Is the awarding gap at UK medical
schools influenced by ethnicity and
medical school attended? A
retrospective cohort study
schools influenced by ethnicity and
medical school attended? A
retrospective cohort study
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Author(s)
Brown, Celia
Goss, Charlotte
Sam, Seyed
Type
Journal Article
Abstract
Objectives: To better characterise the Awarding Gap (AG) between black and other minority ethnic (BAME) and white students in UK undergraduate medical education by examining how it affects eight minority ethnicity subgroups (Bangladeshi, black, Chinese, Indian, Pakistani, mixed, other Asian background and other ethnic background) and whether the AG varies by medical school attended.
Design: Retrospective cohort study.
Setting: Data extracted from the UK Medical Education Database on students enrolled at 33 UK medical schools in the academic years starting 2012, 2013 and 2014.
Participants: 16,020 ‘Home’ tuition fee status students who sat the University Clinical Aptitude Test on entry to university and obtained a UK Foundation Programme Application (UKFPO) score on exit.
Primary Outcome Measure: UKFPO Z-scores on exit from medical school.
Results: There were significant differences in UKFPO Z-scores between ethnicity subgroups. After white students, mixed ethnicity students performed best (coefficient -0.15 standard deviations [SD] compared with white students, 95% confidence interval [CI] -0.23 to -0.08, p<0.001) and Pakistani students scored lowest (coefficient -0.53 SD, 95% CI -0.60 to -0.46, p<0.001). In pairwise comparisons of scores between all nine individual ethnicity subgroups, 15/36 were statistically significant. The AG varied considerably across medical schools. The largest gap showed the coefficient for BAME was -0.83 SD compared with white students (95% CI -1.18 to -0.49, p<0.001), while the smallest demonstrated no statistically significant difference in performance between BAME and white students (+0.05 SD, 95% CI -0.32 to 0.42, p=0.792).
Conclusions: BAME students are significantly disadvantaged by the current UK medical education system. There are clear differences in medical school outcomes between students from different ethnicity subgroups, and the size of the AG also varies by medical school attended. Urgent and effective action must be taken to address the AG and achieve an equal learning environment for our future doctors.
Design: Retrospective cohort study.
Setting: Data extracted from the UK Medical Education Database on students enrolled at 33 UK medical schools in the academic years starting 2012, 2013 and 2014.
Participants: 16,020 ‘Home’ tuition fee status students who sat the University Clinical Aptitude Test on entry to university and obtained a UK Foundation Programme Application (UKFPO) score on exit.
Primary Outcome Measure: UKFPO Z-scores on exit from medical school.
Results: There were significant differences in UKFPO Z-scores between ethnicity subgroups. After white students, mixed ethnicity students performed best (coefficient -0.15 standard deviations [SD] compared with white students, 95% confidence interval [CI] -0.23 to -0.08, p<0.001) and Pakistani students scored lowest (coefficient -0.53 SD, 95% CI -0.60 to -0.46, p<0.001). In pairwise comparisons of scores between all nine individual ethnicity subgroups, 15/36 were statistically significant. The AG varied considerably across medical schools. The largest gap showed the coefficient for BAME was -0.83 SD compared with white students (95% CI -1.18 to -0.49, p<0.001), while the smallest demonstrated no statistically significant difference in performance between BAME and white students (+0.05 SD, 95% CI -0.32 to 0.42, p=0.792).
Conclusions: BAME students are significantly disadvantaged by the current UK medical education system. There are clear differences in medical school outcomes between students from different ethnicity subgroups, and the size of the AG also varies by medical school attended. Urgent and effective action must be taken to address the AG and achieve an equal learning environment for our future doctors.
Date Issued
2023-12-12
Date Acceptance
2023-10-31
Citation
BMJ Open, 2023, 13 (12)
ISSN
2044-6055
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open
Volume
13
Issue
12
Copyright Statement
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Identifier
https://bmjopen.bmj.com/content/13/12/e075945.info
Publication Status
Published
Article Number
e075945
Date Publish Online
2023-12-12