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Differential attainment in higher surgical training: scoping pan-specialty spectra

Luton, Oliver William, Mellor, Katie, Robinson, David Bryan Thomas, Barber, Zoe, James, Osian Penri, Powell, Arfon Gethyn Morgan Tregellis ORCID:, Hemington-Gorse, Sarah, Walsh, Leona, Egan, Richard John and Lewis, Wyn Griffith 2023. Differential attainment in higher surgical training: scoping pan-specialty spectra. Postgraduate Medical Journal 99 (1174) , pp. 849-854. 10.1136/postgradmedj-2022-141638

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Introduction This study aimed to evaluate differential attainment during higher surgical training (HST; all specialties) related to three ethnic cohorts: White UK (WUKG), Black and Minority Ethnic UK Graduates (BMEUKG), and International Medical Graduates (IMG). Method Anonymised records of 266 HSTs (126 WUKG, 65 BMEUKG, 75 IMG; 7 years) in a single UK Statutory Education Body were examined. Primary effect measures were Annual Record of Competency Progression Outcome (ARCPO) and Fellowship of the Royal College of Surgeons (FRCS) pass. Results ARCPOs related to ethnicity and specialty were similar with the exception of general surgery (GS) trainees, four of whom received ARCPO 4 (GS 4.9% (75% BME; p=0.025) vs all other 0%). ARCPO 3 was commoner in women (22/76, (28.9%) than men 27/190 (14.2%), OR 2.46, p=0.006). FRCS pass rates (WUKG vs BMEUKG vs IMG) were 76.9%, 52.9% and 53.9% respectively (p=0.064) but unrelated to gender (M 70.4% vs F 64.3%). On multivariable analyses: ARCPO 3 was associated with Female gender and Maternity Leave (OR 8.05, p=0.001); FRCS pass with ethnicity (OR 0.21, p=0.028) and Hirsch Indices of ≥5 (OR 11.17, p=0.001). Conclusion Differential attainment was plain with BMEUKG FRCS performance almost a third poorer than WUKG, and women twofold more likely to receive adverse ARCPOs, with return from statutory leave independently associated with training extension. Focused counter measures targeted at non-operative technical skills (including academic reach), Keeping in Touch, Return to Work, and re-induction programmed support are urgently needed for trainees at risk.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: BMJ Publishing Group
ISSN: 0032-5473
Date of First Compliant Deposit: 7 October 2022
Date of Acceptance: 16 April 2022
Last Modified: 13 Jun 2024 14:02

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