The impact of disability on recruitment to higher surgical specialty training: A retrospective cohort study.

Background: UK examining bodies are required to eliminate discrimination against people with protected characteristics. To achieve this in surgery, differential attainment (DA) in assessments used as gatekeepers to career progression must be ruled out. This study investigated the impact of disability status on the likelihood of success at national selection for Higher Surgical Training (HST).

Methods: A retrospective cohort study of all UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST (ST3) from 2012 to 2019 (n = 2875). Univariate analysis identified differences in success rates at first-application. Logistic regression models identified whether disability was a predictor of success after adjusting for sociodemographic factors and prior MRCS performance.

Results: There was no significant difference in success rates between candidates with and without disabilities (all p > 0.05) for any surgical specialty. Disability status was not a statistically significant predictor of success. Female candidates were 25 % more likely to be successful (OR 1.25 [95%CI 1.05 to 1.49]) and Non-White candidates were 20 % less likely to be successful (OR 0.80 [95%CI 0.68 to 0.96]). Candidates who passed MRCS Part A and Part B at the first attempt were 49 % (OR 1.49 [95%CI 1.25 to 1.77]) and 90 % (OR 1.90 [95%CI 1.58 to 2.28]) more likely to be successful.

Conclusion: No significant difference was found in the likelihood of being successful at HST selection for any surgical specialty between applicants with and without disabilities, regardless of type of disability. DA was identified between other sociodemographic groups which requires further exploration.