A stark reality has emerged from a new analysis of NHS England data, revealing that black doctors in the UK are significantly less likely to secure specialist training placements within the NHS compared to their white colleagues. According to the research, conducted by BMJ researchers, black doctors were four times less likely to land a place in competitive specialities such as psychiatry, obstetrics and gynaecology, and emergency medicine.
The disparity is particularly concerning when considering specific fields. For instance, in 2024, black applicants competing for a core training 1 placement in anaesthetics had a less than 1 in 100 chance of receiving an offer – making them 30 times less likely to succeed than their white counterparts. Out of 1,158 black applicants, only 10 were offered a place, while 7% of Asian applicants and a third of white applicants were successful. Similarly, in the first year of speciality training for obstetrics and gynaecology, black applicants were almost 11 times less likely to be offered a place than white applicants.
The analysis reveals that although shortlisting rates are often similar across various specialities for black or Asian candidates compared to white candidates, the significant difference emerges at the selection stage. Overall, black applicants for specialist training received an offer 12% of the time, compared to 19% for Asian applicants and 47% for white applicants.
Sheila Cunliffe, author of the report and independent researcher into racism in the NHS, highlights that the disparity becomes evident during candidate selection rather than shortlisting. She raises concerns about the robustness of the selection process, the training provided to panel members, and whether factors like available finance or personal connections could influence final decisions in highly competitive medical fields.
Cunliffe also questions how NHS England is fulfilling its statutory Public Service Equality Duty to monitor and act on ethnicity-based disparities in selection. Both Cunliffe and Anton Emmanuel, Head of the Workforce Race Equality Standard for Wales, suggest that systemic racism and implicit bias are key factors contributing to lower selection rates for ethnic minority doctors.
Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, describes the figures as 'dismal' and 'alarming', underscoring the need for diverse medical representation across all specialities. Professor Mumtaz Patel, President of the Royal College of Physicians, echoes these concerns, stating that the NHS relies on a diverse workforce and that all doctors should have confidence in fair and transparent recruitment processes.