Equity and fairness in post-graduate training are essential for a number of reasons. When done well, they help to attract and retain the best, diverse and brightest talent. When everyone has a fair chance to succeed, more people will be motivated to pursue a career in public health. This is essential for ensuring that the public health workforce is able to meet the growing demands of a complex and ever-changing world.
Equity and fairness in post-graduate training also ensures that the specialist public health workforce is representative of the population it serves. This is important because it allows public health professionals to better understand the needs of the communities they work with and to develop more effective interventions. When everyone has the same opportunity to reach their full potential, society as a whole benefits.
Our report on Fairer Training Culture highlights the disturbing level of discrimination present in the recruitment process for public health training in the UK, particularly in relation to ethnic differences at the Assessment Centre. This is unacceptable and we must work together to eliminate discrimination from all aspects of public health training.
In this blog we provide an update on our progress thus far and our continued actions to address the situation.
In October 2022, we noted the first step to develop a Fairer Training Culture with the publication of an in-depth report examining recruitment processes in detail. This report highlighted some concerning issues of differential attainment in the recruitment process, particularly in relation to ethnic differences in tests used at the Assessment Centre, but it has also galvanised activity and debate across the system.
In the 2023 recruitment round (starting November 2022) NHSE’s Recruitment Executive Group:
- Revised the Situational Judgement Test (SJT) with a broader, more diverse, group of question setters and reviewers, to make sure they are fairer questions. This should also allow the availability of more example questions for candidates to look at in advance.
- Moved all available information on recruitment from the Faculty of Public Health (FPH) and Health Education England (HEE) to a single site. This ensures improved consistency of information and allows us to develop better information for all applicants.
- Continued to train assessors to reduce bias in the selection centre.
HEE’s merger into NHS England’s Workforce, Training and Education Directorate has delayed a proposed review of available numerical reasoning and critical reasoning tests for the assessment centre, but they will be trying to ensure this happens this year.
The way in which ethnicity of applicants and appointments is monitored was improved to increase the number of categories in this round. Whilst positive, this means that we do not have a comparison to measure the impact of changes, though we will be able to do so better in the next round.
FPH’s Equality and Diversity Special Interest Group has been working closely with NHSE’s Recruitment Executive Group to publish an options appraisal of future actions, develop an action plan, and prioritise next steps.
The FPH itself is also currently developing an anti-racism strategy and action plan.
Further changes are planned for the 2024 recruitment round starting November 2023, including:
- Separating the scoring for the Assessment Centre (AC) from the Selection Centre so there is no carry-through of any potential biases at AC into final scores.
- Further developments in the information hub, including links to regional recruitment events.
- In the South-East, trainees themselves are leading the development of targeted support to disadvantaged groups.
We will continue to report on developments in this area, as well as reporting on other aspects of a fair training culture such as exam success rates later in the year.
In summary, we are encouraged to see the progress that has been made to improve equity and fairness in the recruitment process for public health training. However, there is still more work to be done.
We call on all stakeholders to work together to create a system where everyone has the same opportunity to succeed in public health training. This includes:
- Continuing to review and revise recruitment processes to reduce bias.
- Providing training and support to assessors to reduce bias.
- Collecting data on the ethnicity of applicants and appointments to track progress over time.
- Developing targeted support to disadvantaged groups.
We urge you to join us in the journey for greater equity and fairness in public health training. Together, we can make a difference.
Please continue to contact the FPH or ourselves directly if you have any ideas or suggestions for how we can improve equity and fairness in public health training. We look forward to hearing from you.
