Medical profession has historically been a noble profession that people of higher class practised and to this day it remains dominated by people of affluent backgrounds. This stems from the consultants all the way down to medical students. In the UK, female and ethnic minority groups are now well represented in medicine, but those from a lower socio-economic status (SES) or disadvantaged students remain under-represented. Disadvantaged students could be someone from an economically deprived place but also someone going to a state school with poor record, having parents without formal/further education or a professional job. All of this provides additional barriers for the students other than purely academia, which on its own is already challenging. 

 

In England, 8.7% of medical students were from the poorest 20% by postcode, against 4.3% in Scotland, 6.5% in Wales and 3.2% in Northern Ireland (Students from wealthy backgrounds dominate medical schools, 2021). There are fewer medical students from lower social class and who do not come from wealthy families and one of the reasons is because of how heavily the application process favours grades, which through better resources and private tuition can be improved therefore giving students from higher SES an unfair advantage. In state schools that lack suitable guidance and resources, students will never even have the thought of applying to medicine because of fewer mentors to look up to whether that’s a student from year above that previously got into medicine or their relatives. Work experience like shadowing is also incredibly difficult to attain if you don’t already have family networks further disadvantaging the student against other applicants coming from a higher SES. This is discouraging to many students who think of applying and will underestimate their chances of getting in and never apply, which is clearly indicated by a study that showed that 50% of secondary schools in the UK never had pupils apply to medical school (Students from wealthy backgrounds dominate UK medical schools, report says – Hospital Dr, 2021). Entry exams for medical school like aptitude tests, situational judgement tests or interviewing and personal statement can also can be improved if the students have access to correct resources, but these are often expensive to access, which means a lot of students from higher SES will be better trained for such tests and perform better over students from lower SES. Many important qualities of a good doctor that cannot be presented on paper like good communication skills, caring personality and resiliency, are more likely be neglected in the application process in students of low SES. 

 

There are fewer students from SES applying to medical school because most students from SES underestimate their chances of getting in and never apply but what about admission rate of those who apply? Another study showed that while SES students made 12% of the applicants only 7.6% of those were accepted, in contrast 42% was the acceptance rate for students from the richest 20% while only 36% of applicants came from those areas (Martin, 2021). So not only are the students from the most deprived postcodes less likely to apply but they are also less likely to become accepted into medical school, most likely because of the reasons same reasons less students from low SES applied. 

 

There are outreach programmes offered by most Universities now for example, medicine with a foundation year or social mobility programmes that are designed to allow access into medicine for high achievers with disadvantaged background. The number of ‘access’or ‘gateway’ courses at medical schools across the UK has increased from 2 in 2002 to 17 in 2019 but the disparity in SES status among medical students is still concerning. It’s important ensure all of the potential future doctors from poorly performing state schools are given the correct guidance and resources by their school in order to even out the odds against applicants that received private education and had access to premium resources. 

 

For readers who are potential applicants it is important to not let these numbers discourage you. In 2018 a hashtag on twitter #mypathtomedicine gained over 2million attention, which let doctors from underprivileged background around the world share their path to medicine and how not everyone has a conventional route into becoming a doctor.  

 

Finally, there are clear benefits of improving the diversity of the medical workforce. It would allow doctors to be more representative of the populations they serve, enabling patients to feel they can better connect with their doctor and believe their doctor has a holistic understanding of them as a person.

References 

 

the Guardian. 2021. Students from wealthy backgrounds dominate medical schools. [online] Available at: <https://www.theguardian.com/society/2016/jan/22/medical-school-students-wealthy-backgrounds> [Accessed 18 November 2021].

 

Hospital Dr. 2021. Students from wealthy backgrounds dominate UK medical schools, report says – Hospital Dr. [online] Available at: <https://www.hospitaldr.co.uk/blogs/web-news/students-from-wealthy-backgrounds-dominate-uk-medical-schools-report-says> [Accessed 18 November 2021].

 

Martin, E., 2021. Introducing: Manchester Outreach Medics – The Mancunion. [online] The Mancunion. Available at: <https://mancunion.com/2018/09/27/introducing-manchester-outreach-medics/> [Accessed 18 November 2021].

 Published 21-08-2022

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