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Hear how we’re addressing differential attainment at the RCR Annual Conference

Dr Jina Pakpoor, Dr Zsuzsanna Iyizoba-Ebozue, and Dr Stephen Harden, on behalf of the RCR Fairer Training Fellows (Dr Rahul Khamar, Dr Abiola Fatimlehin, Dr Ishaan Bhide & Dr Keerthini Muthuswamy).


Differential attainment is a recognised phenomenon in medical training. It is defined as the unexplained differences in performance between groups of varying protected characteristics and socio-economic backgrounds. The literature suggests this cannot be attributed solely to a learner deficit.  

Differential attainment in clinical radiology and clinical oncology

Clinical radiology (CR) and clinical oncology (CO) trainees are not exempt from existing reward gaps. Using exams as a proxy for attainment, the pass rate at first attempt for RCR exams of black, black British, Caribbean, or African ethnicity trainees has been 20 -52% lower than their white ethnicity counterparts (unpublished data, RCR). For Asian or Asian British ethnicity entrants, the difference in pass rate is 9-17%. Evidence from the surgical specialties, where differential attainment has been extensively studied, suggests that group-level differences also extend to disabled trainees, those of female gender and older trainees.

Importance of tackling inequities in training

Tackling inequities in CR/CO training is of importance for trainees, trainers, and healthcare institutions. On an individual level, there is a great personal, social and financial cost of repeat FRCR attempts and delayed training progression. On an institutional level, achieving equity in radiology or clinical oncology training goes hand-in-hand with workforce retention and cultural competency in patient care. There are also legal and regulatory requirements to address differential attainment, in part mandated by the General Medical Council. Identifying the problem of differential attainment is just the first step and we must implement interventions to bridge the attainment gap.

Join us to hear more at the RCR Annual Conference 2023

On the first day of the RCR’s Annual Conference on 12 October, we will explore this topic further, discussing the fairer training fellows and RCR collaborations to address this issue. We will report the latest data on differential attainment specifically in our specialties, including the results of the CR 2023 survey and mixed method CO study on experiences of inclusion and fairness among UK trainees.

We will update you on the joint faculty RCR reverse mentoring pilot, which is aimed at embedding the experiences of trainees from minority ethnic backgrounds into the College educational leadership consciousness, offering an opportunity to explore and challenge systemic biases in training.

You will hear about plans for the RCR Equity and Allyship in Practice programme, ongoing work by the RCR for widening access to FRCR examination preparatory resources and increasing the diversity of the FRCR examiner panel.

Register your place at the RCR Annual Conference with sessions covering clinical updates, professional development, career support and peer-to-peer networking. Book now to secure your spot.


References:

1. Woolf K. Differential attainment in medical education and training. BMJ. Feb 11 2020;368:m339. doi:10.1136/bmj.m339

2. Woolf K, Rich A, Viney R, Needleman S, Griffin A. Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study. BMJ Open. Nov 25 2016;6(11):e013429. doi:10.1136/bmjopen-2016-013429

3. Ellis R, Brennan PA, Lee AJ, Scrimgeour DS, Cleland J. Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study. J R Soc Med. Jul 2022;115(7):257-272. doi:10.1177/01410768221079018

4. Ellis R, Cleland J, Scrimgeour D, Lee AJ, Brennan PA. The impact of disability on performance in a high-stakes postgraduate surgical examination: a retrospective cohort study. J R Soc Med. Feb 2022;115(2):58-68. doi:10.1177/01410768211032573

5. Woolf K, Potts HW, McManus IC. Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis. BMJ. Mar 08 2011;342:d901. doi:10.1136/bmj.d901