The BMA has welcomed efforts to reform the ‘absurd’ rotational training placement programme for resident doctors, following the launch of more than 200 pilot placements.

The association has hailed the introduction of a series of training pilots across England, which it says will aim to address long-standing problems with how doctors are required to complete their training years.

Under the placement system, doctors are forced to relocate to different trusts repeatedly and employers in different parts of the country every four months, a practice which many say is disruptive, financially draining and detrimental to their wellbeing. 

As part of the 2024 pay deal agreed with the Government, NHS England developed a series of 18 pilot schemes designed to address the existing challenges in rotational training and improve experiences and outcomes for doctors.

Consisting of more than 200 individual placements, the new programmes will aim to reduce the geographic area in which placements take place, keep doctors in the same hospital trust where possible and make rotations longer and less frequent.

Shivam Sharma, deputy co-chair of BMA UK resident doctors committee with education and training portfolio, said the system of rotations was ‘absurd’ and ‘well overdue for reform’, and hampered doctors’ efforts to settle into their careers or give focus to other aspects of their lives.

‘Doctors with their whole career ahead of them are currently being thrust into a system that sends them up and down the country with a new location every four months. They are given no choice but to uproot their lives, find new accommodation, new friends, new circumstances – and then four months later do it all again.

‘How are doctors meant to concentrate on caring for their patients when they are driving hours across the country to get to a new job every few months? How are they meant to start a family or even hold down a relationship when they are also trying to find a new flat in a new town over and again?’

He added: ‘This constant change can also make life difficult for hospitals. In some departments, colleagues barely have time to learn a doctor’s name before they move on. Resident doctors lose the opportunity to develop lasting relationships with consultants who understand their strengths, can invest in their development and gradually give them greater clinical responsibility to become the experienced specialists we need.’

Although operating on a limited scale, Dr Sharma said he was hopeful the pilot programmes would demonstrate an alternative approach to placements was viable.

He said: ‘These reforms should not have needed industrial action to secure but if we can extend these pilot programmes so that doctors across the country can enjoy longer rotations and shorter distances to travel, it will show what we can do when we stick together and fight for our working conditions.’

Frustrations with rotational placements are long-standing. However, a BMA survey conducted in February 2025 laid bare the extent of the dissatisfaction and despair felt by many doctors.

With close to 5,000 resident doctors contributing to the survey, participants report that placements were often too short with rotations too frequent, while the large geographic spread of different postings are also a concern.

The survey finds that doctors working less than full-time, international medical graduates or who had to balance their training alongside other responsibilities such as carer roles, feel particularly unhappy with the nature of the existing placement system.

East of England specialty trainee 3 Alex Boulton is one of those with first-hand experience as to how hard and unforgiving the current placement system can be, explaining how a last-minute change to the location of his placement forced him into an untenable position.

He says: ‘After I graduated as a doctor, I was initially not allocated a specific job and instead told I was going to be placed in West Yorkshire, Leeds and the surrounding areas, where both my friends and my partner lived.

‘As we approached our start date, I started renting a flat in the centre of Leeds as I was going to be working locally and it made the most sense.

‘With mere weeks to go before my first day of work as a doctor I was unceremoniously told I was instead being placed in an entirely different area of northern Lincolnshire, approximately 90 miles away from where I was living at the time.’

Despite the almost 100-mile distance between his accommodation and new placement, Dr Boulton says he had no option but to press ahead, a situation that ultimately left him physically and mentally exhausted.

He says: ‘I had no choice but to do it – I had already signed my tenancy agreement. Shifts longer than 12 hours, night shifts, weekends and each day driving more than four hours on top of this. It made it physically impossible for me to get a full eight hours of sleep on many days, and the impact of this was tangible.

‘I was exhausted, as anyone would be in my position, and this exhaustion was persistent and unrelenting because there was nothing I could do about this. Even after discussing with my employer it took months and months for them to even recognise this and compensate my travel. This would not happen in any other industry.’