‘Critical’: only one in 20 medical students from poorest backgrounds

Just one in 20 UK medical students are from disadvantaged backgrounds, according to a new report which warns that working-class entry into medicine is in “critical condition”.

Academics at UCL analysed about half of all UK applicants to medical schools between 2012 and 2022 from the UK Medical Education Database (UKMED).

Published by the Sutton Trust, the report found that medical students from the lowest socio-economic backgrounds made up only 5 per cent of entrants in 2021.

This was double the proportion of 2012, but still a long way behind the 75 per cent who were from higher socio-economic backgrounds.

The proportion of state school applicants grew over this period, but applicants from independent schools remained much more likely to receive an offer to study medicine. And a very high number of students were found to come from a select group of schools.

The report warns that those from disadvantaged backgrounds, who may lack wider support, can find the application process particularly complex and challenging.

Admissions processes can vary considerably between medical schools, including the use of multiple mini-interviews, how University Clinical Aptitude Test (UCAT) scores are considered, the use of personal statements and requirements for prior attainment.

The UCAT test was found to be a particular challenge. Applicants from lower socio-economic backgrounds with the highest predicted A-level points achieved significantly lower UCAT scores than those from medium or higher socio-economic backgrounds.

Despite the increased use of contextual admissions, Katherine Woolf, professor of medical education research at UCL, said low prior attainment remained a major barrier to many aspiring doctors from the poorest backgrounds. 

“Providing enough doctors to meet the country’s needs will require better support for future doctors, especially those from disadvantaged backgrounds,” she said.

“This support is needed at all stages of a doctor’s career: from school, before and during application to medical school, and throughout the many years of medical education and training that are essential to practise as a doctor.”

Students from the poorest backgrounds were more likely to be successful if they applied to gateway medical courses, which include an additional foundation year with lower entry requirements.

And the Sutton Trust found that new medical schools – established in areas with relatively fewer doctors per person – had a more balanced intake of state school applicants.

Nick Harrison, chief executive of the Sutton Trust, said working-class representation in medical schools was “outrageous” when the medical profession is stretched to breaking point.

“Urgent action is needed to widen access and create a more diverse pipeline of talent from all parts of society. Patients benefit from doctors who reflect the diversity of the communities they serve, but it’s clear that we’re a long way from that today,” he said.

“Working-class entry into medicine is in a critical condition. The profession urgently needs a shot of equality.”

To increase the size of the workforce, the Sutton Trust recommends that the government prioritises medical schools with a successful widening participation record, conducts a fair access review of the sector, and provides a more accessible “one-stop shop” of information for all medical school applicants.

It also calls for medical schools to be more ambitious with their use of contextual offers, review the use of UCAT in admissions, and look to reduce additional costs and complexities for applicants.

patrick.jack@timeshighereducation.com