The GMC's 2025 national training survey, of more than 71,000 doctors and trainers, found that while 79% of trainees reported never feeling apprehensive, 21% said they had hesitated at least once in the past 12 months. The figure rose to nearly a third in specialties such as surgery, obstetrics and gynaecology, medicine, and emergency medicine. Those most hesitant to escalate care were also more likely to experience burnout.

The findings come at a pivotal moment, as the UK Government's 10-Year Health Plan for NHS England: Fit for the Future sets out a bold vision to transform the health services through a new workforce model.

Professor Pushpinder Mangat, medical director and director of education and standards at the GMC, said: ‘These findings are extremely concerning because doctors need to work in environments where they feel comfortable escalating. When they don't, there are potentially serious risks to patient safety.

‘The Government's 10-Year Health Plan rightly recognises that a modern health service must empower its workforce and foster a culture of openness and safety. The GMC is committed to supporting this transformation and playing our part. The national training survey is one of several vital data resources we produce to help to identify where change is needed, and ensure that training environments are safe, inclusive, and fit for the future.'

In addition, the survey reveals that the majority of trainees remain positive about their training, with 76% saying their teaching was good or very good and 87% rating their clinical supervision highly.

This year's data highlights the general pressures faced by trainers, with 29% reporting that training was adversely affected because of rota gaps.