Performance of ethnic minority versus White doctors in the MRCGP assessment 2016–2021: a cross-sectional study

Siriwardena, Aloysius Niroshan; Botan, Vanessa; Williams, Nicki; Emerson, Kim; Kameen, Fiona; Pope, Lindsey; Freeman, Adrian; Law, Graham

doi:10.3399/bjgp.2022.0474

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…Induction and training support schemes are attempting to address the differential exam attainment of IMGs in the GP licensing exams [34], and policies have been introduced to remove potential barriers to IMG GP trainees joining the NHS workforce once they have completed their training. The effectiveness of such initiatives needs ongoing monitoring.…”

Section: Discussionmentioning

confidence: 99%

A hole in the bucket? Exploring England’s retention rates of recently qualified GPs

Palmer,

Rolewicz,

Tzortziou-Brown

et al. 2024

Preprint

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Background As the senior medics within primary care services, general practitioners (GPs) have a pivotal role within the National Health Service (NHS). Despite several commitments made by government to increase the number of GPs in England, the level has consistently fallen. Much attention has been paid to recruitment of trainee GPs and overall retention, whereas this study sought to examine the specific transition from ending training to joining the NHS. Methods The study used aggregated, published administrative data to examine rates at which 14,302 doctors leaving their third year of specialty training (GP ST3s) became fully qualified NHS GPs between 2018 and 2023. We separately analysed average levels of part-time working of those joining the NHS from 21,293 fully qualified joiners in England between 2017 and 2023. We calculated joiner and participation rates and used generalised linear mixed-effects models to explore possible demographic, period and cohort effects. Results Of those doctors leaving their third year of training since 2018, around a third (34.3%) had taken up a fully qualified GP role in NHS general practice six months after finishing training, rising to 47.5% within one year, and 62.2% within two years. Average estimated participation rates of joiners seemed to remain consistent at about 65-69% of a full-time contract between 2017 and 2023. Joiner rates were lower for doctors with a primary medical qualification from outside the UK and, over a two-year timeframe, both UK and non-UK trained male GP ST3s. Our statistical modelling suggests that there is a significant ‘period effect’ in connection to the recent Covid-19 pandemic, with apparent differences in the likelihood of GP ST3s joining the NHS in a fully-qualified role at certain points in time, and an effect among some cohorts, with doctors who left specialty training in specific periods having significantly different joiner rates. Conclusion The GP pipeline is expanding, but we find no evidence that retention of newly trained GPs is improving. We discuss possible factors for such attrition, from barriers to hiring new doctors, to their diminishing interest in joining the NHS. More work is needed to further explore the changing career behaviours of subsequent cohorts and demographics of doctors completing GP training.

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Section: Discussionmentioning

confidence: 99%

A hole in the bucket? Exploring England’s retention rates of recently qualified GPs

Palmer,

Rolewicz,

Tzortziou-Brown

et al. 2024

Preprint

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Perceptions and experiences of trainers and trainees of UK workplace-based assessment for general practice licensing: a mixed methods survey

Siriwardena,

Phung,

Emerson

et al. 2024

Education for Primary Care

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Performance of ethnic minority versus White doctors in MRCGP assessment

Bhatti¹,

Nayar

2023

Br J Gen Pract

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In reviewing the performance of ethnic minority versus White doctors in MRCGP assessment (2016)(2017)(2018)(2019)(2020)(2021), Siriwardena et al conclude that ethnic background did not reduce the chance of passing GP licensing exams once sex, place of primary medical qualification (PMQ), declared disability, and MSRA scores were accounted for. 1 This conclusion is not in keeping with the recent GMC report 2 that found that UK graduates of Black/Black British heritage have lower pass rates in specialty exams (62%) than UK White (79%), Asian (68%), and mixed-heritage trainees (74%). Having a non-White ethnic background may in itself be an over-simplification and further granularity of the data is required to reach any meaningful conclusions.Further, there is differential attainment in the MRSA exam, 'upstream' so to speak, which mirrors that seen in the GMC report. In the MRSA proportionally more Black and Muslim candidates do less well, findings similar to those in the MRCGP, whether UK or non-UK graduates. The disparities in attainment due to ethnicity seen in the MRSA do not seem to have been taken into account in the article.The article followed up GP trainees recruited in 2016 of which 23.2% were non-UK graduates. In 2022 this figure was 57% and the profile of our trainees has changed significantly over that time with increased numbers from a non-White background. Also, Health Education England has introduced a number of initiatives to reduce the impact of differential attainment that may affect the reliability of the data presented in the article.Lastly, this analysis does not take into account the lived experience reported by our trainees, whether they be UK non-White trainees or IMGs, as shown in WRES 3 and MWRES 4 data as well as primary care surveys 5 and the work of Katherine Woolf. 6 The conclusions in this report should not detract from the fact that differential attainment exists and that ethnicity is a key contributory factor whether qualifying here or abroad. We need to ensure that we level the medical education field and that all trainees regardless of their background receive the support they need to reach their full potential.

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Performance of ethnic minority versus White doctors in the MRCGP assessment 2016–2021: a cross-sectional study

Cited by 5 publications

References 23 publications

A hole in the bucket? Exploring England’s retention rates of recently qualified GPs

A hole in the bucket? Exploring England’s retention rates of recently qualified GPs

Perceptions and experiences of trainers and trainees of UK workplace-based assessment for general practice licensing: a mixed methods survey

Performance of ethnic minority versus White doctors in MRCGP assessment

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