Exploring differential attainment in surgical exams

Sep 30, 2022

The Royal College of Surgeons of England has identified that there is differential attainment (the variation in attainment in groups of people who share protected characteristics versus those who do not share that characteristic) in both parts of its surgical exams for trainees. For example, male candidates are more likely to pass than female candidates, and White candidates are more likely to pass than candidates from any other ethnic background.

To understand the causes of differential attainment and what targeted interventions could be implemented to reduce the attainment gap, Enventure Research was commissioned to deliver a programme of research with surgical trainees who have recently completed the MRCS exams.

A quantitative and qualitative approach employed. Recent exam candidates were invited to take part in an online survey which asked about experiences of supervisors and training environments, preparing for exams, support networks, experiences of taking the exams, and perceived impacts of personal characteristics. The online survey was followed by a series of in-depth interviews with survey respondents who felt their personal characteristics had a negative impact on exam success.

The findings provided invaluable insight for RCS England into this issue, highlighting key barriers to exam preparation, perceptions of the impact of personal characteristics on exam success, feedback on the preconceived ideas of what a surgeon should look and sound like, and what support RCS England could offer to tackle differential attainment.

Whilst research participants were pleased to see the College acknowledging differential attainment and that things were beginning to change, with increasing diversity seen in those entering the profession, it was felt that more could be done to create a culture shift amongst the profession to ensure that it is accessible and welcomes trainees from all backgrounds.

Alastair Shaw from RCS England commented: “Enventure Research provided a fantastic service from the first meeting to the production of the final report. They were responsive and easy to work with, and showed genuine interest in the research we wanted to undertaken. I cannot recommend highly enough.”

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