Equality, diversity and developing a fair training culture

Overview

Public Health is a clinical specialty committed to reducing inequalities and our workforce must represent and reflect the diversity of the communities that we serve. Public health should also have an inclusive workforce where everyone is treated fairly and feels fully part of the profession.

FPH work on the equalities agenda is led by the Equity, Diversity and Inclusion Committee and the Equality, Diversity and Inclusion SIG. More recently, FPH has also embarked on a programme of work to look at public health training through a diversity and inclusion lens. It will include reviewing the recruitment processes, progress through training and differential attainment at examination and ARCP. We will further look at appointments and career progression where possible.

The Faculty's work in this area will be from a UK perspective where possible, recognising some differences in data sources across the UK. We will look at the public health career journey across the wider protected characteristics (such as gender, and disability) and these may become a focus for future reports.

Overall objectives

• Analyse available relevant data from various sources (FPH, GMC, Statutory Education Boards, UKPHR)
• Identify gaps in fair training culture and any biases
• Identify where support or interventions may best be focussed to minimise disadvantages
• Identify improvements in data that could be used to monitor actions
• Identify areas of good practice

Expected outcomes

We will produce an action plan to ensure:

• Equality of opportunity for learning and career progression across gender, ethnicity, disability, etc.
• Collaborative working to eliminate discrimination and advance equality of opportunity in the design of education
• Ensure that training and the working and learning environment are flexible, inclusive and diverse
• Inform future public health workforce planning
• Share good practice and lessons learnt

Recruitment to public health training

The first output from the overall programme of work is a report on recruitment into public health training.

In February 2020 the BMJ published an article which suggested that, amongst all the medical specialties, public health recruitment resulted in the largest gap between the proportion of candidates deemed appointable from ethnic minority backgrounds (15%) and those from white backgrounds (36%). This clearly required further investigation so Health Education England (HEE) and the Public Health National Recruitment Executive Group (REG), supported by the FPH, commissioned a package of analytic work specifically to investigate the apparent differential attainment within the recruitment process. The results and report of this work can be found here along with an accompanying blog by the Faculty President (Professor Kevin Fenton) and Academic Registrar (Dr David Chappel). 

Differential attainment in Postgraduate Examinations

Following the first phase of the Faculty's work to address disparities in recruitment to public health specialty training, the Faculty has now published the first output of the second phase of the Fair Training Culture Workstream, a new report on differential attainment in the Faculty’s postgraduate examinations (executive summary available here).

This new report analyses ten years of national performance data for all DFPH and MFPH first attempts and finds that some demographic groups are significantly less likely to pass FPH examinations on the first attempt.

The report makes a total of 27 recommendations to be addressed by the Faculty of Public Health and other stakeholders, grouped under 7 categories;

•  Leadership
• Improve data collection to better understand and monitor differential attainment in public health postgraduate examinations 
• Understand the unique experiences of candidates from minoritised groups
• Inclusive assessment practices
• Inclusive working and learning environments
• Targeted assessment support and feedback
• Evaluation of implemented interventions

The Faculty has established a Fair Exams Task and Finish Group to lead on the recommendations included in the report and support work to close the existing gaps in attainment.

Through our Fair Training Culture workstream we are committed to working transparently and in partnership with the wider public health system to address inequalities throughout the training pathway, and we will provide further updates as work on the second phase of the workstream continues.