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Socioeconomic and demographic predictors of extracurricular achievements among UK medical students (FAST study)

Por: Ferreira · T. · Collins · A. M. · Handscomb · A. · French · B. · Bolton · E. · Fortescue · A. · Plumb · E. · Feng · O. · The FAST Collaborative · Fallows · Valnarov-Boulter · Kuo · Sagdeo · McDermott · Luo · Wong · Fitzsimons-West · Ho · Hemayet · Sreekumar · Burley · Stavrinou · Lew
Objective

To investigate the relationship between demographic characteristics and extracurricular achievements among UK medical students.

Design

National, cross-sectional survey.

Setting

All 44 UK medical schools recognised by the General Medical Council.

Participants

8,395 medical students.

Outcomes

Binary indicators of extracurricular engagement, including PubMed-indexed authorship, academic presentations, quality improvement projects, leadership roles and academic prizes. Logistic regression models were used to explore associations with demographic and extracurricular achievement predictors.

Results

Logistic regression analysis showed that students from private schools (OR 1.35, CI 1.20 to 1.53, p

Conclusions

Significant disparities in extracurricular achievement exist among UK medical students, principally associated with gender, private schooling and familial links to medicine. Apparent ethnic differences were largely attenuated after adjustment for other variables, indicating socioeconomic factors as stronger predictors of engagement. Given the role of these achievements in postgraduate selection, targeted interventions by medical schools and professional bodies to widen access to funding, mentorship and structured guidance for all students, regardless of perceived advantage, may support equitable opportunity without undermining merit-based standards.

Specialty choices among UK medical students: certainty, confidence and key influences--a national survey (FAST Study)

Por: Ferreira · T. · Collins · A. M. · Handscomb · A. · French · B. · Bolton · E. · Fortescue · A. · Plumb · E. · Feng · O. · the FAST Collaborative · Fallows · Valnarov-Boulter · Kuo · Sagdeo · McDermott · Luo · Wong · Fitzsimons-West · Ho · Hemayet · Sreekumar · Burley · Stavrinou · Lew
Objective

To explore factors influencing UK medical students’ specialty choices and examine variations in these influences across demographic groups and stages of training.

Design

National, cross-sectional online survey.

Setting

All 44 UK medical schools recognised by the General Medical Council.

Participants

8,395 medical students.

Primary and secondary outcomes

The primary outcome was the specialty preferences of UK medical students. The secondary outcomes were factors behind these preferences and how these factors vary across demographic groups and different stages of training.

Results

General Practice (15.3%), Paediatrics (10.6%) and Anaesthetics (9.9%) were the most preferred specialties among final-year students. Work-life balance (84.1%), compatibility with family life (78.2%), positive training experiences (85.2%) and future specialty outlook (74.9%) were key factors influencing specialty choice. Only 23.1% of students felt confident about securing a specialty training post, with confidence higher among males (OR 1.36, 95% CI 1.21 to 1.52, p

Conclusions

This study highlights disparities in specialty preferences and influencing factors among UK medical students. A focus on improving career guidance, exposure to various specialties and supporting equitable access to training opportunities is essential for fostering a motivated and sustainable medical workforce.

Protocol for an observational study to assess the impact of pharmacogenetics on outcomes in vascular surgery (PROSPER)

Por: Burke · K. A. · Mirza · S. · Wright · S. · Greaves · N. S. · Newman · W. G. · McDermott · J. H.
Introduction

Patients with chronic limb-threatening ischaemia (CLTI) are often prescribed clopidogrel in order to reduce their risk of major adverse limb and cardiovascular events. Clopidogrel is metabolised by the CYP2C19 enzyme and genetic variations in CYP2C19 are common. These variants can influence an individual’s ability to metabolise clopidogrel to its active metabolite. Few studies have investigated the relationship between patient genotype and outcomes in vascular surgery. This work aims to establish the relationship between patient genotype and outcomes after revascularisation in patients with CLTI who are prescribed clopidogrel. It will consider whether pharmacogenetics can be used to ensure patients are prescribed effective medications to optimise their outcomes.

Methods and analysis

This is an observational cohort study of patients undergoing lower limb surgical, endovascular or hybrid revascularisation for CLTI at Manchester University NHS Foundation Trust. Patients taking clopidogrel post-procedure, as well as those prescribed a non-clopidogrel based medication regimen, will be recruited prior to or shortly after revascularisation. Patients will undergo CYP2C19 genotyping and will be followed up using online records. The study has 90% power to detect 114 amputations with a target sample size of 483 participants. The primary outcomes are risk of amputation at 1 year and a composite endpoint for the risk of major adverse limb events (MALE) or death from any cause at 1 year. Secondary outcomes are risk of MALE at 1 year, risk of major adverse cardiovascular events (MACE) or death from any cause at 1 year, death within 30 days of revascularisation, minor re-interventions at 1 year, total number of re-interventions at 1 year and rate of systemic or gastrointestinal bleed at 1 year.

Risk of amputation, MALE and MACE will be analysed using Cox models. All remaining outcomes will be analysed using negative binomial models. Potential competing events for the risk of amputation will be investigated as part of a sensitivity analysis. Patients given a non-clopidogrel-based medication will be compared as an additional analysis.

Ethics and dissemination

Manchester University Research Ethics Committee approval obtained as part of the Implementing Pharmacogenetics to Improve Prescribing (IPTIP) trial process (IRAS 305751). The results of the study will be published in a peer-reviewed journal and presented at international conferences.

Registration

This work is a sub-protocol for the IPTIP study which is registered as ISRCTN14050335.

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