Tiffin Paul A, Orr James, Paton Lewis W, Smith Daniel T, Norcini John J
Health Sciences, University of York, York, UK.
Emergency Department, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
BMJ Open. 2018 Jul 10;8(7):e023060. doi: 10.1136/bmjopen-2018-023060.
To compare the likelihood of success at selection into specialty training for doctors who were UK nationals but obtained their primary medical qualification (PMQ) from outside the UK ('UK overseas graduates') with other graduate groups based on their nationality and where they gained their PMQ. We also compared subsequent educational performance during postgraduate training between the graduate groups.
Observational study linking UK medical specialty recruitment data with postgraduate educational performance (Annual Review of Competence Progression (ARCP) ratings).
Doctors recruited into national programmes of postgraduate specialist training in the UK from 2012 to 2016.
34 755 UK-based trainee doctors recruited into national specialty training programmes with at least one subsequent ARCP outcome reported during the study period, including 1108 UK overseas graduates.
Odds of being deemed appointable at specialty selection and subsequent odds of obtaining a less versus more satisfactory category of ARCP outcome.
UK overseas graduates were more likely to be deemed appointable compared with non-EU medical graduates who were not UK citizens (OR 1.29, 95% CI 1.16 to 1.42), although less so than UK (OR 0.25, 95% CI 0.23 to 0.27) or European graduates (OR 0.66, 95% CI 0.58 to 0.75). However, UK overseas graduates were subsequently more likely to receive a less satisfactory outcome at ARCP than other graduate groups. Adjusting for age, sex, experience and the economic disparity between country of nationality and place of qualification reduced intergroup differences.
The failure of recruitment patterns to mirror the ARCP data raises issues regarding consistency in selection and the deaneries' subsequent annual reviews. Excessive weight is possibly given to interview performance at specialty recruitment. Regulators and selectors should continue to develop robust processes for selection and assessment of doctors in training. Further support could be considered for UK overseas graduates returning to practice in the UK.
比较英国国民但在英国境外获得其初级医学资格（PMQ）的医生（“英国海外毕业生”）与其他基于国籍和获得PMQ地点的毕业生群体入选专科培训成功的可能性。我们还比较了各毕业生群体在研究生培训期间随后的教育表现。
将英国医学专科招聘数据与研究生教育表现（能力进展年度评估（ARCP）评级）相联系的观察性研究。
2012年至2016年被招募进入英国国家研究生专科培训项目的医生。
34755名在英国的实习医生被招募进入国家专科培训项目，在研究期间至少有一次后续的ARCP结果报告，其中包括1108名英国海外毕业生。
在专科选拔中被视为可任命的几率以及随后获得较不满意与较满意ARCP结果类别的几率。
与非英国公民的非欧盟医学毕业生相比，英国海外毕业生更有可能被视为可任命（比值比1.29，95%置信区间1.16至1.42），尽管比英国毕业生（比值比0.25，95%置信区间0.23至0.27）或欧洲毕业生（比值比0.66，95%置信区间0.58至0.75）可能性小。然而，英国海外毕业生随后在ARCP中获得较不满意结果的可能性比其他毕业生群体更大。对年龄、性别、经验以及国籍国与资格获得地之间的经济差异进行调整后，组间差异减小。
招聘模式未能反映ARCP数据，这引发了关于选拔一致性以及各地区随后年度评审的问题。在专科招聘中可能过度重视面试表现。监管机构和选拔人员应继续制定完善的培训医生选拔和评估流程。对于返回英国执业的英国海外毕业生可考虑给予进一步支持。
