White doctors are almost three times more likely to land hospital jobs than ethnic minority doctorsBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5697 (Published 26 September 2013) Cite this as: BMJ 2013;347:f5697
Data suggest that ethnic minority doctors are less successful in securing posts in the NHS. Helen Jaques looks at the figures
White doctors are almost three times more likely to be successful in applying for hospital jobs than doctors from ethnic minorities, an investigation by BMJ Careers has found.
In 2012, 13.8% of white applicants to senior hospital doctor jobs in England were successful in securing the role they applied for, compared with 4.8% of doctors from ethnic minority backgrounds.
The overall success rate of applicants to consultant, staff and associate specialist, and trust doctor jobs was 7.2%. However, doctors who described their ethnicity as “other” or did not disclose their ethnicity had a 9.2% success rate in landing hospital jobs.⇓
A total of 165 hospital trusts in England were asked for ethnicity data from 2012 on the applicants, shortlisted candidates, and appointed candidates for fully qualified hospital doctor jobs. Although 127 (77.0%) hospital trusts responded to the Freedom of Information request, only 50 (30.3%) provided full data. Most of the data provided by these trusts was taken from records on NHS Jobs, with much of the remaining data coming from electronic staff records.
Black or black British applicants were the ethnic group least likely to secure hospital doctor jobs in 2012 (2.7% success rate), followed by doctors of mixed ethnicity (3.5%), and Asian and Asian British doctors (5.7%).
A similar disparity between white and ethnic minority doctors emerged when considering whether applicants were shortlisted and whether those on the shortlist for jobs were appointed after interview. White doctors were more likely to be both shortlisted for jobs and appointed to roles once they had been shortlisted.
These data add weight to the possibility that the NHS is discriminatory in how it appoints doctors to posts, said Umesh Prabhu, national vice chairman of the British International Doctors Association and medical director of Wrightington, Wigan and Leigh NHS Foundation Trust.
He said that there has been evidence that ethnic discrimination exists in the NHS recruitment process since 1993, when a pair of researchers found that identical applications for medical posts were twice as likely to be shortlisted if they were made with an English name than with an Asian name.1 Earlier this year, an investigation by the whistleblowing campaigning group Patients First reported that between 2010 and 2013, white applicants were three times more likely to be appointed to any NHS job than candidates from black and minority ethnic backgrounds.2
The BMA agrees that the possible discrimination pointed to by the data collected by BMJ Careers is a problem for doctors. “These findings are concerning as any form of discrimination is unacceptable in today’s NHS,” a spokesperson for the union said. “Any form of prejudice needs to be tackled and a much more detailed investigation is needed.”
The NHS stands to lose a huge amount by not appointing suitable ethnic minority candidates to senior doctor posts, Prabhu suggested, and not only in terms of missing out on the clinical and leadership skills of talented doctors.
“The safety in a trust is reflected by how much the leadership represents the staff,” he said. “At my trust 55% of medical directors and clinical directors are from [black and minority ethnic groups], which represents the trust composition of doctors.” This policy is reflected in the safety record of the hospital, he said, because staff have a sense of belonging and they feel part of the organisation.
It is difficult to pinpoint where and how discrimination might arise in the appointment process. NHS Jobs collects data on characteristics protected under the equality act, such as ethnicity and sex, from the point of application. But these data and other personal information are made available to employing trusts only after shortlisting has been completed.
The fact that white doctors were more likely to be shortlisted, when the process is “blind” to ethnicity, suggests that any discrimination that arises is not being directly influenced by doctors’ stated ethnicity.
Interestingly, doctors who did not disclose their ethnicity during the application process had the highest success rate in landing jobs of any ethnic group—23.0%—further muddying the waters around potential discrimination in the appointment of NHS doctors.
It is possible that other factors could be contributing to the disparity in job success rate between white and ethnic minority doctors, agreed Prabhu. “Once they are shortlisted and get to interview, doctors from ethnic minorities can have communication problems,” he says. “The same applies with cultural differences. [For] doctors who have trained overseas, when we were trained, not much importance was given to subtle skills—body language, tone of voice.”
Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.