Improving Formative Feedback in the Context of Differential Attainment

Priyanka Singhal, Samuel Yosef

Research output: Book/ReportReport


International medical graduates (IMG) and UK Black and minority ethnic (BME) doctors are frequently disadvantaged in their career progression when compared to their UK White counterparts (GMC, 2020). This phenomenon is called differential attainment (DA) where there is variation between different demographic groups. One of the possible driving factors of DA is a lack of feedback, which is an important area to explore further (Woolf et al, 2017).

One of the organisational priorities in the equality, diversity and inclusion strategy of the GMC is to embed fair training cultures in postgraduate training environments (GMC, 2023). We therefore conducted a qualitative study to further understand the day-to-day feedback experiences of doctors in training from different demographic groups. We ran three focus groups in January and February of 2023. In total, 17 doctors in training attended the focus groups: five IMGs, six UK BME, and six UK White. Each focus group had doctors from a variety of specialties, training grades, and deaneries. The focus group transcripts were analysed using a thematic framework analysis method. We discussed the outcomes of our analysis with internal and external stakeholder roundtables in May 2023.

Through our analysis and roundtable discussions, we identified priority areas and recommendations to improve feedback experiences for IMG and UK BME learners. Across all the focus groups, there were numerous suggestions on how formative feedback can be improved in the workplace. The recommendations focus on three main areas:
• Standards
• Training for learners and educators
• Removing barriers such as lack of awareness, time, and blame

Our research also highlighted areas that should be researched further, such as UK BME trainees feeling less confident in asking for feedback with increased seniority, educator’s experiences of feedback, and experiences of feedback for Locally Employed Doctors (LEDs).
Original languageEnglish
PublisherGeneral Medical Council
Number of pages67
Publication statusPublished - Sept 2023


  • Differential Attainment
  • Medical Education
  • Formative Feedback


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