Fair training pathways for all: understanding experiences of progression part 2
What were the key findings?
The additional risks faced by UK graduate – black and minority ethnic (BME UK) doctors and those graduating from a medical school outside the European Economic Area (international medical graduates) identified in part 1 of the research were all regarded as significant by participants representing medical royal college and faculties and NHS employers. Particularly significant was being ‘different’ from the dominant or majority group (eg lack of familiarity with UK cultural norms).
Participants were more pessimistic about the possibility of removing or mitigating the identified risks requiring large-scale political or cultural change than those risks they felt able to influence personally.
The risk regarded as most significant, that international medical graduates are inexperienced with UK systems and cultural norms, was perceived as most amenable to change.
A range of initiatives which attempt to reduce risks to progression, particularly for international medical graduates, were identified by participants. Examples of these, from royal colleges and other institutions, are detailed in the report.
Barriers to change include the difficulty of discussing race with trainees and the potential unfairness of ‘positive action’.
Facilitators of change included research evidence. This could help persuade the need for change, and improve knowledge of effective interventions.
Why did we commission this research?
We run a broad programme of work to better understand the nature of ‘differential attainment’. (why groups of doctors with certain characteristics on average perform less well in postgraduate training than their peers) and the actions we and others can take to help mitigate this. In 2015 we commissioned research to understand what doctors in training and trainers perceived to be barriers to and enablers of progression. In part 2, we explored the findings from part 1 of the research with representatives from royal colleges and employers of doctors.
What did the research involve?
Focus groups and individual interviews were undertaken with key stakeholders to explore their perceptions of how significant the risks identified in Part 1 were felt to be in hindering the progression of BME UK and international medical graduate trainees, and how amenable to change those risks were believed to be. There were 31 participants from 11 medical royal colleges or faculties or the Academy of Medical Royal Colleges (n=29), and NHS employers (n=2).