Why Do Ethnic Minority Students Under-Achieve Academically?

1. Why Do Ethnic Minority Students Under-Achieve Academically? MARK CARROLL ~ Senior Lecturer in Biochemistry JAMES MACKENZIE ~ Intercalated BSc student Barts and The London

2. Evidence for a general problem Ethnic minority students and graduates under-achieve academically in many areas of Medicine: ~ Predicting the ‘strugglers’ (Yates & James, 2006) ~ ‘Early performance’ predictors (Lumb & Vail, 2004) ~ Year 3 OSCE (Woolf et al., 2008) ~ Year 5 OSCE (Wass et al., 2003) ~ Year 5 written exams (McManus et al., 1996) ~ MRCP (UK) exams (Dewhurst et al., 2007) But there have been few studies of the early years of the MBBS course.

3. How to address the question? • Study one cohort of MBBS students (2007 intake) at an early stage of the course (Years 1+2): • Statistical analysis of academic outcomes and related variables • Qualitative research with students • On basis of self-declared ethnicity, categorised as ‘white’ or ‘non-white’.

4. Quantitative studies ~ variables studied Academic achievement at medical school: ~ Pass/Fail MBBS Part 1 (end of Year 1) ~ scores in end-of-year exam papers (coursework, EMQs, SAQs, practical/OSCE) Variables: ~ age ~ sex ~ ethnicity ~ highest qualification on entry (HQE) ~ UCAS tariff scores (A/AS levels); UKCAT scores (entrance test) ~ Home/EU or International ~ attendance (at PBL tutorials)

5. Quantitative studies ~ t-tests and correlations ~ Significant differences between ‘white’ (n = 92) and ‘non-white’ (n = 168) students with respect to: Age (white students older, p < 0.05) Verbal reasoning skills (white students better, p < 0.001) HQE (relatively more white graduates, p < 0.001) Performance in MBBS Part 1 exams (white students better in terms of fewer Fails and higher % scores, p < 0.001) ~ No differences with respect to: UCAS tariff scores; most UKCAT domain scores; attendance ~ Excluding International students does not affect outcomes

6. Quantitative studies ~ regression analysis Performance at MBBS Part 1: ~ Significant unique variables with respect to Pass/Fail end-of-Year 1 exams are: UCAS tariff scores and Ethnicity ~ Significant unique variables with respect to end-of-Year 1 % exam scores are: UCAS tariff scores (all papers); Ethnicity and HQE (some papers) ~ Other variables in the model do not make a significant unique contribution: UKCAT scores, sex, age, Home/International status ~ Model only accounts for 10~20% of total variance

7. Qualitative studies ~ questionnaire ~ Single paper-based question at end of tutorial; written responses; anonymous (n = 24) ~ Factors identified: family pressures (problems, commitments) work ethic (attitude, time management, independent study) distractions (peer group pressure, paid employment)

8. Qualitative studies ~ focus groups ~ Difficult to engage students from Asian ethnic backgrounds ~ 4 ethnically homogeneous focus groups (Asian, Black, White) (n = 14) ~ Emerging themes: motivation to study Medicine social transition work ethic time constraints educational transition peer pressure It’s like, ”I’m finally here”, and so they kind of just kick back a bit ~ female, Sri Lankan, focus group 4

9. Conclusions ~ Main significant unique variables contributing to academic success at MBBS Part 1 are: prior educational attainment (no surprise there!) ethnicity (‘white’ / ‘non-white’) ~ Multiple contributory factors to academic under-achievement by ‘non-white’ students in Year 1: family-related constraints time- and money-related constraints academic constraints (work ethic and study patterns) ~ Haven’t captured all significant contributory variables in this study

10. Further work? ~ Combine cohorts and repeat quantitative studies ~ Study ethnic sub-groups in combined cohorts ~ Include socio-economic background data and award of Merits ~ Extend ethnographic qualitative studies Acknowledgements: Viv Cook (BL) – qualitative analysis Kath Woolf (UCL) - multiple aspects

11. Any questions? Mark Carroll, m.carroll@qmul.ac.uk