ArticleBMJ open2025
Differential attainment at national selection for higher surgical training: a retrospective cohort study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Admission Routes and Demographics as Predictors of Academic Performance in Medical Students: A Retrospective Cohort of Grade Point Averages (GPAs) and Comprehensive Exam Scores.Advances in medical education and practice · 2026Article
- Differential attainment in UK postgraduate medical examinations: examining the relationship between sociodemographic differences and examination performance.BMC medicine · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesNational selection for higher surgical specialty training (HST) in the UK is a high-stakes gatekeeping assessment. If barriers, such as differential attainment, exist at HST selection for some groups and not others, then this will have a significant and lasting impact on trainees' career progression and the diversity of the workforce, which should reflect the population it provides care for. The objective of this study was to characterise the relationship between candidate sociodemographic factors and performance at National Selection for HST in the UK.
designA retrospective cohort study.
settingNational Selection for HST in the UK.
participantsAll UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST from 2012 to 2019. OUTCOMES AND MEASURES: Performance at HST Selection for each surgical specialty is measured by assessment of the candidate's academic portfolio and multiple objective structured clinical examination style stations testing knowledge and skills. Univariate analysis identified differences in success rates at first application. Logistic regression models identified sociodemographic predictors of success after adjusting for prior academic attainment (Membership of the Royal College of Surgeons (MRCS) performance).
resultsOf all applications to HST (n=2875), 66.5% were successful at the first attempt. Females were 32% more likely than males to be successful at selection for HST (OR 1.32 (95% CI 1.05 to 1.67)). MRCS performance was found to be a strong independent predictor of future success at HST selection. Females were more likely to be successful at general surgery selection (OR 2.69 (95% CI 1.63 to 4.45)), older candidates (graduates) were less likely to be successful at ENT selection (OR 0.21 (95% CI 0.05 to 0.95)), and candidates that were the first in their family to attend University were less likely to be successful at urology selection (OR 0.41 (95% CI 0.21 to 0.78)).
conclusionsOur findings highlight few statistically significant associations and no consistent patterns between sociodemographic factors and performance at HST selection once we adjusted for prior academic attainment. This suggests that differences in performance on selection into HST may be more likely due to individual rather than group-level differences.
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