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Ethnic minority and non-UK doctors are more likely to fail exams, GMC data show

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4100 (Published 22 July 2016) Cite this as: BMJ 2016;354:i4100
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}bmj.com

Black and minority ethnic (BME) doctors and international medical graduates (IMGs) are less likely to pass specialty exams than their white UK counterparts, data from the General Medical Council show.

On Thursday 21 July the GMC published research and data on the progression of doctors from different ethnicities and backgrounds through exams and recruitment. The findings showed that white UK medical graduates remained more likely to pass specialty exams than their BME UK counterparts. IMG doctors whose primary qualification was gained outside the UK or European Economic Area (EEA) were even less likely to do well in exams or recruitment, the GMC found.

In 2014-15 three quarters (73%) of UK graduates but only 50% of graduates from the EEA and 46% of IMGs overall passed exams taken while they were on a specialist training programme, the GMC found.

The average pass rate for UK white doctors was 75% in 2014-15, while the average for UK BME doctors in the same year was 63%. “The difference between the two groups remains statistically significant,” the GMC said.

The GMC said that it remained concerned about the differences between these groups of doctors. To investigate further, the GMC said that it had commissioned research to look into the barriers and enablers to success perceived by doctors in training and their trainers.

“We hope that together the reports and research findings will encourage a conversation between doctors in training and their trainers about what support they might benefit from,” the GMC said. It added that improving exam success rates among doctors in training could help to reduce workforce planning issues and gaps in specialties with staffing shortages.

As part of its research the GMC also looked at how socioeconomic status affected doctors’ attainment. The regulator said that white people were predominant in the most affluent groups, while BME doctors made up a greater proportion of the most deprived groups. The GMC found that in 2015, of all annual review of competence progression (ARCP) outcomes among core medical training doctors, doctors from the most deprived backgrounds received the highest proportion of unsatisfactory outcomes: just under 13%, whereas the overall average was 5%.

However, the GMC said that ethnicity and socioeconomic status were independent factors and that white doctors outperformed BME doctors in exams, even when comparing individuals from the same socioeconomic background.

Responding to the findings, Niall Dickson, the GMC’s chief executive, said, “We have been looking at the fairness of training pathways for some time.

“These data will help organisations involved in medical education to ensure there is no unfairness or bias in their training and assessments. We all need to be confident that assessments are fair and that doctors who need extra support are able to access it.”

Anthea Mowat, chair of the BMA’s representative body, said that the association welcomed the GMC’s ongoing monitoring and echoed its “call to action to ensure that fairness and equality were embedded in everything that the medical royal colleges, postgraduate training organisations, and medical schools do.”

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