Differential Attainment in Healthcare Professions

‘Bridging the Gap Alliance’ led by British Association of Physicians of Indian Origin

It is well recognised that that there is inherent inequality in many aspects of education, training, career progression or handling of human resource procedures/ protocols and disparity in the experience of different cohorts of people within the health professions, based on factors which are beyond the control of the individual’s ability, motivation or engagement. Differential Attainment (DA) is defined as the observed gap in the achievements of different cohorts of individuals based on factors beyond their individual ability. It exists globally, in both undergraduate and postgraduate contexts, across exam pass rates, recruitment and progression/ outcomes and can be an indicator that training and medical education may not be fair. Differentials connected to age, gender, ethnicity of a particular group or other diverse characteristics are unfair. The UK General Medical Council and a ‘fair society’ standards require training pathways, assessment and opportunities to progress, should be fair for everyone.

Since 2014, when BAPIO led a legal challenge against the Royal College of General Practitioners there has been a seismic shift in transparency and reporting of the differential attainment data for all examinations and specialty progression reports by the UK GMC. Acting onProfessor Esmail’s report and the committee set to address his recommendations, GMC, AoMRC, Medical Schools Council, Health Education England have undertaken a multi-pronged approach from reviewing of curricula, training of examiners/ surrogates, and investing in enablers within different regions for bridging the DA gap.

However, the sequential data from 2015-2020 suggests that there is little progression in bridging the gap. There are many areas of uncertainty and much more research is needed. There have been 2 major events in 2020, which has exposed the devastating impact of societal inequalities on both on lives and livelihoods (#COVID-19) and the persistence of disparities in society as a whole (#BlackLivesMatter). Five years on from the landmark  ruling in 2014, BAPIO working with its alliance partners is keen to pursue its mission to achieve equality through bridging the gap.

Through a series of roundtables and workshops, the alliance for equality in healthcare professions (AEHP) led by BAPIO will engage in exploring the achievements and challenges in implementing equality in medical education, training and career progression. The output will be a white paper (Bridge the Gap) to be presented during the BAPIO silver jubilee celebrations in 2021; which will include a comprehensive systematic review of the evidence to date for causes and solutions and a series of recommendations for further research, policy enablers and actions for individual organisations.

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