Organisational perspectives on addressing differential attainment in postgraduate medical education: A qualitative study in the UK

Katherine Woolf, Rowena Viney, Antonia Rich, Hirosha Jayaweera, Ann Griffin

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.

    Original languageEnglish
    Article numbere021314
    JournalBMJ Open
    Volume8
    Issue number3
    DOIs
    Publication statusPublished - 1 Mar 2018

    Fingerprint

    Medical Education
    Organizations
    Minority Groups
    Information Dissemination
    Medical Schools
    Ethnic Groups
    Curriculum
    Interviews

    Cite this

    Woolf, Katherine ; Viney, Rowena ; Rich, Antonia ; Jayaweera, Hirosha ; Griffin, Ann. / Organisational perspectives on addressing differential attainment in postgraduate medical education : A qualitative study in the UK. In: BMJ Open. 2018 ; Vol. 8, No. 3.
    @article{46f62c4c8b074fabb7d1bf583147efcf,
    title = "Organisational perspectives on addressing differential attainment in postgraduate medical education: A qualitative study in the UK",
    abstract = "Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55{\%} medically qualified, 61{\%} male, 71{\%} white British/Irish, 23{\%} Asian/Asian British, 6{\%} missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.",
    keywords = "differential attainment, equality, ethnicity, health policy, medical education & training;, quality in health care",
    author = "Katherine Woolf and Rowena Viney and Antonia Rich and Hirosha Jayaweera and Ann Griffin",
    year = "2018",
    month = "3",
    day = "1",
    doi = "10.1136/bmjopen-2017-021314",
    language = "English",
    volume = "8",
    journal = "BMJ (Open)",
    issn = "2044-6055",
    publisher = "John Wiley & Sons",
    number = "3",

    }

    Organisational perspectives on addressing differential attainment in postgraduate medical education : A qualitative study in the UK. / Woolf, Katherine; Viney, Rowena; Rich, Antonia; Jayaweera, Hirosha; Griffin, Ann.

    In: BMJ Open, Vol. 8, No. 3, e021314, 01.03.2018.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Organisational perspectives on addressing differential attainment in postgraduate medical education

    T2 - A qualitative study in the UK

    AU - Woolf, Katherine

    AU - Viney, Rowena

    AU - Rich, Antonia

    AU - Jayaweera, Hirosha

    AU - Griffin, Ann

    PY - 2018/3/1

    Y1 - 2018/3/1

    N2 - Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.

    AB - Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.

    KW - differential attainment

    KW - equality

    KW - ethnicity

    KW - health policy

    KW - medical education & training;

    KW - quality in health care

    UR - http://www.scopus.com/inward/record.url?scp=85044173746&partnerID=8YFLogxK

    U2 - 10.1136/bmjopen-2017-021314

    DO - 10.1136/bmjopen-2017-021314

    M3 - Article

    VL - 8

    JO - BMJ (Open)

    JF - BMJ (Open)

    SN - 2044-6055

    IS - 3

    M1 - e021314

    ER -