Analysis of NHS England data reveals significant disparities in training placement offers across medical specialties based on ethnicity. Black doctors applying for specialist training positions were offered placements only 12% of the time, compared with 19% for Asian applicants and 47% for white applicants, according to findings published in the BMJ.
The disparities were particularly pronounced in certain specialties. In anaesthetics core training, black applicants had less than a 1 in 100 chance of receiving an offer in 2024, with only 10 of 1,158 black applicants receiving positions compared to 7% of Asian applicants and one-third of white applicants. In obstetrics and gynaecology at the first year of specialty training, black applicants were almost 11 times less likely to be offered a place than white counterparts.
Researchers noted that while black and Asian candidates were shortlisted at comparable rates to white candidates across specialties, they faced substantially lower selection rates once advanced in the process. Report author Sheila Cunliffe, a senior HR professional investigating racism in the NHS, suggested the disparity raises concerns about panel training, financial resources, and whether personal connections influence final decisions in competitive fields. She questioned whether NHS England was meeting statutory equality monitoring requirements.
Medical professionals attributed the patterns to systemic racism and implicit bias. Anton Emmanuel, a consultant gastroenterologist, noted that subjective language during selection discussions—such as describing candidates as “too assertive”—went unchallenged without independent oversight. NHS leadership acknowledged the findings as concerning, with Prof Habib Naqvi of the NHS Race and Health Observatory calling the figures “dismal” and “alarming.” An NHS England spokesperson stated the organization continues improving recruitment processes through external observers and mandatory equality training for panelists.
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