Vol. 14 No. 1 (2021): Year of the Nurse

Differential Attainment in Career Progression for Doctors in the UK: A Scoping Review

Veena Daga
Leeds Teaching Hospitals NHS Trust, Leeds, UK
Robert Blizzard
Health Education England Yorkshire & Humber
Anshoo Dhelaria
Lister Hospital, Stevenage, UK
Saraswati Hosdurga
Bristol Children's Hospital, Bristol, UK
Saba Hussein
Bristol Children's Hospital, Bristol, UK
Spandana Madabhushi
Lister Hospital, Stevenage, UK
Geraldine Sawney
Lister Hospital, Stevenage, UK
Arvind Shah
North Middlesex Hospital, London, UK
Lambrini Theocharidou
Countess of Chester Hospital, Chester, UK
Rupal Shah
Health Education England, London
capt Tom Moore by Aria

Published 2020-12-29


  • Differential attainment,
  • Career progression,
  • Doctors,
  • BAME,
  • IMGs

How to Cite

Daga, V., Blizzard, R., Dhelaria, A., Hosdurga, S., Hussein, S., Madabhushi, S., Sawney, G., Shah, A., Theocharidou, L., & Shah, R. (2020). Differential Attainment in Career Progression for Doctors in the UK: A Scoping Review. Sushruta Journal of Health Policy & Opinion, 14(1), 1–10. https://doi.org/10.38192/14.1.8


Differential attainment in career progression in the NHS is a complex issue with many interplaying factors apart from individual protected characteristics. In this paper, we examine the attainment gap, causes for these disparities and some recommendations to reduce the gap.

Our review shows that there is significant DA between groups of doctors on the basis of gender, ethnicity, race and country of primary medical qualification. The likely causes are bias, lack of opportunity, poor supervision, mentorship, sponsorship, dichotomous treatment of doctors based on training or non-training status and cultural exclusion. Data is not monitored or reported and there is little organisational accountability. Solutions are likely to include transparent data on recruitment as well as progression for benchmarking, training support for all doctors, initiatives which are sensitive to gender, parental responsibility, cultural heritage, language and robust supervision including mentorship and sponsorship.

This scoping review forms part of the Alliance for Equality in Healthcare Professions project on Differential Attainment chaired by the British Association of Physicians of Indian Origin (BAPIO) and will be integrated into the Bridging the Gap project undertaken by BAPIO Institute for Health Research (BIHR). This work is part of six domains of doctors' careers in the NHS.


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