Characteristics of consultants who hold distinction awards in England and Wales: database analysis with particular reference to sex and ethnicity.
OBJECTIVE
To determine whether women, ethnic minorities, and particular specialties are discriminated against in the receipt of NHS distinction awards.


METHODS
Analysis of database of consultants eligible for distinction awards.


METHODS
England and Wales, 2002.


METHODS
Holding of B, A, and Aplus distinction awards, analysed for all awards, irrespective of when made, and for awards made in the last five years studied.


RESULTS
Women and doctors from ethnic minorities were substantially under-represented among award holders when no account was taken of potential confounding factors. Differences diminished after multivariate analysis, but some remained significant. For example, the adjusted odds ratio of women holding awards compared with men was 0.69 (95% confidence interval 0.59 to 0.82) for any award and 1.37 (0.86 to 2.20) for Aplus awards; the odds ratio for any award for non-white doctors trained abroad compared with white doctors trained in the United Kingdom was 0.45 (0.37 to 0.56). In the last five years studied the adjusted ratio of women to men was 0.94 (0.79 to 1.10) for B awards and 1.54 (0.85 to 2.83) for Aplus awards. The adjusted ratio for non-white British trained consultants was 0.86 (0.62 to 1.17) for B awards and 1.20 (0.37 to 3.87) for Aplus awards; for non-white consultants trained abroad it was 0.68 (0.54 to 0.85) for B awards and 0.69 (0.15 to 3.10) for Aplus awards; and for white consultants trained abroad it was 0.70 (0.54 to 0.91) for B awards and 0.90 (0.38 to 2.15) for Aplus awards.


CONCLUSIONS
Historical under-representation in award holding by women and doctors from ethnic minorities was partly explained by time spent as a consultant. Recent awards showed no under-representation of women and no appreciable under-representation of ethnic minorities overall. However, doctors who trained abroad-both white and non-white-remained under-represented for B awards.
Lambert
Trevor W
TW
UK Medical Careers Research Group, Department of Public Health, University of Oxford, Oxford OX3 7LF.
Goldacre
Michael J
MJ
Vallance
Elizabeth
E
Mallick
Netar
N
D001363:Awards and Prizes; D003253:Consultants; D004739:England; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D008511:Medicine / Q000592:standards / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D012737:Sex Factors; D013038:Specialization; D014852:Wales