Egalitarianism in surgical training: let equity prevail
- 5 May 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Postgraduate Medical Journal
- Vol. 96 (1141), 650-654
- https://doi.org/10.1136/postgradmedj-2020-137563
Abstract
This study aimed to quantify core surgical trainee (CST) differential attainment (DA) related to three cohorts; white UK graduate (White UKG) versus black and minority ethnic UKG (BME UKG) versus international medical graduates (IMGs). The primary outcome measures were annual review of competence progression (ARCP) outcome, intercollegiate Membership of the Royal College of Surgeons (iMRCS) examination pass and national training number (NTN) selection. Intercollegiate Surgical Curriculum Programme (ISCP) portfolios of 264 consecutive CSTs (2010–2017, 168 white UKG, 66 BME UKG, 30 IMG) from a single UK regional post graduate medical region (Wales) were examined. Data collected prospectively over an 8-year time period was analysed retrospectively. ARCP outcomes were similar irrespective of ethnicity or nationality (ARCP outcome 1, white UKG 60.7% vs BME UKG 62.1% vs IMG 53.3%, p=0.395). iMRCS pass rates for white UKG vs BME UKG vs IMG were 71.4% vs 71.2% vs 50.0% (p=0.042), respectively. NTN success rates for white UKG vs BME UKG vs IMG were 36.9% vs 36.4% vs 6.7% (p=0.023), respectively. On multivariable analysis, operative experience (OR 1.002, 95% CI 1.001 to 1.004, p=0.004), bootcamp attendance (OR 2.615, 95% CI 1.403 to 4.871, p=0.002), and UKG (OR 7.081, 95% CI 1.556 to 32.230, p=0.011), were associated with NTN appointment. Although outcomes related to BME DA were equitable, important DA variation was apparent among IMGs, with iMRCS pass 21.4% lower and NTN success sixfold less likely than UKG. Targeted counter measures are required to let equity prevail in UK CST programmes.Keywords
Funding Information
- Joint Surgical Research Fellowship from the Royal College of Surgeons of England
- Health Education and Improvement Wales
- Joint Surgical Research Fellowship from the Royal College of Surgeons of England
- Health Education and Improvement Wales
This publication has 9 references indexed in Scilit:
- Stress and Burnout in Training; Requiem for the Surgical DreamJournal of Surgical Education, 2020
- Effect of sex on specialty training application outcomes: a longitudinal administrative data study of UK medical graduatesBMJ Open, 2019
- Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UKBMJ Open, 2018
- Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical GraduatesBMC Medical Education, 2016
- Racial and Gender Influences on Pass Rates for the UK and Ireland Specialty Board ExaminationsJournal of Surgical Education, 2015
- Annual Review of Competence Progression (ARCP) performance of doctors who passed Professional and Linguistic Assessments Board (PLAB) tests compared with UK medical graduates: national data linkage studyBMJ, 2014
- Affirmative Action and Medical School AdmissionsThe AMA Journal of Ethic, 2012
- The mediators of minority ethnic underperformance in final medical school examinationsBritish Journal of Educational Psychology, 2011
- Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysisBMJ, 2011