Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study

Ben Kumwenda; Jennifer A Cleland; Gordon J Prescott; Kim Walker; Peter W Johnston

doi:10.1136/bmjopen-2017-021329

Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study

Ben Kumwenda^* (Corresponding Author), Jennifer A Cleland, Gordon J Prescott, Kim Walker, Peter W Johnston

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

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Abstract

INTRODUCTION: Knowledge about allocation of doctors into postgraduate training programmes is essential in terms of workforce planning, transparency and equity issues. However, this is a rarely examined topic. To address this gap in the literature, the current study examines the relationships between applicants' sociodemographic characteristics and outcomes on the UK Foundation Training selection process.

METHODS: A longitudinal, cohort study of trainees who applied for the first stage of UK postgraduate medical training in 2013-2014. We used UK Medical Education Database (UKMED) to access linked data from different sources, including medical school admissions, assessments and postgraduate training. Multivariable ordinal regression analyses were used to predict the odds of applicants being allocated to their preferred foundation schools.

RESULTS: Applicants allocated to their first-choice foundation school scored on average a quarter of an SD above the average of all applicants in the sample. After adjusting for Foundation Training application score, no statistically significant effects were observed for gender, socioeconomic status (as determined by income support) or whether applicants entered medical school as graduates or not. Ethnicity and place of medical qualification were strong predictors of allocation to preferred foundation school. Applicants who graduated from medical schools in Wales, Scotland and Northern Ireland were 1.17 times, 3.33 times and 12.64 times (respectively), the odds of applicants who graduated from a medical school in England to be allocated to a foundation school of their choice.

CONCLUSIONS: The data provide supportive evidence for the fairness of the allocation process but highlight some interesting findings relating to 'push-pull' factors in medical careers decision-making. These findings should be considered when designing postgraduate training policy.

Original language	English
Article number	e021329
Number of pages	10
Journal	BMJ Open
Volume	8
Issue number	6
DOIs	https://doi.org/10.1136/bmjopen-2017-021329
Publication status	Published - 30 Jun 2018

Bibliographical note

We are grateful to UKMED for releasing the data for this project. We also are grateful to the following for their support of the application to UKMED for this and other research projects: Sally Curtis (University of Southampton, UK), Sandra Nicholson (Barts and The London School of Medicine and Dentistry, UK), PWJ (NHS Education for Scotland, UK) and Rhoda MacKenzie (University of Aberdeen, UK). We thank Daniel Smith and Andy Knapton of the General Medical Council of the UK for their support for the application and throughout the project, particularly regarding data linkage and troubleshooting.

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Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes a national cohort study
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Cite this

@article{2939a4b41a6b4daba502ce1bf590a7e6,

title = "Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study",

abstract = "INTRODUCTION: Knowledge about allocation of doctors into postgraduate training programmes is essential in terms of workforce planning, transparency and equity issues. However, this is a rarely examined topic. To address this gap in the literature, the current study examines the relationships between applicants' sociodemographic characteristics and outcomes on the UK Foundation Training selection process.METHODS: A longitudinal, cohort study of trainees who applied for the first stage of UK postgraduate medical training in 2013-2014. We used UK Medical Education Database (UKMED) to access linked data from different sources, including medical school admissions, assessments and postgraduate training. Multivariable ordinal regression analyses were used to predict the odds of applicants being allocated to their preferred foundation schools.RESULTS: Applicants allocated to their first-choice foundation school scored on average a quarter of an SD above the average of all applicants in the sample. After adjusting for Foundation Training application score, no statistically significant effects were observed for gender, socioeconomic status (as determined by income support) or whether applicants entered medical school as graduates or not. Ethnicity and place of medical qualification were strong predictors of allocation to preferred foundation school. Applicants who graduated from medical schools in Wales, Scotland and Northern Ireland were 1.17 times, 3.33 times and 12.64 times (respectively), the odds of applicants who graduated from a medical school in England to be allocated to a foundation school of their choice.CONCLUSIONS: The data provide supportive evidence for the fairness of the allocation process but highlight some interesting findings relating to 'push-pull' factors in medical careers decision-making. These findings should be considered when designing postgraduate training policy.",

author = "Ben Kumwenda and Cleland, {Jennifer A} and Prescott, {Gordon J} and Kim Walker and Johnston, {Peter W}",

note = "We are grateful to UKMED for releasing the data for this project. We also are grateful to the following for their support of the application to UKMED for this and other research projects: Sally Curtis (University of Southampton, UK), Sandra Nicholson (Barts and The London School of Medicine and Dentistry, UK), PWJ (NHS Education for Scotland, UK) and Rhoda MacKenzie (University of Aberdeen, UK). We thank Daniel Smith and Andy Knapton of the General Medical Council of the UK for their support for the application and throughout the project, particularly regarding data linkage and troubleshooting.",

year = "2018",

month = jun,

day = "30",

doi = "10.1136/bmjopen-2017-021329",

language = "English",

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T2 - a national cohort study

AU - Kumwenda, Ben

AU - Cleland, Jennifer A

AU - Prescott, Gordon J

AU - Walker, Kim

AU - Johnston, Peter W

N1 - We are grateful to UKMED for releasing the data for this project. We also are grateful to the following for their support of the application to UKMED for this and other research projects: Sally Curtis (University of Southampton, UK), Sandra Nicholson (Barts and The London School of Medicine and Dentistry, UK), PWJ (NHS Education for Scotland, UK) and Rhoda MacKenzie (University of Aberdeen, UK). We thank Daniel Smith and Andy Knapton of the General Medical Council of the UK for their support for the application and throughout the project, particularly regarding data linkage and troubleshooting.

PY - 2018/6/30

Y1 - 2018/6/30

N2 - INTRODUCTION: Knowledge about allocation of doctors into postgraduate training programmes is essential in terms of workforce planning, transparency and equity issues. However, this is a rarely examined topic. To address this gap in the literature, the current study examines the relationships between applicants' sociodemographic characteristics and outcomes on the UK Foundation Training selection process.METHODS: A longitudinal, cohort study of trainees who applied for the first stage of UK postgraduate medical training in 2013-2014. We used UK Medical Education Database (UKMED) to access linked data from different sources, including medical school admissions, assessments and postgraduate training. Multivariable ordinal regression analyses were used to predict the odds of applicants being allocated to their preferred foundation schools.RESULTS: Applicants allocated to their first-choice foundation school scored on average a quarter of an SD above the average of all applicants in the sample. After adjusting for Foundation Training application score, no statistically significant effects were observed for gender, socioeconomic status (as determined by income support) or whether applicants entered medical school as graduates or not. Ethnicity and place of medical qualification were strong predictors of allocation to preferred foundation school. Applicants who graduated from medical schools in Wales, Scotland and Northern Ireland were 1.17 times, 3.33 times and 12.64 times (respectively), the odds of applicants who graduated from a medical school in England to be allocated to a foundation school of their choice.CONCLUSIONS: The data provide supportive evidence for the fairness of the allocation process but highlight some interesting findings relating to 'push-pull' factors in medical careers decision-making. These findings should be considered when designing postgraduate training policy.

AB - INTRODUCTION: Knowledge about allocation of doctors into postgraduate training programmes is essential in terms of workforce planning, transparency and equity issues. However, this is a rarely examined topic. To address this gap in the literature, the current study examines the relationships between applicants' sociodemographic characteristics and outcomes on the UK Foundation Training selection process.METHODS: A longitudinal, cohort study of trainees who applied for the first stage of UK postgraduate medical training in 2013-2014. We used UK Medical Education Database (UKMED) to access linked data from different sources, including medical school admissions, assessments and postgraduate training. Multivariable ordinal regression analyses were used to predict the odds of applicants being allocated to their preferred foundation schools.RESULTS: Applicants allocated to their first-choice foundation school scored on average a quarter of an SD above the average of all applicants in the sample. After adjusting for Foundation Training application score, no statistically significant effects were observed for gender, socioeconomic status (as determined by income support) or whether applicants entered medical school as graduates or not. Ethnicity and place of medical qualification were strong predictors of allocation to preferred foundation school. Applicants who graduated from medical schools in Wales, Scotland and Northern Ireland were 1.17 times, 3.33 times and 12.64 times (respectively), the odds of applicants who graduated from a medical school in England to be allocated to a foundation school of their choice.CONCLUSIONS: The data provide supportive evidence for the fairness of the allocation process but highlight some interesting findings relating to 'push-pull' factors in medical careers decision-making. These findings should be considered when designing postgraduate training policy.

U2 - 10.1136/bmjopen-2017-021329

DO - 10.1136/bmjopen-2017-021329

M3 - Article

C2 - 29961026

SN - 2044-6055

VL - 8

JO - BMJ Open

JF - BMJ Open

IS - 6

M1 - e021329

ER -

Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study

Abstract

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