What matters in medical training in Wales: a thematic analysis of Wales-specific responses to the NHS England Medical Training Review Call for Evidence

A qualitative analysis of Wales-specific responses to the NHS England Medical Training Review identified 11 cross-cutting themes shaping postgraduate medical education in Wales. The findings indicate that concerns about training are closely connected to wider UK workforce pressures while also reflecting the Welsh service and workforce context. The authors concluded that reform must treat training capacity, workforce planning, protected educational time, equitable progression, flexibility and sustainable working conditions as interconnected features of postgraduate medical education.

The study analyzed free-text responses submitted during phase 1 of the NHS England Medical Training Review Call for Evidence. Its dataset comprised responses from 133 respondents who identified with, or commented on, the Welsh medical training context. Researchers used thematic analysis, beginning with inductive coding within the broad question-led domains of the parent survey and drawing on reflexive principles. At the theme level, the findings were compared with the broader Medical Training Review Call for Evidence summary and workplace evidence from the General Medical Council’s State of Medical Education and Practice.

Eleven themes were identified: training capacity and workforce pressures; recruitment, progression and career development; geographical stability and flexibility; training quality, supervision and protected educational time; workload, wellbeing and flexibility; equity and inclusion; curriculum modernisation; service-training conflict; community and interface training; digital infrastructure and artificial intelligence; and system-level reform. The strongest correspondence with the broader evidence related to workforce capacity, constraints on supervision, service pressure and structural reform. The Wales-specific material added detail about how these pressures were connected to place-based retention, progression from non-training roles and training being displaced by service demand. The analysis therefore situated Wales within wider UK medical education and workforce issues rather than treating its experiences as entirely separate.

The abstract supports these findings as themes reported by the authors, not as measured effects on training outcomes, patient care or workforce supply. It describes a qualitative synthesis of consultation responses rather than a survey designed to estimate the prevalence of each concern, and the comparison with other evidence was conducted at theme level. The available abstract also does not provide respondent demographics, response rates, coding reliability measures or details of the full manuscript. Within those limits, the study identifies service and training tensions as mutually related areas for postgraduate medical education reform in Wales. The authors’ conclusion calls for change addressing training capacity, workforce planning, protected educational time, equitable progression, flexibility and sustainable working conditions together.

Subject of Research: Qualitative analysis of Wales-specific stakeholder responses on postgraduate medical training pressures and reform priorities.

Article Title: What matters in medical training in Wales: a thematic analysis of Wales-specific responses to the NHS England Medical Training Review Call for Evidence

Article References: Islam, I., Lawson, T., Groves, C., & Saayman, A. (2026). What matters in medical training in Wales: a thematic analysis of Wales-specific responses to the NHS England Medical Training Review Call for Evidence. BMC Medical Education. https://doi.org/10.1186/s12909-026-10573-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10573-4

Keywords: medical education, Wales, postgraduate training, NHS England, thematic analysis, medical workforce, clinical supervision, health service pressure, matters, medical, training, thematic