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Bias blamed for lower exam pass rate in BME medical graduates

26 July 2016

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The General Medical Council (GMC) has said “unconscious bias” could be the reason why black and minority ethnic UK medical graduates pass specialty exams at a lower rate to their white counterparts.

The GMC’s annual report on the progression of doctors in training shows that while white UK medical graduates have an exam pass rate of 75.8%, their black and minority ethnic (BME) counterparts have a pass rate of 63.2%

Meanwhile, doctors whose primary qualification was gained outside the UK or European Economic Area (EEA) are even less likely to do well in exams or recruitment, with a pass rate of just 41.4%.

The average exam pass rate for all UK medical graduates was found to be 71%.

As part of the report, the GMC commissioned University College London (UCL) to conduct independent research into the findings using focus groups and interviews with doctors in training and those who train them.

UCL found that BME UK graduates, and doctors who qualified overseas, were believed to face risks of unconscious bias in assessments, recruitment and day-to-day working.

Other issues included separation from their support networks outside work, because of a lack of autonomy about job locations, difficulties in “fitting in” at work and, occasionally, overt prejudice.

These risks restricted opportunities for learning, lowered morale and could, in severe cases, cause mental health problems.

Some doctors who graduated outside the UK also discussed how cultural differences in their backgrounds could make it difficult to build rapport and to fit in with colleagues and trainers, and that it could take years to learn the UK’s cultural norms.

Niall Dickson, chief executive of the GMC, said: “The GMC is committed to doing everything we can to make sure that every doctor in training has the opportunity and support necessary to fulfil their potential.

“We have been looking at the fairness of training pathways for some time. This data will help organisations involved in medical education to ensure there is no unfairness or bias in their training and assessments.

“We all need to be confident that assessments are fair, and that doctors who need extra support are able to access it.

“This is a complex problem – not unique to medical training – and we are at the early stages of understanding its causes.

“Differences in the way doctors progress through training may be influenced by a range of factors, such as individual characteristics and approaches to learning, institutions’ support systems and wider socio-cultural factors.

“These are difficult to untangle and influence and, unfortunately, there are no quick fixes. However, we want to work with everyone involved to make the system as fair and supportive as possible.”

However Dickson also said that these numbers need to be “treated with caution”.

He said: “This is only the second year this data has been collated and it is too early to draw definitive conclusions about trends – that will come but only after continuous monitoring.”

This is the second year the GMC has published this data, and it is sharing the information with other organisations involved in medical education and training to help them identify and tackle the possible causes of these differences in attainment.