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Diversity and Widening participation in Medicine

By Dr Oonagh King 8 months ago 692 Views No comments


When medical schools review applications for places on their courses, there is a lengthy and in-depth selection process to choose their desired applicants. Nowadays, this process includes analysing academic background; aptitude test performance; and personal statements, which demonstrate a candidate’s motivation, communication skills, empathy, team-working skills etc. It also considers work experience, voluntary activities and positions of leadership. Often, all of these things are looked at, before a candidate is even invited to interview. You might well wonder, with medical school places being so oversubscribed, why admissions boards will go to these lengths to select future doctors. Why not simply take the top X-hundred students in the country, based on their A level results, or GCSEs? The answer to this question is because medical schools are not simply looking for academic individuals who can be sure of completing their degrees, but instead they are recruiting future doctors who can give patients healthcare according to their needs. NHS doctors don’t need to have an A* in their GCSE Spanish or French (unless practising in a French or Spanish-speaking country!), but they do need to be able to empathise with their patients and communicate with them, not only to give correct diagnoses and treatment, but also to enable the patient to understand what their condition is and what effects their treatment will have


While all doctors are trained and expected to practise in a professional manner, with due consideration for equality and diversity, this is made so much more feasible by having a diverse medical workforce. As politicians represent their constituents (in theory anyway!), so the background of doctors should reflect that of their patients. This promotes trust in the doctor-patient relationship and helps to break down traditional patriarchal barriers that have existed in Western Medicine for centuries.


The need for widening participation in professional careers such as Medicine, has been recognised on a national level also. A government report, entitled ‘Fair Access to Professional Careers’ (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/61090/IR_FairAccess_acc2.pdf), demonstrates the economic need for social mobility and greater movement of more members of society into professional employment. It describes barriers which contribute to the ‘glass ceiling’ effect, preventing many desirable candidates for Medicine progressing to medical school training. These include: ‘unfocused aspiration-raising programmes, poor careers advice, lack of school choices, artificial barriers between vocational and academic education, unfair university admissions, limited work experience opportunities, non-transparent internships, antiquated recruitment processes [and] inflexible entry routes.’


So how are medical schools tackling this at the moment?


Some medical schools, such as Durham University medical school, have specific programmes for eligible students from under-represented groups. Durham’s Gateway to Medicine programme offers a Foundation Year to develop the baseline skills and subject knowledge in order to progress into the first year of the medical degree. Class sizes are small and students who need support with language or academic subjects are offered up to 4 extra hours of tutor contact per week. To be eligible, applicants must be from the North East of England and meet at least two criteria of the following: they are first-generation university attenders; they attend a school where GCSE performance is lower than the national average; they receive free school meals; they have spent time in local authority care; or they reside in an area which falls in the lowest 40% of the Index of Multiple Deprivation (which seems to be a technical way of saying that the area has a lower than average income). Students are identified by their schools in their AS year and participate in a range of programmes in their A2 year, and are then eligible to apply to the Gateway programme with A level grades AAB-BBC, as opposed to the typical AAA for the standard Medicine programme.


Other medical schools such as Birmingham have partnership schemes such as Access to Birmingham, which offer suitable candidates preliminary support with application and interview skills, and candidates who successfully complete the programme (along with the A2B module, examined by essay) will receive an offer with lower grades than the standard for A level and GCSE. They may also be eligible for a scholarship, depending on their grades and scores in the examined A2B module. Another tool to assist medical schools in widening access to Medicine is contextual data provided by UCAS. This is information regarding a candidate’s residential area and school performance, which may help to identify talented applicants with greater social, economical and educational barriers to applying to Medicine. UCAS provides this information, usually based on the applicant’s postcode and school. Different medical schools will use contextual data in different ways, and will approach widening access in different ways. Often that means building partnerships with local schools, so a visit to your school’s careers adviser is a good idea to find out what is available to you locally, as well as nationally. Note that most widening participation routes are aimed towards undergraduate applicants/applicants who have not undertaken a previous degree. Listed on the next page is a table of the UK universities and the different methods they have to encourage widened participation./p>


One of the reasons I feel particularly strongly about widening participation in Medicine, is that only one of my grandparents was educated beyond the age of fourteen, yet both of my parents went to university and became healthcare professionals – brilliant and caring healthcare professionals (in my biased opinion!). If becoming a doctor is something you want to do and it is within your capability to do the job, don’t be put off if you have to step into a pioneer role to do this – do your research, talk to your school careers advisers and see what pathways are out there that can help you on the road to Medicine. Email/telephone local hospitals and GPs and ask if you can have some work experience with them. Have a look at the MSAG website – we have lots of blogs to support you around application dilemmas and topical healthcare issues. Don’t be put off if things don’t work out first-time, keep going, and just think that every time you pick yourself up after a setback, you are showing the admissions teams that you are committed to Medicine. And remember that things don’t have to work out first-time. I left Medicine twice due to anxiety and a lack of self-confidence, thinking that I could never do the job of a doctor, but I came back each time and although it took me twelve years from my first year of medical school to completing my Foundation years, I did it, and I learned more about myself during that time, than I would have if I had taken the usual course of completing this training in 7/8 years.


Dr Oonagh King


Ways in which the UK medical schools help to widen participation (please see individual school page for further details and eligibility)


UK Medical School
Widening Participation Initiatives
Aberdeen
The admissions team can add discretionary points to candidates whose postcode of residence falls within the fourth and fifth most deprived postcodes as measured by the Scottish Index of Multiple Deprivation, as well as to candidates who have serious extenuating circumstances. The medical school is also involved with the following schemes:
  • Aim 4 Uni
  • S6 Enhancement
  • Reach
  • ASPIRE North
Barts and the London
Barts have a 6-year extended medical programme, known as the Barts Health Scheme (formerly the Newham Docs Scheme), offered for students in certain state schools in East London. The A level grade offers for this course will be in the range of AAB-BBB depending on the contextual data from the candidate’s educational and socio-economic background.
Birmingham
Birmingham medical school liaises with the following schemes to support students from disadvantaged backgrounds in applications:
Brighton and Sussex
Brighton and Sussex Medical School considers contextual data from UCAS to review each undergraduate candidates application in light of their individual circumstances.
Bristol
Candidates may apply to a 6-year foundation programme if their schools were ranked in the bottom 40% of schools in the previous academic year, with A levels BBC.
Cambridge
Cambridge considers contextual data from UCAS to review each candidate’s application in light of their individual circumstances. They do not make any specific guarantees as to whether a candidate would be guaranteed an interview on that basis, or whether they would consider an applicant suitable for a lower offer.
Cardiff
The admissions team will take contextual data from UCAS into account when offering interviews, but will not adjust their minimum grade requirements needed for an offer. Applicants who have taken part in the Step Up to University Scheme will have a guaranteed interview, provided that they meet the minimum academic entry requirements.
Dundee
Durham offers approximately 10 spaces on their 6-year Gateway to Medicine programme, aimed towards applicants from the North East of the UK who meet certain eligibility criteria (see the Durham medical school page in this guidebook).
Edinburgh
The medical school supports LEAPS, REACH and the Pathways to the Professions Initiative as well as the university’s contextual admissions policy
Exeter
Exeter medical school runs a number of outreach programmes in Cornwall, Devon and Somerset.
Glasgow
The medical school works with the Reach Programme which links to 95 different schools in the West of Scotland to encourage students with academic potential and an interest in Medicine to apply to the course. Applicants may be eligible for lower offer grades or added points for their UKCAT score.
Hull-York
Students from the following programmes have previously been given lower grade offers as well as fast-track interviews:
  • University of York Next Step programme 
  • Realising Opportunities Programme 
  • HYMS Pathways to Medicine programme
Previously applicants who have attended the HYMS summer school and applicants who have spent 3 months or more in local authority care were given guaranteed interviews.
The medical admissions team will also award discretionary points in the selection process to candidates who are from schools with records of low academic achievement and those who meet certain contextual data indicators.
Imperial
Imperial runs a Pathway to Medicine programme for school students from low and middle income families who have the academic potential to achieve the grades for Medicine. It is a 3 year programme that runs throughout Years 11, 12 and 13. https://www.imperial.ac.uk/be-inspired/student-recruitment-and-outreach/schools-and-colleges/students/on-campus-activities/pathways-to-medicine/
Keele
The medical school offers a programme for local Year 12 students called Steps2Medicine, and candidates who complete this programme may be eligible for a reduced grade offer for admission.
King’s College London
King’s run a 6-year medical programme for students from non-selective state schools in Greater London, known as the Extended Medical Degree Programme, enabling applications from students who might not otherwise achieve the grades necessary to apply to the 5-year programme. They also consider contextual data when assessing UKCAT results for applicants to this programme.
Lancaster
Lancaster University Widening Participation Scheme offers a summer school for potential students who meet the Widening Participation criteria. Summer school students who show the most promise and aptitude for the PBL learning curriculum will be offered a guaranteed interview.
Leeds
Amongst other Widening Access schemes, the medical school supports the Access to Leeds programme, that allows eligible candidates applying via UCAS, to receive a lower A level offer (usually ABB) in addition to the standard offer. These candidates may come from a low income family or be the first in their family to attend university (see the Leeds school page for further details).
Leicester
Applicants who have completed a Realising Opportunities (ROP) or Leicester Enhanced Access (LEAP) programme may be given an alternative offer of ABB at A-Level. Leicester Medical School also runs a widening participation outreach scheme known as Medreach. Medreach offers workshops and an e-mentoring scheme for those who wish study Medicine and health-related professions.
Liverpool
The medical school is involved with a number of local outreach activities – see https://www.liverpool.ac.uk/health-sciences/about-us/widening-participation/ for further details
Manchester
Manchester medical school uses contextual data when deciding UKCAT thresholds for selection. Applicants from similar educational and socio-demographic backgrounds are considered against each other and those who meet widening participation criteria may be selected for interview with a lower UKCAT cut-off score. The 6-year programme for students with a non-science background also aims to encourage widening of participation and to that end may consider candidates with 'contextual flags' who have not met the UKCAT cut-off for that year.
Newcastle
Newcastle works with the PARTNERS Scheme to enable students from disadvantaged backgrounds to apply to medical school with lower entrance grades at A level (this has been ABB in previous years). Please see: http://www.ncl.ac.uk/schools/partners/ The medical school also encourages widened participation is by allowing Newcastle Stage 1 BSc students (of good academic standing) to apply to Stage 1 of the 5-year Medicine programme.
Norwich
Norwich run a 6-year medical programme with lower entry grades compared to the standard 5-year programme. It is aimed towards applicants from disadvantaged backgrounds (for full eligibility criteria, please see the information on the Norwich Medical School Page in this guide)
Nottingham
Nottingham offers a 6-year programme with lower entry grades compared to the standard 5-year programme. It is aimed towards applicants from disadvantaged backgrounds (for full eligibility criteria, please see the information on the Nottingham Medical School Page in this guide)
Oxford
Oxford offers a number of different outreach schemes to enapply. https://www.medsci.ox.ac.uk/study/medicine/pre-clinical/outreach courage students from diverse backgrounds to
Plymouth
A student-led group called WAMS (Widening Access to Medical School) runs a number of outreach schemes locally. https://www.plymouth.ac.uk/your-university/about-us/university-structure/faculties/medicine-dentistry/widening-access-to-medical-school-wams 
Queen's Belfast
The medical school recognises that applicants from secondary schools in Northern Ireland may not have performed to their full potential at GCSE level, or may not have had the opportunity to sit 9 GCSEs. To enable students from these backgrounds, with the academic potential for Medicine, to apply, the university will consider them on the basis of their AS grades, their predicted A level grades and their UKCAT results, as these have been shown to more accurately reflect the academic potential of these candidates.
Sheffield
Students who have taken part in the Sheffield Outreach and Access to Medicine Scheme (SOAMS) or the Realising Opportunities Scheme may be eligible for a lower grade offer (ABB at A level and 6 A*-B grades in lieu of 6As at GCSE).
Southampton
Southampton offers 30 spaces on their 6-year programme, which is aimed towards applicants from certain backgrounds (see eligibility criteria on our Southampton Medical School page), who may have experienced unequal barriers in applying to Medicine.
St Andrews
The medical school will take into account contextual data when selecting candidates for interview, but candidates must meet the minimum grade requirements. The medical school also has links to the following programmes:
  • The First Chances Programme (open to selected secondary schools in the Fife area) 
  • Reach Scotland 
  • The Sutton Trust Summer School 
https://www.st-andrews.ac.uk/students/ambassadors/wideningaccess/firstchances/
St George’s
If your school’s A level performance is in the bottom 20% nationally, and your grades are between AABb and BBCb (must include B in both Biology and Chemistry), you will be considered for interview. A list of eligible schools is published on the St George’s website: http://www.sgul.ac.uk/study/undergraduate/undergraduate-courses/medicine-mbbs/entry-criteria
Swansea
N/A – graduate course only
UCL
UCL run an outreach programme which aims to inspire Year 8 and 9 students from non-selective state schools to consider a career in Medicine
Warwick
N/A – graduate course only