Country of training and ethnic origin of UK doctors: database and survey studies
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.38202.364271.BE (Published 09 September 2004) Cite this as: BMJ 2004;329:597
- Michael J Goldacre, professor of public health (michael.goldacre{at}dphpc.ox.ac.uk)1,
- Jean M Davidson, research officer1,
- Trevor W Lambert, statistician1
- 1 UK Medical Careers Research Group, Department of Public Health, University of Oxford, Oxford OX3 7LF
- Correspondence to: M J Goldacre
- Accepted 6 July 2004
Abstract
Objectives To report on the country of training and ethnicity of consultants in different specialties in the NHS, on trends in intake to UK medical schools by ethnicity, and on the specialty choices made by UK medical graduates in different ethnic groups.
Design Analysis of official databases of consultants and of students accepted to study medicine; survey data about career choices made by newly qualified doctors.
Setting and subjects England and Wales (consultants), United Kingdom (students and newly qualified doctors).
Results Of consultants appointed before 1992, 15% had trained abroad; of those appointed in 1992-2001, 24% had trained abroad. The percentage of consultants who had trained abroad and were non-white was significantly high, compared with their overall percentage among consultants, in geriatric medicine, genitourinary medicine, paediatrics, old age psychiatry, and learning disability. UK trained non-white doctors had specialty destinations similar to those of UK trained white doctors. The percentage of UK medical graduates who are non-white has increased substantially from about 2% in 1974 and will approach 30% by 2005. White men now comprise little more than a quarter of all UK medical students. White and non-white UK graduates make similar choices of specialty.
Conclusions Specialist medical practice in the NHS has been heavily dependent on doctors who have trained abroad, particularly in specialties where posts have been hard to fill. By contrast, UK trained doctors from ethnic minorities are not over-represented in the less popular specialties. Ethnic minorities are well represented in UK medical school intakes; and white men, but not white women, are now substantially under-represented.
Footnotes
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An extra table appears on bmj.com giving details of career choices of newly qualified doctors from ethnic minority groups -
We thank the Advisory Committee on Clinical Excellence Awards (formerly the Advisory Committee on Distinction Awards) for making its database available for analysis, and its chair, Lady Elizabeth Vallance, and medical director, Sir Netar Mallick, for their support for this study. We thank UCAS for supplying and giving permission to publish data on accepted applicants to medicine. We are grateful to all the doctors who participated in the Medical Careers Research Group surveys. Karen Hollick administered the surveys, and Janet Justice and Alison Stockford entered the data.
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Contributors MJG, JMD, and TWL planned the study. JMD and TWL analysed the data. MJG and JMD wrote the first draft. All authors contributed to subsequent drafts and approved the final version. All are guarantors for the study.
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Funding The UK Medical Careers Research Group and the Unit of Health-Care Epidemiology are funded by the Department of Health.
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Competing interests None declared.
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Ethical approval UK Medical Careers Research Group surveys in the past have been overseen by an independent advisory group convened by the funding body. Ethical approval for the current programme of surveys has been obtained through the Central Office for Research Ethics Committees. Data from the Advisory Committee on Distinction Awards and from UCAS were provided by these bodies in their roles as the custodians of the respective databases.