Abstract
Differential attainment in career progression in the NHS is a complex issue with many interplaying factors apart from individual protected characteristics. In this paper, we examine the attainment gap, causes for these disparities and some recommendations to reduce the gap. Our review shows that there is significant DA between groups of doctors on the basis of gender, ethnicity, race and country of primary medical qualification. The likely causes are bias, lack of opportunity, poor supervision, mentorship, sponsorship, dichotomous treatment of doctors based on training or non-training status and cultural exclusion. Data is not monitored or reported and there is little organisational accountability. Solutions are likely to include transparent data on recruitment as well as progression for benchmarking, training support for all doctors, initiatives which are sensitive to gender, parental responsibility, cultural heritage, language and robust supervision including mentorship and sponsorship. This scoping review forms part of the Alliance for Equality in Healthcare Professions project on Differential Attainment chaired by the British Association of Physicians of Indian Origin (BAPIO) and will be integrated into the Bridging the Gap project undertaken by BAPIO Institute for Health Research (BIHR). This work is part of six domains of doctors' careers in the NHS.
Highlights
A career in medicine is one of the most sought-after options for school leavers, even though the trajectory towards becoming a General Practitioner (GP) or a Hospital consultant is long and arduous
The medical profession typically attracts motivated, hardworking and enthusiastic individuals, who make considerable sacrifices to gain a place at medical school, during postgraduate training and through a firm commitment to the cycle of life-long learning, appraisals and recertification/ renewal of the licence to practice
Our review demonstrated a significant differential between doctors in the rate of career progression, access to training posts, geographical variation, variation by specialty and more often than not, these appeared to be determined by certain non-academic characteristics of groups of doctors
Summary
A career in medicine is one of the most sought-after options for school leavers, even though the trajectory towards becoming a General Practitioner (GP) or a Hospital consultant is long and arduous. It involves multiple postgraduate exams and many additional years of training after leaving medical school. The medical profession typically attracts motivated, hardworking and enthusiastic individuals, who make considerable sacrifices to gain a place at medical school, during postgraduate training and through a firm commitment to the cycle of life-long learning, appraisals and recertification/ renewal of the licence to practice. Due to the length and complexity of medical training pathways, there are many barriers and facilitators with regard to career progression.
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