Abstract
BackgroundMale students and students from ethnic minorities have been reported to underperform in undergraduate medical examinations. We examined the effects of ethnicity and gender on pass rates in UK medical graduates sitting the Membership of the Royal Colleges of Physicians in the United Kingdom [MRCP(UK)] Examination in 2003–4.MethodsPass rates for each part of the examination were analysed for differences between graduate groupings based on self-declared ethnicity and gender.ResultsAll candidates declared their gender, and 84–90% declared their ethnicity. In all three parts of the examination, white candidates performed better than other ethnic groups (P < 0.001). In the MRCP(UK) Part 1 and Part 2 Written Examinations, there was no significant difference in pass rate between male and female graduates, nor was there any interaction between gender and ethnicity. In the Part 2 Clinical Examination (Practical Assessment of Clinical Examination Skills, PACES), women performed better than did men (P < 0.001). Non-white men performed more poorly than expected, relative to white men or non-white women. Analysis of individual station marks showed significant interaction between candidate and examiner ethnicity for performance on communication skills (P = 0.011), but not on clinical skills (P = 0.176). Analysis of overall average marks showed no interaction between candidate gender and the number of assessments made by female examiners (P = 0.151).ConclusionThe cause of these differences is most likely to be multifactorial, but cannot be readily explained in terms of previous educational experience or differential performance on particular parts of the examination. Potential examiner prejudice, significant only in the cases where there were two non-white examiners and the candidate was non-white, might indicate different cultural interpretations of the judgements being made.
Highlights
Male students and students from ethnic minorities have been reported to underperform in undergraduate medical examinations
White candidates with an overall pass rate of 50.3% [95% confidence interval (CI) 48.6–52.0%] performed significantly better than did candidates from other groups
Our study reveals that white candidates achieved the highest pass rates in all three parts of the MRCP(UK) Examination and it seems likely that trends already observed by others in undergraduate examinations continue through into the "high-stakes" postgraduate arena
Summary
Male students and students from ethnic minorities have been reported to underperform in undergraduate medical examinations. We examined the effects of ethnicity and gender on pass rates in UK medical graduates sitting the Membership of the Royal Colleges of Physicians in the United Kingdom [MRCP(UK)] Examination in 2003–4. The Membership of the Royal Colleges of Physicians in the United Kingdom [MRCP(UK)] Examination is a threepart examination providing summative assessment of knowledge requirements and clinical skills necessary for trainee physicians before undertaking higher training in internal medicine and/or a medical specialty. The Part 2 Clinical Examination (Practical Assessment of Clinical Skills; PACES) assesses trainees against an agreed standard of competence in all aspects of clinical consultation. The aim of this study was to assess effects of ethnicity and gender for UK medical graduates on pass rates in the MRCP (UK) Examination sat in the UK in 2003–4. In the Part 2 Clinical Examination (PACES) we examined the potential for interaction between ethnicity and gender of examiners and candidates
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