To think medical school admissions favour people from a middle class (or upper middle class) background?

[CampionMN]

The medical school admissions process in this country is deeply flawed in my opinion. It favours people from middle class backgrounds (or upper middle class) and disadvantages people from poorer backgrounds.

I know plenty of people will come in to talk about how they grew up in a council estate, went to the local comp and went to medical school easily. I am aware this happens sometimes but we all know such situations are rare and not the norm.

The typical medical student (and doctor) is a middle class boy or girl who went to a private school or a highly selective grammar school (where teachers knew the medical school admissions process and coached them heavily beforehand). Had family access to doctors and had parents who were very involved in their medical school admission process (some of them wrote their child’s personal statements). This isn’t their fault, nor is it necessarily wrong. However I still feel medical schools should take these factors into account before granting admissions to students and admit those (from all backgrounds) who have a genuine desire to study medicine and a genuine passion to work as a doctor. Not just those who are doing it because it’s the expected path for them or because their parents really want it for them.

There are many, many people from disadvantaged backgrounds who have the desire to do medicine but will never be given the chance. This is because growing up in a home where parents are uneducated/have never been to university means they do not receive anywhere near the level of parental help required for medical school. Going to a not so great comprehensive school means a lot of teachers there cannot advise on how to navigate the entire process of getting into medical school (because it’s so rare for them to send a student to medical school). Having no access to doctors in the family means that no one can help you study for the admissions exams or help you write a good personal statement or help you get medical work experience. It also means your grades may not be the highest because you had additional challenges outside of school that may have affected your ability to revise properly (although they may be considered high for your school).

I also wonder if the selection process is contributing to doctors not being able to cope with working as a doctor. Struggling to accept criticism or being judged negatively. Struggling with to deal with 12 hour shifts (whereas most working class jobs, like care work are 12-12.5 hours long for a minimum wage salary and often no breaks because care homes are usually short staffed).

There’s a class problem within medicine (and dentistry too - everything I’ve said applies to becoming a dentist as well but slightly less so because of the difference in working hours and because dentistry isn’t necessarily seen as the end goal for all smart middle class students).

People from upper class backgrounds tend not to do medicine. So that’s why I haven’t included them.

If you have a ‘poorer’ postcode you are now positively discriminated for by universities for all courses- including medicine.

@mummywithtwokidsplusdog

If you have a ‘poorer’ postcode you are now positively discriminated for by universities for all courses- including medicine.

Universities might say in public that this happens but in reality we all know it doesn’t.

YANBU. I used to work in Pathology and we had a steady stream of med school applicants do work experience all of whom had Drs for parents or whose parents were friends with Drs.

There’s a certain level of privilege and sense of entitlement that comes with being from that sort of background. It was never the child of a staff nurse or HCA or domestic, always a Dr or surgeon.

I think maybe we need to vastly increase the number of medical school places and admit basically everyone who wants to be a doctor and has a base level of intellectual aptitude for it.

Could you give some actual evidence for your opinion?

That’s really unfair and it annoys me. It doesn’t surprise me though.

If the student has the grades they need then why on earth should their postcode matter? It almost feels like people higher up don’t want poorer people to have a better life and want keep them in their place.

Universities might say in public that this happens but in reality we all know it doesn’t

Again, evidence please. We all do NOT know it doesn't happen at all.

Yes in many ways I think someone's background either favours them going or not going to university, not just to do medicine. Because it's a mindset (one that can be changed).

I'm not sure medical school itself favours people middle class or upper middle class backgrounds per se. It's more to be with affluence. Medical school is expensive. The person who could have be the best doctor you ever met might be out there now, working in an office or on a site, simple because they couldn't afford to go to university.

I think there are a lot of higher end professions in a similar situation.

I went to uni as first from a wc background and was baffled by the number of classmates who were from generations of alumni.

Imagine medicine and some parts of law are the far end of that.

One of the problems for recent applicants is that they have too many vocational qualifications at GCSE, where there High schools offered and promoted courses like BTEC PE instead of GCSE PE. We have had several former pupils turned down for this reason. I suspect less vocational qualifications are offered at Grammar or Independent schools.

Medical school is expensive.

Eh? It costs the same as any other degree, including the much-maligned Media Studies from Uni of Localtown.

That's certainly my recent experience based on a relative who is from a working class family. 4 As at a level and no offers for medicine. She's studying aeronautical engineering instead.

I'm sure most will disagree as their children benefit from this system and won't want to see it changed.

@mummywithtwokidsplusdog

If you have a ‘poorer’ postcode you are now positively discriminated for by universities for all courses- including medicine.

Positive discrimination is illegal.

@HPandTheNeverEndingBedtime

One of the problems for recent applicants is that they have too many vocational qualifications at GCSE, where there High schools offered and promoted courses like BTEC PE instead of GCSE PE. We have had several former pupils turned down for this reason. I suspect less vocational qualifications are offered at Grammar or Independent schools.

Again, med schools don't care, as long as there are 8 normal GCSEs. Matters hugely at A level of course, and I have heard anecdotally of schools telling kids who want to do medicine that a BTEC extended diploma in Health and social care is just the same as 3 A levels in Maths Biology and Chemistry. 🤦‍♀️

surely its just that its a very competitive course and would favour children who are more prepared (by parents or organised school teachers) and do the "right things" to get good experience and can write about that on their personal statement?

Plus very good grades too.

What a post full of generalisations.

Yes, I assume that in some schools, pupils may not have access to teachers or careers staff to guide them in the application process but the assumptions you've made about "middle class" students is really quite inappropriate.

My DD is intending to apply. Yes she'd probably be classed as middle class and at a grammar school.

BUT - we (as parents) have tried to talk her out of it (simply because we think its early (at 16) to decide what you want to do for the rest of your life) but she is 100% committed.

She has applied for (and got) work experience (without any family friends / associates - we don't have any - giving her a so-called leg up) and volunteers in a hosppital.

She has researched herself what she needs to do and is doing everything to be prepared for that. She will write a Personal Statement herself.

I also think your assertion that "middle class" applicants can't cope with doctors hours is really insulting. What on earth is the basis for that? My DD works 2 part time jobs, volunteers and studies really hard (as well as having a social life). Why on earth would be cope any less well with a 12 hour shift than someone else?!!

Positive discrimination is illegal.

Errr what? Contextual offers based on postcode are perfectly legal.

And in recruitment guaranteeing an interview for all disabled applicants is also a perfectly legal form of positive discrimination.

Why on earth do you think it's illegal?

@JackieCollinshasnoauthority

That's certainly my recent experience based on a relative who is from a working class family. 4 As at a level and no offers for medicine. She's studying aeronautical engineering instead.

I'm sure most will disagree as their children benefit from this system and won't want to see it changed.

My DDad was involved in university admissions. 20 years ago (when A didn’t exist) they didn’t have an applicant for medicine predicted less than 4As at A-level. DH is a teacher…the successful medical applicants from his school have at least AA*AA. It’s brutal. And yes, they do give lower offers if a child is deprived…again DH has been involved in negotiating these.

I think medicine should be postgraduate to eliminate those who don’t want to be a doctor but whose parents insist.

It’s the work experience that’s hard. If my kids wanted to do medicine I wouldn’t have a clue where to start getting them the work experience that is required to get in to study medicine. If your parent is a GP however, you can do a stint as a receptionist and that ticks the right box.

The whole university education system does however medicine is trying to be more inclusive but you are correct it is still massively in favor of private school kids especially ones from medical families. They get extra help with personal statements etc also have better teachers and are more clued up on the whole admissions process in general.

@JackieCollinshasnoauthority

That's certainly my recent experience based on a relative who is from a working class family. 4 As at a level and no offers for medicine. She's studying aeronautical engineering instead.

I'm sure most will disagree as their children benefit from this system and won't want to see it changed.

Do you really think they google street viewed her house, stalked her on SM etc to see if she was middle class or working class before deciding to decline her application?

Plenty of private school kids get turned down for medicine you know!

Your thoughts may have been true historically, but are not so much now. (DOI: doctor from a pretty working class background, with no other doctors in the family, and who had no particular support from my teachers (who thought I wasn’t clever enough) but still somehow conned my way into a place.)

@Cheerychirpy

It’s the work experience that’s hard. If my kids wanted to do medicine I wouldn’t have a clue where to start getting them the work experience that is required to get in to study medicine. If your parent is a GP however, you can do a stint as a receptionist and that ticks the right box.

Presumably you, and them, would use google to find out what was needed and how to get it no?

Is there any evident that working class people don't know of Google's existence?

@burnoutbabe

surely its just that its a very competitive course and would favour children who are more prepared (by parents or organised school teachers) and do the "right things" to get good experience and can write about that on their personal statement?

Plus very good grades too.

Which is why I think doing "the right things" and having a killer personal statement should be irrelevant — it advantages those with the social capital and other privilege to obtain those things.

I am unconvinced that writing the right things in your personal statement and knowing how to get certain types of experience are relevant factors in whether someone can become a good doctor. Sure, some people are temperamentally unsuited, but a carefully crafted statement from a 17yo, which may or may not be mostly written by the teenager, doesn't seem to me like a good way to detect that. Nor does checking to see if the teenager knew about hurdles such as "getting experience" and had the privilege to be able to do that (spare time, contacts, etc.).

So, check they've got the basic qualifications and intellectual aptitude, let them all in, train them all, then sort out who's suited, rather than imposing a hundred extra hurdles to whittle down the intake, because extra hurdles will always advantage those with privilege.

This happens to a certain extent for all professions - military, law, veterinary medicine - even films (think about the number of second-generation actors in Hollywood).

If your parents are active in a profession, it's a lot easier for you to envisage doing it - not to mention you get a headstart in knowing the requirements, training and costs. It erases a lot of the mental hurdles and often the financial, too.

As others have said; we need to address the finance side along with an expansion in places.