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Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study
  1. Ben Kumwenda1,
  2. Jennifer A Cleland1,
  3. Gordon J Prescott2,
  4. Kim Walker3,
  5. Peter W Johnston4
  1. 1 Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
  2. 2 Medical Statistics Team, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
  3. 3 NHS Grampian, NHS Education for Scotland and UK Foundation Programme, Aberdeen, UK
  4. 4 NHS Education for Scotland, Scotland Deanery, Aberdeen, UK
  1. Correspondence to Ben Kumwenda; r01bk15{at}


Introduction Knowledge about allocation of doctors into postgraduate training programmes is essential in terms of workforce planning, transparency and equity issues. However, this is a rarely examined topic. To address this gap in the literature, the current study examines the relationships between applicants’ sociodemographic characteristics and outcomes on the UK Foundation Training selection process.

Methods A longitudinal, cohort study of trainees who applied for the first stage of UK postgraduate medical training in 2013–2014. We used UK Medical Education Database (UKMED) to access linked data from different sources, including medical school admissions, assessments and postgraduate training. Multivariable ordinal regression analyses were used to predict the odds of applicants being allocated to their preferred foundation schools.

Results Applicants allocated to their first-choice foundation school scored on average a quarter of an SD above the average of all applicants in the sample. After adjusting for Foundation Training application score, no statistically significant effects were observed for gender, socioeconomic status (as determined by income support) or whether applicants entered medical school as graduates or not. Ethnicity and place of medical qualification were strong predictors of allocation to preferred foundation school. Applicants who graduated from medical schools in Wales, Scotland and Northern Ireland were 1.17 times, 3.33 times and 12.64 times (respectively), the odds of applicants who graduated from a medical school in England to be allocated to a foundation school of their choice.

Conclusions The data provide supportive evidence for the fairness of the allocation process but highlight some interesting findings relating to ‘push-pull’ factors in medical careers decision-making. These findings should be considered when designing postgraduate training policy.

  • cohort study
  • ordinal logistic regression
  • postgraduate training
  • equality
  • socio-economic class

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  • Contributors JAC led the funding bid which was reviewed by KW, BK and PWJ. KW and PWJ advised on the nature of the data. BK managed the data, carried out the data analysis under the supervision of GJP and JAC, and wrote the first manuscript. GJP advised on all the statistical analysis. JAC guided the first draft of the introduction and discussion sections of this paper. BK and GJP wrote the first drafts of the methods and results sections. JAC edited the drafts. All authors reviewed and agreed on the final draft of the paper.

  • Funding This study is part of BK’s doctoral programme of research funded by the UKCAT Research Panel, of which JAC is a member.

  • Competing interests KW is the special advisor (Recruitment) for the UK’s Foundation Programme (UKFPO).

  • Patient consent Not required.

  • Ethics approval The Chair of the local ethics committee ruled that formal ethical approval was not required for this study given the fully anonymised data was held in safe haven, and all students who sit UKCAT and GAMSAT are informed that their data and results will be used in educational research. All students applying for the UKFPO also sign a statement confirming that their data may be used anonymously for research purposes.No patients or the general public were involved in this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement UK Medical Education Database (UKMED) UKMEDP 026 extract generated on 12 August 2016. Approved for publication on 27 March 2017. UKMED bears no responsibility for data analysis or interpretation. The dataset is held in safe haven and only members of the research, BK, GP and JC had access to the data. The data include information derived from that collected by the Higher Education Statistics Agency Limited (HESA) and provided to the GMC (HESA Data). Source: HESA Student Record 2007/2008 and 2008/2009 Copyright Higher Education Statistics Agency. The Higher Education Statistics Agency 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.

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