despite the requirement to hold a dental degree.
Can the prioritised group change in future?
Yes. The legislation gives the Secretary of State for Health and Social Care the power to change, through regulation, who is prioritised for the foundation programme and for specialty training. The BMA reports that the government intends this power to respond to changes in application patterns. The example given is telling: if applications for a particular programme, such as general practice, fell significantly, that specialty could be removed from prioritisation. The stated aim is to avoid doing this by attracting more UK graduates into the specialties where service need is greatest.
This means the 2026 and 2027 groups are not permanent. Each year, check the current position rather than assuming last year’s rules still apply.
What should IMGs do differently for the 2027 round?
First, do not let the word prioritisation stop you applying. The law orders the queue; it does not close the door. In rounds where prioritised applicants do not fill the posts, non-prioritised applicants are still appointed.
Second, understand where you actually stand. The categories are specific, and the biggest planning mistakes come from assuming that a UK passport, a GMC-accredited overseas campus degree, or an unfinished training stage buys you priority it does not. Read the BMA explainer and your specialty’s recruitment guidance against your own facts.
Third, if you are already in the UK system, there is one route into the prioritised group that you can still affect: completing the foundation programme or relevant core training. An IMG who has completed the foundation programme is prioritised for specialty training under the same rules as a UK graduate. That makes securing and completing foundation-level experience one of the most strategically valuable things an IMG in the UK can do, and it is also the foundation on which a serious training portfolio is built. If you have not started, my earlier checklist on building a specialty training portfolio from day one, with audits, quality improvement and teaching, is the companion piece to this guide.
Fourth, keep watching the regulations. The 2027 priority group will be defined in detail by the Department of Health and Social Care, and the “significant NHS experience” category is the one with the most scope to move. Do not rely on second-hand summaries; read the regulations when they land.
The 2027 round is the first where the queue is ordered at interview as well as at offer. That makes accurate self-assessment more valuable than optimism. Know your group, apply honestly, and build the experience that moves you into the priority group for the year after.
Frequently asked questions
Does the prioritisation law stop IMGs from applying for UK training posts?
No. The BMA is explicit: not being prioritised does not mean IMGs cannot apply. Posts are allocated to the prioritised group first, and remaining posts can go to other eligible applicants. The law changes the order of consideration, not eligibility.
If I am a UK citizen with a medical degree from abroad, am I prioritised?
It depends on the round. For the foundation programme, no: UK citizens with international medical degrees were not prioritised in 2026. For specialty training in 2026, yes: British citizens with international medical degrees were included in the prioritised group because the specialty criteria recognised certain immigration statuses. Check the 2027 regulations for the current position.
Are international students who trained at UK medical schools prioritised?
Yes. International students are considered UK graduates for prioritisation purposes, regardless of their nationality or immigration status.
Will prioritisation really apply at shortlisting in the 2027 round?
Yes. The legislation provides that for specialty training posts starting in 2027 onwards, prioritisation applies at the interview and offer stage. In 2026 it applied only at the offer stage, so this is a genuine change for the round opening on 22 October 2026.
I completed core psychiatry but want to apply for core surgery. Am I prioritised?
Probably not on that basis. Applicants who completed core training were prioritised only for higher specialty training in a relevant specialty. A core psychiatry doctor applying to core surgery would not be prioritised for that reason, unless they met another criterion such as having completed the foundation programme.
Can the government change which groups are prioritised?
Yes. The Secretary of State for Health and Social Care can change the prioritised groups through regulation. The government has said this power is intended to respond to changes in applications, though the stated aim is to avoid doing so.
Sources: BMA, “What we know about the law on UK graduate prioritisation” (published 13 January 2026, updated 2 September 2026); explanatory notes to the Medical Training (Prioritisation) Bill, parliament.uk; NHS England deanery page for 2027 national neurosurgery ST1/ST2 recruitment, confirming Round 1 dates of 22 October to 19 November 2026.