UK-trained doctors from ethnic minority groups underperform academically

A third of all UK medical students and junior doctors come from ethnic groups. In 2009, 36% of newly qualified doctors and 52% of all other NHS doctors were from these groups. A new study conducted by UCL researchers found that UK-trained medical students and doctors from ethnic minority groups underpeformed academically compared with their white counterparts. They systematically analysed 22 reports involving about 24,000 UK- trained medical students and doctors from different ethnic groups and found that the odds of failure in non-white candidates was 2.5 times higher than the white candidates. They said that ethnic differences in academic performance are widespread across different medical schools, different types of exams and in both undergraduate and postgraduate assessments. It was persistent for 30 years and "cannot be dismissed as atypical or local problems". They called for further research into the causes to ensure that all future doctors are assessed fairly. In an accompanying editorial, the author said that soultions will be found through critically appraising assessment methods, curricula and interactions with students.

What do you think may have caused the ethnic differences in attainment and how can they be resolved?

Source: Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis. BMJ 2011; 342:d901 ( free access) Editorial - Ethnicity and academic performance in the UK. BMJ 2011; 342:d709 ( free access)

Junior doctors to be tested for prescribing skills

A study commissioned by the GMC into the causes and prevalence of prescribing errors by Foundation Year doctors found that 8.9% of the prescriptions issued by doctors had errors, some of which could harm patients.

124,260 prescriptions were checked by pharmacists in 19 hospital trusts in north-west England and 11,077 errors were found. The errors included omitting drugs, wrong doses, patients’ allergies not taking into account, illegible handwriting or ambiguous orders.

When the hospital doctors were interviewed about their mistakes, some admitted they relied heavily on pharmacists and nurses as “safety net” to help catch the errors. It was found that junior doctors were ill prepared in medical school where they filled out only a few prescription forms a year, but have to complete dozens of prescriptions a day when they start as junior doctors.

The chairman of British Pharmacological Society (BPS) Prescribing Committee, Professor Simon Maxwell, said that the evidence indicated that there are serious medication errors and “such an error rate would not be acceptable”. He believed that focus on training in prescribing can improve the standards and is calling on the doctors to take the National Prescribing Assessment before they are qualified.

Sources :

GMC Press Release on 03 Dec 2009


BPS press briefing on 14 December 2009
A Blueprint for safer prescribing: BPS expresses concern about poor prescribing and calls for greater collaboration in solving the problem

Depressed junior doctors six times more likely to make mistakes

A Harvard team of researchers studied 123 paediatric residents at three children's hospitals in the USA to establish the prevalence of depression and burnout and whether medication errors are associated with these conditions.


They found that 20% of the participants were depressed and 74% were burned out, 45 medication errors were made. Depressed doctors in training made six times more medication errors than their non-deperessed peers, but burnout did not seem to link with a higher rate of medical errors.


In an accompanying editorial, the commentator cautioned against interpreting the findings and large studies are needed to study how individual factors correlate with medical errors.


Source: "Rates of medication errors among depressed and burnt out residents: prospective cohort study" BMJ 2008;0(2008):bmj.39469.763218.BEv1 (7 February)

New medical training body needed in England

After the chaos of MTAS last year, Professor John Tooke, Dean of the Peninsula School of Medicine, was asked by the DH to lead an independent inquiry into Modernising Medical Careers. His interim report was published last October and was backed by doctors.

The Tooke final report was out yesterday with recommendations that a new body - NHS Medical Education England to be set up to manage postgraduate medical training and the training budget should be ring-fenced to prevent the NHS from using it to plug deficits.
The report also warns that junior doctors training could suffer when the European Working Time Directive comes into force next year, so measures need to be taken to ensure doctors have enough training time.

Junior doctors across the UK are being warned that they will face tough competition this year for specialist training jobs in the NHS after the government failed in a legal bid to give UK medical graduates priority. The report says that the Government failed to resolve its two policies that have caused the severe competition for training posts in the UK - British medical schools increasing the intake of students and the "open door" policy toward overseas doctors who want specialist training in the UK. Read more at TimesOnline .

Living with MTAS

This week's BMJ Careers provides a collection of articles focusing on the issue of the current job situation as a result of MMC and MTAS.


The Editor's choice : "living with MTAS" suggests junior doctors should be flexible and consider options and alternative careers.

This week and the next two, the BMJ Careers will feature articles about careers outside the NHS with the hope that junior doctors will be inspired and informed to consider alternative careers. There are some interesting articles :

• Working for the pharmaceutical industry


• Voluntary work is a good idea


• Pastures green - working abroad


• Having the best of both worlds - locuming


• Banking on it - a medical student's experience of working in the City finance sector
• Career decision making in an age of uncertainty

Impact of MTAS on junior doctors' mental health

In a BMJ letter "Mental health of applicants seems to be deteriorating", BMJ 2007;334:1335 (30 June 2007), The Royal College of Psychiatrists reported the preliminary findings of an online survey about the imapct of MMC and MTAS on junior doctors' mental health.

The results showed that there were 790 anonymous responses that indicated increased level of stress and disturbances, most attributing it to MMC/MTAS. The authors said that this requires an urgent response.

A SHO said he doubted the validity of the survey and that doctors and other professionals need resilience and MTAS has reflected that.