Fairer Training in public health, the UK FPH example

Abstract Background Public Health (PH) advocates for health equity and social justice. The UK Faculty of Public Health (FPH) is committed to tackling inequalities across the public health career pathway. The Fair Training project is a multi-phased programme which focuses on fair recruitment into PH, reducing differential attainment during PH training and postgraduate examinations. Objectives • Analyse available data from various sources; • 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. Variables explored were demographic characteristics e,g, age, sex, ethnicity, disability status, professional background, candidate status (UK or overseas), place of primary qualification. Results Results show that candidates from ethnic minority backgrounds, those who are older, from international medical graduate backgrounds and backgrounds other than medicine are under-represented at the end of recruitment. Multivariable analysis of the diplomate exam shows that an attainment gap exists across increase with age, and those from black, Asian or white other ethnicity, professional background other than medicine, and overseas candidates. For the membership exam, multivariable analysis shows the attainment gap persists across those of increasing age and black ethnicity. Conclusions Recognising differential attainment as a structural problem requires organisational and individual leadership. Recommendations include an action plan to ensure: • Equality of opportunity for learning and career progression; • Collaborative working to eliminate discrimination in the design of education; • Ensure that training and the working environment are inclusive and diverse; • Inform future PH workforce planning; • Share good practice. FPH will implement the recommendations and share with other organisations and countries. Key messages • Structural causes of differential attainment during recruitment and training in public health do exist and should be mitigated. • FPH aims to promote Fair Training and excellence in public health practice.