Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study
Objective: A recent independent review on diversity and inclusivity highlighted concerns that barriers to surgical career progression exist for some groups of individuals and not others. Group-level differences in performance at the Intercollegiate Membership of the Royal Colleges of Surgeons (MRCS)...
| Main Authors: | , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
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2022
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| Online Access: | https://hdl.handle.net/10356/162617 |
| _version_ | 1826120535893868544 |
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| author | Ellis, Ricky Brennan, Peter A. Lee, Amanda J. Scrimgeour, Duncan S. G. Cleland, Jennifer |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Ellis, Ricky Brennan, Peter A. Lee, Amanda J. Scrimgeour, Duncan S. G. Cleland, Jennifer |
| author_sort | Ellis, Ricky |
| collection | NTU |
| description | Objective: A recent independent review on diversity and inclusivity highlighted concerns that barriers to surgical career progression exist for some groups of individuals and not others. Group-level differences in performance at the Intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examinations have been identified but are yet to be investigated. We aimed to characterise the relationship between sociodemographic differences and performance at MRCS. Design: Retrospective cohort study. Setting: Secondary care. Participants: All UK MRCS candidates attempting Part A (n = 5780) and Part B (n = 2600) between 2013 and 2019 with linked sociodemographic data in the UK Medical Education Database (https://www.ukmed.ac.uk). Main outcome measures: Chi-square tests established univariate associations with MRCS performance. Multiple logistic regression identified independent predictors of success, adjusted for medical school performance. Results: Statistically significant differences in MRCS pass rates were found according to gender, ethnicity, age, graduate status, educational background and socioeconomic status (all p < 0.05). After adjusting for prior academic attainment, being male (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.87–2.92) or a non-graduate (OR 1.98, 95% CI 1.44–2.74) were independent predictors of MRCS Part A success and being a non-graduate (OR 1.77, 95% CI 1.15–2.71) and having attended a fee-paying school (OR 1.51, 95% CI 1.08–2.10) were independent predictors of Part B success. Black and minority ethnic groups were significantly less likely to pass MRCS Part B at their first attempt (OR 0.41, 95% CI 0.18–0.92 for Black candidates and OR 0.49, 95% CI 0.35–0.69 for Asian candidates) compared to White candidates. Conclusions: There is significant group-level differential attainment at MRCS, likely to represent the accumulation of privilege and disadvantage experienced by individuals throughout their education and training. Those leading surgical education now have a responsibility to identify and address the causes of these attainment differences. |
| first_indexed | 2024-10-01T05:18:22Z |
| format | Journal Article |
| id | ntu-10356/162617 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T05:18:22Z |
| publishDate | 2022 |
| record_format | dspace |
| spelling | ntu-10356/1626172023-03-05T16:51:09Z Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study Ellis, Ricky Brennan, Peter A. Lee, Amanda J. Scrimgeour, Duncan S. G. Cleland, Jennifer Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Medical Education Non-Clinical Objective: A recent independent review on diversity and inclusivity highlighted concerns that barriers to surgical career progression exist for some groups of individuals and not others. Group-level differences in performance at the Intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examinations have been identified but are yet to be investigated. We aimed to characterise the relationship between sociodemographic differences and performance at MRCS. Design: Retrospective cohort study. Setting: Secondary care. Participants: All UK MRCS candidates attempting Part A (n = 5780) and Part B (n = 2600) between 2013 and 2019 with linked sociodemographic data in the UK Medical Education Database (https://www.ukmed.ac.uk). Main outcome measures: Chi-square tests established univariate associations with MRCS performance. Multiple logistic regression identified independent predictors of success, adjusted for medical school performance. Results: Statistically significant differences in MRCS pass rates were found according to gender, ethnicity, age, graduate status, educational background and socioeconomic status (all p < 0.05). After adjusting for prior academic attainment, being male (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.87–2.92) or a non-graduate (OR 1.98, 95% CI 1.44–2.74) were independent predictors of MRCS Part A success and being a non-graduate (OR 1.77, 95% CI 1.15–2.71) and having attended a fee-paying school (OR 1.51, 95% CI 1.08–2.10) were independent predictors of Part B success. Black and minority ethnic groups were significantly less likely to pass MRCS Part B at their first attempt (OR 0.41, 95% CI 0.18–0.92 for Black candidates and OR 0.49, 95% CI 0.35–0.69 for Asian candidates) compared to White candidates. Conclusions: There is significant group-level differential attainment at MRCS, likely to represent the accumulation of privilege and disadvantage experienced by individuals throughout their education and training. Those leading surgical education now have a responsibility to identify and address the causes of these attainment differences. Published version The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Royal College of Surgeons of Ireland, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of England and Royal College of Surgeons of Edinburgh (Award/ Grant number is not applicable). 2022-11-01T04:28:47Z 2022-11-01T04:28:47Z 2022 Journal Article Ellis, R., Brennan, P. A., Lee, A. J., Scrimgeour, D. S. G. & Cleland, J. (2022). Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study. Journal of the Royal Society of Medicine, 115(7), 257-272. https://dx.doi.org/10.1177/01410768221079018 0141-0768 https://hdl.handle.net/10356/162617 10.1177/01410768221079018 35171739 2-s2.0-85125059455 7 115 257 272 en Journal of the Royal Society of Medicine © 2022 The Royal Society of Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution License application/pdf |
| spellingShingle | Science::Medicine Medical Education Non-Clinical Ellis, Ricky Brennan, Peter A. Lee, Amanda J. Scrimgeour, Duncan S. G. Cleland, Jennifer Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study |
| title | Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study |
| title_full | Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study |
| title_fullStr | Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study |
| title_full_unstemmed | Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study |
| title_short | Differential attainment at MRCS according to gender, ethnicity, age and socioeconomic factors: a retrospective cohort study |
| title_sort | differential attainment at mrcs according to gender ethnicity age and socioeconomic factors a retrospective cohort study |
| topic | Science::Medicine Medical Education Non-Clinical |
| url | https://hdl.handle.net/10356/162617 |
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