UK Black doctors four times less likely to secure NHS training posts

Black doctors applying for specialist NHS training in England are four times less likely to secure a place than their white colleagues, according to new analysis that has reignited concerns over racial bias in medical recruitment.

Researchers examining NHS England data found that while ethnic minority candidates were often shortlisted at similar rates to white applicants, they were significantly less likely to receive a final job offer.

Huge disparities uncovered

The analysis, published by the BMJ, examined applications for specialist training posts across a range of medical disciplines, including anaesthetics, psychiatry, emergency medicine and obstetrics.

Overall, white applicants received offers in 47% of cases, compared with 19% for Asian doctors and just 12% for black applicants.

The findings suggest the biggest disparities emerge during the final selection stage rather than the initial shortlisting process.

Anaesthetics figures raise alarm

The widest gap was found in applications for Core Training Year 1 posts in anaesthetics.

In 2024, only 10 of 1,158 black applicants secured a training place—giving them a success rate of less than 1%.

By comparison, around one-third of white applicants were successful, while 7% of Asian candidates received offers.

Researchers calculated that black applicants were around 30 times less likely than white applicants to secure one of these highly competitive posts.

Obstetrics also showed major gap

Large differences were also identified in obstetrics and gynaecology.

For first-year specialty training, black applicants were found to be almost 11 times less likely to receive an offer than white candidates.

Because shortlisting rates were often comparable across ethnic groups, researchers questioned whether bias may be occurring during interviews and final selection.

Researchers question recruitment process

Report author Sheila Cunliffe said the figures raised serious questions about how candidates are assessed once they reach the interview stage.

She suggested selection panels, interview practices and wider issues—including access to internships, mentoring and professional networks—may influence outcomes in highly competitive specialties.

Cunliffe also questioned whether NHS England was fully meeting its legal obligations under the Public Sector Equality Duty to identify and address ethnic disparities in recruitment.

Experts point to systemic bias

Several senior NHS figures said the data was consistent with long-standing concerns about discrimination within medical recruitment.

Dr Anton Emmanuel, head of the Workforce Race Equality Standard for Wales, said he had personally witnessed subjective judgments during interview panels.

He recalled candidates from some ethnic backgrounds being labelled "too assertive", while female applicants were criticised for "talking too much"—comments he said often went unchallenged without independent oversight.

While the data cannot pinpoint exactly where bias enters the process, Emmanuel said the scale of the disparities suggested systemic problems that required urgent attention.

Calls for reform

Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, described the findings as both "dismal" and "alarming."

He said the NHS needed diverse representation across every medical specialty and called for stronger leadership, greater accountability and evidence-based reforms to tackle racial inequality.

Professor Mumtaz Patel, President of the Royal College of Physicians, said every doctor should have confidence that recruitment into postgraduate medical training is fair, transparent and based solely on merit.

NHS England responds

Responding to the report, an NHS England spokesperson said the health service has become more diverse than ever and continues to strengthen recruitment procedures.

Measures already introduced include equality, diversity and inclusion training for interview panel members, alongside the use of external observers to help ensure recruitment decisions are fair.

However, the latest figures are likely to increase pressure on NHS England to investigate why such large disparities persist between applicants who reach the final stages of the selection process.

SOURCE

When the data demonstrates systematic racism.

I look forward to the usual members who claim to fight racism to comment.

9 minutes ago, Chomper Higgot said:

When the data demonstrates systematic racism.

I look forward to the usual members who claim to fight racism to comment.

I really struggle with that thought because it's impossible to get an honest answer. Is it racism or are they just not as capable? I personally saw two women get promoted to foremen (forepersons?) in the Toolmaker shop I worked in. They were absolutely worthless, but satisfied a mandatory quota necessary at that time.

16 minutes ago, HappyExpat57 said:

I really struggle with that thought because it's impossible to get an honest answer. Is it racism or are they just not as capable? I personally saw two women get promoted to foremen (forepersons?) in the Toolmaker shop I worked in. They were absolutely worthless, but satisfied a mandatory quota necessary at that time.

That’s why data matters.

No doctor gets to apply for posts unless they are qualified, when there is such a clear racial disparity in hiring that acts against black and Asian applicants in favour of white applicants then ‘qualification’ is clearly not the issue.