Differential attainment: how can we close the gap in paediatrics?

2021 ◽  
pp. edpract-2020-321066
Author(s):  
Laura Kelly ◽  
Sailesh Sankaranarayanan
Keyword(s):  
Medical Education ◽  
Postgraduate Medical Education ◽  
Annual Review ◽  
Full Potential ◽  
Medical Specialties ◽  
Demographic Groups ◽  
Personal Cost ◽  
Medical Graduates ◽  
Satisfactory Outcome ◽  
The Uk

Differential attainment is the gap in attainment between different demographic groups undertaking the same assessment. Across the UK, we see differences in outcome in undergraduate and postgraduate medical education on the basis of gender, age, ethnicity and country of primary medical qualification which cannot be explained by a difference in ability. The largest gaps appear when we look at the variation in outcome between UK and international medical graduates (IMGs) and between white British and black, Asian and minority ethnic (BAME) doctors in postgraduate medical education. If we look to postgraduate medical examinations, the differences in attainment are stark and occur across all medical specialties, with paediatrics being no exception. The differences are also seen in the rates of relative success in recruitment to training posts and in a trainee’s likelihood of getting a satisfactory outcome at the Annual Review of Competence Progression. Ensuring all doctors reach their full potential is undoubtedly an issue of fairness that is of particular significance to paediatrics as IMGs make up 47% of our medical workforce and 36% of the paediatric workforce identifies as being from a BAME group. It is clear that if we fail to close the gap in differential attainment, there will be both a personal cost to affected individuals, but also a cost to the wider paediatric profession and the children they serve. This paper hopes to summarise the background and causes to differential attainment and look towards possible interventions that might tackle this issue.

scholarly journals Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021314 ◽  
Author(s):  
Katherine Woolf ◽  
Rowena Viney ◽  
Antonia Rich ◽  
Hirosha Jayaweera ◽  
Ann Griffin
Keyword(s):  
Medical Education ◽  
Curriculum Design ◽  
Postgraduate Medical Education ◽  
Change Strategies ◽  
Effect Change ◽  
Medical Graduates ◽  
Minority Ethnic Groups ◽  
The Uk ◽  
Evaluation Of Evidence ◽  
Minority Ethnic

ObjectivesTo explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change.DesignQualitative semistructured individual and group interview study.SettingPostgraduate medical education in the UK.ParticipantsIndividuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers.ResultsRepresentatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty.ConclusionsRepresentatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.

scholarly journals Health informatics competencies in postgraduate medical education and training in the UK: a mixed methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025460 ◽  
Author(s):  
Lydia Jidkov ◽  
Matthew Alexander ◽  
Pippa Bark ◽  
John G Williams ◽  
Jonathan Kay ◽  
...  
Keyword(s):  
Medical Education ◽  
Health Informatics ◽  
Postgraduate Medical Education ◽  
International Standards ◽  
Mixed Methods Study ◽  
Expert Consultation ◽  
Medical Specialties ◽  
Curricular Content ◽  
The Uk ◽  
Competency Domains

ObjectiveTo assess health informatics (HI) training in UK postgraduate medical education, across all specialties, against international standards in the context of UK digital health initiatives (eg, Health Data Research UK, National Health Service Digital Academy and Global Digital Exemplars).DesignA mixed methods study of UK postgraduate clinician training curricula (71 specialties) against international HI standards: scoping review, curricular content analysis and expert consultation.Setting and participantsA scoping literature review (PubMed until March 2017) informed development of a contemporary framework of HI competency domains for doctors. National training curricula for 71 postgraduate medical specialties were obtained from the UK General Medical Council and were analysed. Seven UK HI experts were consulted regarding findings.OutcomesThe International Medical Informatics Association (IMIA) Recommendations for Biomedical and Health Informatics Education were used to develop a framework of competency domains. The number (maximum 50) of HI competency domains included in each of the 71 UK postgraduate medical specialties was investigated. After expert review, a universal HI competency framework was proposed.ResultsA framework of 50 HI competency domains was developed using 21 curricula from a scoping review, curricular content analysis and expert consultation. All 71 UK postgraduate medical curricula documents were mapped across 29 of 50 framework domains; that is, 21 domains were unrepresented. Curricula mapped between 0 (child and adolescent psychiatry and core surgical training) and 16 (chemical pathology and paediatric and perinatal pathology) of the 50 domains (median=7). Expert consultation found that HI competencies should be universal and integrated with existing competencies for UK clinicians and were under-represented in current curricula. Additional universal HI competencies were identified, including information governance and security and secondary use of data.ConclusionsPostgraduate medical education in the UK neglects HI competencies set out by international standards. Key HI competencies need to be urgently integrated into training curricula to prepare doctors for work in increasingly digitised healthcare environments.

scholarly journals A trainee's perspective of the ISCP: are we any clearer?

2010 ◽  
Vol 92 (8) ◽  
pp. 276-278 ◽  
Author(s):  
J Ansell ◽  
S Davies ◽  
A Hollowood ◽  
J Livingstone
Keyword(s):  
Medical Education ◽  
Postgraduate Medical Education ◽  
Annual Review ◽  
Surgical Trainee ◽  
Web Based ◽  
Medical Education And Training ◽  
Educational Supervisor ◽  
The Uk ◽  
And Training ◽  
Web Based System

The Intercollegiate Surgical Curriculum Programme (ISCP) is a web-based system, approved by the Postgraduate Medical Education and Training Board, designed for the modern surgical trainee. First launched in August 2007, the ISCP provides the syllabus for surgical training in the UK. The website can be utilised by the trainee to record workplace-based assessments (WBAs), operations and appraisals under the guidance of an assigned educational supervisor (AES). This evidence is then used to demonstrate that the trainee has achieved the necessary targets set by the programme director (PD). The trainee then attends an annual review of competencies progression (ARCP), in which his or her suitability to progress within the programme is evaluated using the collated data.

Use of work-based assessments in postgraduate medical education

2019 ◽  
Vol 80 (5) ◽  
pp. 285-287
Author(s):  
Sulaiman Alazzawi ◽  
James Berstock
Keyword(s):  
Medical Education ◽  
Adult Learners ◽  
Mobile Devices ◽  
Medical Training ◽  
Postgraduate Medical Education ◽  
Time Constraints ◽  
Educational Value ◽  
Postgraduate Medical Training ◽  
The Uk

Work-based assessments are ubiquitous in postgraduate medical training in the UK. This article discusses the variety of these assessments and explores barriers to their use and solutions for improving the educational value of these tools for adult learners. The focus should be on feedback and learning rather than assessment, and this may promote discussion of more challenging scenarios where the opportunity for learning is greater. Mobile devices may help reduce the administrative, geographical and time constraints of completing work-based assessments.

scholarly journals The Postgraduate Medical Education and Training Board (PMETB) goes live

2005 ◽  
Vol 29 (11) ◽  
pp. 431-433 ◽  
Author(s):  
Nick Brown
Keyword(s):  
Medical Education ◽  
Medical Practice ◽  
Postgraduate Medical Education ◽  
Postgraduate Education ◽  
Education And Training ◽  
Medical Education And Training ◽  
The Uk ◽  
And Training ◽  
Practice Education

The Postgraduate Education and Training Board (PMETB) was established by the General and Specialist Medical Practice (Education and Qualifications) Order, approved by parliament on 4 April 2003 to develop a single, unifying framework for postgraduate medical education and training across the UK. The Order placed a duty on the Board to establish, maintain and develop standards and requirements relating to all aspects of postgraduate medical education and training in the UK.

scholarly journals UK nationals who received their medical degrees abroad: selection into, and subsequent performance in postgraduate training: a national data linkage study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023060 ◽  
Author(s):  
Paul A Tiffin ◽  
James Orr ◽  
Lewis W Paton ◽  
Daniel T Smith ◽  
John J Norcini
Keyword(s):  
Postgraduate Training ◽  
Medical Specialty ◽  
Linkage Study ◽  
Annual Review ◽  
Educational Performance ◽  
Specialty Training ◽  
Subsequent Performance ◽  
Satisfactory Outcome ◽  
Training Programmes ◽  
The Uk

ObjectivesTo compare the likelihood of success at selection into specialty training for doctors who were UK nationals but obtained their primary medical qualification (PMQ) from outside the UK (‘UK overseas graduates’) with other graduate groups based on their nationality and where they gained their PMQ. We also compared subsequent educational performance during postgraduate training between the graduate groups.DesignObservational study linking UK medical specialty recruitment data with postgraduate educational performance (Annual Review of Competence Progression (ARCP) ratings).SettingDoctors recruited into national programmes of postgraduate specialist training in the UK from 2012 to 2016.Participants34 755 UK-based trainee doctors recruited into national specialty training programmes with at least one subsequent ARCP outcome reported during the study period, including 1108 UK overseas graduates.Main outcome measuresOdds of being deemed appointable at specialty selection and subsequent odds of obtaining a less versus more satisfactory category of ARCP outcome.ResultsUK overseas graduates were more likely to be deemed appointable compared with non-EU medical graduates who were not UK citizens (OR 1.29, 95% CI 1.16 to 1.42), although less so than UK (OR 0.25, 95% CI 0.23 to 0.27) or European graduates (OR 0.66, 95% CI 0.58 to 0.75). However, UK overseas graduates were subsequently more likely to receive a less satisfactory outcome at ARCP than other graduate groups. Adjusting for age, sex, experience and the economic disparity between country of nationality and place of qualification reduced intergroup differences.ConclusionsThe failure of recruitment patterns to mirror the ARCP data raises issues regarding consistency in selection and the deaneries’ subsequent annual reviews. Excessive weight is possibly given to interview performance at specialty recruitment. Regulators and selectors should continue to develop robust processes for selection and assessment of doctors in training. Further support could be considered for UK overseas graduates returning to practice in the UK.

scholarly journals How Much do Doctors know about Consent and Capacity?

2002 ◽  
Vol 95 (12) ◽  
pp. 601-603 ◽  
Author(s):  
Elizabeth Jackson ◽  
James Warner
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Medical Treatment ◽  
Old Age ◽  
General Practitioners ◽  
Postgraduate Medical Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Structured Questionnaire

To assess knowledge of capacity issues across different medical specialties we conducted a cross-sectional survey with a structured questionnaire at academic meetings, lectures and conferences. Of 190 individuals who received the questionnaire 129 (68%) responded-35 general practitioners, 31 psychiatrists, 29 old-age psychiatrists and 34 final year medical students. Correct answers on capacity to consent to or refuse medical treatment were given by 58% of the psychiatrists, 34% of the geriatricians, 20% of the general practitioners and 15% of the students. 15% of all respondents wrongly believed that a competent adult could lawfully be treated against his or her will, with no obvious differences by specialty. As judged by this survey, issues of capacity and consent deserve more attention in both undergraduate and postgraduate medical education.

Evaluating leadership development in postgraduate medical education

2014 ◽  
Vol 27 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Stavros Bekas
Keyword(s):  
Medical Education ◽  
Leadership Development ◽  
Postgraduate Medical Education ◽  
Empirical Literature ◽  
Content Type ◽  
Pedagogical Content ◽  
Leadership Initiatives ◽  
The Uk ◽  
Quality In Healthcare ◽  
Medical Leadership

Purpose – Medical leadership has attracted significant attention over the recent years as one of the factors that could potentially improve quality in healthcare. In response, various stakeholders in UK medical education have been looking into the most efficient ways of developing leadership among trainee doctors and invested in various courses and programmes. This paper aims to briefly set the theoretical basis for evaluating leadership development in postgraduate medical education. Design/methodology/approach – Critical review of available theoretical and empirical literature and review of the content of a number of leadership and management development programmes available to postgraduate trainee doctors in the UK. Findings – This review suggests that programme evaluation can be approached through four different “frames”: their pedagogical content, the conceptualisation and achievement of leadership, the contribution in quality improvement and the consideration of practical aspects that increase engagement and participation. On this basis empirical methodologies of evaluation can be developed. Originality/value – The evaluation of leadership initiatives for medical trainees is an important task that has not been adequately addressed in the literature. This paper provides a theoretical approach to developing more robust methodologies of evaluation.

scholarly journals Venereology at the Polyclinic: Postgraduate Medical Education Among General Practitioners in England, 1899–1914

2015 ◽  
Vol 59 (2) ◽  
pp. 199-221 ◽  
Author(s):  
Anne Hanley
Keyword(s):  
Medical Education ◽  
General Practitioners ◽  
Postgraduate Medical Education ◽  
Clinical Practices ◽  
Medical Graduates ◽  
Teaching College ◽  
Medical Undergraduates ◽  
History Of ◽  
Knowledge Claims

AbstractIn 1899 theBritish Medical Journalenthusiastically announced that a new postgraduate teaching college was to open in London. The aim of the Medical Graduates’ College and Polyclinic (MGC) was to provide continuing education to general practitioners. It drew upon emerging specialisms and in so doing built upon the generalist training received at an undergraduate level. Courses were intended to refresh knowledge and to introduce general practitioners to new knowledge claims and clinical practices. The establishment of postgraduate institutions such as the MGC marked an important stage in the development of medical education in England. Yet these institutions, and the emergence of postgraduate medical education more broadly, have been largely overlooked by historians. Moreover the history of venereological training among medical undergraduates and postgraduates alike has been overlooked. The study of such special subjects characterised postgraduate study. This article examines the dissemination of venereological knowledge among subscribers to MGC as an important case study for the development of institutionalised postgraduate medical education in England at the turn of the twentieth century.

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