Executive summary and recommendations

GP equalities impact report

The GP Equalities Impact Report outlines further research aimed at understanding the nature of group differences in selection centre performance, specifically in relation to candidates’ place of medical qualification, and exploring potential interventions aimed at reducing such differences.

A multi-stage project was conducted, comprising a desk review and data collection and focusing on equality and diversity (E&D) issues in relation to selection.

Equalities impact reports 2007-11

Consistent findings across annual equalities impact reports 2007-2011 indicate that female candidates, younger candidates and UK-trained candidates significantly outperform others in terms of Selection Centre (SC) total scores and scores for individual exercises and competencies.

Generally White candidates significantly outperform other ethnic groups; variations existed for particular exercises/competencies across reports 2007-2011.

Equalities impact reports 2009-11

Since 2009, data on Foundation Programme (FP) attendance was monitored. Results from 2009 consistently demonstrate that candidates who attended an FP performed significantly better than those who had not and a greater proportion were successful.

Place of Medical qualification

Consistently, UK-trained candidates perform significantly better than non-UK-trained candidates on SC total scores, all exercises and competencies.

The proportion of UK- trained candidates successful at SC is significantly higher than the proportion of successful non-UK-trained candidates; since 2007 there has been no variation to these patterns.

• Additional regression analysis in 2011 indicated that place of medical qualification independently explained the greatest amount of variance in SC total scores.

Literature review

The literature highlighted similar patterns in group differences as those identified during GP selection; group differences in relation to ethnicity, age, gender and place of qualification/training are often observed during selection in a number of contexts.

The literature offered possible explanations in terms of unconscious bias, stereotyping and cultural differences although there was limited evidence of effective interventions aimed at reducing group differences.

Existing guidance and interventions

Information and support available to doctors who qualified overseas focuses on practical issues such as immigration and examinations; research suggests guidance does not necessarily provide adequate information about ethical/professional standards.

Stakeholder consultation

Six key themes were identified including ‘Best Practice in Assessment and Selection’ and ‘Cultural Differences’ following consultation with stakeholders from public sector, private sector and academic organisations.

• Stakeholders were familiar with group differences identified within GP selection and were in agreement that a standardised assessment/selection process, in accordance with best practice, plays the most significant role in reducing and avoiding adverse impact in selection.

Recommendations

Selection and assessment practice

Recommendations for selection best practice are presented, including benchmarking GP selection with other medical specialities and the use of external E&D advisors or specialists to review the cultural impact of processes.

Selection process

Recommendations relevant to the selection process itself are also presented.

These include selector-candidate matching, equal representation of ethnic groups during pilot phases and within the selector group, reduction in time pressure, comprehensive selection information and greater regulation of E&D awareness on the selector training agenda.

Equal and diversity

Recommendations in relation to wider consideration of equality and diversity issues, e.g. equal opportunities monitoring and organisational familiarisation, are presented for consideration.

Additional research

The Equalities Impact Report did not conclusively identify an explanation for group differences in selection (in terms of place of qualification or wider ethnicity) or identify evidence-based intervention strategies effectively reducing such differences.

A number of additional areas for further research have therefore been identified.