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GPs go forth

Female GPs 'perform better than male GPs' in GMC clinical tests

Female GPs tend to score more highly than their male counterparts in GMC clinical competency tests, a study of 600 GPs has found.  

Researchers from the University of London, the Royal Free Hospital and the National Institute for Health Research analysed GMC data to see if the outcome of a fitness-to-practise investigation was linked to being a female or male GP and accompanying tests results.

Doctors who are under investigation for poor performance by the GMC can be asked to complete competency tests as part of the regulator's assessment of their fitness to practise.

Female GPs are already known to perform better than male GPs in RCGP examinations.

The study found that among the 120 GPs under investigation by the GMC that were included in the analysis, women fared better in both written and clinical assessments - which the researchers suggested may be due to a tendency to 'ask more psychosocial questions' that allow female GPs to glean more patient information.

Researchers compared this with test results for 480 GPs not under investigation and found while there was no difference in score in the written assessement, female GPs again obtained a better score than males in the clinical assessment.

In addition, the study noted despite male GPs under investigation having lower test scores in the clinical assessments - which increases the chances of disciplinary action - they were no more likely than female GPs to have a warning or sanction imposed.

The study authors said this 'suggests that the final decision on warnings or sanctions showed no sex bias beyond the differences in test performance,' noting that a decision to enforce disciplinary action is based on other evidence about the GP as well.

The GMC's competency tests involve a written assessment and objective structured clinical examination - and for GPs, they are also observed in a surgery simulating a real-life practice.

The study looked at 120 GPs - including 24 females and 96 males - under GMC investigation between 2008 and 2013 who were asked to complete tests of competence.

The cohort's results were then compared with those of 482 GPs not under investigation - of whom 43% were men - who voluntarily completed both tests between 1997 and 2006, and 2008 and 2014.

The paper, published in BJGP, said: 'Female GPs outperform male GPs on clinical assessments, even among GPs with generally very poor performance. Male GPs under investigation may have particularly poor knowledge. 

’Among GPs under investigation by the GMC, females outperformed males on the written and clinical components of the tests of competence. Among GPs not under investigation, females outperformed males on the simulated surgery test only.’ 

The researchers argued female doctors might perform better due to greater interaction with patients - as well as better knowledge.

They said: ’Female doctors in general have a more patient-centred approach and ask more psychosocial questions than male doctors, which stimulates more patient disclosure. Female doctors, including those under investigation, may therefore learn more information from patients, and perform better at the clinical assessment.’

’It is plausible that female GPs’ higher performance is therefore due to differences in skills and attitudes, as well as knowledge,’ they added.

Readers' comments (14)

  • The volunteers are a self selected group which makes statistical analysis challenging. However the low ratio of female GPs under investigation says enough on its own

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  • don't know about now but in my sho years i was regularly told i would not be offered a training post in hospital in case i got pregnant and because i was a girl - orthopedics especially, most of the women i knew then who went onto hospital specialist training decided not to have children as a consequence. Most females, therefore, chose to be GPs because it was more family friendly. This would suggest a higher standard of female doctors in primary care generally. To get into medical school, when i joined, you had to be better than the men in general, something i have witnessed over the years as a sho to senior reg level. Much happier as a GP where i am treated as an equal. The losers in this case are hospital medicine. Fortunately more women are becoming consultants now so hopefully this will improve.

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  • No surprises here, both the Educational system and Healthcare system have institutionalised bias against men.

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  • Lol Stelvio, you gonna start the masculinist movement? Burn our pants? lol

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  • The GMC's competency tests involve a written assessment and objective structured clinical examination - and for GPs, they are also observed in a surgery simulating a real-life practice.

    -Face a fitness to practice inquisition and be forced to sit the AKT and CSA again! Do the same fees apply?

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  • I agree it is impossible to say what the exact causes are:
    - Could be that one group is better than the other.
    - Could be that female and male GPs have a different range of skills, but that the assessments focus more on the female skills and less on the male skills.

    IF it is the second statement that is true - then men should be given an artificial head start in assessments (i.e. 5 bonus points for being a man or similar).

    The same logic can apply to the actual referrals. You are much more likely to be referred to the GMC as a man. Is it because of a higher number of errors? Or is it because patients (and coronors/ colleagues/ etc) who ultimately complain or instigate referrals are much less forgiving to men - therefore refer more easily. If that is the case, there should be some type of correcting factor - like men being given 'an extra life' if struck off or suspended.

    Now just to be even more controversial. Swap out men/ women and replace it with ethnicity, race or even social class - they try to work out how to correct all the social injustices in the world; while applied to a medical career.

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  • More male bashing. Organisations are now institutionally biased against men which is really unacceptable in this day and age. Trying to say women are suppressed is rather rich considering most of the medical schools are made up of women and the top job of Prime minister is a woman. The GMC tests are biased just on selection. I find the male GPs just as, or if not more popular at my surgery.

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  • So true Obi One. Women are allowed a lot more leeway than men who are told to man up or suck it up on anything. I thought men have the same kind of nerves too and can actually feel pain, fall ill and die?

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  • Vinci Ho

    You see
    Sometimes I just think these researchers need to think outside the box before undergoing and reporting certain ‘researches’ . Did this report help anything to our reality ; a hostile environment for GPs with recruitment and retention crisis , disproportionate rise in patients’ demands , poor and ignorant leadership from technocrats/ politicians etc (list goes on).
    Remember the infamous story of Agent Hunt exploiting BMJ’s study of more deaths were reported in hospitals in weekends than in week days ? And now BMJ has become a lot politically charged these days!
    I know academics do not like or even care politics ( none of us do) but it is like, ‘think carefully before you open our gob’ with a bit more political wisdom , please .

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  • Must be unconscious bias -time for another judicial review.

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