New analysis of NHS training applications has revealed a substantial gap in the chances of being offered a specialty training post between doctors of different ethnic backgrounds. Data examined by researchers for the BMJ shows doctors from Black ethnic groups in England are offered training positions at a fraction of the rate of white applicants.
How big is the disparity?
The review indicates that Black applicants were offered posts at around one-quarter of the rate experienced by white applicants — in other words, roughly four times less likely to receive an offer. In some specialities the difference was much sharper.
| Speciality / Stage | Offer rate for Black applicants | Offer rate for white applicants |
|---|---|---|
| Core Training 1 – Anaesthetics (2024) | ~1% (10 of 1,158 applicants) | ~30% (approximate comparator) |
| Year 1 Specialty Training – Obstetrics & Gynaecology | ~9% (relative to white applicants) | ~100% (reference: much higher offer rate) |
Overall, the figures cited by the analysis show an offer rate of 12% for Black applicants, compared with 19% for Asian applicants and 47% for white applicants when seeking specialty training posts.
Where in the process does this happen?
Researchers report that shortlisting rates for interviews or assessment were often similar across ethnic groups, but the gap appears during the subsequent selection stage when offers are made. That pattern points attention to the final decision-making step rather than initial screening.
“This raises questions about the robustness of the process, the training of panels, and whether issues such as available finance and personal connections enabling internships or training opportunities can influence final decisions in highly competitive fields,”
The comment came from the report’s author, a senior HR professional and independent researcher into racism in the NHS, who argued that such disparities should prompt closer scrutiny of how selection panels operate.
Local and practical implications
For hospital trusts and medical schools in and around Reading, the findings add urgency to ongoing efforts to ensure the workforce pipeline is fair and representative. If doctors from particular backgrounds face barriers into speciality training, that can translate over time into reduced diversity in senior roles and potential gaps in culturally competent care.
- Medical trainees from Black backgrounds are substantially less likely to receive offers for specialty training posts than white peers.
- The divergence mostly emerges at the point of selection after shortlisting, suggesting issues with interview or panel decisions.
- The disparity is especially pronounced in some high-demand specialties such as anaesthetics and obstetrics.
Trusts, deaneries and NHS England have statutory duties under the Public Sector Equality Duty to monitor outcomes and address ethnicity-based differences. The analysis’ author urged further investigation and action to ensure compliance and to tackle potential structural barriers, including panel training and transparency around selection criteria.
Locally, doctors and medical students who are affected may wish to raise concerns with their training leads, deanery offices or staff networks, and to seek advice from professional bodies about appeals or equality monitoring. Meanwhile, training providers will be watching such data closely as they review recruitment procedures and equality safeguards.
The analysis has prompted renewed calls for transparency and remedial action to ensure that selection for NHS specialty training is equitable and based on merit rather than unconscious bias or uneven access to preparatory opportunities.
