Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Mar 8:342:d901.
doi: 10.1136/bmj.d901.

Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis

Katherine Woolf  1 , Henry W W Potts, I C McManus
Affiliations
Meta-Analysis

Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis

Katherine Woolf et al. BMJ. .

Abstract

Objective: To determine whether the ethnicity of UK trained doctors and medical students is related to their academic performance.

Design: Systematic review and meta-analysis.

Data sources: Online databases PubMed, Scopus, and ERIC; Google and Google Scholar; personal knowledge; backwards and forwards citations; specific searches of medical education journals and medical education conference abstracts.

Study selection: The included quantitative reports measured the performance of medical students or UK trained doctors from different ethnic groups in undergraduate or postgraduate assessments. Exclusions were non-UK assessments, only non-UK trained candidates, only self reported assessment data, only dropouts or another non-academic variable, obvious sampling bias, or insufficient details of ethnicity or outcomes. Results 23 reports comparing the academic performance of medical students and doctors from different ethnic groups were included. Meta-analyses of effects from 22 reports (n = 23,742) indicated candidates of "non-white" ethnicity underperformed compared with white candidates (Cohen's d = -0.42, 95% confidence interval -0.50 to -0.34; P<0.001). Effects in the same direction and of similar magnitude were found in meta-analyses of undergraduate assessments only, postgraduate assessments only, machine marked written assessments only, practical clinical assessments only, assessments with pass/fail outcomes only, assessments with continuous outcomes only, and in a meta-analysis of white v Asian candidates only. Heterogeneity was present in all meta-analyses.

Conclusion: Ethnic differences in academic performance are widespread across different medical schools, different types of exam, and in undergraduates and postgraduates. They have persisted for many years and cannot be dismissed as atypical or local problems. We need to recognise this as an issue that probably affects all of UK medical and higher education. More detailed information to track the problem as well as further research into its causes is required. Such actions are necessary to ensure a fair and just method of training and of assessing current and future doctors.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Fig 1 Flowchart showing reports retrieved, excluded, and articles included in review
None
Fig 2 Meta-analysis of all included studies of effect of non-white ethnicity on academic performance in medical students and postgraduates trained in UK. Negative signs are arbitrary and correspond to how data were coded, in this case white=0 and non-white=1; thus a negative sign indicates negative effect on non-white ethnicity on performance
None
Fig 3 Funnel plot of effect size by inverse standard error, showing no evidence of publication bias in studies of ethnicity and academic performance in trained doctors and medical students
None
Fig 4 Results of meta-analysis of 16 reports (27 datasets) on non-white ethnicity on performance in undergraduate medical students, showing significantly poorer performance in non-white students
None
Fig 5 Results of meta-analysis of 16 reports (27 datasets) on non-white ethnicity on performance in postgraduate medical studies, showing significantly poorer performance in non-white candidates
See this image and copyright information in PMC

Comment in

References

    1. Dillner L. Manchester tackles failure rate of Asian students. BMJ 1995;310:209. - PMC - PubMed
    1. Ferguson E, James D, Madeley L. Factors associated with success in medical school: systematic review of the literature. BMJ 2002;324:952-7. - PMC - PubMed
    1. Broecke S, Nicholls T. Ethnicity and degree attainment. Research report RW92. Department for Education and Skills, 2007.
    1. Fielding A, Charlton C, Kounali D, Leckie G. Degree attainment, ethnicity and gender: interactions and the modification of effects. A quantitative analysis. Equality Challenge Unit, Higher Education Academy, 2008.
    1. Richardson JTE. Degree attainment, ethnicity and gender: a literature review. Higher Education Academy, 2008.

MeSH terms