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In reviewing the performance of ethnic minority versus White doctors in MRCGP assessment (2016–2021), Siriwardena et al conclude that ethnic background did not reduce the chance of passing GP licensing exams once sex, place of primary medical qualification (PMQ), declared disability, and MSRA scores were accounted for.1
This conclusion is not in keeping with the recent GMC report2 that found that UK graduates of Black/Black British heritage have lower pass rates in specialty exams (62%) than UK White (79%), Asian (68%), and mixed-heritage trainees (74%). Having a non-White ethnic background may in itself be an over-simplification and further granularity of the data is required to reach any meaningful conclusions.
Further, there is differential attainment in the MRSA exam, ‘upstream’ so to speak, which mirrors that seen in the GMC report. In the MRSA proportionally more Black and Muslim candidates do less well, findings similar to those in the MRCGP, whether UK or non-UK graduates. The disparities in attainment due to ethnicity seen in the MRSA do not seem to have been taken into account in the article.
The article followed up GP trainees recruited in 2016 of which 23.2% were non- UK graduates. In 2022 this figure was 57% and the profile of our trainees has changed significantly over that time with increased numbers from a non-White background. Also, Health Education England has introduced a number of initiatives to reduce the impact of differential attainment that may affect the reliability of the data presented in the article.
Lastly, this analysis does not take into account the lived experience reported by our trainees, whether they be UK non- White trainees or IMGs, as shown in WRES3 and MWRES4 data as well as primary care surveys5 and the work of Katherine Woolf.6
The conclusions in this report should not detract from the fact that differential attainment exists and that ethnicity is a key contributory factor whether qualifying here or abroad. We need to ensure that we level the medical education field and that all trainees regardless of their background receive the support they need to reach their full potential.
- © British Journal of General Practice 2023
