DEEP-ROOTED inequality continues to limit opportunities for ethnic minority and non-UK trained doctors in the NHS, weakening workplace culture and harming long-term patient care, a new report has warned.
The equality, diversity and inclusion report, published on Thursday (15) by the General Medical Council (GMC), said progress in tackling discrimination is uneven, with clear improvements in some areas but slow or limited change in others.
According to the report, the biggest improvement was seen among non-UK graduates in postgraduate exams, where the pass rate gap narrowed by seven percentage points. While there were early signs of improvement in specialty training, exam pass rates and competency reviews, these gains were modest.
The report added that ethnic minority staff were more likely to leave the organisation, with turnover rates nearly five percentage points higher than other employees.
The medical regulator has called on governments, NHS bodies and health leaders across the UK to treat equality and inclusion as central to workforce planning and patient safety. It urged stronger action to tackle racial discrimination, support international doctors, and make training environments more inclusive.
Among its recommendations, the regulator called for mandatory induction programmes for international medical graduates, better monitoring of disciplinary actions, stronger anti-racism resources, and closer collaboration across the health system.
GMC chief executive Charlie Massey said inequality in medicine is “not inevitable” and urged healthcare leaders and employers to take stronger action.
“Fairness and equality aren’t simply matters of principle – they are prerequisites for productivity and translate to better patient care,” Massey said. “Every doctor, no matter their background, must be able to work, learn and thrive in an environment where they feel they belong.”
One area showing clear progress is employer referrals to the regulator. Ethnic minority and internationally qualified doctors have historically been more likely to be referred to the GMC for fitness to practise concerns.
The GMC said it remains on track to meet its target of eliminating disproportionate employer referrals by the end of 2026.
The latest report showed that the proportion of employers with excess referrals linked to ethnicity or place of qualification has fallen by 48 per cent, from 5.6 per cent to 2.9 per cent, compared with the 2016–2020 benchmark period.
According to the regulator, this improvement reflects better referral processes, closer scrutiny by employers and increased use of mentoring and support schemes for doctors.
The GMC has set a longer-term goal of eliminating discrimination and unfair outcomes in education by 2031, but the latest findings show limited improvement for ethnic minority doctors who trained in the UK and for medical students.
Massey added, “Our report shows we have a system moving at two speeds. There is unmistakable momentum towards eradicating disproportionality in employer referrals, but limited, and in some measures absent, progress in education, which must be addressed.”
The regulator also acknowledged challenges within its own organisation. While the GMC is on track to meet its target for ethnic minority representation across its workforce by 2026, it is unlikely to meet the same goal at management level unless current trends change.
Massey warned that disadvantage early in a doctor’s career can have lasting effects.
“If doctors face disadvantage early in their careers, or before they begin them, they are already on an unequal footing,” he pointed out. “Inequalities are not inevitable, but they can reverberate throughout a lifetime.
“Entrenched disadvantage will have far-reaching consequences for doctors, services and patients. We must all play our part to tackle this challenge head-on.”
