Differential attainment in medical education and training

Doctors from ethnic minority backgrounds face disadvantage throughout their careers, as highlighted by this collection of articles in The BMJ (bmj.com/racism-in-medicine). It is therefore unsurprising that despite being selected for high academic achievement, medical students from ethnic minority groups end up performing worse on average than their white counterparts during education and training. This phenomenon is called “differential attainment.”

Differential attainment appears at medical school and persists after qualification. As a result, ethnic minority graduates of UK medical schools have worse outcomes during recruitment for foundation, specialty training, and consultant posts; are more likely to fail examinations; and progress more slowly through training even when exam failure has been accounted for.1

Differential attainment is a difference in average group performance, not individual performance. Many ethnic minority students and doctors excel, and many white doctors perform poorly. The finding, however, that ethnic minority medical graduates in the UK have 2.5 times higher odds of failing exams compared with their white peers 2 is hugely important …