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.

coincidentally

This wasn't true 45 years ago when I got into medical school. My parents were born in slums, left school at 14, and nobody in my family had previously been to uni, never mind to study medicine.
I went to the local state school. The teachers had no idea how to help with the admissions process, and in fact gave incorrect advice.
My best friend on the medical course was also working class - her dad was a carpenter.
Our particular medical school didn't interview applicants at all. Selection was based on A level results, and accompanying statement plus school reference.
I had a satisfying 36 year career in hospital medicine (anaesthetics and critical care).
But I think nowadays the massive student loan debt must be a big disincentive to poorer students - we got a free maintenance grant.

My v average comp regularly gets 15 + students into medicine. It just requires a knowledge of strategic applying and a bit of research. Loads of work experience not vital, in fact a lot of medical schools want volunteering as shows comportment. Part times jobs are helpful too.
The main barrier to more less affluent applicants is belief. Some don't think they are capable, but once you show them they are then there's no stopping them.
Vet work experience on the other hand is a nightmare unless you 'know' people, and that is vital.

[quote rrhuth]@HollaHolla

If you have a PhD, you presumably appreciate and value evidence. Evidence shows that who you know plays a significant part in the career you enter. Of course it does not follow that it applies to everyone, and you may not think it applies to you, but I think you have rose-tinted glasses on if you think all those internships that children coincedentally secure in the same firm their parent/other relative works in is not a factor in future career path.

I think it is important that those who have achieved success from a wc background do not dismiss the barriers that exist that prevent more people from wc backgrounds achieving the same.

You remind me of a female professor I spoke to who said they did not think there was any male/female inequality in academia because they were a senior professor . One swallow does not make a summer.

I understand the desire to think that we live in a true meritocracy, because that means those of us who have achieved truly deserve it, but the fact is that the meritocracy is something of an illusion.[/quote]
Of course I value evidence.
I am sitting in a role where I can view the entry requirement, and graduate destinations, for c3500 students per year. I would say that my institution gets a higher than average proposition of students through widening participation routes. We offer a wide variety of professionally qualifying awards such as Nursing, Teaching, Social Work - all which are proven to be more attractive to those from SIMD (I’m in Scotland) postcodes, and students from working class, and care experience settings - just for example.
I would say that our evidence shows that most of our students don’t have a lot of experience in any of these settings before they come to us. The broad brush ‘everyone has help/family connections/internships’ statements are not what I have experienced in my 15 years working in HE. (… and I have the evidence from 3 different institutions to prove it.)

On the topic of medical degree entrance, it’s not something I have close experience of, or data, on - but I would say that HEIs are audited to within an inch of their lives on EVERYTHING these days. This means slight of hand, or favouritism, happens so seldom now.

Based on the med students we see at work I don't think your hypothesis is right.
The one thing I would say is that the hoop jumping is not necessarily favouring those from schools without a xperience of supporting pupils through the process.I also think , but this may just be my experience, that a lot of very cl ver and hard working DC with perfectionist tendencies are becoming doctors . The drawback to this is that living with uncertainty and resilience are qualities that are essential for almost all medics. I have seen a lot of young people struggling terribly with anxiety and can only feel that their background and training are leaving them unprepared for the realities of life as a doctor . Getting 4 A* and negotiating the admissions process might not be finding the most suitable candidates. I'm not sure what system would be better mind you.

@yikesanotherbooboo

Based on the med students we see at work I don't think your hypothesis is right. The one thing I would say is that the hoop jumping is not necessarily favouring those from schools without a xperience of supporting pupils through the process.I also think , but this may just be my experience, that a lot of very cl ver and hard working DC with perfectionist tendencies are becoming doctors . The drawback to this is that living with uncertainty and resilience are qualities that are essential for almost all medics. I have seen a lot of young people struggling terribly with anxiety and can only feel that their background and training are leaving them unprepared for the realities of life as a doctor . Getting 4 A* and negotiating the admissions process might not be finding the most suitable candidates. I'm not sure what system would be better mind you.

To be fair @yikesanotherbooboo, it's an increasing problem across all of HE - only exacerbated by the pandemic. It's a massive issue across the sector, with a lot of work being put in to support students with ever-increasing mental health/pastoral support needs. The issue of resilience is also a hot topic (and really runs alongside the other), which I don't think anyone has the answer to right now, sadly.

@yikesanotherbooboo

Based on the med students we see at work I don't think your hypothesis is right. The one thing I would say is that the hoop jumping is not necessarily favouring those from schools without a xperience of supporting pupils through the process.I also think , but this may just be my experience, that a lot of very cl ver and hard working DC with perfectionist tendencies are becoming doctors . The drawback to this is that living with uncertainty and resilience are qualities that are essential for almost all medics. I have seen a lot of young people struggling terribly with anxiety and can only feel that their background and training are leaving them unprepared for the realities of life as a doctor . Getting 4 A* and negotiating the admissions process might not be finding the most suitable candidates. I'm not sure what system would be better mind you.

This is certainly true re. the anxiety. I think it is likely to be worse in medicine/dentistry because so many people have the necessary grades, the selection can seem arbitrary and beyond a pupil's control (after all, they are already working as hard as they can and have all A* predictions, so what more can they do?).

I would say that the pandemic has democratised the process since no-one could use their personal connections to get work experience because the NHS has pretty much banned medical and dental work experience during the pandemic (rationale being that if people can't have visitors, why are these non-staff work experience school kids here...?).

So all the work experience has moved online and available equally to all. The sites are medicportal and medicmentor (that I know of). Anyone can join and do the work experience sessions on-line.

The coaching for the entrance tests is available on-line also (subscriptions don't cost that much, and there are free resources from the testing agencies also).

The best work experience is volunteering/working with children, charities, people with disabilities, social care, befriending the elderly etc. These opportunities are also freely available to all.

Also the widespread access free to all of online MOOCs is also levelling the playing field. Anyone can take a relevant (often for free) from a respected organisation. This can go on references, personal statement etc.

So it really no longer about having the right connections. Things have changed.

(and as a by the way, all sixth forms are selective, not just private schools and grammars - they typically all have requirements for what a pupil achieved at GCSE, it is just that these differ between colleges/schools)

@mumsneedwine

My v average comp regularly gets 15 + students into medicine. It just requires a knowledge of strategic applying and a bit of research. Loads of work experience not vital, in fact a lot of medical schools want volunteering as shows comportment. Part times jobs are helpful too. The main barrier to more less affluent applicants is belief. Some don't think they are capable, but once you show them they are then there's no stopping them. Vet work experience on the other hand is a nightmare unless you 'know' people, and that is vital.

medicmentor has a vet stream (vetmentor?) - online work experience, free.

Also I think animal shelter volunteering is easier to come by than vet practice work experience.

I'd say @secondaries post has given a lot of useful advice to any would-be medical students (in a nice succinct way) there....

@HollaHolla I think you make some excellent points regarding resilience and mental health of young people being a wide spread problem, and one think that extends across the whole of society.

Parents are largely to blame, often living vicariously through their children. I recently attended a post grad event and was chatting to the course convener who remarked about the number of disinterested students that come to undergrad events and the parents spend most of the time saying how much they wish they had done x course. Rather than getting off their backsides to do it themselves they push their kid into it.

You see it on here, parents worried about little Johnny getting into a school with excellent academic results, regardless of their kids ability having little thought about how unhappy their kid will be in that environment.

Well paid, prestigious careers are seen as synonymous with happiness, rather than understanding what makes the child happy.

Kids are growing up in an environment where being mediocre is not acceptable, kid picks up a guitar, oh they’ll be the next Jimi Hendrix, kid scores a goal between two jumpers in the park, oh they will be next Beckham. Everything they do needs to lead somewhere, kids can’t just be. Parents won’t accept their kid isn’t going to achieve great things and do everything to make sure no barriers exist so when the kids suddenly doesn’t they have no experience of failure and therefore no resilience.

Fame and fortune or fancy careers appear easily achievable and only have good sides because that what appears on social media.
Expectations are impossible to meet.

Kids aren’t taught to be balanced any more. They are measured against arbitrary targets even before they leave the womb. Private schools are much better at this single focused pursuit of we will teach you to be winners attitude.a good medical student won’t necessarily make a good doctor,

The pandemic has fucked kids over because they’re resilient right? Everything has been made uncertain and one thing kids need is certainty and stability.

YANBU - this is why my Dr husband mentors pupils from the state school that I work in. He believes that medics need to reflect the demographics of their patients.

@HollaHolla

Well yes social work is not the sort of career where you need family connections to get you in, nor is teaching or nursing. Teaching in particular is a career where the government pays incentives to attract people to do it.

But surely you must understand the situation in high earning careers e.g. in the city, at the bar? Absolutely connections matter in those type of careers.

[quote rrhuth]@HollaHolla

Well yes social work is not the sort of career where you need family connections to get you in, nor is teaching or nursing. Teaching in particular is a career where the government pays incentives to attract people to do it.

But surely you must understand the situation in high earning careers e.g. in the city, at the bar? Absolutely connections matter in those type of careers.[/quote]
I’m not saying it’s perhaps not an advantage, but to say it’s the only way to get these roles, is not my experience at all.

A point of accuracy - incentives for teaching are only offered in England & Wales. Not Scotland (nor NI, if I recall correctly.)

[quote rrhuth]@HollaHolla

Well yes social work is not the sort of career where you need family connections to get you in, nor is teaching or nursing. Teaching in particular is a career where the government pays incentives to attract people to do it.

But surely you must understand the situation in high earning careers e.g. in the city, at the bar? Absolutely connections matter in those type of careers.[/quote]
Ps. Your tone comes across as being fairly sneery against perfectly well-respected, and good careers, such as social work, teaching and nursing. All are really valuable roles to have - and having that type of approach to these roles probably does more in not encouraging young people to go into these professions.
It may not have been meant, but it’s certainly how it’s coming across.

@hollaholla I am not sneery about the jobs ffs, I would be very proud if my kids did that and I was previously a teacher myself.

Of course they are valuable roles, but it is pretty obvious that jobs like teaching, social work and nursing are not highly competitive/desirable amongst the group of students this thread is about.

Go to the right Uni…. They’re highly competitive!
Anyway. I think we need to agree to disagree on those points. ☺️

@HollaHolla

Go to the right Uni…. They’re highly competitive! Anyway. I think we need to agree to disagree on those points. ☺️

I agree with @rrhuth teaching, nursing and social work are not competitive in the sense that most who meet the minimum criteria and apply are likely to get in. It doesn't matter that it's 'competitive' at certain unis, it's still not on the same level as medicine where a high proportion of rejected candidates have the aptitude.

While on the surface 'decent' professions chronic government underfunding and bad management contributes to the high rate of burnout, and eventual resignation of teachers and nurses. Family/friends of mine in these professions strongly advise against it. If you're going to be that stressed and held accountable for everything according to them you might as well enter a profession where you'll be much better paid.

I really don’t wish to labour the point, but it really isn’t the case that most who meet the criteria get into most degree programmes….
For example, we have around 15 applications for every place on our Nursing programme; circa 12 for occupational therapy; about 25 for our physio programme….. so I do know what I’m talking about on that. It’s around a 17% acceptance rate to medical schools. (All my figures relate to Scotland - and all of these programmes have controlled numbers.)

Yes - they’re not as well paid, or have the same status to some, but, let’s face it, we all know that there’s no point in being well paid, but miserable. I would agree that medicine is very competitive, but it’s not the unattainable programme or career that some seem to be outlining.

@HollaHolla

I really don’t wish to labour the point, but it really isn’t the case that most who meet the criteria get into most degree programmes…. For example, we have around 15 applications for every place on our Nursing programme; circa 12 for occupational therapy; about 25 for our physio programme….. so I do know what I’m talking about on that. It’s around a 17% acceptance rate to medical schools. (All my figures relate to Scotland - and all of these programmes have controlled numbers.)

Yes - they’re not as well paid, or have the same status to some, but, let’s face it, we all know that there’s no point in being well paid, but miserable. I would agree that medicine is very competitive, but it’s not the unattainable programme or career that some seem to be outlining.

It’s not just the number of applications ; but the number of suitable candidates. medicine has all sorts of filtering because there are too many ‘suitable’ applicants . it’s possible to get no offers despite meeting the minimum requirement for all unis - a minimum that’s already high. For most other degrees you can get at least one offer, your safety choice unless you messed up so badly that you don’t even meet the lowest entrance requirements.

Also r.e being well paid but miserable- teaching and nursing certainly aren’t ‘happy, low stress jobs’ in fact quite the opposite. If they weren’t that stressful people wouldn’t be leaving In droves. It’s not about the social status.

Anyway since you don’t want to discuss further that’s all I’ll say for now.

@titchy
How's that then? 5 or 6:years of tuition fees and living costs, advised not to work because of the volume of learning and placements.
My DC looking at £120k of debt at the end.

God this thread is depressing. My DD is considering medicine and we're currently in the process of researching grade/work experience requirements. I'm a single parent with a lowish income and she's an ethnic minority so from what I've read here so far from some posters she stands no chance! It's been quite deflating to read to be honest.

Is there any advice on increasing her chance of getting a medical school place? A previous poster suggested online work experience which I've noted and I've contacted St Johns Ambulance Service (currently on waiting list for a volunteer role for DD). Anything else?

Definitely some med schools say that they are aware not all students have access to opportunities for experience. Cardiff definitely says this.

Also some med schools say that any work experience counts. They like gap year workers too.

@X2Kids

God this thread is depressing. My DD is considering medicine and we're currently in the process of researching grade/work experience requirements. I'm a single parent with a lowish income and she's an ethnic minority so from what I've read here so far from some posters she stands no chance! It's been quite deflating to read to be honest.

Is there any advice on increasing her chance of getting a medical school place? A previous poster suggested online work experience which I've noted and I've contacted St Johns Ambulance Service (currently on waiting list for a volunteer role for DD). Anything else?

Get your daughter to look at some of the medical schools online prospectuses - she could also check out if her nearest medical school runs any programs for disadvantaged students I think it’s is good to,get some work experience even though it’s not required. I think it’s good as it helps students to really understand what being a doctor entails. It is also helpful to talk about in interviews and UCAS forms. St Johns ambulance is a great idea. The fact you are low income may be an advantage as your daughter may then be eligible to the maximum student loan. This may mean she is better off than many of the children of slightly higher earners who can’t afford to contribute towards their children’s university courses. My DC all went to Unis in the North of England in cities where living costs were much lower than down south.
Also, if she knows she want to do medicine she could work during her last two summers at school. The summer after A’levels is really long and if she finds a job then she could easily bank a few grand. One of my DC did babysitting throughout her Alevels and saved almost all her money for uni.
The scare mongering on this thread is ridiculous. You will be the one disadvantagung your daughter if you believe it 🤷🏻‍♀️

Very interesting thread

My cousin is a doctor- qualified as a GP in recent years- she went to a bog standard state school, did a degree in Neuroscience at a top 10 university and then went to a London medical school as a graduate on the 5 year course

At school she was constantly told she wouldn't get into medical school, didn't have the grades, it was all too competitive blah blah blah

She achieved in spite of of her secondary school. In fairness they had no clue how to prepare pupils for medical school entry (or dentistry or vet)- kids just didn't go down that path

No doctors in our family

Sorted out her own work experience while working full time, wrote her own personal statement and "coached" herself for the interviews by using a few websites

I remember her saying during her first year at medical school, a number of students were from the same sixth forms- think top public/private schools in London- and a few knew each other well already.

It seemed those places were like factories churning out medical school applicants, a conveyor belt to medical school.

And some often wondered what indeed they were doing there once they had arrived...not to say they dropped out, but struggled with the reality of medical school...they couldn't really drop out after all the expensive education & parental expectation

So mental health can suffer for those in a situation where they realise the reality doesn't quite live up to the dream of studying medicine...and that's even before they sit finals/start work as a junior doctor

For me, my cousin is just innately suited to be a doctor; she had the drive, motivation and resilience to get herself into medical school by herself in her 20s, succeed & graduate and finally finish her post graduate training

Oh and not to mention thanks to the Student Loan Company for making it all happen financially & professional studies loan from a high street bank (believe these are permanently withdrawn now)!