MRCGP CSA: are the examiners biased, favouring their own by sex, ethnicity, and degree source?

Mei Ling Denney; Adrian Freeman; Richard Wakeford

doi:10.3399/bjgp13X674396

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Figure 1
Mean case scores (0–9 with 95% CI) of candidate subgroups by parallel examiner subgroups. BME = black and minority ethnic. IMG = international medical graduate. UKG = UK graduate.

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Table 1

Sample numbers, percentages and mean case scores of candidate, examiner subgroups, encounters in which examiner–candidate transaction demographics were the same, and where they were different

Demographic variable			Candidates in demographic subgroup	Examiners in demographic subgroup	*Cases with same* transactional demographic**	*Cases with different* transactional demographic**
Ethnicity	White	n	1586	215	17 433	3185
		Total, %	39.4	85.7	33.5	6.1
		Mean	6.67	6.03	6.67	6.66
	BME	n	2414	36	4721	26 661
		Total, %	60.6	14.3	9.1	51.3
		Mean	5.64	6.15	5.81	5.61
Sex	Female	n	2044	96	9921	16 651
		Total, %	51.1	38.2	19.1	32.0
		Mean	6.38	6.08	6.39	6.37
	Male	n	1956	155	16 179	9249
		Total, %	48.9	61.8	31.1	17.8
		Mean	5.70	6.03	5.67	5.75
Degree source	UKG	n	2224	241	27 472	1440
		Total, %	55.6	96.0	52.8	2.8
		Mean	6.61	6.06	6.62	6.38
	IMG	n	1776	10	981	22 107
		Total, %	44.4	4.0	1.9	42.5
		Mean	5.35	5.84	5.04	5.36
Total		n	4000	251	52 000
Total		Total, %	100.0	100.0	100.0

BME = black and minority ethnic. IMG = international medical graduate. UKG = UK graduate.

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Table 2

Stepwise multiple regression of predictors of case score (0–9)

Model	Variable entered	Multiple R	R²	R² change	B	β	95% CI	F change	P-value	Variance explained
1	Candidate: UK/non-UK graduate	0.321	0.103	0.103	−0.955	−0.244	−0.993 to −0.916	5965.41	<0.001	10.3%
2	Candidate: male/female	0.338	0.114	0.011	0.378	0.097	0.346 to 0.410	669.72	<0.001	1.1%
3	Candidate: white/BME	0.348	0.121	0.007	−0.396	−0.100	−0.435 to −0.357	395.29	<0.001	0.7%
4	Examiner: UK/non-UK graduate	0.349	0.122	0.001	−0.440	−0.048	−0.522 to −0.359	53.84	<0.001	0.1%
5	Examiner: white/BME	0.351	0.123	0.001	0.236	0.043	0.187 to 0.284	87.78	<0.001	0.1%
6	Examiner: male/female	0.351	0.123	0.000	0.041	0.010	0.008 to 0.074	6.09	<0.020	<0.1%