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Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the United Kingdom

Woolf, KVM; Viney, R; RICH, A; Jayaweera, HK; Griffin, A; (2018) Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the United Kingdom. BMJ Open , 8 (3) , Article e021314. 10.1136/bmjopen-2017-021314. Green open access

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Abstract

OBJECTIVES: To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates, IMGs). To identify the barriers to and facilitators of change. DESIGN: Qualitative semi-structured individual and group interview study. SETTING: Postgraduate medical education in the United Kingdom. Participants Individuals with roles in examinations and/or curriculum design from UK Medical Royal Colleges. Employees of NHS Employers. RESULTS: Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence lead to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race, and the isolation of interventions. Participants felt organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs, and were largely unevaluated. Participants felt national change was needed, but only felt empowered to effect change locally or within their specialty. CONCLUSIONS: Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.

Type: Article
Title: Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the United Kingdom
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2017-021314
Publisher version: https://doi.org/10.1136/bmjopen-2017-021314
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
URI: http://discovery.ucl.ac.uk/id/eprint/10043559
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