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Differential Attainment and Fair Training Culture in Public Health Training

Public Health is a specialty committed to reducing population-level inequalities, and our workforce must represent and reflect the diversity of the communities that we serve.

Currently, there are clear inequalities in public health recruitment, with this article in the BMJ identifying a large gap between the proportion of candidates deemed appointable from ethnic minority backgrounds (15%) compared to those from white backgrounds (36%).

Recognising the urgent need to tackle these disparities, and support an inclusive public health workforce, the Faculty has worked through its Board, Education Committee, Equality, Diversion and Inclusion Committee, and Equality and Diversity Special Interest Group to outline actions to tackle inequalities across the public health career pathway.

We must be transparent about the problems we face, and the first output of this work has been a report to investigate differential attainment in recruitment to public health specialty training, delivered by Imperial College London and commissioned by the UK Recruitment Group of Health Education England and the Faculty of Public Health. The report, written by Fran Bury and Richard Pinder, shows that the recruitment process unacceptably disadvantages candidates from several groups, particularly those from minority ethnic backgrounds.

Identifying the scope and scale of differential attainment is an important step in tackling these inequalities and is necessary to inform our work with Health Education England, who are responsible for the delivery of the recruitment process, to assure a fair training culture in public health.

The report, representing the first full investigation from a UK medical specialty into bias in its recruitment process, identifies that assessment centre tests for numeracy, critical reasoning and situational judgement are a primary driver in differential attainment. The Faculty has worked with Health Education England to recruit a more diverse group of assessors and improve the availability of support materials, and will look to explore alternatives to the current tests.

The Faculty will identify where support or interventions must be targeted to minimise disadvantage,  learning from, and sharing, best practice in delivering an equitable training programme and workforce. We will ensure that training, working, and learning environments are flexible and inclusive, collaborating our partners to advance equality of opportunity in the design of education.

The Faculty will also continue to monitor and evaluate differential attainment in public health specialty training, including collecting and publishing demographic data from all candidates and reporting on progress to improve diversity and inclusion in the public health workforce.

Reflecting on the challenges we face as we commence on this work, and the actions that the Faculty will take, Faculty President Kevin Fenton and Academic Registrar David Chappel have written this joint blog to accompany the Imperial College London report.

Solving these problems will take collaborative effort, and as the Faculty continues to prioritise issues of equity we invite members to engage with us on this work through our Special Interest Groups and Sub-committees.

Published 02 November 2022

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