Posted on September 8, 2004

Professor Questions Ethnic Balance In NHS

Jeremy Laurance, Independent (UK), Sep. 3

An Oxford University professor has questioned whether Britain is training too many black and Asian doctors.

Michael Goldacre, a professor of public health at the University of Oxford, claims that the proportion of newly qualified doctors from the ethnic minorities has risen from 2 per cent in 1974 and will approach 30 per cent in 2005. By contrast, only about 9 per cent of the population of England and Wales is from an ethnic minority.

Professor Goldacre, who conducted the study with two colleagues and published the findings in the British Medical Journal, writes: “This raises important questions for policy makers: should the ethnic mix of intake to medical schools broadly reflect the ethnic mix of the community . . . If so, what should be the mechanisms to achieve such representation?”

Professor Goldacre said he was seeking only to raise the question about the composition of the medical workforce — not to answer it. He said that medical schools had been focused on combating discrimination against ethnic minorities and women, and the figures demonstrated their success.

“People have been sufficiently pleased with the good news story that the very obvious other side of the story has not received the same attention. There has been much concern about broadening the base of medicine and there is now slightly anxious pleasure that ethic minorities and women are doing so well.”

He argued that the issue demanded attention. “We are raising the question, not offering an answer. We have to hope our policy makers will think about these things.”

His study reveals the decline in medical schools of white men, who have dominated medicine for decades. Little more than a quarter of all British medical students are now Caucasian males, their places taken by women, who account for over 60 per cent of places, and ethnic minorities.

The academic said that NHS hospitals were becoming increasingly dependent on doctors trained abroad, who account for almost 25 per cent of consultants appointed since 1991.

Professor Goldacre said: “We are pointing out the blindingly obvious. There has been a substantial increase in women medical students so there must have been a decline in men. Asian students have done particularly well. They are high achieving with high ambition and medicine is seen as a profession they are proud to go into. It is possible white men are not performing as well or that they are not applying in the same numbers.”

Yesterday Sam Everington, deputy chairman of the British Medical Association and a GP in east London, whose research has uncovered discrimination by medical schools against ethnic minority students, rejected Professor Goldacre’s comments. He said: “Colour and sex should not make any difference. It is the quality that counts. The absolutely fundamental principle is that the selection process must be fair. Our research showed that it wasn’t.”

Professor Goldacre is the second senior figure in medicine to raise concern about the changing composition of the medical workforce. Last month Carol Black, president of the Royal College of Physicians, said that British medical schools were training too many women doctors and the profession could lose its influence as a result.

In an interview with The Independent, Dr Black said that medicine was becoming “feminised”. “I would like to see equal numbers of male and female doctors. I think it makes for a more natural balance,” she said.

‘Future Doctors Will Be Mostly From Ethnic Minority Groups’

Nabanita Sircar,, Sep. 3

It is no longer a matter of surprise for a patient in Britain to be treated by an Indian or Chinese doctor. A new research has found that doctors in the future will be overwhelmingly female and from ethnic minority groups.

The study by the UK Medical Careers Research Group at Oxford University has found that only a quarter of today’s medical students are white men. The biggest gain is among Asian (including Chinese) students. They comprise eight per cent of the population in this age range, but make up 20.8 per cent of medical students.

The research has also found that the NHS has become increasingly dependent on doctors who have trained overseas. These doctors are also particularly used to fill posts that UK-trained medics do not want, such as in geriatric and sexual health medicine. The analysis follows continued rising trends in foreign doctors joining the British medical register. Last year 13,926 doctors joining the General Medical Council’s register came from overseas, with doctors from South Africa and India in the lead, compared to 4,730 who were trained in the UK.

In 2002, white men comprised 43.5 per cent of the population of Britain but only 26 per cent of the medical students. Professor Michael Goldacre, who led the research, said: “I don’t have an answer. There has been a tremendous amount of interest in widening participation in medicine to all social classes and minority groups. But people have missed one part of the big picture, which is the huge decline in white men.”

He added: “There may be simply too few qualified white males coming through the system.” The team measured the change by comparing medical school graduates in 1974 with those of 2000. In 1974 (excluding overseas students) 98.4 per cent were white and 1.6 per cent non-white. By 2000, the proportion of white students was down to 78.5 per cent and non-whites up to 21 per cent.

However, in senior posts the white male still dominates, but that is also changing. In 1964-71, more than 95 per cent of hospital consultants were white, and most of them male. By 2001, the proportion was down to around 60 per cent, according to the research.

The proportion who are non-white was only about 2 per cent in 1974 but will approach 30 per cent by 2005. Ethnic minorities comprise 12.8 per cent of those aged 20-24, so they are substantially over-represented at medical schools.