eprintid: 1527438
rev_number: 33
eprint_status: archive
userid: 608
dir: disk0/01/52/74/38
datestamp: 2016-11-09 11:09:14
lastmod: 2021-09-23 22:51:49
status_changed: 2016-11-09 11:09:14
type: article
metadata_visibility: show
creators_name: Woolf, KVM
creators_name: Rich, A
creators_name: Viney, R
creators_name: Needleman, S
creators_name: Griffin, A
title: Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D20
note: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
abstract: Objectives: 
Explore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification.

Design: 
Qualitative semistructured focus group and interview study.

Setting: 
Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales.

Participants: 
137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad.

Results: 
Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work–life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising.

Conclusions: 
BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee–trainer relationships at work and organisational changes to improve trainees’ ability to seek social support outside work.
date: 2016-11-25
date_type: published
publisher: BMJ Publishing Group
official_url: http://dx.doi.org/ 10.1136/bmjopen-2016-013429
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
article_type_text: Article
verified: verified_manual
elements_id: 1190384
doi: 10.1136/bmjopen-2016-013429
language_elements: eng
lyricists_name: Griffin, Ann
lyricists_name: Rich, Antonia
lyricists_name: Viney, Rowena
lyricists_name: Woolf, Katherine
lyricists_id: AGRIF93
lyricists_id: AERIC50
lyricists_id: RAEVI51
lyricists_id: KWOOL71
actors_name: Woolf, Katherine
actors_id: KWOOL71
actors_role: owner
full_text_status: public
publication: BMJ Open
volume: 6
number: 11
article_number: 013429
issn: 2044-6055
citation:        Woolf, KVM;    Rich, A;    Viney, R;    Needleman, S;    Griffin, A;      (2016)    Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study.                   BMJ Open , 6  (11)    , Article 013429.  10.1136/bmjopen-2016-013429 <https://doi.org/10.1136/bmjopen-2016-013429>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1527438/1/e013429.full.pdf