Sociodemographic and educational factors associated with early clinical academic career progression among UK medical graduates: a retrospective cohort study using linked national data from the UK Medical Education Database (UKMED).

Abstract

To examine associations between sociodemographic and educational factors and early clinical academic career progression among UK medical graduates, focusing on intercalation, Academic Foundation Programme (AFP) participation and predoctoral fellowships (PFs). Retrospective cohort study using linked national data from the UK Medical Education Database. Multivariable logistic regression models examined associations between sociodemographic and educational factors and outcome measures, adjusting for relevant covariates. All UK medical schools with graduates entering the UK Foundation Programme between 2017 and 2022. 32 580 graduates (25 290 standard-entry (SE); 7290 graduate-entry (GE)). Completion of an intercalated degree; application to and acceptance for AFP; application to and acceptance for a PF during specialty training. Among SE graduates, 63.9% intercalated, 21.4% applied to AFP and 7.6% were accepted. Male, minority ethnic, privately educated and less deprived graduates were more likely to intercalate; disability and higher deprivation were associated with lower intercalation rates. Intercalation, publications, high Education Performance Measure (EPM) scores were associated with AFP application and acceptance while attendance to a 6-year programme was associated with only AFP application. At PF stage, minority ethnic SE doctors were less likely to be accepted (OR 0.60, 95% CI 0.45 to 0.80, p<0.001) despite similar application rates. AFP completion was strongly associated with PF application (OR 7.82, 95% CI 6.68 to 9.15, p<0.001). GE graduates had similar AFP application (21.9%) and acceptance (6.3%) rates as SE graduates. Male, minority ethnic graduates were more likely to apply to the AFP, while low EPM scores reduced acceptance (OR 0.46, 95% CI 0.37 to 0.57, p<0.001). Few sociodemographic factors were associated with PF applications, although prior AFP acceptance was associated with this outcome. Early clinical academic career progression is associated with educational achievements and persistent sociodemographic inequalities. Equitable access to funded research opportunities during medical school may strengthen and diversify the future clinical academic workforce.