Data has shown that there are disparities between representation at senior levels and pay between ethnic minorities and white staff, with white staff more likely to progress and hold higher band roles. These disparities were especially evident for international medical graduates (IMGs) and specialty and associate specialist (SAS) doctors. In response to these disparities, NHS England published the Medical Workforce Race Equality Standard (MWRES). MWRES outlines five domains ('the First Five') to address the inequity experienced by ethnic minority doctors. These domains address recruitment, promotion, pay, experience of bullying and harassment, and representation in senior positions.

Data from the MWRES highlights disparities between ethnic minority and white staff. It notes that ethnic minority doctors are underrepresented in consultant grade roles and academic positions and overrepresented in other doctor grades and postgraduate training. It also highlights that ethnic minority doctors are overrepresented at agenda for change pay band five at 36.8% (Workforce Race Equality Standard (WRES) 2023) for clinical roles outside of medicine, the base grade for registered nurses.

With 32.6% of doctors being ethnic minority international recruits (UK Parliament), board members should consider how these disparities affect this section of the workforce as they grow in their role and career. Access to high quality training and inclusive talent management processes for international recruits is essential to ensure that they have the skills and knowledge to succeed. It ensures staff members are aware of and can adhere to local policies and procedures, national guidelines, and regulations (UK Parliament).

Trust leaders can ensure their internationally educated workforce (IEW) have access to high quality training by:

  • Ensuring processes are in place to identify learning needs, and providing tailored training programmes that address those needs.
  • Ensuring programmes are delivered by qualified trainers who have experience working with diverse groups of people, and that they are regularly evaluated and updated to ensure their effectiveness.
  • Providing adequate resources and support for training, such as funding for language courses or support for study leave.
  • Fostering a culture of continuous learning and development within the organisation to create a positive learning environment.

Having robust inclusive talent management initiatives for the IEW ensures that they have equal opportunities for career advancement and professional development. It also ensures that they can progress based on their skills and qualifications, rather than their ethnicity or nationality. This helps to address issues of discrimination, unconscious bias, and lack of representation in leadership positions, which can in turn impact the morale, retention and diversity of the workforce. By promoting inclusivity of international recruits, organisations' workforces can benefit from the impact of having diverse perspectives, experiences, and expertise. This can in turn lead to improved patient care and organisational performance.

Inclusive talent management principles regarding promotion include:

  • Ensuring that stretch, acting up, and promotion opportunities are transparent and communicated clearly to all staff.
  • Providing opportunities for the IEW to participate in leadership and development programmes, mentoring schemes and other initiatives that support career advancement.
  • Fostering the participation of the IEW in leadership and development programmes, mentoring schemes and other initiatives that support career advancement.
  • Ensuring inclusive recruitment principles, such as the evidenced-based interventions identified in No more tick boxes, are applied to all processes and that training is provided to all hiring participants.
  • Monitoring and evaluating promotion rates and career progression data for the IEW to inform the development of necessary interventions.

Click here to explore this topic further with a case study from University Hospitals of North Midlands NHS Trust.