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Fair access to higher surgical training in the UK: an equity, diversity and inclusion analysis of national selection in 2024.

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Titel: Fair access to higher surgical training in the UK: an equity, diversity and inclusion analysis of national selection in 2024.
Autoren: Seehra JK; University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, England, UK drjazseehra@gmail.com., Ellis R; University of Aberdeen, Aberdeen, Scotland, UK., Doleman B; University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, England, UK., McLarty E; Department of Urology, University Hospitals Plymouth NHS Trust, Plymouth, England, UK., Lund J; University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, England, UK.
Quelle: BMJ open [BMJ Open] 2025 Nov 13; Vol. 15 (11), pp. e106487. Date of Electronic Publication: 2025 Nov 13.
Publikationsart: Journal Article
Sprache: English
Info zur Zeitschrift: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH-Schlagworte: Specialties, Surgical*/education , Personnel Selection* , Education, Medical, Graduate* , School Admission Criteria*, Humans ; Female ; Male ; United Kingdom ; Cross-Sectional Studies ; Retrospective Studies ; Adult ; Sex Factors ; Age Factors ; Career Choice
Abstract: Competing Interests: Competing interests: None declared.
Objectives: To assess the impact of gender, age, ethnicity and country of primary medical qualification (CoQ) on outcomes in the 2024 UK ST3 surgical national selection process.
Design: Retrospective cross-sectional analysis of national recruitment data.
Setting: UK-wide ST3 surgical training recruitment.
Participants: 2009 unique ST3 applicants to six surgical specialties (otolaryngology, plastic surgery, urology, paediatric surgery, trauma and orthopaedics and general surgery); neurosurgery, cardiothoracic surgery and oral and maxillofacial surgery were excluded.
Primary Outcome Measure: Offer of a ST3 National Training Number (NTN).
Results: CoQ was the strongest factor associated with success. International medical graduates had lower odds of receiving offers in all specialties, notably in general surgery (adjusted OR (aOR)=0.21, 95% CI 0.14 to 0.33, p<0.001), and trauma and orthopaedics (T&O) (aOR=0.14, 95% CI 0.08 to 0.23, p<0.001). Older age reduced odds in T&O (aOR=0.44, 95% CI 0.26 to 0.72, p=0.001). Female applicants in T&O also had lower odds of success (aOR=0.44, 95% CI 0.25 to 0.79, p=0.006). Ethnicity was not independently associated with outcomes after adjustment.
Conclusions: ST3 selection outcomes are primarily associated with CoQ. UK-trained applicants have a consistent advantage. Women remain less likely to be offered an NTN than men in Trauma and Orthopaedics. This analysis enables detailed and timely equity monitoring across surgical specialties and flags areas for intervention.
(© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)
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Contributed Indexing: Keywords: Education, Medical; MEDICAL EDUCATION & TRAINING; SURGERY
Entry Date(s): Date Created: 20251114 Date Completed: 20251114 Latest Revision: 20251120
Update Code: 20251121
PubMed Central ID: PMC12625904
DOI: 10.1136/bmjopen-2025-106487
PMID: 41238369
Datenbank: MEDLINE
Beschreibung
Abstract:Competing Interests: Competing interests: None declared.<br />Objectives: To assess the impact of gender, age, ethnicity and country of primary medical qualification (CoQ) on outcomes in the 2024 UK ST3 surgical national selection process.<br />Design: Retrospective cross-sectional analysis of national recruitment data.<br />Setting: UK-wide ST3 surgical training recruitment.<br />Participants: 2009 unique ST3 applicants to six surgical specialties (otolaryngology, plastic surgery, urology, paediatric surgery, trauma and orthopaedics and general surgery); neurosurgery, cardiothoracic surgery and oral and maxillofacial surgery were excluded.<br />Primary Outcome Measure: Offer of a ST3 National Training Number (NTN).<br />Results: CoQ was the strongest factor associated with success. International medical graduates had lower odds of receiving offers in all specialties, notably in general surgery (adjusted OR (aOR)=0.21, 95% CI 0.14 to 0.33, p&lt;0.001), and trauma and orthopaedics (T&O) (aOR=0.14, 95% CI 0.08 to 0.23, p&lt;0.001). Older age reduced odds in T&O (aOR=0.44, 95% CI 0.26 to 0.72, p=0.001). Female applicants in T&O also had lower odds of success (aOR=0.44, 95% CI 0.25 to 0.79, p=0.006). Ethnicity was not independently associated with outcomes after adjustment.<br />Conclusions: ST3 selection outcomes are primarily associated with CoQ. UK-trained applicants have a consistent advantage. Women remain less likely to be offered an NTN than men in Trauma and Orthopaedics. This analysis enables detailed and timely equity monitoring across surgical specialties and flags areas for intervention.<br /> (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)
ISSN:2044-6055
DOI:10.1136/bmjopen-2025-106487