Research Department of Medical Education, University College London Medical School, Royal Free Hospital, London.
Institute of Health Informatics, University College London, London.
Br J Gen Pract. 2019 Apr;69(681):e287-e293. doi: 10.3399/bjgp19X701789. Epub 2019 Feb 25.
Tests of competence are written and clinical assessments taken by doctors under investigation by the General Medical Council (GMC) who have significant performance concerns. Male doctors on average perform more poorly in clinical assessments than female doctors, and are more likely to be sanctioned. It is unclear why.
To examine sex differences in the tests of competence assessment scores of GPs under investigation by the GMC, compared with GPs not under investigation, and whether scores mediate any relationship between sex and sanction likelihood.
Retrospective cohort study of GPs' administrative tests of competence data.
Analysis of variance was undertaken to compare written and clinical tests of competence performance by sex and GP group (under investigation versus volunteers). Path analysis was conducted to explore the relationship between sex, written and clinical tests of competence performance, and investigation outcome.
On the written test, female GPs under investigation outperformed male GPs under investigation (Cohen's = 0.28, = 0.01); there was no sex difference in the volunteer group (Cohen's = 0.02, = 0.93). On the clinical assessment, female GPs outperformed male GPs in both groups (Cohen's = 0.61, <0.0001). A higher clinical score predicted remaining on the UK medical register without a warning or sanction, with no independent effect of sex controlling for assessment performance.
Female GPs outperform male GPs on clinical assessments, even among GPs with generally very poor performance. Male GPs under investigation may have particularly poor knowledge. Further research is required to understand potential sex differences in doctors who take tests of competence and how these impact on sex differences in investigation outcomes.
在受到英国医学总会（GMC）调查的医生中，有相当多的人表现不佳，他们需要参加能力测试，包括笔试和临床评估。男性医生在临床评估中的表现平均不如女性医生，而且更有可能受到制裁。目前尚不清楚原因。
比较 GMC 调查的和未被调查的全科医生在能力测试中的成绩，以探讨性别差异，并检验成绩是否在性别与制裁可能性之间起中介作用。
这是一项对 GMC 调查的全科医生的行政能力测试成绩的回顾性队列研究。
采用方差分析比较性别和医生群体（调查组与志愿者组）的笔试和临床能力测试表现。进行路径分析以探索性别、笔试和临床能力测试表现与调查结果之间的关系。
在笔试中，受调查的女性全科医生的表现优于受调查的男性全科医生（Cohen's = 0.28， = 0.01）；而在志愿者组中，性别间没有差异（Cohen's = 0.02， = 0.93）。在临床评估中，两组中的女性全科医生的表现均优于男性全科医生（Cohen's = 0.61，<0.0001）。更高的临床评分预示着在英国医疗注册系统中没有警告或制裁的情况下继续执业，性别对评估表现没有独立影响。
即使在表现普遍较差的全科医生中，女性全科医生在临床评估中也优于男性全科医生。受调查的男性全科医生可能知识特别薄弱。需要进一步研究，以了解参加能力测试的医生中潜在的性别差异，以及这些差异如何影响调查结果的性别差异。
