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2019 survey of medical certificate of completion of training (CCT) holders’ career progression

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This is the eleventh survey reporting the experiences of, and outcomes for, CCT holders within one year of gaining their CCT. It covers physicians who gained their CCT in 2018 in all 30 medical specialties in the UK.

This unique survey is a collaboration between the RCP’s Medical Workforce Unit and the Joint Royal Colleges of Physicians Training Board (JRCPTB) on behalf of the Federation of the Royal Colleges of Physicians of the UK. It has monitored changing outcomes for CCT holders since 2009.

Discrimination in shortlisting and appointment

In previous years, CCT holders who described themselves as being of white ethnicity appeared to apply for fewer posts, but were more likely to be shortlisted and be offered a post. As these data appeared consistent for several years, we said they were a clear warning signal of potential bias in appointment processes and we would investigate further.

We have analysed the data from the past eight years of surveys and have found consistent evidence of trainees from a black, Asian or minority ethnic (BAME) background being less successful at consultant interview. This is despite adjustment for potential confounding factors.

The results will be published shortly in an academic peer reviewed publication, but they suggest there is bias that needs to be acted on. We will work with NHS England and Improvement, NHS Employers and the GMC to make sure that employers are aware of these findings and that more needs to be done to ensure a level playing field.

Our initial highlighting of this finding in 2018 has already had an impact. One of the NHS England Workforce Race Equality Standard (WRES) indicators for the medical workforce published in September 2020 is ‘consultant recruitment following completion of postgraduate training’ and is attributed to our report.

The collection, analysis and publication of this data will help to highlight and address discrimination. We will also continue to pay close attention to the data in our future surveys of CCT holders.

Key findings

  • 20% of all respondents had trained less than full time (LTFT) at some point in their training: 91% would recommend it to others. 75% of those who trained LTFT at some point were in substantive consultant posts compared with 72% of those who trained full time throughout. LTFT training therefore did not appear to be a barrier to attaining a substantive consultant post.
  • 23% of respondents who were working full time would have preferred a less than full time (LTFT) contract.
  • 18% said they found the transition from trainee to consultant difficult. The most difficult areas reported during transition were dealing with complaints, administrative tasks and service improvements. Only 25% had access to a trust delivered new consultant development programme. Only 64% had a job planning meeting before they began their consultant post.
  • Only 41% of respondents were offered mentoring, lower than in previous years. Of those who did take up mentoring, 88% found it helpful.

Contact details and CCT dates for trainees in all 30 medical specialties were obtained from the JRCPTB.