Strengths and limitations of this study ► Our review consolidates the full continuum of factors affecting equitable participation in clinical academia at all stages of the pipeline and across a range of protected characteristics. ► Our findings will have limited relevance to nursing, midwifery, allied health professions or other geographies where there may be divergent issues in relation to gender, sexuality and ethnicity or the nature of clinical academia. ► The majority of papers identified in the scoping review focused on gender, therefore the factors identified within each theme may not fully represent issues related to ethnicity and sexual orientation. No studies related to disability were identified. ► Policy is in constant transition and it will need to be studied and addressed locally. This paper focused on current UK policy as an illustrative case. AbStrACtObjectives To examine and synthesise current evidence on the factors that affect recruitment, retention, participation and progression within the clinical academic pathway, focusing on equitable participation across protected characteristics including gender, ethnicity and sexual orientation. Design Scoping review and meta-thematic synthesis. Data sources Web of Science, Google Scholar. Article selection We conducted a scoping review of English language articles on factors affecting recruitment, retention, progression and equitable participation in clinical academic careers published in North America, Australasia and Western Europe between January 2005 and April 2019. The most recent and relevant 39 articles were selected for meta-thematic synthesis using detailed inclusion/exclusion criteria. Data extraction The articles were purposively sampled to cover protected characteristics and career stages and coded for factors related to equitable participation. 17 articles were fully coded. No new themes arose after nine papers. Themes and higher level categories were derived through an iterative consensual process. results 13 discrete themes of factors impacting on equitable participation were identified including societal attitudes and expectations; national and organisational policies, priorities and resourcing; academic and clinical workplace cultures; supportive, discriminatory and compensatory interpersonal behaviours and personal factors related to social capital, finances, competing priorities, confidence and ambition, and orientation to clinical, academic and leadership roles.Conclusions The broad and often interconnected nature of these factors suggests that interventions will need to address structural and cultural factors as well as individual needs. In addition to standard good practice on equality and diversity, we suggest that organisations provide equitable support towards early publication success and targeted mentoring; address financial and role insecurity; address the clinical workplace culture; mitigate clinical-academic-personal role conflicts and overload; ensure that promotional structures and processes encourage diverse applicants an...

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using paired two-tailed T tests and MANOVA. Reaction time and systolic blood pressure post-exercise were significantly increased following sleep deprivation (mean ± SD change: reaction time: 0.15 ± 0.04 s, p = 0.003; systolic BP: 6 ± 17 mmHg, p = 0.012). No significant differences were found in other variables. Reaction time and vascular response to exercise were significantly affected by sleep deprivation in university students, whilst other cognitive and cardiopulmonary measures showed no significant changes. These findings indicate that acute sleep deprivation can have an impact on physical but not cognitive ability in young healthy university students. Further research is needed to identify mechanisms of change and the impact of longer term sleep deprivation in this population.

Background As a result of the COVID-19 pandemic Imperial College School of Medicine developed a structured volunteering programme involving 398 medical students, across eight teaching hospitals. This case study aims to explore the relationship between the processes, context, participant experiences and impacts of the programme so that lessons can be learned for future emergencies and service-learning programmes. Methods Using an illuminative approach to evaluation we invited all volunteers and supervisors to complete a mixed-methods survey. This explored differences in experience across demographics and contextual factors, correlations between aspects of induction, supervision and overall experience, and reviewed the impacts of the programme. Quantitative responses were statistically analysed and qualitative reflections were thematically coded to triangulate and explain quantitative findings. Follow up interviews were carried out to check back findings and co-create conclusions. Results We received responses from 61 students and 17 supervisors. Student participants described predominantly altruistic motivations and transformational changes to their professional identity driven by feeling included, having responsibility, and engaging in authentic workplace-based learning afforded by freedom from the assessed curriculum. They reported new perspectives on their future professional role within the multidisciplinary team and the value of workplace-based learning. They reported increases in wellbeing and self-esteem related to feeling included and valued, and positively contributing to service provision at a time of need. Significantly higher overall satisfaction was associated with a personalised induction, active supervision, earlier stage of training, and male gender. Gender-related differences were not explained through our data but have been reported elsewhere and warrant further study. The duration, intensity and type of role that volunteers performed was similar across demographics and did not appear to modulate their overall experience. Conclusions Whilst acknowledging the uniqueness of emergency volunteering and the survey response rate of 15% of volunteers, we suggest the features of a successful service-learning programme include: a learner-centred induction, regular contact with engaged and appreciative supervisors, and roles where students feel valued. Programmes in similar settings may find that service learning is most impactful earlier in medical students’ training and that students with altruistic motivations and meaningful work may flourish without formal outcomes and assessments.

Objective The existing provision of ENT teaching in the undergraduate curriculum is deemed inadequate by medical students, general practitioners and ENT surgeons alike. This study aims to explore the perceptions of a variety of stakeholders on how undergraduate ENT provision can be optimised. Methods This study involved semi-structured interviews with seven participants (two medical students, two general practitioners, two ENT surgeons and a curriculum developer). Inductive thematic analysis was used to identify key themes that emerged from the interviews. Results The four emergent themes were evaluation of current ENT provision, barriers to learning and teaching, alternate means of delivery of ENT education, and professional identity development. A number of barriers to learning and teaching in the clinical environment were identified including student-related, teacher-related and environmental factors. Conclusion The existing ENT provision should be re-considered to help students achieve a basic level of competence in managing common ENT conditions. This can be achieved by ENT teaching in additional contexts including general practice, e-learning and simulation workshops.