Abstract
Background Recent studies suggest that ethnic minority students underperform in standardized assessments commonly used to evaluate their progress. This disparity seems to also hold for postgraduate medical students and GP-trainees and may affect primary healthcare quality, which requires an optimally diverse workforce.
Aims (1) determine to what extent ethnic minority GP-trainees are more at risk of being assessed as underperforming than their majority peers; (2) investigate whether established underperformance appears in specific competence areas; and (3) explore 1st and 2nd-generation minority trainees deviations.
Design & setting Quantitative retrospective cohort design in the Dutch GP-specialty training (start years: 2015-2017).
Method In 2020/21, the authors evaluated files on assessed underperformance of 1,700 GP-trainees at seven Dutch GP-specialty training institutes after excluding five opt-outs and 165 incomplete data sets (17% ethnic minority trainees). Underperformance was defined as the occurrence of (1) preliminary dropout, (2) extension of the educational pathway, and/or (3) mandatory coaching pathways, all prompted by the training institute. The Dutch Central Service for Statistics (CBS) anonymized the files and added data about ethnicity. Thereafter, the authors performed logistic regression for potential underperformance analysis and Chi-square tests for competence area analysis.
Results Ethnic minority GP-trainees were more likely to face underperformance assessments than the majority group (OR 2.41 (95% CI: 1.67–3.49). Underperformance was not significantly nested in particular competence areas. First-generation minority trainees seemed more at risk than their second-generation peers.
Conclusion Minority GP-trainees seem more at risk of facing educational barriers. Additional qualitative research on underlying factors is essential.
- Received June 4, 2022.
- Revision received September 20, 2022.
- Accepted September 28, 2022.
- Copyright © 2022, The Authors
This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)