Exploring reasons for differences in performance between UK and international medical graduates in the Membership of the Royal College of General Practitioners Applied Knowledge Test: a cognitive interview study

Pattinson, Julie; Blow, Carol; Sinha, Bijoy; Siriwardena, Aloysius Niroshan

doi:10.1136/bmjopen-2019-030341

Cited by 18 publications

(21 citation statements)

References 34 publications

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“…However, these students are eligible for the FP and specialty training pathways in the same way as ‘home’ students, and their continued contribution to the medical workforce and healthcare delivery is expected and indeed required. Unlike international medical graduates who come to the UK to work after graduating in another country,57–62 international students who graduate from UK medical students are a relatively understudied group. The relative patterns of this group compared with ‘home’ students merit further research.…”

Section: Discussionmentioning

confidence: 99%

Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study

et al. 2019

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IntroductionKnowledge about the career decisions of doctors in relation to specialty (residency) training is essential in terms of UK workforce planning. However, little is known about which doctors elect to progress directly from Foundation Year 2 (F2) into core/specialty/general practice training and those who instead opt for an alternative next career step.ObjectiveTo identify if there were any individual differences between these two groups of doctors.DesignThis was a longitudinal, cohort study of ‘home’ students who graduated from UK medical schools between 2010 and 2015 and completed the Foundation Programme (FP) between 2012 and 2017.We used the UK Medical Education Database (UKMED) to access linked data from different sources, including medical school performance, specialty training applications and career preferences. Multivariable regression analyses were used to predict the odds of taking time out of training based on various sociodemographic factors.Results18 380/38 905 (47.2%) of F2 doctors applied for, and accepted, a training post offer immediately after completing F2. The most common pattern for doctors taking time out of the training pathway after FP was to have a 1-year (7155: 38.8%) or a 2-year break (2605: 14.0%) from training. The odds of not proceeding directly into core or specialty training were higher for those who were male, white, entered medical school as (high) school leavers and whose parents were educated to degree level. Doctors from areas of low participation in higher education were significantly (0.001) more likely to proceed directly into core or specialty training.ConclusionThe results show that UK doctors from higher socioeconomic groups are less likely to choose to progress directly from the FP into specialty training. The data suggest that widening access and encouraging more socioeconomic diversity in our medical students may be helpful in terms of attracting F2s into core/specialty training posts.

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Section: Discussionmentioning

confidence: 99%

Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study

et al. 2019

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“…In many cases, this is the same licensing exam used for peers educated within the country. [1][2][3][4][5] However, the pass rate of MPs is usually lower. This delays their licensing, which has negative effects on both MPs and on the new country in need of physicians.…”

Section: Introductionmentioning

confidence: 99%

“…Studies from Australia, Canada, the UK, the USA and Sweden have shown a considerably lower success rate on exams for MPs than for nationally trained physicians. [1][2][3][4][5][6] These exams include those mandated before receiving a medical licence and those required for specialist/postgraduate training. 1-3 7 8 In Sweden, over 30% of MPs with a medical degree from outside the European Union/European Economic Area (EU/EEA) fail to pass the licensing examination on the first attempt, while the corresponding figure for nationally trained physicians is approximately 3%.…”

Section: Introductionmentioning

confidence: 99%

‘Did I pass the licensing exam?’ aspects influencing migrant physicians’ results: a mixed methods study

et al. 2020

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ObjectivesMigrant physicians (MPs) who wish to practise their profession in a new country often must undergo a recertification process, including a licensing exam. In many cases, this is the same licensing exam used for peers educated within the country; however, the pass rate of MPs is usually lower. This study aimed to explore MPs exam results, focusing on MPs that had participated in a complementary programme (CPP) for physicians with a medical degree from outside the European Union/European Economic Area (EU/EEA), and aspects that may influence these.MethodsMixed methods were applied. The data consisted of 2013 to 2019 licensing exam results of 564 physicians in Sweden that were educated outside of the EU. The data was analysed using linear and logistic regression analysis. Further, 14 interviews with MPs were conducted and thematically analysed.ResultsAn interaction between age and CPP participation was found for both the total score in per cent (p=0.01) and for the proportion failing their first attempt (p=0.04). Age was found to be a very strong predictor for failing on the first attempt, with those 45 and older failing on the first attempt in 72 and 82 per cent for CPP and non-CPP participants, respectively. Interview data was categorised into two themes: preparations and biographical aspects, and the exam and exam situation.ConclusionsAge seems to be an important predictor for failing the first attempt. MPs have had less time to familiarise themselves with the exam type and the language used on the exam. To improve exam results, MPs used different strategies and tools, that is, studying with nationally trained physicians, and using old exams and a web-based study tool consisting of common exam subjects. At the same time, these strategies and tools have also become mediators in the socialisation of MPs into the exam context.

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“…The concept for this course resulted from informal 'interview practice' sessions with many non-UK graduates and non-rst-time applicants. There is a perception amongst these groups that they are disadvantaged by individual factors (6). Non-UK graduates struggle to communicate their knowledge effectively in a time-limited, pressurised environment (7).…”

Section: Discussionmentioning

confidence: 99%

Impact of peer-delivered tuition/feedback on appointment to United Kingdom Higher Surgical Training

Choong

Joy

Madurska³

et al. 2020

Preprint

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Background In the United Kingdom, Core Surgical Trainees (or equivalent) undergo a rigorous National Selection (NS) process to secure a ST3 Training Post in General or Vascular Surgery. Despite a decrease in competition ratio from 3:1 in 2012 to 1.48:1 in 2017, many applicants were unable to secure ST3 Training Posts. We hypothesise that this is due to applicant performance anxiety rather than lack of clinical experience. Methods This is a prospective observational study following 27 delegates who have completed a 2-day course consisting of didactic lecture and interactive practice with a 1:1 faculty:delegate ratio. The course was delivered by surgical consultants and trainees. A specific mentor was nominated to oversee the delegate’s progress throughout and post course. Personalised feedback was given by the entire faculty throughout the course. Delegates were asked to complete evaluation forms to track their perceived confidence levels of success at NS at different timeframes, measured by a visual analogue scale. Paired t -test was performed to compare the mean confidence level pre- and post- course. Results Evaluation forms were received from all (n = 27) delegates. Delegate self-reported confidence increased significantly for all domains except Professional Communication. 23 (85%) of the participants were successful in the NS post course. There was no statistically significant difference between UK and non-UK graduates; and first time and not-first-time applicants. Conclusions Peer-delivered teaching, practice and feedback as a structured interview practice course can significantly improve applicants’ overall confidence levels in preparing for the UK ST3 General and Vascular Surgery NS. Improvement in confidence levels translates to high attrition rate of ST3 Training Posts. Communication skills require longer practice time extending beyond the duration of the 2-day course.

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Exploring reasons for differences in performance between UK and international medical graduates in the Membership of the Royal College of General Practitioners Applied Knowledge Test: a cognitive interview study

Cited by 18 publications

References 34 publications

Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study

Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study

‘Did I pass the licensing exam?’ aspects influencing migrant physicians’ results: a mixed methods study

Impact of peer-delivered tuition/feedback on appointment to United Kingdom Higher Surgical Training

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