WE-R NHS (Workforce and Education Research NHS)

Tackling differential attainment in specialist GP training in England and Scotland

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In this article NHS England and NHS Education for Scotland describe practical ways we are tackling differences in the attainment of people training as general practitioners (GPs).

Trainees from minority ethnic groups and international medical graduates are less likely than others to qualify as GPs. It is difficult to change systemic inequalities, but over the past five years we have made practical changes to GP speciality training. Educators recognise there is an issue and are trying to tackle it.

For example, people who had not successfully qualified had an opportunity to return to GP training. When we provided individualised targeted support, the proportion who completed training significantly increased (76%). This was a catalyst for reviewing unconscious bias in GP training. We implemented a national programme to tackle differential attainment and system-level bias. Educators now work with all GP trainees to identify their individual needs. Supervisors are trained to recognise bias and provide targeted support. There is mental health support and regular reviews to see whether trainees are ready to sit exams. Trainee representatives are championing the learner voice in national committees. Exams are being altered to reduce unconscious bias. We are monitoring attainment over time.

The key message is that differential attainment should not be in the ‘too hard basket’. The narrative is changing from ‘can’t do’ to ‘must do’, supported by appropriate leadership, promotion and resourcing. There is much more to do, but we are making changes, evaluating and applying our learning. We have moved from talking to taking action.

This article is Open Access at the weblink.

Additional information

Published in August 2023.

Resource details

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Contributed by: WE-R NHS (Workforce and Education Research NHS)
Authored by: Debra de Silva, Department of primary care, The Evidence Centre, London, UK
Rachel Roberts, Department of primary care, The Evidence Centre, London, UK
Vijay Nayar, Department of primary care, NHS England, London, UK
Graham Rutt, Department of primary care, NHS England, London, UK
Simon Gregory, Department of primary care, NHS England, London, UK
Amjad Khan, Department of primary care, NHS Education for Scotland, Edinburgh, UK
Licence: More information on licences
Last updated: 30 April 2024
First contributed: 08 March 2024
Audience access level: General user

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