Diversity and Widening participation in Medicine
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)
- Aim 4 Uni
- S6 Enhancement
- ASPIRE North
- University of York Next Step programme
- Realising Opportunities Programme
- HYMS Pathways to Medicine programme
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.
- The First Chances Programme (open to selected secondary schools in the Fife area)
- Reach Scotland
- The Sutton Trust Summer School