The impact of disability on recruitment to higher surgical specialty training: A retrospective cohort study

Ricky Ellis; Yasin Al-Tawarah; Peter A. Brennan; Amanda J. Lee; John Hines; Duncan SG. Scrimgeour; Jennifer Cleland

doi:10.1016/j.surge.2024.07.006

The impact of disability on recruitment to higher surgical specialty training: A retrospective cohort study

Ricky Ellis^* (Corresponding Author), Yasin Al-Tawarah, Peter A. Brennan, Amanda J. Lee, John Hines, Duncan SG. Scrimgeour, Jennifer Cleland

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background UK examining bodies are required to eliminate discrimination against people with protected characteristics. To achieve this in surgery, differential attainment (DA) in assessments used as gatekeepers to career progression must be ruled out. This study investigated the impact of disability status on the likelihood of success at national selection for Higher Surgical Training (HST). Methods A retrospective cohort study of all UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST (ST3) from 2012 to 2019 (n = 2875). Univariate analysis identified differences in success rates at first-application. Logistic regression models identified whether disability was a predictor of success after adjusting for sociodemographic factors and prior MRCS performance. Results There was no significant difference in success rates between candidates with and without disabilities (all p > 0.05) for any surgical specialty. Disability status was not a statistically significant predictor of success. Female candidates were 25 % more likely to be successful (OR 1.25 [95%CI 1.05 to 1.49]) and Non-White candidates were 20 % less likely to be successful (OR 0.80 [95%CI 0.68 to 0.96]). Candidates who passed MRCS Part A and Part B at the first attempt were 49 % (OR 1.49 [95%CI 1.25 to 1.77]) and 90 % (OR 1.90 [95%CI 1.58 to 2.28]) more likely to be successful. Conclusion No significant difference was found in the likelihood of being successful at HST selection for any surgical specialty between applicants with and without disabilities, regardless of type of disability. DA was identified between other sociodemographic groups which requires further exploration.

Original language	English
Number of pages	8
Journal	The Surgeon
Early online date	31 Jul 2024
DOIs	https://doi.org/10.1016/j.surge.2024.07.006
Publication status	E-pub ahead of print - 31 Jul 2024

Bibliographical note

The authors would like to acknowledge Daniel Smith for his help with the UKMED database. Our thanks to members of the UKMED Research Group who provided useful feedback on an earlier version of this manuscript, and whose comments helped refine the paper. Data Source: Source - UK Medical Education Database (“UKMED”) UKMEDP111 extract generated on September 15, 2021. Approved for publication on December 01, 2023. I am grateful to UKMED for the use of these data. However, UKMED bears no responsibility for their analysis or interpretation. The data includes information derived from that collected by the Higher Education Statistics Agency Limited (“HESA”) and provided to the GMC (“HESA Data”). Source: HESA Student Record 2002/2003 and 2013/2014 Copyright Higher Education Statistics Agency Limited. The Higher Education Statistics Agency Limited makes no warranty as to the accuracy of the HESA Data, cannot accept responsibility for any inferences or conclusions derived by third parties from data or other information supplied by it.

Keywords

Clinical
Medical education
Non-clinical
Postgraduate
Surgery

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https://www.sciencedirect.com/science/article/pii/S1479666X24000726Licence: CC BY

Cite this

@article{9b0a9de5b7d843568f1bca745ccfb8b5,

title = "The impact of disability on recruitment to higher surgical specialty training: A retrospective cohort study",

abstract = "Background UK examining bodies are required to eliminate discrimination against people with protected characteristics. To achieve this in surgery, differential attainment (DA) in assessments used as gatekeepers to career progression must be ruled out. This study investigated the impact of disability status on the likelihood of success at national selection for Higher Surgical Training (HST). Methods A retrospective cohort study of all UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST (ST3) from 2012 to 2019 (n = 2875). Univariate analysis identified differences in success rates at first-application. Logistic regression models identified whether disability was a predictor of success after adjusting for sociodemographic factors and prior MRCS performance. Results There was no significant difference in success rates between candidates with and without disabilities (all p > 0.05) for any surgical specialty. Disability status was not a statistically significant predictor of success. Female candidates were 25 % more likely to be successful (OR 1.25 [95%CI 1.05 to 1.49]) and Non-White candidates were 20 % less likely to be successful (OR 0.80 [95%CI 0.68 to 0.96]). Candidates who passed MRCS Part A and Part B at the first attempt were 49 % (OR 1.49 [95%CI 1.25 to 1.77]) and 90 % (OR 1.90 [95%CI 1.58 to 2.28]) more likely to be successful. Conclusion No significant difference was found in the likelihood of being successful at HST selection for any surgical specialty between applicants with and without disabilities, regardless of type of disability. DA was identified between other sociodemographic groups which requires further exploration.",

keywords = "Clinical, Medical education, Non-clinical, Postgraduate, Surgery",

author = "Ricky Ellis and Yasin Al-Tawarah and Brennan, {Peter A.} and Lee, {Amanda J.} and John Hines and Scrimgeour, {Duncan SG.} and Jennifer Cleland",

note = "The authors would like to acknowledge Daniel Smith for his help with the UKMED database. Our thanks to members of the UKMED Research Group who provided useful feedback on an earlier version of this manuscript, and whose comments helped refine the paper. Data Source: Source - UK Medical Education Database (“UKMED”) UKMEDP111 extract generated on September 15, 2021. Approved for publication on December 01, 2023. I am grateful to UKMED for the use of these data. However, UKMED bears no responsibility for their analysis or interpretation. The data includes information derived from that collected by the Higher Education Statistics Agency Limited (“HESA”) and provided to the GMC (“HESA Data”). Source: HESA Student Record 2002/2003 and 2013/2014 Copyright Higher Education Statistics Agency Limited. The Higher Education Statistics Agency Limited makes no warranty as to the accuracy of the HESA Data, cannot accept responsibility for any inferences or conclusions derived by third parties from data or other information supplied by it.",

year = "2024",

month = jul,

day = "31",

doi = "10.1016/j.surge.2024.07.006",

language = "English",

journal = "The Surgeon",

issn = "1479-666X",

publisher = "Elsevier Limited",

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T1 - The impact of disability on recruitment to higher surgical specialty training: A retrospective cohort study

AU - Ellis, Ricky

AU - Al-Tawarah, Yasin

AU - Brennan, Peter A.

AU - Lee, Amanda J.

AU - Hines, John

AU - Scrimgeour, Duncan SG.

AU - Cleland, Jennifer

N1 - The authors would like to acknowledge Daniel Smith for his help with the UKMED database. Our thanks to members of the UKMED Research Group who provided useful feedback on an earlier version of this manuscript, and whose comments helped refine the paper. Data Source: Source - UK Medical Education Database (“UKMED”) UKMEDP111 extract generated on September 15, 2021. Approved for publication on December 01, 2023. I am grateful to UKMED for the use of these data. However, UKMED bears no responsibility for their analysis or interpretation. The data includes information derived from that collected by the Higher Education Statistics Agency Limited (“HESA”) and provided to the GMC (“HESA Data”). Source: HESA Student Record 2002/2003 and 2013/2014 Copyright Higher Education Statistics Agency Limited. The Higher Education Statistics Agency Limited makes no warranty as to the accuracy of the HESA Data, cannot accept responsibility for any inferences or conclusions derived by third parties from data or other information supplied by it.

PY - 2024/7/31

Y1 - 2024/7/31

N2 - Background UK examining bodies are required to eliminate discrimination against people with protected characteristics. To achieve this in surgery, differential attainment (DA) in assessments used as gatekeepers to career progression must be ruled out. This study investigated the impact of disability status on the likelihood of success at national selection for Higher Surgical Training (HST). Methods A retrospective cohort study of all UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST (ST3) from 2012 to 2019 (n = 2875). Univariate analysis identified differences in success rates at first-application. Logistic regression models identified whether disability was a predictor of success after adjusting for sociodemographic factors and prior MRCS performance. Results There was no significant difference in success rates between candidates with and without disabilities (all p > 0.05) for any surgical specialty. Disability status was not a statistically significant predictor of success. Female candidates were 25 % more likely to be successful (OR 1.25 [95%CI 1.05 to 1.49]) and Non-White candidates were 20 % less likely to be successful (OR 0.80 [95%CI 0.68 to 0.96]). Candidates who passed MRCS Part A and Part B at the first attempt were 49 % (OR 1.49 [95%CI 1.25 to 1.77]) and 90 % (OR 1.90 [95%CI 1.58 to 2.28]) more likely to be successful. Conclusion No significant difference was found in the likelihood of being successful at HST selection for any surgical specialty between applicants with and without disabilities, regardless of type of disability. DA was identified between other sociodemographic groups which requires further exploration.

AB - Background UK examining bodies are required to eliminate discrimination against people with protected characteristics. To achieve this in surgery, differential attainment (DA) in assessments used as gatekeepers to career progression must be ruled out. This study investigated the impact of disability status on the likelihood of success at national selection for Higher Surgical Training (HST). Methods A retrospective cohort study of all UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST (ST3) from 2012 to 2019 (n = 2875). Univariate analysis identified differences in success rates at first-application. Logistic regression models identified whether disability was a predictor of success after adjusting for sociodemographic factors and prior MRCS performance. Results There was no significant difference in success rates between candidates with and without disabilities (all p > 0.05) for any surgical specialty. Disability status was not a statistically significant predictor of success. Female candidates were 25 % more likely to be successful (OR 1.25 [95%CI 1.05 to 1.49]) and Non-White candidates were 20 % less likely to be successful (OR 0.80 [95%CI 0.68 to 0.96]). Candidates who passed MRCS Part A and Part B at the first attempt were 49 % (OR 1.49 [95%CI 1.25 to 1.77]) and 90 % (OR 1.90 [95%CI 1.58 to 2.28]) more likely to be successful. Conclusion No significant difference was found in the likelihood of being successful at HST selection for any surgical specialty between applicants with and without disabilities, regardless of type of disability. DA was identified between other sociodemographic groups which requires further exploration.

KW - Clinical

KW - Medical education

KW - Non-clinical

KW - Postgraduate

KW - Surgery

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DO - 10.1016/j.surge.2024.07.006

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SN - 1479-666X

JO - The Surgeon

JF - The Surgeon

ER -

The impact of disability on recruitment to higher surgical specialty training: A retrospective cohort study

Abstract

Bibliographical note

Keywords

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