Medical Students / JMOsNews / Opinion

BMJ – Widening access to medical education for under-represented socioeconomic groups


Objective To determine whether new programmes developed to widen access to medicine in the United Kingdom have produced more diverse student populations.

Design Population based cross sectional analysis.

Setting 31 UK universities that offer medical degrees.

Participants 34 407 UK medical students admitted to university in 2002-6.

Main outcome measures Age, sex, socioeconomic status, and ethnicity of students admitted to traditional courses and newer courses (graduate entry courses (GEC) and foundation) designed to widen access and increase diversity.

Results The demographics of students admitted to foundation courses were markedly different from traditional, graduate entry, and pre-medical courses. They were less likely to be white and to define their background as higher managerial and professional. Students on the graduate entry programme were older than students on traditional courses (25.5 v 19.2 years) and more likely to be white (odds ratio 3.74, 95% confidence interval 3.27 to 4.28; P<0.001) than those on traditional courses, but there was no difference in the ratio of men. Students on traditional courses at newer schools were significantly older by an average of 2.53 (2.41 to 2.65; P<0.001) years, more likely to be white (1.55, 1.41 to 1.71; P<0.001), and significantly less likely to have higher managerial and professional backgrounds than those at established schools (0.67, 0.61 to 0.73; P<0.001). There were marked differences in demographics across individual established schools offering both graduate entry and traditional courses. Conclusions The graduate entry programmes do not seem to have led to significant changes to the socioeconomic profile of the UK medical student population. Foundation programmes have increased the proportion of students from under-represented groups but numbers entering these courses are small.

Widening access to medical education for under-represented socioeconomic groups: population based cross sectional analysis of UK data, 2002-6

Interesting question being asked here, do graduate entry schools truly access students who missed out on missed out on medicine at a school leaving age because of lack of educational opportunity. Anecdotally I would say "No", and this seems to be the conclusion from this study as well. The conclusion is that only affirmative action type programs truly achieve these aims.<br />
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Also interseting to note this study cites an underrepresentation of white males in medical schools.<br />
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Further, it cites this article; which suggests cognitive tests like the UMAT have an inherent favourable bias to students from affluent backgrounds who attend private or selective-entry secondary schools: <br />
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James D, Yates J, Nicholson S. Comparison of A level and UKCAT performance in students applying to UK medical and dental schools in 2006: cohort study. BMJ2010;349:c478<br />
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Available <a href=>here</a>.
    I'm not sure that the intention of broadening access to socioeconomically disadvantaged people by way of establishing graduate entry schools was ever a widely acknowledged goal, so it's a bit of a stretch to suggest it's failed a task it never set out to achieve in the first place. I find the significant demographic differences (eg ethnicity, professional background) cited in the article interesting.
  • J
  • February 27, 2011
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Anecdotally I have heard that the graduate entry programs in the UK are so competitive that just about everyone granted entry has a PhD. Not sure if that would be a good or a bad thing, or what it would mean for access to disadvantaged people.