A multivariate analysis to identify the relationship between sociodemographic differences and examination performance...

Significant differences in group-level performance have been identified in UK postgraduate medical examinations. However, few examinations have been investigated independently, and those that have, focus on a limited number of sociodemographic factors. This study addresses these gaps by identifying predictors of success in each UK postgraduate medical examination, accounting for prior academic attainment and other sociodemographic differences.

Retrospective cohort study.

Secondary care.

Anonymised pass/fail data at the first attempt held within the General Medical Council Database were analysed for all candidates (UK medical school graduates [UKG] and international, non-UK graduates [IMG]) attempting a postgraduate examination between 2014 and 2020.

Multivariate logistic regression models identified independent predictors of success at each postgraduate examination.

During the study period, 180,890 examination first-attempts were made by candidates, and 121,745 (67.3%) passed at their first attempt. Multivariate regression models revealed that place of primary qualification, gender, age, ethnicity, religion, sexual orientation, disability and LTFT status were all statistically significant independent predictors of success or failure in written and clinical examinations. The strongest independent predictors of failing written and clinical examinations were being an IMG, being from a minority ethnic background and having a registered disability.

This was the largest study to date investigating independent predictors of outcomes at each UK postgraduate medical examination. Significant differences in pass rates were seen according to sociodemographic differences in each examination. These data can be used by Medical Royal Colleges, the GMC and training institutions to guide more granular research and future interventions.