Fair and equal assessment in postgraduate training? A future research agenda

Abstract

Assessment of GP training has historically shown differences in performance according to ethnicty and sex.1 A recent meta-analysis2 shows that ethnic differences in attainment are a consistent feature of medical education in the UK, ‘being present across medical schools, exam types, and undergraduate and postgraduate assessments, and have persisted for at least the past three decades’. The most substantial differences are found for doctors taking postgraduate examinations as international medical graduates, who frequently under-perform compared to their locally-trained peers.3 Although these differences have been repeatedly found, we lack a satisfactory explanation that can guide what may be done to address the issues. In this editorial, we propose an agenda to guide future research and to encourage debate within the broader scientific and academic community. Using an interdisciplinary approach, we draw on expert inputs from a variety of academic and stakeholder experiences to summarise key issues surrounding fairness in assessment. These opinions were gathered at a 1-day seminar at the University of Cambridge. There exists understandable concern amongs key stakeholders regarding the threat of litigation when research findings expose unexplained significant group differences in assessment outcomes. We argue that postgraduate assessment methodologies are not inherently ‘biased’. The reasons for observed group differences are far more complex, and in need of far more systematic research, leading to more open dialogue between all stakeholders. The use of innovative research designs …