The warning comes as new data in the medical regulator's ‘The state of medical education and practice in the UK: workforce report 2024' highlights the changing nature of the country's medical workforce.

UK-wide, the overall headcount of doctors rose in the last year at the fastest rate since the report began more than a decade ago, but one group has been growing much faster than others – locally employed (LE) doctors.

In England and Wales, the only places where specific data is currently available, the number of LE doctors grew by 75% between 2019 and 2023. By comparison, doctors on the specialist register grew by 13%, and those on the GP register grew by 9% over the same period.

In England and Wales alone there are at least 36,000 LE doctors, and more than two-thirds qualified outside the UK.

However, the regulator says, the roles are too often poorly defined with limited opportunities for career progression and training and many are employed in short-term or non-permanent posts.

Massey said: ‘Locally employed doctors have a lot to offer our health services. But too often they find themselves in roles without proper access to the education and training they need to develop their skills. Without changing the way we think about training, the UK risks sleepwalking into a situation where these doctors are overlooked and undervalued, to the detriment of good patient care.'

In addition, the report shows the growth in headcount marks an increase in doctors joining from abroad, principally India and Pakistan. Last year, more than two-thirds of new joiners came to the UK from abroad, compared to under half in 2017.

For those joining from abroad, the GMC says ‘concerted, sustained efforts' are needed to provide the inductions, integration, and inclusion vital for doctors to thrive in the UK.

Between 2016 and 2023, the number of doctors on the medical register from an ethnic minority background increased by 78%. Around one third of all doctors are now Asian or Asian British and, for the first time, the UK now has more doctors from ethnic minority backgrounds than white doctors.

The GMC warns the infrastructure to train and support doctors across the UK is already struggling to keep pace with growing numbers. Urgent action is needed to provide proper access to training for an increasingly diverse workforce.

Doctors in GMC-approved training roles are also under pressure, and in need of greater support. Many report unsustainably high workloads, and up to one in four are at high risk of burnout.

Based on existing government commitments to expand medical school places, the GMC projects that by 2034 there will be more than 6,000 additional UK graduates entering the profession each year. The regulator says the number of trainers available must keep pace, and their time should be protected in upcoming job planning.

Massey added: ‘As we look to the next decade, it's critical that all doctors have the infrastructure, support and resources they need to achieve their ambitions. That's in their interests, but also the interests of a growing and ageing population, who have never needed their skills more.'

In response, Suzie Bailey, director of leadership and Organisational Development at The King's Fund, said: ‘To provide the number of staff the NHS needs, greater investment in training and staff development will be needed, alongside improved retention rates.

‘There are immediate actions the government can take to improve working conditions and therefore keep hold of the staff it already has. These include introducing minimum standards for facilities like staff access to food and water, supporting flexible working patterns, tackling race discrimination, bullying and unprofessional behaviours, introducing key indicators to measure staff wellbeing improvements and supporting the development of high-quality leaders in health and care.' 

Saffron Cordery, deputy chief executive, NHS Providers, added: ‘NHS trust leaders appreciate the huge contribution skilled LE doctors make. They work hard to support the wellbeing of this growing staff group and tackling inequalities is a priority.

‘Everyone in the NHS must feel valued and part of an organisation offering staff the right conditions to ensure high-quality care for patients.

‘Well trained and supported staff are good not just for the quality of patient care but are more likely to stay in the NHS which, at the last count, has nearly 113,000 vacancies across England.'