From Trainees to Assessors: Demographic Differences Between UK Surgical Trainees and ARCP Panels

OBJECTIVE: Compare the demographics of UK surgical trainees and Annual Review of Competence Progression (ARCP) panel members to assess proportional representation. DESIGN: Retrospective cross-sectional analysis of national trainee and assessor records, with a consultants-only sensitivity analysis. SETTING: UK surgical training programs across 11 surgical specialties (including core surgical training) from August 2024 to July 2025. PARTICIPANTS: A total of 9848 surgical trainees and 2667 consultant surgeons serving on ARCP panels. MAIN OUTCOME MEASURE: Odds of ARCP panel membership by gender, ethnicity, and sexual orientation. RESULTS: Male representation was higher among ARCP panels (68.1%) than trainees (55.3%), while women were underrepresented (20.5% vs 35.4%). White surgeons were proportionally overrepresented on panels (51.5% vs 39.2%), whereas Asian (24.9% vs 27.8%), Black (1.8% vs 5.3%), mixed/multiple (2.7% vs 4.2%), and other/Chinese (19.0% vs 23.5%) groups were underrepresented. LGBTQ+ surgeons comprised 2.0% of ARCP panel members and 4.0% of trainees. In multivariable analysis, female gender (aOR 0.43, 95% confidence intervals CI 0.37-0.49), Asian (aOR 0.62, 95% CI 0.54-0.70), Black (aOR 0.23, 95% CI 0.16-0.33), mixed/multiple (aOR 0.47, 95% CI 0.34-0.64), other/Chinese ethnicity (aOR 0.36, 95% 0.30-0.44), and LGBTQ+ orientation (aOR 0.34, 95% CI 0.23-0.48) were significantly associated with lower odds of panel membership. When panel membership was compared with the consultant population rather than trainees, gender differences reversed (female consultants had higher odds of panel membership), ethnic differences were attenuated with underrepresentation persisting for the other/Chinese group (aOR 0.60, 95% CI 0.47-0.75), and no significant difference was observed for LGBTQ+ orientation. CONCLUSIONS: ARCP panels are less diverse than the trainee population by gender, ethnicity, and sexual orientation. Differences appear to reflect both pipeline effects and assessor selection. Aligning panel composition with trainee demographics is a feasible step toward equitable assessment in surgical training.