Intended for healthcare professionals

Feature Racism in Medicine

Taking the difference out of attainment

BMJ 2020; 368 doi: (Published 12 February 2020) Cite this as: BMJ 2020;368:m438

Read all of the articles in our special issue on Racism in Medicine

Linked Editorial

Differential attainment in medical education and training

  1. Samara Linton, junior doctor, writer, and BBC production trainee
  1. London
  1. samara.linton{at}

UK doctors from ethnic minorities don’t do as well as white doctors in academic tests and securing the top jobs. Samara Linton looks for solutions

“The person who came first in your class, does he have two heads?”

Frank Chinegwundoh, consultant urological surgeon at Barts Health NHS Trust in London, laughs, recalling a saying many Nigerians know well. Achievement was not for the exceptional few, he was taught, but for everyone with hard work and opportunity.

For many UK medical students and graduates from ethnic minority backgrounds the phrase might ring hollow. Data show that they have consistently poorer academic and job recruitment outcomes than their white peers (box 1).1

Box 1

Mapping differential attainment

  • Doctors and medical students from ethnic minority backgrounds are up to three times as likely as their white counterparts to fail an examination.1 These include undergraduate and postgraduate assessments, machine marked written assessments, practical clinical assessments, assessments with pass or fail outcomes, and assessments with continuous outcomes.

  • In 2017 the pass rate in postgraduate examinations was 75% among white students and 63% among UK ethnic minority students. Among international medical graduates, the pass rate was 46% for white students and 42% for students from other ethnic groups.2

  • In 2016 94% of white GP trainees who were educated in the UK passed the clinical assessment skills (CSA) examination set by the RCGP at their first attempt, whereas 80% of ethnic minority GP trainees educated in the UK did so.3

  • Among UK medical graduates, 72% of ethnic minority foundation doctors applying for a specialty training programme succeeded on their first attempt, while 81% of white doctors did so.4

  • In 2016 UK doctors from an ethnic minority background applying for consultant posts were:

    • more likely to apply for more posts than white doctors (1.66 versus 1.29 posts) …

View Full Text

Log in

Log in through your institution


* For online subscription