{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:23:11Z","timestamp":1791814991065,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J R Soc Med"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate recruitment equity for NHS specialty training posts between 2021\u20132024, characterising demographics, quantifying appointment disparities by protected characteristics and assessing temporal trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Longitudinal cohort study using national recruitment data via annual Freedom of Information requests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>National Health Service, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>All medical and surgical specialty training applications to NHS England (2021\u20132024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures:<\/jats:title>\n                    <jats:p>Application success by protected characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 214,893 applications, 52,998 (24.7%) were appointed. Annual success rates fell from 12,419\/37,971 (32.7%) in 2021 to 13,929\/81,189 (17.2%) in 2024. Competitiveness increased but non-UK graduate applications did not reduce successful UK graduate numbers. Gender segregation persisted: surgical specialties had the highest proportion of male applicants, whereas for females this was observed in obstetrics and gynaecology. Female applicants had higher success rates than males (27.5% vs 22.2%; \u03945.3%, 95% CI 4.95\u20135.70,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Pregnant\/maternity-leave candidates had lower success (21.3% vs 25.8%, \u03944.5%, 95% CI 3.15\u20135.82,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), most markedly in paediatrics (\u039414.8%, 95% CI 8.95\u201320.58,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and surgery (\u039413.7%, 95% CI 7.60\u201319.82,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.008). UK graduates outperformed non-UK graduates (40.7% vs 15.5%; \u039425.2%, 95% CI 24.8\u201325.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Adjusted for country of graduation, 15\/15 minority ethnic groups had lower odds of success versus White-British, with steepest declines among Black Caribbean and Bangladeshi graduates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Inequities persist in NHS specialty recruitment. Gender segregation remains and disparities disadvantage pregnant\/maternity-leave applicants. Disparities impacting minority ethnic UK graduates have widened. While data constraints preclude adjusting for confounders, these consistent trends require continuous monitoring and targeted interventions to ensure equitable access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01410768261475034","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:52:28Z","timestamp":1786539148000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Competition and equity in NHS specialty training, 2021\u20132024: longitudinal cohort analysis of protected-characteristic outcomes"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5938-8172","authenticated-orcid":false,"given":"Dinesh","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Imperial College London, Faculty of Medicine, London, UK"},{"name":"Wellcome Sanger Institute, Hinxton, Saffron Walden, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Roy-Chowdhury","sequence":"additional","affiliation":[{"name":"Jones Lang LaSalle, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Xiang","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-2782","authenticated-orcid":false,"given":"Sharon J","family":"Peacock","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Cambridge, UK"},{"name":"Cambridge University Hospital NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Department of Health and Social Care. 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