By Branwen Jeffreys
Health correspondent, BBC News
Junior doctors across the UK are being warned the competition they will face this year for specialist training jobs in the NHS will be tougher than ever.
The BMA says it will be monitoring the process for fairness
As recruitment begins for August, the NHS employers body says there may be an average of three applicants per post.
Many applicants will be NHS doctors who qualified outside the EU, after the government failed in a 2007 legal bid to give UK medical graduates priority.
Without a training post a junior doctor cannot become a consultant or GP.
After a computer fiasco and complaints of unfairness when a new system was introduced for 2007, the process for this year has been changed.
The controversial system - known as the medical training application service (MTAS) - was shelved by ministers.
Doctors complained about a lack of posts, poorly designed recruitment forms, and technical failures with the online application system.
In the wake of the controversy, BMA chairman James Johnson resigned amid accusations that he had failed to put across the feelings of doctors about the system.
Now, thousands of applications will be handled by local medical deaneries and there is no limit to the number of applications an individual doctor can make.
In England there will be around 9,000 places on speciality training programmes and employers expect there may be as many as 23,000 applications.
Sian Thomas, from NHS Employers, said young doctors needed to make realistic decisions.
In some popular specialities, such as surgery, there may be as many as 10 applications for each training post, she said.
"It is a good thing for patients that there is competition for jobs - it should mean they get the best doctors wherever they live."
One reason the competition for jobs is expected to be intense is the large number of overseas doctors who want specialist training in the UK.
In 2008 it is expected that doctors who qualified outside the EU may make up half the applications for training posts.
But UK medical schools have also increased the number of doctors they are training, at an estimated cost to the taxpayer of £250,000 for every medical graduate.
Pressure group Remedy UK has launched a specialist website to help doctors with their job search.
Remedy UK's Chris McCullough said: "Our view is that the system is essentially appalling.
"Doctors aren't afraid of competition, but what we have this year is doctors facing a one-in-19 chance of getting a job in some areas."
The Department of Health tried to give UK medical graduates priority in the recruitment process this year, but that was overturned after a legal challenge.
Now the government is appealing to the House of Lords but any decision will be too late to affect the rules for 2008.
A Department of Health spokesman said: "Doctors from outside Europe have made and continue to make a huge contribution to the NHS.
"The issue is not, and never has been, whether they can continue to work as NHS doctors - which they can - but whether the taxpayer should be investing in training them instead of UK medical graduates."
'Waste of resources'
Meanwhile, shadow health secretary Andrew Lansley said: "Unless the government recognises the exceptional need for additional posts this year and in the next two years, we will see a new 'lost tribe' of doctors who fail to complete training."
Similarly, Liberal Democrat health spokesman Norman Lamb said the UK faces an "insane waste of resources" which will see "expensively-educated junior doctors having no jobs to go to at the end of their training".
The British Medical Association is worried that the volume of applications this year could overwhelm medical deaneries.
It said it would be monitoring the process to ensure fairness.
Ram Moorthy, chairman of the BMA junior doctors committee, said: "Our concern is that without adequate planning, the levels of competition could result in a lottery.
"Trusts need to get their recruitment practices in order, and start preparing now to ensure that there is no unfairness, and no negative impact on patient care."