Differential outcomes at the Fellowship of the Royal College of Radiologists (FRCR) exams according to demographic and socioeconomic factors

Abstract

BACKGROUND

In the recent years, there has been an increase in the medical education literature showing that there are barriers to postgraduate exam success for some trainee groups compared to others. To date, there is little published data on whether these differences exist in UK radiology training. In this longitudinal cohort study, we aimed to evaluate the relationship between demographic and socioeconomic factors with Fellowship of the Royal College of Radiologists (FRCR) exam outcomes.

MATERIALS AND METHODS

A longitudinal retrospective cohort study of UK radiology trainees attempting the FRCR Part 1 examination between 2014 and 2021 (n=1,860), with linked socioeconomic, demographic, and FRCR 2A and 2B results, was conducted. Chi-square tests assessed univariate associations between age, gender, ethnicity, and socioeconomic variables, with outcomes at each exam. Multivariate logistic regression analyses examined likelihood of FRCR success after adjusting for other variables.

RESULTS

Among Part 1 candidates, 79.3% (1,465/1,850) passed at first attempt. Of these, 63.7% (600/940) subsequently passed 2A, and 77.2% (480/625) passed 2B. Significant associations with FRCR outcomes were seen with gender, ethnicity, and age (p < .005). Among socioeconomic variables, associations with FRCR outcomes were seen with parental education level, free school-meals, state-funded school (<.0.05 for Part 2A), and index of multiple deprivation (<0.05 for Part 1 and 2A). After adjusting for demographic factors, socioeconomic factors were not independently associated with exam success.

CONCLUSION

Our study demonstrates that significant group-level differences exist at the FRCR examinations for candidates with protected characteristics (gender, ethnicity, and age) and other socioeconomic factors. These can act as barriers to career progression and may warrant interventions to support these groups.