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Graduates from widening participation medical programs are disadvantaged on residency selection
Emma Fletcher1, Judith Cave2, Jennifer Cleland3
1Medical Schools Council, 20-24 Tavistock Square, London, UK.
Medical Teacher
|July 16, 2026
Summary
Graduates from graduate entry (GEM) and Gateway (GY) medical programs face disadvantages in securing postgraduate specialty training compared to standard entry (SEM) graduates. Addressing structural factors in recruitment is crucial for medical education equity.
Area of Science:
- Medical Education
- Health Equity
- Postgraduate Training
Background:
- Efforts to diversify medical student enrollment persist.
- Evidence indicates underrepresented graduates face postgraduate progression barriers.
- Structural factors may perpetuate disadvantage in medical careers.
Purpose of the Study:
- To examine postgraduate career progression differences based on medical school program type.
- To investigate the relationship between program type, examination success, and residency offers.
- To identify potential inequities in specialty training applications.
Main Methods:
- Retrospective cohort study using UK Medical Education Database (UKMED) data.
- Analysis of UK-domiciled doctors graduating 2012-2021 applying for specialty training.
- Multivariable logistic regression adjusted for prior attainment and socio-demographics.
Main Results:
- Graduate entry (GEM) and Gateway (GY) graduates were less likely to be appointed or receive offers than Standard Entry (SEM) graduates.
- Fewer GY graduates secured offers within five years compared to GEM and SEM graduates.
- Significant differences observed in prior Royal College examination success and specialty preferences.
Conclusions:
- Group-level disparities in specialty training applications highlight an equity concern.
- Findings necessitate changes in postgraduate recruitment to ensure fairness.
- Addressing these inequities is vital for an inclusive medical profession.
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