Medical Workforce Race Equalities Standards - five years on
In 2020, NHS England introduced the Medical Workforce Race Equality Standards (MWRES). Now, five years on, an independent and unfunded report revisits the original 11 indicators to assess progress and identify areas requiring attention and calls for renewed commitment from NHS employers and national stakeholders.
Why this report matters
BME doctors now make up the majority of the UK’s licensed medical workforce, driven largely by the rise in international medical graduates (IMGs).
Despite modest improvements in leadership representation and fairness of referrals, deep-rooted inequalities persist in career progression, training outcomes and workplace experience.
The report highlights inconsistent induction practices, gaps in data collection, and under representation in academic and leadership roles.
Key findings
Leadership representation
BME doctors remain underrepresented in senior roles such as consultants, clinical directors and medical directors.
Only 24.2 per cent of council members across Royal Colleges are from BME backgrounds, despite BME doctors comprising over 50 per cent of the workforce.
Differential attainment
BME and IMG doctors continue to face lower pass rates in speciality exams and higher rates of unsatisfactory ARCP outcomes.
Revalidation deferrals are more common among BME doctors, impacting career progression and confidence.
Disciplinary referrals
BME doctors are disproportionately referred to the GMC, though recent data shows encouraging progress in reducing the gap through targeted interventions.
Workplace experience
BME staff report higher rates of bullying, harassment and discrimination from both patients and colleagues.
Fewer BME doctors feel they have equal access to career development opportunities compared to non-BME colleagues.
Induction and support for IMGs
Many IMGs, especially locums report receiving no formal induction before assuming clinical responsibilities.
The GMC’s welcome to practice programme needs wider implementation within trusts.
SAS and locally employed doctors
SAS doctors, many of whom are IMGs, face barriers to leadership and extended roles.
A third of NHS trusts report having no SAS doctors in leadership positions.
What employers can do
Strengthen data collection
- Ensure robust, granular data on race, ethnicity, and other protected characteristics is collected and published annually.
- Include SAS and LE doctors in national surveys and workforce datasets.
Improve induction and career support
- Adopt the welcoming and valuing IMGs guidance as standard practice.
- Provide tailored support for SAS and LEDs, including mentorship, leadership development and access to training.
Promote inclusive leadership
- Ensure BME representation in decision making bodies.
- Focus on competence and commitment to equity, not just representation for meaningful change.
Audit and reform disciplinary processes
- Use fairness checks and early resolution models to reduce disproportionate referrals.
- Engage with GMC and NHS Resolution frameworks to improve local investigation practices.
A call to action
The MWRES five years on report is a powerful reminder that equity in the medical workforce is not just a moral imperative - it’s essential for patient safety, staff wellbeing and organisational excellence. NHS employers play a critical role in driving this change by committing to transparent data, inclusive practices and targeted support.
