Cross-comparison of MRCGP & MRCP(UK) in a database linkage study of 2,284 candidates taking both examinations: assessment of validity and differential performance by ethnicity.

MRCGP and MRCP(UK) are the main entry qualifications for UK doctors entering general [family] practice or hospital [internal] medicine. The performance of MRCP(UK) candidates who subsequently take MRCGP allows validation of each assessment. In the UK, underperformance of ethnic minority doctors taking MRCGP has had a high political profile, with a Judicial Review in the High Court in April 2014 for alleged racial discrimination. Although the legal challenge was dismissed, substantial performance differences between white and BME (Black and Minority Ethnic) doctors undoubtedly exist. Understanding ethnic differences can be helped by comparing the performance of doctors who take both MRCGP and MRCP(UK)

Disciplined doctors: Does the sex of a doctor matter? A cross-sectional study examining the association between a doctor's sex and receiving sanctions against their medical registration.

To examine the association between doctors' sex and receiving sanctions on their medical registration, while controlling for other potentially confounding variables

Sex differences in medico-legal action against doctors: a systematic review and meta-analysis

The relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time

Rossby wave breaking, the upper level jet, and serial clustering of extratropical cyclones in western Europe

Winter 2013/14 was the stormiest on record for the UK and was characterized by recurrent clustering of extratropical cyclones. This clustering was associated with a strong, straight and persistent North Atlantic jet and was also associated with Rossby wave breaking (RWB) on both flanks, pinning the jet in place. The occurrence of RWB and cyclone clustering is further studied in 36 years of the ERA-Interim Reanalysis. Clustering at 55°N is associated with an extended and anomalously strong eddy-driven jet flanked on both sides by RWB. However, clustering at 65(45)°N has a dominance of RWB to the south (north) of the jet, deflecting the jet northward (southward). A positive correlation was found between clustering and RWB occurrence to the north and south of the jet. However, there is considerable spread in these relationships

The role of serial European windstorm clustering for extreme seasonal losses as determined from multi-centennial simulations of high resolution global climate model data

Extratropical cyclones are the most damaging natural hazard to affect western Europe. Serial clustering occurs when many intense cyclones affect one specific geographic region in a short period of time which can potentially lead to very large seasonal losses. Previous studies have shown that intense cyclones may be more likely to cluster than less intense cyclones. We revisit this topic using a high resolution climate model with the aim to determine how important clustering is for windstorm related losses. The role of windstorm clustering is investigated using a quantifiable metric (storm severity index, SSI) that is based on near surface meteorological variables (10-metre wind speed) and is a good proxy for losses. The SSI is used to convert a wind footprint into losses for individual windstorms or seasons. 918 years of a present-day ensemble of coupled climate model simulations from the High-Resolution Global Environment Model (HiGEM) are compared to ERA-Interim re-analysis. HiGEM is able to successfully reproduce the wintertime North Atlantic/European circulation, and represent the large-scale circulation associated with the serial clustering of European windstorms. We use two measures to identify any changes in the contribution of clustering to the seasonal windstorm loss as a function of return period. Above a return period of 3 years, the accumulated seasonal loss from HiGEM is up to 20% larger than the accumulated seasonal loss from a set of random resamples of the HiGEM data. Seasonal losses are increased by 10-20% relative to randomised seasonal losses at a return period of 200 years. The contribution of the single largest event in a season to the accumulated seasonal loss does not change with return period, generally ranging between 25-50%. Given the realistic dynamical representation of cyclone clustering in HiGEM, and comparable statistics to ERA-Interim, we conclude that our estimation of clustering and its dependence on the return period will be useful for informing the development of risk models for European windstorms, particularly for longer return periods

'It gives you an understanding you can't get from any book.' The relationship between medical students' and doctors' personal illness experiences and their performance: a qualitative and quantitative study.

Anecdotes abound about doctors' personal illness experiences and the effect they have on their empathy and care of patients. We formally investigated the relationship between doctors' and medical students' personal illness experiences, their examination results, preparedness for clinical practice, learning and professional attitudes and behaviour towards patients

Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study

Objective To explore ethnic stereotypes of UK medical students in the context of academic underachievement of medical students from ethnic minorities.Design Qualitative study using semistructured one to one interviews and focus groups.Setting A London medical school.Participants 27 year 3 medical students and 25 clinical teachers, purposively sampled for ethnicity and sex.Methods Data were analysed using the theory of stereotype threat ( a psychological phenomenon thought to negatively affect the performance of people from ethnic minorities in educational contexts) and the constant comparative method.Results Participants believed the student- teacher relationship was vital for clinical learning. Teachers had strong perceptions about "good" clinical students ( interactive, keen, respectful), and some described being aggressive towards students whom they perceived as quiet, unmotivated, and unwilling. Students had equally strong perceptions about "good" clinical teachers ( encouraging, interested, interactive, non- aggressive). Students and teachers had concordant and well developed perceptions of the "typical" Asian clinical medical student who was considered over- reliant on books, poor at communicating with patients, too quiet during clinical teaching sessions, and unmotivated owing to being pushed into studying medicine by ambitious parents. Stereotypes of the "typical" white student were less well developed: autonomous, confident, and outgoing team player. Direct discrimination was not reported.Conclusions Asian clinical medical students may be more likely than white students to be perceived stereotypically and negatively, which may reduce their learning by jeopardising their relationships with teachers. The existence of a negative stereotype about their group also raises the possibility that underperformance of medical students from ethnic minorities may be partly due to stereotype threat. It is recommended that clinical teachers be given opportunities and training to encourage them to get to know their students as individuals and thus foster positive educational relationships with them

The mediators of minority ethnic underperformance in final medical school examinations

Background: UK-trained medical students and doctors from minority ethnic groups underperform academically. It is unclear why this problem exists, which makes it difficult to know how to address it. Aim: Investigate whether demographic and psychological factors mediate the relationship between ethnicity and final examination scores. Sample: Two consecutive cohorts of Year 5 (final year) UCL Medical School students (n=703; 51% minority ethnic). 587 (83%) had previously completed a questionnaire in Year 3. Methods: Participants were administered a questionnaire that included a short version of the NEO-PI-R, the Study Process Questionnaire, and the General Health Questionnaire as well as socio-demographic measures in 2005 and 2006. Participants were then followed up to final year (2007 to 2010). White and minority ethnic students’ questionnaire responses and final examination grades were compared using univariate tests. The effect of ethnicity on final year grades after taking into account the questionnaire variables was calculated using hierarchical multiple linear regression. Results: Univariate ethnic differences were found on age, personality, learning styles, living at home, first language, parental factors and prior education. Minority ethnic students had lower final exam scores, were more likely to fail, and less likely to achieve a merit or distinction in finals. Multivariate analyses showed ethnicity predicted final exam scores even after taking into account questionnaire factors. Conclusions: Ethnic differences in the final year performance of two cohorts of UCL medical students were not due to differences in psychological or demographic factors, which suggests alternative explanations are responsible for the ethnic attainment gap in medicine