Black and Asian doctors are up to 30 times less likely to be offered medical training posts in some specialties, according to a news analysis published in The BMJ.

Across all specialties, Black doctors are four times less likely to be offered a training place than White applicants, official data from NHS England (NHSE) show. The picture is generally less stark for Asian applicants, but they too face significant disadvantage.

The gap varies hugely by specialty. The starkest example is core trainee 1 in anaesthetics, where Black applicants had less than a 1 in 100 chance of being offered a place in 2024 — 30 times less likely than their White counterparts. Only 10 of 1158 Black applicants received an offer, compared with 7% of Asian applicants, and a third of White applicants.

In obstetrics and gynaecology at specialty trainee 1, White applicants were nearly 11 times more likely to be offered a place than Black candidates. In core psychiatry and general practice — both high-volume specialties — Black and Asian applicants were offered places at a fraction of the rate of White applicants, despite being shortlisted at similar rates.

The disparity was present at entry level in every specialty examined, though it lessened at later training stages.

How the Research Was Done

The analysis was based on data from Sheila Cunliffe, a senior human resources professional and independent researcher on racism in the NHS. 

Cunliffe sent a freedom of information request to NHSE requesting a breakdown by ethnicity of applicants for specialty medical training, shortlisted candidates, and candidates offered positions in 2024. She had previously published research showing that White doctors in London were six times more likely to be offered jobs than Black doctors.

The data showed that across all specialties, Black or Asian candidates were often shortlisted at a similar rate to White applicants. However, they were then much less likely to be offered posts — Black applicants just 12% of the time, Asian applicants 19%, and White applicants 47% of the time.

Commenting in The BMJ, Anton Emmanuel — a consultant gastroenterologist who is head of the Workforce Race Equality Standard (WRES) for Wales and a former WRES director at NHSE — said the discrepancies had been “hiding in plain sight” for years.

“These are not isolated anomalies,” he said. Across specialties, “the pattern repeats.”

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.