The venue for the talk yesterday evening was the UCL Art museum which has an impressive 12,000 objects of which only a few hundred can be shown at any one time. The earliest are from the 15thC whilst a significant collection derives from the Slade School of Art which was established in 1872. On the day of the lecture works by Dora Carrington and others were on show.
First a little background to the talk
As far back as 1995 there was a report in the BMJ from Manchester University which looked at failure rates in Asian medical students (of 250 student 10 failed all male Asians)
Because 65.3% of international graduates failed their first attempt at the Clinical Skills Assessment component of the MRCGP exam in 2011/12, compared with 9.9% of UK graduates and there were similar significant differences in the previous two year analysed the British Association of Physicians of Indian origin (BAPIO) who in 2013 launched a legal challenge to the GMC and the Royal College of General Practioners alleging that membership exam was discriminatory and sought a judicial review of the way the RCGP conducts the test. However the review judged the Royal College of General Practitioners was neither racially discriminatory nor in breach of its public sector equality duty. but ithe RCGP needed to ‘eliminate discrimination’ in the MRCGP and address the disparity in pass rates for non-white groups
Dr Woolf’s talk
A few years back I went to a lecture given by Katherine Woolf which looked a students social networks. In a small way it had an effect on some of the ways I do my teaching in groups.
Dr Katherine Woolf gave another thought provoking talk on the fairness of medical training. Her discussion was on the ethnical differences in attainment in medicine and she focused on a two part study funded by the GMC.
The report showed that white UK medical graduates remain more likely to pass specialty exams than their black and minority ethnic (BME) counterparts, while doctors whose primary qualification was gained outside the UK or European Economic Area (EEA) are even less likely to do well in exams or recruitment.
Dr Woolf went on to discuss more evidence and possible causes
The following are bullet points of her talk
- Homophily means “love of the same” is the tendency of individuals to associate and bond with similar others,
- as in the proverb “birds of a feather flock together”
- ie similarity breeds connection.
- Learning is a social activity
- Friendships will influence learning
- Who you know is not random
- Who you share confidences with may be a problem
- Ethnicity can influence the social environment
She discussed the main categories of risk in the context of
- Juniors relationship with seniors
- Perceived bias in recruitment and assessment
- The fear of living up to expectations
- Lack of autonomy
- Stigma about asking for support
- Being labelled as the problematic trainee
She then discussed the protecting processes
- Building the trainer – trainee relationship
- Trainer and trainees having time to get to know each other and building up trust.
- Facilitating peer support
- Improving the trainees well being by enabling them to gain support
Discussing the part 2 of the GMC Study which has today been published (I cannot find a link to this yet but will hopefully amend this blog) Dr Woolf discussed the research evidence with all the sources specialty specific.
- How significant are the risks
- Are they amenable to change
- The increase significance to International Medical Graduates.
- The source of evidence in personal experiences
- The difficulties of having discussion and sensitivities about race.
- Concerns about positive action
- The perception that change needs to happen at a macro level
- Good practice may be isolated at local or specialty level.
Dr Woolf finished by stating there was a need for a change in practice with a greater openness about individual and organisational sensitivity around race with more focus on BME’s amd IMGs. There is a need, she said for more research that is specialty specific and more sharing of examples of good practice. A very useful talk to reflect on for supervisors, trainers and trainees.