A cross-sectional study examining MRCS performance by core surgical training location

Figures & data

Table 1. MRCS first attempt pass rates by gender, ethnicity, age, and first language.

Predictor	Part A (n = 1104)	Part B (n = 659)
Gender
Male	56.4% (352/624)	81.1% (335/413)
Female	39.8% (185/465)	81.1% (193/238)
Missing	n = 15	n = 8
p-Value	<0.001	0.995
Ethnicity
White	53.6% (321/599)	83.4% (306/367)
Non-White	41.1% (134/326)	78.2% (147/188)
Missing	n = 179	n = 104
p-Value	<0.001	0.135
Age
<29 years old at graduation	50.7% (519/1024)	82.5% (514/623)
≥29 years old at graduation	32.5% (26/80)	58.3% (21/36)
Missing	n = 0	n = 0
p-Value	0.002	<0.001
First language
English	49.6% (353/712)	81.9% (326/398)
Other	50.0% (49/98)	77.4% (41/53)
Missing	n = 294	n = 208
p-Value	0.938	0.424

MRCS: Membership of the Royal College of Surgeons.

The difference in N is due to 445 doctors with Part A not having obtained Part B at the time of data collection.

Note. All p-values presented are from chi-squared analysis.

Figure 1. Mean (95% confidence interval) MRCS pass rates by core surgical training deanery.

Table 2. Variation in MRCS performance at first attempt between CST deaneries and their corresponding NTS overall trainee satisfaction scores.

Training deanery	NTS overall satisfaction score 2018	MRCS Part A			MRCS Part B
		First attempt pass rate	Mean percentage score relative to pass mark (SD)	Mean number of attempts to pass (SD)	First attempt pass rate	Mean percentage score relative to pass mark (SD)	Mean number of attempts to pass (SD)
Thames Valley	71.32%	69.4% (25/36)	1.8% (15.3)	1.5 (0.9)	93.3% (28/30)	21.2% (8.9)	1.0 (0.2)
North Central and East London	75.12%	68.1% (32/47)	2.9% (15.5)	1.5 (1.0)	97.4% (37/38)	22.5% (8.2)	1.0 (0.2)
North West London	76.61%	65.9% (27/41)	1.4% (10.9)	1.6 (1.0)	86.2% (25/29)	20.4% (9.8)	1.1 (0.4)
South London	70.63%	61.5% (40/65)	0.2% (13.3)	1.5 (0.8)	88.4% (38/43)	19.5% (7.0)	1.1 (0.4)
Scotland	77.34%	56.5% (48/85)	−1.7% (13.8)	1.8 (1.1)	82.0% (41/50)	19.3% (9.8)	1.1 (0.4)
North West	74.95%	55.3% (78/141)	−1.5% (12.9)	1.7 (1.0)	78.8% (63/80)	16.7% (9.4)	1.2 (0.5)
South West	79.09%	50.0% (40/80)	−1.5% (10.5)	1.8 (1.0)	84.6% (44/52)	18.3% (9.4)	1.1 (0.4)
West Midlands	75.21%	48.2% (40/83)	−3.1% (15.2)	2.0 (1.1)	77.8% (35/45)	16.6% (11.2)	1.2 (0.5)
Wales	70.29%	46.1% (35/76)	−5.0% (16.3)	1.9 (1.1)	86.8% (33/38)	16.5% (6.8)	1.1 (0.4)
Kent, Surrey, and Sussex	78.01%	45.9% (28/61)	−2.8% (12.5)	1.9 (1.0)	84.2% (32/38)	17.1% (9.3)	1.1 (0.4)
East Midlands	73.00%	45.3% (29/64)	−2.6% (13.6)	1.8 (1.0)	79.5% (31/39)	14.6% (10.3)	1.1 (0.3)
East of England	68.65%	44.3% (31/70)	−2.0% (13.0)	2.0 (1.1)	80.5% (33/41)	18.6% (7.4)	1.2 (0.4)
Northern Ireland	71.85%	37.9% (25/66)	−6.2% (13.3)	2.0 (1.1)	55.6% (15/27)	16.9% (9.8)	1.3 (0.6)
North East	76.39%	36.5% (19/52)	−4.1% (12.6)	2.1 (1.1)	70.0% (21/30)	17.4% (10.1)	1.3 (0.6)
Yorkshire and the Humber	69.64%	35.1% (33/94)	−4.7% (13.6)	2.0 (1.1)	74.0% (37/50)	16.2% (9.8)	1.2 (0.4)
Wessex	75.21%	34.9% (15/43)	−3.8% (12.4)	2.2 (1.1)	75.9% (22/29)	15.1% (10.6)	1.2 (0.5)

MRCS: Membership of the Royal College of Surgeons; SD: standard deviation.

Table 3. Odds ratios for passing MRCS Part A and B at first attempt by training deanery before and after adjusting for sociodemographic predictors of success.

Training deanery	MRCS Part A		MRCS Part B
	Unadjusted Odds Ratio (95% confidence interval) (n = 1104)	Adjusted Odds Ratio (95% confidence interval) (n = 910)	Unadjusted Odds Ratio (95% confidence interval) (n = 659)	Adjusted Odds Ratio (95% confidence interval) (n = 659)
Thames Valley	2.27 (0.99–5.23)	2.52 (1.00–6.42)	3.40 (0.67–17.31)	3.10 (0.60–15.90)
North Central and East London	2.13 (1.00–4.53)	2.37 (1.04–5.40)	8.97 (1.07–35.57)	10.59 (1.23–51.00)
North West London	1.93 (0.88–4.21)	2.27 (0.93–5.58)	1.52 (0.41–5.60)	1.49 (0.40–5.57)
South London	1.60 (0.82–3.11)	2.36 (1.09–5.10)	1.85 (0.55–6.18)	1.95 (0.57–6.66)
Scotland	1.30 (0.70–2.40)	1.30 (0.66–2.56)	1.10 (0.38–3.18)	1.17 (0.40–3.44)
North West	1.24 (0.71–2.15)	1.32 (0.72–2.42)	0.90 (0.35–2.30)	0.90 (0.35–2.33)
South West	Reference category	Reference category	1.33 (0.45–3.92)	1.27 (0.43–3.76)
West Midlands	0.93 (0.50–1.72)	1.09 (0.55–2.16)	0.85 (0.30–2.41)	0.81 (0.28–2.31)
Wales	0.85 (0.46–1.60)	0.84 (0.42–1.69)	1.60 (0.47–5.40)	1.72 (0.50–5.92)
Kent, Surrey, and Sussex	0.85 (0.44–1.65)	1.16 (0.56–2.44)	1.29 (0.40–4.14)	1.38 (0.42–4.51)
East Midlands	0.83 (0.43–1.60)	1.01 (0.48–2.13)	0.94 (0.31–2.81)	0.99 (0.32–3.00)
East of England	0.80 (0.42–1.51)	0.96 (0.47–1.94)	Reference category	Reference category
Northern Ireland	0.61 (0.31–1.18)	0.85 (0.38–1.88)	0.30 (0.10–0.90)	0.32 (0.11–0.96)
North East	0.58 (0.28–1.18)	0.60 (0.28–1.32)	0.57 (0.19–1.70)	0.52 (0.17–1.56)
Yorkshire and the Humber	0.54 (0.29–1.00)	0.57 (0.29–1.13)	0.69 (0.25–1.87)	0.65 (0.24–1.79)
Wessex	0.54 (0.25–1.15)	0.63 (0.26–1.51)	0.76 (0.24–2.40)	0.83 (0.26–2.68)
Gender Male vs. Female	–	2.30 (1.74–3.04)	–	–
Ethnicity White vs. Non-white	–	2.00 (1.48–2.70)	–	–
Age at graduation <29 vs. ≥29 years	–	2.55 (1.45–4.47)	–	3.93 (1.86–8.29)