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Unconscious bias against BME doctors identified

UK BME medical graduates 13% less likely to pass exams than white graduates

Adrian O'Dowd

Thursday, 21 July 2016

Black and minority ethnic doctors’ career prospects are being damaged by “unconscious bias” against them, suggests research and data* from the General Medical Council (GMC), published today.

The GMC published new research and data on the progression of doctors from different ethnicities and backgrounds through exams and recruitment.

It shows that white UK medical graduates remain more likely to pass specialty exams than their black and minority ethnic (BME) counterparts, while 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.

The GMC’s data on how doctors progress through postgraduate training in 2014-15 showed that the average exam pass rate for all UK medical graduates was 71%.

The pass rate for white doctors was 75.8% compared with 63.2% for UK BME medical graduates, while international medical graduates (IMGs) – doctors who qualified outside the UK and EEA – had a pass rate of just 41.4%.

The GMC, which has a responsibility to ensure the pathways through medical training are fair and do not disadvantage entrants from different backgrounds, said it was sharing the data with other organisations involved in medical education and training to help them identify and tackle the possible causes of these differences in attainment.

Niall Dickson, GMC chief executive, 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.

“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.”

The GMC also commissioned University College London (UCL) to conduct independent research** including 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
  • difficulties in ‘fitting in’ at work
  • overt prejudice

One unnamed black doctor who qualified outside the UK and Europe and who is training to become a GP, told researchers how he had immersed himself in British culture.

“It was a conscious decision on my part to try as much as possible to immerse myself in the [NHS] system and in the culture around me. When you don’t do that, it makes it harder,” he said.

Dr Katherine Woolf, of the UCL Medical School, said: “Doctors from BME backgrounds – even those who are British and went to medical school in the UK – can face barriers during their training that impede their learning and performance, such as feeling less supported by senior staff in highly-pressurised work environments and unconscious bias.”

* How do doctors progress through key milestones during training? General Medical Council, 2016

** Woolf K, et al. Fair Training Pathways for All: Understanding Experiences of Progression. UCL Medical School. Prepared for the General Medical Council 17th March 2016, and revised 28th April 2016

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