Training · Updated for the 2026 round

Specialty competition ratios 2026: every specialty, with 2025 and 2024 beside it

NHS England publishes the ratios one year at a time. We put them side by side, add what the prioritisation Act did to them, and keep this page updated each round.

Figures from NHS England’s Medical Hub, checked 9 November 2026. Ratio = applications ÷ posts. In 2026 each applicant could apply to up to five specialties, so one person can appear in several rows.

Round 1 (ST1 and CT1): 2026, 2025 and 2024

Sorted by 2026 ratio, highest first. Blank cells mean the programme wasn’t listed separately that year. Green means the ratio fell since 2025; red means it rose.

Specialty	Ratio 2026	Ratio 2025	Ratio 2024	Change since 2025	Applications 2026	Posts 2026
Emergency Medicine (Northern Ireland) ST1	76.80			–	768	10
Community Sexual and Reproductive Health ST1	64.78	98.50	25.61	−33.72	583	9
Broad Based Training (Scotland) CT1	61.73			–	926	15
General Practice and Public Health Medicine (Dual CCT) ST1	61.54	167.15	112.13	−105.61	800	13
Trauma and Orthopaedic Surgery (Scotland) ST1	35.29			–	494	14
Core Surgical Training (Northern Ireland) CT1	24.12			–	1,013	42
Neurosurgery ST1	23.63	26.71	19.67	−3.08	378	16
Public Health Medicine ST1	22.41	28.53	17.46	−6.12	2,241	100
Core Psychiatry Training CT1	21.63	21.83	9.45	−0.20	11,940	552
Cardiothoracic Surgery ST1	14.43	73.70	45.33	−59.27	202	14
ACCS Emergency Medicine ST1	12.35	14.23	7.57	−1.88	4,410	357
Anaesthetics CT1	10.54	12.56	6.50	−2.02	5,766	547
Obstetrics and Gynaecology ST1	9.98	16.65	7.00	−6.67	3,532	354
Ophthalmology ST1	9.92	21.54	14.41	−11.62	1,141	115
Clinical Radiology ST1	8.71	11.27	11.92	−2.56	2,849	327
Histopathology ST1	8.62	9.47	5.04	−0.85	681	79
Internal Medicine Training (Scotland) CT1	7.14			–	885	124
Core Surgical Training CT1	6.91	8.57	5.25	−1.66	4,975	720
Paediatrics ST1	5.13	5.63	3.30	−0.50	2,605	508
Internal Medicine Training CT1	5.03	5.27	3.69	−0.24	8,468	1,683
General Practice ST1	4.74	4.91	3.67	−0.17	24,014	5,064
Oral and Maxillo Facial Surgery ST1	3.37	3.50	1.89	−0.13	64	19
All Round 1 posts, 2026	7.37	39,387 individual applicants; overall ratio 3.69, and 1.86 within the priority group			78,735	10,682

What the 2026 numbers actually say

The headline ratios are only half the picture. Read next to NHS England’s prioritisation data, they tell a different story, which we worked through in the 15 November issue.

2.2%Of the 19,479 applicants outside the priority group, 427 accepted a post. Last year, non-priority doctors took 28% of all posts.
9,700Priority applicants who still ended the round without a post. 19,908 applied; 10,242 accepted one.
73%Share of posts that went to UK graduates. “Priority” is not the same as “UK graduate”: in GP the figure was 65%.
7,528Psychiatry applicants deemed appointable, for 552 posts. 5,973 of them were non-priority. Anaesthetics had 1,733 non-priority applications and found 10 appointable: MSRA-only selection versus interview-weighted selection.
49%Northern Ireland’s IMT posts that went to non-priority applicants (35 of 71), against 13% in England and none in Scotland. Geography was the loophole.
13Posts unfilled in the whole round. All were Core Surgical Training, all in England.
788Of the roughly 1,000 extra posts this year, the number that were GP. Radiology shrank from 356 posts to 327.

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Who put all their eggs in one basket, 2026

NHS England also reports how many applicants applied to one specialty only, and how many of those were appointed.

Specialty	Single-specialty applicants	Share of its applications	Of those, appointed	Appointment rate
Public Health Medicine ST1	1,374	61.3%	76	5.5%
Internal Medicine Training CT1	5,053	59.7%	1,509	29.9%
Internal Medicine Training (Scotland) CT1	359	40.6%	118	32.9%
Oral and Maxillo Facial Surgery ST1	25	39.1%	11	44.0%
Paediatrics ST1	870	33.4%	285	32.8%
Histopathology ST1	203	29.8%	33	16.3%
General Practice ST1	7,115	29.6%	2,158	30.3%
Core Surgical Training CT1	968	19.5%	288	29.8%
Anaesthetics CT1	1,012	17.5%	220	21.7%
Ophthalmology ST1	170	14.9%	49	28.8%
Neurosurgery ST1	49	13.0%	4	8.2%
Clinical Radiology ST1	369	13.0%	76	20.6%
Cardiothoracic Surgery ST1	24	11.9%	7	29.2%
ACCS Emergency Medicine ST1	481	10.9%	111	23.1%
Obstetrics and Gynaecology ST1	346	9.8%	130	37.6%
Core Psychiatry Training CT1	770	6.5%	225	29.2%
Community Sexual and Reproductive Health ST1	34	5.8%	3	8.8%
Trauma and Orthopaedic Surgery (Scotland) ST1	27	5.5%	2	7.4%
Core Surgical Training (Northern Ireland) CT1	23	2.3%	7	30.4%
Emergency Medicine (Northern Ireland) ST1	13	1.7%	1	7.7%
General Practice and Public Health Medicine (Dual CCT) ST1	13	1.6%	2	15.4%
Broad Based Training (Scotland) CT1	13	1.4%	2	15.4%

Higher specialty training (ST3 and ST4), 2025 round

The 2026 higher specialty figures hadn’t been published when this page was last updated. We’ll add them when they are.

Specialty	Applications	Posts	Ratio
Acute Internal Medicine ST4	443	100	4.43
Allergy ST3	29	3	9.67
Anaesthetics ST4	699	423	1.65
Audiovestibular Medicine ST3	32	2	16.00
Cardiology ST4	540	134	4.03
Chemical Pathology ST3	46	20	2.30
Clinical Genetics ST3	84	15	5.60
Clinical Neurophysiology ST3	41	9	4.56
Clinical Oncology ST3	276	105	2.63
Clinical Pharmacology and Therapeutics ST4	16	8	2.00
Clinical Radiology ST3	88	9	9.78
Combined Infection Training ST3	154	36	4.28
Combined Infection Training ST4	112	10	11.20
Dermatology ST3	261	57	4.58
Diagnostic Neuropathology ST3	8	4	2.00
Emergency Medicine ST3 (ACCS)	9	11	0.82
Emergency Medicine ST3 (DRE-EM)	283	25	11.32
Emergency Medicine ST4	104	71	1.46
Endocrinology and Diabetes Mellitus ST4	362	73	4.96
Gastroenterology ST4	383	104	3.68
General (Internal) Medicine ST4	191	17	11.24
General Surgery ST3	834	161	5.18
Genitourinary Medicine ST4	46	45	1.02
Geriatric Medicine ST4	323	157	2.06

Specialty	Applications	Posts	Ratio
Haematology ST3	236	103	2.29
Immunology ST3	37	5	7.40
Intensive Care Medicine ST3	537	181	2.97
Medical Oncology ST3	319	101	3.16
Medical Ophthalmology ST3	14	3	4.67
Neurology ST4	197	55	3.58
Obstetrics and Gynaecology ST3	504	60	8.40
Occupational Medicine ST3	119	7	17.00
Otolaryngology ST3	243	41	5.93
Paediatric Cardiology ST4	63	10	6.30
Paediatric Surgery ST3	109	16	6.81
Paediatrics ST3	507	49	10.35
Palliative Medicine ST4	136	58	2.34
Plastic Surgery ST3	281	42	6.69
Psychiatry (all specialties) ST4	683	491	1.39
Rehabilitation Medicine ST3	69	17	4.06
Renal Medicine ST4	206	58	3.55
Respiratory Medicine ST4	413	104	3.97
Rheumatology ST4	240	51	4.71
Sport and Exercise Medicine ST3	107	12	8.92
Stroke Medicine/General (Internal) Medicine ST4	145	32	4.53
Trauma and Orthopaedic Surgery ST3	684	150	4.56
Urology ST3	343	74	4.64
Vascular Surgery ST3	225	35	6.43

Sources and method

All ratios are NHS England’s, from the 2026, 2025 and 2024 competition ratios pages on the Medical Hub. ACCS Emergency Medicine was listed as CT1/ST1 in earlier years. The priority-group findings come from NHS England’s prioritisation spreadsheet for the 2026 round, as analysed in On-Call. If NHS England revises a figure, theirs wins; tell us and we’ll correct it.

Last updated 9 November 2026. Earlier years’ issues: 2025 and 2024 competition ratios write-ups.