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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.