Evidence map›Paper›PMID 40223107›Full record

ArticleBMC medicine2025

Differential attainment in UK postgraduate medical examinations: examining the relationship between sociodemographic differences and examination performance.

Ricky Ellis, Andy Knapton, Jane Cannon, Amanda J Lee, Jennifer Cleland

Abstract read
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ricky EllisInstitute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland. rickyellis@nhs.net.ORCID http://orcid.org/0000-0001-7310-6904
Andy KnaptonGeneral Medical Council, Education & Standards, Regent's Place, 350 Euston Rd., London, NW1 3AW, UK.
Jane CannonGeneral Medical Council, Education & Standards, Regent's Place, 350 Euston Rd., London, NW1 3AW, UK.
Amanda J LeeMedical Statistics Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland.ORCID http://orcid.org/0000-0002-4865-9061
Jennifer ClelandLee Kong Chian School of Medicine, Nanyang Technological University Singapore, i1 Mandalay Road, Singapore, 308232, Singapore.ORCID http://orcid.org/0000-0003-1433-9323

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDifferential attainment (DA), or differences in performance of groups (rather than individual differences), has been observed in a number of postgraduate medical specialty examinations used in UK medical training. Until now, much of the published research on DA has been limited in scope and size to one specialty, one examination or one type of assessment. This retrospective cohort study addressed this gap by examining the relationship between numerous sociodemographic differences and performance in almost all UK postgraduate medical examinations using a dataset of more than 180,000 examination attempts by UK and international medical graduates, adjusting for prior academic attainment.

methodsThis retrospective cohort study used the UK Medical Education Database (UKMED) to analyse the impact of a range of sociodemographic factors on performance in all UK postgraduate medical examinations aggregated into written and clinical exams. Pass/fail data at the first examination attempt were analysed for all candidates (UK medical school graduates (UKG) and those from non-UK schools (IMG)) sitting an examination between 2014 and 2020. Univariate analyses identified variables to carry forward into multivariate logistic regression models. Informed by previous research, all models were adjusted for prior academic attainment.

results180,890 examination first-attempts were made by UKG and IMG candidates, and 121,745 (67.3%) passed at the first attempt. Multivariate regression models showed that place of primary qualification (UKG vs IMG), gender, age, ethnicity, religion, sexual orientation, disability status and working less than full-time were all statistically significant, independent predictors of examination outcomes for all examination candidates. Additionally, there were significant associations between socioeconomic backgrounds and performance for UKGs alone. The strongest independent predictors of failing written and clinical examinations were graduating from a non-UK medical school, having a minority ethnic background and having a registered disability.

conclusionsThis, the largest study of UK postgraduate medical examination outcomes, identified sociodemographic differences that were independently predictive of performance in written and clinical postgraduate medical examinations. Further analysis is now required to ascertain whether these group-level differences exist in each postgraduate medical examination, the majority or a select few.

trial registrationNot applicable.

Indexed as

Educational MeasurementEducation, Medical, GraduateAdultFemaleForeign Medical GraduatesHumansMaleRetrospective StudiesSociodemographic FactorsUnited KingdomAssessmentMedical educationTraining

Identifiers

PMID40223107
PMCPMC11995605

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.