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