Black doctors in England four times less likely to get training places than white counterparts

Black doctors in England face significantly lower odds of obtaining crucial training placements within the NHS, being four times less likely than their white colleagues to be offered a spot. This disparity, revealed by an analysis of NHS England data conducted by researchers at the BMJ, affects doctors applying for various specialities, including psychiatry, obstetrics, gynaecology, and emergency medicine.

The gap widens dramatically in certain fields. For instance, in 2024, black applicants for core training in anaesthetics had less than a 1 in 100 chance of receiving an offer, a staggering 30 times less likely than white applicants. Out of 1,158 black applicants, only 10 received an offer, contrasting sharply with the 7% of Asian applicants and one-third of white applicants who were successful.

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This raises questions about the robustness of the process, the training of panels, and whether issues such as available finance and personal connections enabling internships or training opportunities can influence final decisions in highly competitive fields.

Further analysis shows that in the first year of speciality training for obstetrics and gynaecology, black applicants were nearly 11 times less likely to be offered a place compared to white applicants. While black and Asian candidates were often shortlisted at rates similar to white candidates, their chances of ultimately being offered a post were considerably lower. Overall, black applicants secured training places 12% of the time, compared to 19% for Asian applicants and 47% for white applicants.

Sheila Cunliffe, the report's author, highlighted that the disparity becomes apparent during the selection stage, not the shortlisting. She questioned the robustness of the process, the training of selection panels, and the potential influence of factors like personal connections. Anton Emmanuel, a consultant gastroenterologist, described the racial disparity as systemic, noting how bias can manifest during selection, citing instances where candidates were labeled "too assertive" or women were told they "talked too much."

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I used to sit on selection panels a decade ago. There were moments when candidates from certain backgrounds were described as ‘too assertive’ or women were told they ‘talked too much’. Without an independent voice in the room, those judgments go unchallenged. The data doesn’t tell us exactly where bias enters the system – but it does tell us that something is going wrong.