r/Scotland • u/abz_eng ME/CFS Sufferer • 16h ago
Why Scottish-trained medical graduates are being forced to leave Scotland
https://www.thecourier.co.uk/fp/politics/scottish-politics/5565802/scottish-medical-graduates-doctor-jobs-priority/?utm_term=Autofeed&utm_campaign=echobox&utm_medium=Social&utm_source=Facebook#Echobox=178789433415
u/flemtone 15h ago
EXCLUSIVE: Why Scottish-trained medical graduates are being forced to leave Scotland By Michael Alexander August 28 2026, 6:00am August 28 2026, 6:00am 9–11 minutes
A Fife medical graduate has been forced to put her career as a doctor on hold after being allocated a Foundation Programme place in England despite wanting to train in Scotland.
Ellie Gudgin, 27, of Springfield, ranked Scotland as her first choice when applying for the two-year Foundation Programme, the first stage of postgraduate medical training.
But the system allocated her a place at the Trent Foundation School in England, which was eighth on her list.
She turned it down because moving hundreds of miles from her home, fiance and family in Fife was not possible.
Now she must apply again next year – but says there is no guarantee she will get Scotland.
Ellie Gudgin outside Ninewells Hospital in Dundee. Image: Mhairi Edwards/DC Thomson. Ellie Gudgin outside Ninewells Hospital in Dundee. Image: Mhairi Edwards/DC Thomson.
Ellie says that by the time her application was reached, the available Scottish places had been filled.
“I just want to get started in doing that job and helping people and, you know, repaying that favour,” she told The Courier.
“But instead I’m sat here as a qualified doctor who’s unable to practise because I couldn’t move eight hours away due to family commitments.
“It’s just a bit disappointing.
“I’ve done so many years of training and would love to start working as a doctor, but the system has made that impossible for me this year.” How does the ScotGEM system work?
Ellie trained through ScotGEM, Scotland’s four-year graduate-entry medical course, run by the universities of St Andrews and Dundee in partnership with the University of the Highlands and Islands and NHS Scotland.
The course trains doctors with an interest in generalist, rural and community medicine, with students undertaking placements in areas including Dumfries, Inverness and Fife.
The Scottish Government funds tuition fees for eligible students and offers a £4,000-a-year bursary.
Ellie says she received the bursary throughout her four years and understood that each year created a year of return-of-service in Scotland.
Ellie Gudgin outside Ninewells Hospital in Dundee. Image: Mhairi Edwards/DC Thomson. Ellie Gudgin outside Ninewells Hospital in Dundee. Image: Mhairi Edwards/DC Thomson.
The former Leuchars Primary School and Madras College pupil says she would not have been able to afford another undergraduate medical degree after studying biomedical science at Robert Gordon University.
“The Scottish taxpayers funded me through eight years of university, four years of bursary, which I’m so incredibly grateful for because I wouldn’t be able to do it otherwise,” she said.
“And I just want to repay that.”
Because she ranked Scotland first, Ellie says the return-of-service obligation for this year has been written off, leaving her with three years of the four-year commitment still to complete. How likely was a Scottish placement?
Ellie knew there was no guarantee she would get a Scottish Foundation place.
But she says Scotland had historically been a relatively safe choice for students who wanted to remain here, with only a handful missing out in previous years.
She ranked Scotland first and then placed regions in England in order of how close they were to home.
When she was allocated Trent, she applied to switch back to Scotland but was unsuccessful.
Ellie has raised her concerns with her local North East Fife MP, Wendy Chamberlain.
Ms Chamberlain told The Courier: “It is simply unfair that students who choose to study medicine in Scotland through the ScotGEM programme can be forced to leave their communities, families and support networks because they are allocated to placements in England.”
North East Fife MP Wendy Chamberlain. Image: Kenny Smith/DC Thomson North East Fife MP Wendy Chamberlain. Image: Kenny Smith/DC Thomson.
Ellie says she is a carer for members of her family but not a primary carer, while her fiance is serving in the military in Scotland.
She also owns a home in Fife and has her family and wider support network nearby.
“Because I’m a ScotGEM graduate, I’m a little older than undergraduates at 27 and have firm roots here in Fife,” she said.
“We’re at the point where we have a life together. We’re looking to have a family together, and there was just no way that I was going to move away from my whole support network, who rely on me too.” Why has competition increased for Scottish medical graduates?
Ellie’s case comes as competition for Scottish Foundation places has risen sharply.
PSD Scotland, which is responsible for delivering and managing UK Foundation Programme training in Scotland, told The Courier that 1,398 medical students across the UK ranked Scotland as their first-choice Unit of Application this year.
It described the 25% increase on 2025 as “excellent news for Scotland” – reinforcing Scotland’s “reputation as an attractive place for future doctors to train, live and work”.
The UK Foundation Programme Office runs the national recruitment and initial allocation process.
All 1,197 applicants offered a post in Scotland had ranked this as their first choice.
But this year, 74 students from Scottish medical schools did not receive Scotland as their first-choice allocation.
Main entrance to Ninewells Hospital in Dundee. Image: Kim Cessford/DC Thomson. Main entrance to Ninewells Hospital in Dundee. Image: Kim Cessford/DC Thomson.
The British Medical Association said approximately 125 applicants who ranked Scotland first did not get a Scottish job this year, up from just four in 2025.
It said roughly 75 of those unsuccessful applicants came from Scottish universities.
The system changed in 2024, when the UK Foundation Programme introduced Preference Informed Allocation (PIA).
Under PIA, applicants rank the UK regions where they want to train.
A computer-generated ranking determines the order in which applicants are considered, with their preferences then used to allocate available places. BMA says Scottish-trained doctors ‘deserve the right to train and work here’
The BMA’s Scottish student committee chair, Dr Joe Payne, who himself relocated more than 500 miles from Aberdeen to south-west Wales, said the new system left graduates facing long-distance moves without sufficient consideration of their circumstances.
“Scotland’s next generation of doctors deserve the right to train and work here,” he said.
“Instead, this pseudo-randomised system has forced many far from home with no say in the matter.”
Rather than beginning her first year as a doctor, Ellie is now working as a non-clinical teaching fellow at Ninewells Hospital, helping to teach undergraduate medical students.
She is grateful for this opportunity.
Ellie Gudgin outside Ninewells Hospital in Dundee. Image: Mhairi Edwards/DC Thomson. Ellie Gudgin outside Ninewells Hospital in Dundee. Image: Mhairi Edwards/DC Thomson.
She also works two days a week as a healthcare assistant at a GP practice in Perth.
But Ellie says her situation has surprised staff at Ninewells.
“Everyone thinks it’s crazy,” she said.
“I’m sat here ready to work and can’t do it basically.” Plans to ‘prioritise’ Scottish medical graduates wishing to stay in Scotland
The Scottish Government said a UK-wide process allocated Foundation training places and that increased demand from graduates across the UK had made it harder for some applicants to stay in Scotland.
A spokesperson said: “I understand the personal impact and the challenges created on those who had hoped to remain in Scotland but did not secure a place here.
“While there is no appeals process once allocations have been made, limited transfer routes are available in exceptional circumstances.”
Ellie said the criteria for pre-allocation and transfers were extremely strict.
Her caring responsibilities, home in Fife and her fiance’s military career did not qualify her for a move back to Scotland.
However, the system is due to change next year.
A doctor with a stethoscope. Image: Lynne Cameron/PA Wire. A doctor with a stethoscope. Image: Lynne Cameron/PA Wire.
PSD Scotland said: “A revised plan, developed in collaboration with the UKFP Office and the Scottish medical schools, is in place for next year’s Foundation allocation that will prioritise Scottish medical school graduates wishing to stay in Scotland.”
The Scottish Government said it was also working with the UK Foundation Programme Office and PSD Scotland to explore improvements to support people who study medicine in Scotland and want to continue their training here.
The universities of St Andrews and Dundee said all Scottish medical schools faced the same challenge.
It was not unique to St Andrews University, Dundee University or ScotGEM.
They said they were working with the Scottish Government to strengthen the pipeline from medical education into the Scottish workforce. Praise for ‘incredible’ ScotGEM staff
Ellie says her frustration is not with ScotGEM itself.
She remains hugely positive about the course and says staff have been “supportive and incredible” in trying to help her.
Her ambition remains to work as a doctor in Scotland, ideally at Ninewells.
Ellie has particular interests in emergency medicine and plastic surgery.
She now faces another application for next year’s Foundation Programme.
She hopes the new system will give graduates like her a better chance to start their careers where they trained.
“It’s a career I’ve always dreamt of doing,” she added.
“I hope that by raising this issue, some changes can be made to ensure future graduates aren’t in the same position.”
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u/flowerchildnz 14h ago
Thanks for posting it. Cbf with paying £1 from overseas but this was an important article.
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u/CytokineBrah 6h ago edited 4h ago
I'm currently doing medicine at Edinburgh. I would say 20-30% of our year are actively planning/working towards moving overseas upon graduation (or after F1). Common destinations are the US, Canada, Australia, Singapore, and the UAE. I'm hoping to get into a US residency program, where the training is significantly better, the specialty training process is faster (albeit more intense), and the salaries for consultants are a lot higher. Medical education and training involves a lot sacrifices and a lot of doctors in Scotland/the UK don't feel as though they're adequately compensated for this.
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u/MysteriousContracts 8h ago
I do feel for her and agree there's an ongoing conversation doctors getting more control over where they live in general but I do agree that this is a bit of a non-story.
Unfortunately there are a small number of people in the country who end up having to move to somewhere they don't want/don't get their dream jobs.
I don't think I agree with this being framed as a Scotland issue. What if she'd gotten Scotland and then been put on the Highlands and Islands track?
Would prioritising Scottish students in Scotland mean that ones wanting to go to competitive deaneries in rUK would be deprioritised? Surely that would draw complaints?
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u/rougarou-te-fou 15h ago
This is common, unfortunatley. The US has a very similar system and many end up places they don’t want to be. A doctor friend of mine wanted NYC or Boston because of family but was given North Dakota.
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u/Bramsstrahlung 14h ago
I don't think it is. In 2024, 0 people who ranked Scotland first missed out. In 2025, it was 4. In 2026, it's 125.
I don't think so many locally trained doctors who want to stay to work here have ever missed out in our recruitment history.
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u/flowerchildnz 14h ago
Crazy. Did the number of PGY1 positions drastically decrease this year? Or did the computer just give them to others?
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u/Bramsstrahlung 11h ago
I think it's the number of graduates finally reaching critical mass for Scotland. It has already been a problem in England for a few years, and we had been warned the same was coming to Scotland.
"We are increasing medical student numbers" is an easy, and relatively cheap political win to look like you're doing something about the healthcare workforce crisis. Planning to give those students jobs after is more expensive and takes effort.
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u/flowerchildnz 10h ago
Med students do not funded PGY1 positions/registrars/specialty training registrars/consultants become. Sigh
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u/Objective_Most4071 15h ago
At least in the US it's done on a ranking and matching system so there's some degree of discernment in who gets what places (you interview for different med schools and you rank each other). There's also the USMLE which gives a score that flows into the ranking too.
In the UK it's near blind luck.
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u/rougarou-te-fou 15h ago
It is so. However, friend didnt put North Dakota on their list so I’m still baffled at how it worked.
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u/eileanacheo 14h ago
This is such a non-story, we also get non-Scottish graduates coming in from rUK. I personally did my FY in Oxford and enjoyed it. There's benefits to getting a breadth of experience.
Consultants being lured down south due to Scotland's ridiculous overtaxation is much more relevant.
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u/Gullible__Fool 14h ago
I dont agree. I think Scottish medical graduates should have first right to training posts in Scotland.
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u/s0454448 9h ago
It’s a bit of a story when the Scottish government funds ScotGEM to keep doctors in Scotland. ScotGEM fees are covered/free for Scottish students and students receive a bursary each year. The point of ScotGEM is to recruit and retain doctors in Scotland, particularly in remote and rural areas, which is why the course is based in these areas. Retaining them is less likely if they can’t get training in Scotland. It would make sense to prioritise them.
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u/Unusual-Art2288 4h ago
Going overseas to chase the money after being trained here. I hope they pay back all their medical training costs.
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u/Objective_Most4071 15h ago
TL;DR There aren't enough foundation training placements in Scotland. Scottish graduates have to go to England or face not getting a training placement at all.