LONDON Differential Attainment Resources – Trainees

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Contributor Profiles

Contributor Profiles

Jacqueline Macdonald-Davis MSc, PGCE.

Jacqueline is a qualified teacher and a trained Careers Education and Guidance specialist and has worked in higher education as a lecturer, a consultant and as Head of Staff and Organisational Development at University College London, Institute of Education.

Jacqueline is a trained mentor, coach, and mediator as well as a Myers Briggs assessor. She is the author of several articles and publications. Jacqueline coordinated and oversaw the editing of HEE’s Differential Attainment (DA) Toolkit and the E-Learning, Support and Self-Review Modules. Her passion is to empower individuals to take the ‘next step’ in their personal and professional development. Jacqueline co-ordinated the development of the resources in the KSS Differential Attainment Project and is a member of the London DA Strategy Group.

Dr Sarah Siddiqui

Sarah Siddiqui is a Differential Attainment Fellow in the Professional Development Team in London and South-East who has co-led the development of the resources in the KSS Differential Attainment Project. She is dual-qualified in Medicine and Dentistry, on sabbatical from surgical training and former National Supported Return to Training Fellow for HEE. She has an interest in teaching and in producing educational material and courses around medical training, wellbeing and diversity and inclusion.

Dr Rupal Shah

Rupal Shah (MA (dist) FRCGP) is a GP and trainer in Battersea. She is also an Associate Dean working in the Professional Development Team in London, supporting trainees and supervisors who have faced difficulty. She has published extensively on various educational topics, including DA and has contributed to the DA web resources available in London. She is a member of the London DA Strategy Group.

Dr Helen Halpern

Helen Halpern is an Associate Dean with a background in General Practice and GP training. She has a Master’s degree in Systemic Family Therapy and has the Institute of Leadership Management Certificate in Executive Coaching. She has worked for a number of years in faculty development and in supporting postgraduate doctors in training who find themselves in difficult situations. Helen has a particular interest in the concept of change and how this can be facilitated through conversations and questions.

Lynne Rustecki

Lynne Rustecki is the Education Lead for Specialist Communication and Linguistic Support in the Professional Support Unit, Professional Development Team for Health Education England. She has a special interest in the communication challenges faced by doctors who are non-native speakers of English, and how linguistic and cultural factors may impact on professional interaction and consequently on Differential Attainment.

Hazel Russo

Hazel Russo is a Professional Support Unit (PSU) Coach, a Coach Supervisor, Facilitator and Trainer with over 20 years experience. She also trains and supports healthcare professionals to maintain professional boundaries, probity and ethics following conduct issues (with The Professional Boundaries Company). Hazel has a private coaching practice and is creator of the coaching board game, Lumination®. Hazel specialises in supporting professionals to improve communication, relationships and performance.

We would like to extend a special thank you to all the Supervisors and doctors in training who have contributed to the training package. 

As well as the following:

Jasveen Kaur Saund

Jasveen is the Business Support Officer for the London and KSS Differential Attainment project.

Femi Adedeji

Femi is the Communication and Engagement Manager for South East England – responsible for overseeing the KSS podcasts, PDFs and videos.

Harrison Davis

Harrison is the KSS Education Programme Manager – responsible for overseeing the collation of this resource on the KSS website.

Tamba Sumana

Tamba is the Communications and Engagement Administrator for South East England – responsible for the podcast transcripts.

Sandrine Massacdo

Sandrine Massacdo led the first phase of the administration of the KSS Differential Attainment Project.


The resource package for trainees has been developed by the Professional Support Unit (PSU) in London for the Kent, Sussex and Surrey Postgraduate School as a compilation of written, audio and video resources produced by experts in their respective fields, to support the learning needs of a diverse workforce and to provide trainees with the tools to navigate postgraduate training.

How the resources are organised

In the first Module we introduce Differential Attainment (DA), the perspectives of trainees from different cultural and linguistic backgrounds and explore the importance of identity and inclusion and effects of culture clash.

In Module two we explore communication, the importance of building good relationships from the beginning, receiving feedback, and approaches. This chapter also captures good local practices from departmental and institutional perspectives.

In Module three we provide resources for career progression including preparing for exams, work-based assessments, ARCPs and other high stakes interviews.

In the final Module we outline additional support and resources from the PSU.

These resources aim to enhance the training experience of trainees and to also demonstrate that they are not a homogenous group, but individuals with different learning needs.

Dear Trainee, please be aware that the Professional Support Unit are offering workshops on the themes outlined below. We do hope you will find the Differential Attainment toolkit useful.

Jacqueline MacDonald-Davis and Dr Sarah Siddiqui


In this module we introduce Differential Attainment in postgraduate medical training and the perspectives of International Medical Graduates.

1.1 An Introduction to Differential Attainment

A recorded lecture presented by Dr Rupal Shah introducing the definition and causes of differing levels of attainment amongst trainees along with PowerPoint slides, work sheets and suggestions for additional reading.

Links to resources:

An Overview of Differential Attainment (Slides)

An Overview of Differential Attainment (video)

1.2 Perspectives on Differential Attainment

1.2.1 Identity and Inclusion

In our Identity and Inclusion video, we outline the experience of doctors commencing work in the NHS for the first time or returning to training. We also speak to Educator Dr Amit Gupta on the impact of the complex interplay of culture, environment, work practices and bias on performance of BAME doctors. In the second podcast he describes the impact of racism and how it affects behaviour from a doctor’s perspective.

Links to resources: Identity & Inclusion Video [13mins] & Accompanying worksheet

Culture Clash – Part 1 – an educational supervisors’ perspective and experiences as an IMG [15mins]

Culture Clash – Part 2 – Micro-bumps – How racism works and affects behaviour – a doctor’s perspective [9mins]

1.2.2 Perspectives of working in the NHS as an International Medical Graduate

This audio podcast captures experiences of an International Medical graduate and the insights of an educational supervisor who supports those new to the NHS.

Links to resources:

Podcast on Trainee and Educator perspectives on working in the NHS as an IMG [50mins]

1.2.3 Culture and Professionalism

In this section we introduce a video where International Medical Graduates and Educators discuss the challenges of adjusting to UK practice and is accompanied with a worksheet with questions and exercises to work through before and after viewing the video.

Links to resources:

PSU podcast on Culture and Professionalism [8mins] & Accompanying worksheet

1.3 Capturing and learning from good educational practice

1.3.1 Capturing Good Educational Practice – Targeted Training for GP trainees

In these videos, Dr Rupal Shah is in discussion with Dr Smart Onukaogu and Dr Rob Gardiner about the challenges of progressing in training, and their experiences of overcoming the attainment gap in GP training. They also reflect on personal circumstances, the support they received and how appreciative enquiry can support trainees to overcome challenges.

Links to resources:

Capturing good practice – In discussion with GP trainee Dr Smart Onukaogu [16mins24s]

Capturing good practice – In discussion with GP trainee Dr Rob Gardiner [14mins22s]

1.3.2 Capturing Good Practice: Institutional Perspectives

This videocast captures the work on race and privilege at East London Foundation Trust. A report of how a trust changed recruitment policy and methods creating a Trust Grade Foundation Programme for IMGs demonstrates how equity can be achieved at local levels.

Links to resources:

Capturing good practice – innovations at the East London Foundation Trust [33mins]

Junior Trust Grade Foundation Program at the Royal Surrey Hospital


2.1 Facilitating Conversations with Supervisors

These worksheets introduce approaches to building relationships with your supervisor, reframing feedback and compassionate leadership. The audio podcasts frame a coaching approach to asking for help and opening challenging conversations with your supervisors.

Links to resources:

Building a good relationship with your trainer

Tips for trainees on how to build good relationships with trainers and why that is useful.

Feedback – tips and tools

Reframing feedback for trainees, introduction to models for giving and receiving feedback, with examples and exercises on how to give feedback and respond to feedback received.

Bringing compassion to the table

Highlighting the evidence for and value of bringing compassion to interactions with patients and references also to compassionate leadership.

Audio Podcast on Asking for Help

In this podcast coach Hazel Russo discusses with Dr Sarah Siddiqui the dynamics around why trainees find it difficult to ask for help and offers a coaching approach to requesting support.

Audio Podcast on Approaching a Challenging Conversation with a Supervisor

In this podcast coach Hazel Russo explores with Dr Sarah Siddiqui the reasons why trainees might find it difficult to approach a challenging conversation or raise a difficult topic with their supervisors and offers some coaching approaches and tips about how to make the process easier.

2.2 Conflict and Mediation

This section offers an introduction to coaching tools and key tips for managing conflict or challenging situations. These worksheets highlight the value in busy and stressful times of bringing compassion to interactions with trainees, while recognising that challenging behaviours can be an indicator of challenges elsewhere in life, and the importance of being ready and willing to listen without judgement. The section also features a podcast with a professional mediator on what mediation is, and when to use it to manage conflict in clinical settings.

Links to resources:

Conflict Modes

Podcast on Mediation [38mins] (This podcast has been created primarily for trainers and supervisors. However, it is included here as trainees may find it useful to learn something about the mediation process if faced with conflict or challenging situations.)


In this section we introduce Mindfulness, including an audio podcast describing its use in supervision and key tips for deciding when it is appropriate to use with trainees. 

Links to resources:

An introduction to Mindfulness

Podcast on Mindfulness in Supervision [10mins]

Mindfulness Session Audio Clip

2.3 Doctors from diverse linguistic and cultural backgrounds

In this presentation we introduce the concept of linguistic and social capital and implications of this for DA.

Links to resources: Supporting doctors from diverse linguistic and cultural backgrounds


3.1 Portfolio and ARCP Preparation

A presentation on portfolio working, perspectives around reflective learning and preparing for an ARCP and common pitfalls. A recorded presentation highlighting the use of language and its interpretation at recruitment interviews, panels (e.g. ARCP) or other educational meetings.

Links to resources:

ARCP Preparation Slide set

Presentation on Language and Inclusion in Interview Insights for IMGs

Tips and Tools for Preparation for ARCP

3.2 Preparation for Postgraduate Exams

A presentation on preparation for postgraduate exams and re-sits with tips around revision, exam technique and additional support available.

Links to resources:

How to prepare for Postgraduate Medical Exams Presentation

How to prepare to Resit Postgraduate Exams Presentation

Specialist Clinical Communication and Linguistic Services

The PSU offers a variety of individual and group sessions where trainees have the opportunity to work with clinical educators, linguists and professional role players to develop their spoken and written communication skills in a variety of contexts.

Specialist Clinical Communication & Linguistic Services | London (

3.3 Career support and self-coaching material

Resources around making choices about your career could be based on the SCAN model that is: self-awareness, career exploration, making decisions and next steps. There are also links to workshops on consultant interviews and 1:1 confidential, impartial career coaching conversations.

Links to resources:

SCAN Career Planning Model

A structured framework designed to offer informed, realistic and robust career planning for health professionals

Networking For Clinicians

This webinar focuses on the advantages of utilising and developing a network of key contacts to inform conversations around your career and clarify understanding of particular roles and opportunities.

Confidential 1:1 Careers Support

The Careers Unit provides free and confidential individual support and coaching to doctors and dentists training in London and KSS. If you wish to discuss how best to manage your career, the careers team can assist you to explore your options. Apply here


4.1 Professional Support Unit Services

London & KSS PSU website & Infographic of PSU Resources

4.2 E-learning, Support and Self-Review Modules

E-learning, Support and Self-Review Modules, including: Assertiveness, Insight, Stress, Mental Health and Wellbeing, Resilience, Examination Support, Personal and Professional Effectiveness including Time Management.

4.3 Online resources from PSU

Key links and Exercises including: breaking unwelcome news, Counselling and Support, Disabilities, Equal Opportunities, Learning and Development, Managing Anxiety, Mental Health, Mindfulness and Stress, Burnout and Vicarious Traumatisation (VT).

Virtual Group Support for Trainees

4.4 Other Useful Resources

BMA: Sources of support for your wellbeing

Help me, I’m a doctor

TEDTalks provide interesting talks on subjects such as: confidence building, resilience, managing stress and well-being.


4.5 Differential Attainment and Disability

Disabled Doctors Network

Support Groups for Health Professionals

One-to-one support